Richmond Til We Die

Sitting on the famous bench in Richmond-Upon-Thames, UK.

Today is February 2, 2022. Twosday. The only palindromic date in 2022. Not only National Heavenly Hash Day, but also National Tater Tot Day, as well as National Girls and Women in Sports Day. And let’s not forget the obvious…Groundhog Day (6 more weeks of Winter predicted, in case you didn’t already know). But more than anything, it has served as a day of reflection for me.

I was extremely fortunate to be able to travel to the UK over the New Years holiday (and even more fortunate for my co-workers that I didn’t contract COVID and was able to return to the states as scheduled). And because of my (borderline) obsession with Ted Lasso, I set aside a few days in Richmond.

I had such big plans for the trip, documented by pictures and videos, with thoughts of a combination blog/vlog so amazing that even Jason Sudeikis would want my expertise and unique take on things on set immediately. However, being the amateur vlogger that I am (I have never done one), my phone’s battery died after the first few stops. I do have a few videos…a lot of pictures…and a post to come.

In the meantime, life has resumed, and I use the memories of that magical trip to the town my favorite fictional European football team calls home as a buffer for the long shifts and the short days. Sadly, my favorite American football team is not advancing to the Superbowl as I had wished but, having been a fan since birth and standing by them during the roughest of seasons, I consider this just a blip. My heart will always belong to the Red and Gold from Kansas City.

But I digress. Being the fan(atic) that I am regarding the show, I took great pleasure in recognizing landmarks and scenes and inserting myself into the landscape (see above). As I sat on that bench, I thought about the times Ted was called a wanker by that unnamed Richmond fan as he sat there. I thought about the time Beard had a pint ready for him after he put Michelle and Henry in the taxi for the airport and they tapped the bench in unison before they took a drink. And I thought about the morning Trent Crimm’s article came out and Beard, once again, displayed his never-ending loyalty and compassion for his friend. But, in all honesty, my first and strongest thought was “Holy shit. My ass is sitting where Jason Sudeikis’ ass sits.” And if anyone knows differently, please keep it to yourself. I’m not sure my Superbowl broken heart could take it.

Richmond is as charming as it appears on your television screen. The people are genuine, the buildings and alleys are beautiful. And while you will have to wait for my in-depth blog/vlog of all the sites and experiences, I not only treasure the memories, but I am grateful to Ted Lasso for making me want to go visit a place I likely would never have known existed. And while I feel that the bartender at the pub that is the exterior for the Crown and Anchor was pretty tired of Americans wearing scarves for a fictional football team and probably not ordering correctly, he hid his annoyance relatively well. And, still to my surprise, the beer was cold. Thank goodness. Seriously…warm beer?

All good things must come to an end. My trip to Richmond ended after only a few short, wonderful days. I’m terrified that Ted Lasso will come to an end after the season they are currently filming…with Jason Sudeikis’ ass on that very bench (*sigh*). But the memories will remain. As well as the show in syndication.

Moving forward I realize that my visit didn’t make the show any less heartwarming or meaningful or ruin any fantasy of this place that has become the home of some of my favorite people. If anything, it confirmed my admiration for the little town that has captured our hearts over the past two seasons. And remembering the lovely people walking their lovely dogs in the lovely parks will give me something to make it through six more weeks of Winter. And yes, I know I live in Alabama so that is likely going to be a very mild six weeks, but you do remember snowmaggedon, right? Not our proudest moment.

So, thank you Jason Sudeikis and thank you Brendan Hunt. And Brett Goldstein and Juno Temple and Hannah Waddingham and Phil Dunster and Jeremy Swift (as much as I love Higgins, I will always remember you as Spratt first), and Toheeb Jimoh, and, yes, even Nick Mohammed. Thank you for the gift of Ted Lasso. But also thank you to the town of Richmond for allowing us in and letting us stay awhile. You are the uncredited cast member that gives us fan(atic)s a beautiful visual background.

Onward. Forward. But don’t be nice to Rupert.

The Truth Will Set You Free…but First it Will Piss You Off

AFC Richmond

While Gloria Steinem said it first, no one texted it louder this week than than Dr. Sharon Fieldstone.

Anyone who knows me knows a few basic things about me. I grew up the youngest of four in a Catholic family in Kansas City, Missouri. After medical school, I followed a boy to Birmingham, Alabama where I have been ever since. I have had so many gains and losses over the years, but here are some of the highlights:

  • I was fortunate enough to gain the best medical training anyone could ask for, from the absolute best in the business, and I was able to trick those same people into keeping me on as faculty once my training was complete.
  • I gained a healthy case of imposter syndrome and let me tell you, that is hard to treat.
  • I lost my dad along the way. He wasn’t perfect, but as a daddy’s girl, I idolized him despite his flaws. And I miss him every day.
  • I lost a 17 year marriage.
  • They say friends are the family you choose. And I gained a family so awesome you couldn’t even begin to imagine.

Obviously, a lot more happened over the years. But one gain that snuck up on me little by little without me realizing it was a sometimes crippling anxiety and depression. When I was in medical school, learning about self care ranked right up there with how to run a practice. And in my very traditional Catholic Italian family, feelings weren’t typically openly discussed. That’s not a criticism…it’s just how it was. That’s how my parents grew up and that’s what they knew. And they did the best they could. But it left me scared. Scared of the feelings I couldn’t explain. Scared to ask for help. Scared because I didn’t know what to do.

As a pediatric emergency medicine physician, I see children every day with anxiety and I realize I was that kid. I had the functional abdominal pain. I remember getting the upper GI and the abdominal ultrasound, and blaming it on eating too much peanut butter. I remember taking antacids every day and sometimes feeling like I was coming out of my own skin. One patient of mine put it best…”I just feel like I want to run.” Yep. I totally get it.

Fast forward 10, 15, 20 years. Same symptoms but now expected to function as an adult. So many days I felt like I was drowning and so many nights I wished I could. For those of you who have been there, you know exactly what I mean. And for those of you who have never been there, I hope with every fiber of my being you never are.

The journey is long. And hard. And dark. And scary. There are days you wonder if you will ever see the light at the end of the tunnel, and other days you wonder if you even want to. Some days you wonder how you got through the day, reminding yourself to breathe and put one foot in front of the other. Other days you are completely numb, and you wonder if you will ever feel anything again, painful or otherwise.

I took a chance and asked a colleague for a referral. And that was when I met my Sharon Fieldstone. Her name is Laura and I thank my lucky stars every day that we clicked from day one. I joke that she is my most stable relationship (in my head I hear Coach Beard saying “Most stable relationship in 12 years, babay!”), but jokes aside I owe her my life. I like to think it has become a give and take relationship…she gave me Shitt’s Creek, I gave her Ted Lasso, we gave each other support through the Trump years…but the truth is I could never repay her for what she has given me.

Hope.

I have a feeling my friends get tired of my continued championship of therapy (“We get it, Annalise. You have a great therapist.”), but it really does my heart good to see shows like Ted Lasso at least attempt to destigmatize mental health issues. They are focusing on sports. I am focusing on medicine. But no matter our walk of life, we are all just people. All flawed. All trying to survive. And hopefully all trying to be the best we can be. There’s nothing wrong in asking for help. It’s what we tell our patients to do every day.

Believe.

January 20, 2021.

January 20, 2021.

A historical day in its own right. But, I can’t help but feel it is a culmination of so many events that have taken place in recent days…weeks…months, on a worldwide stage, but also on a personal level.

2020 started well enough, especially for this lifelong Kansas City Chiefs fan. A huge fan of teamwork, as much as I loved seeing the Lombardi trophy return to Arrowhead after 50 years, I even more enjoyed watching those coaches and players come together as a team. I know every fan wants to think their team is like a big band of brothers that have each other’s backs, so there’s a good chance I may have some fantasy wrapped in naivety. However, seeing your starting quarterback, out with a concussion, tweet “Hennething is possible” when his back-up QB, Chad Henne, and the rest of the team pull out a playoff win? Heartwarming. Supportive. Loyal.

And then began the longest 10 months in the history of the Gregorian calendar.

I quarantined. I binge watched TV (and may have developed obsessions with Hamilton and Schitt’s Creek). I gained the COVID-19. I thanked my lucky stars for job security.

I got COVID. I lost my sense of smell. I gained a new sense of guilt. I quarantined again. And, again thanked my lucky stars for job security and colleagues who are like my family.

There were some other events that occurred toward the end of the year…some sporting events, a milestone birthday, some natural disasters (other than the milestone birthday), an election or two…

But, just prior to Christmas, I received the best gift I could have ever asked for. My first COVID vaccine, with the promise of a second in 3 short weeks. The mild arm soreness I experienced was actually a wonderful reminder of the precious serum doing its job. The holidays came and went, looking very different for many people than it has in the past, and 2021, with all the pressures of being the solution to all the problems that seemed to come with 2020.

One week in to 2021, many people were ready to give up their free 7 day trial. It was not living up to the (unrealistic) expectations that we all had that things were going to get markedly better, literally overnight. Poor 2021. Didn’t stand a chance.

Fast forward to today. January 20, 2021.

COVID cases (and deaths) continue to rise. The threat of resistant strains loom. Issues with efficient, widespread distribution of the vaccine persist. Racial tensions remain high. Educators and students struggle with virtual and hybrid learning. Individuals battle all the issues that come with a pandemic…isolation, fear, anxiety, uncertainty, just to name a few.

But, there is something different about today. All day, I have been trying to figure out this feeling that has come over me. It’s a good feeling…warm and enveloping. I couldn’t put my finger on exactly what it was at first. It seemed familiar, yet not something I had felt for awhile. And then, while I was watching the inaugural activities, I realized what I was feeling.

Hope.

Anyone who knows me also knows that there are two topics I avoid in any conversation…religion and politics. Much of it comes from a strong desire to avoid any potential conflict. A lot of it comes from my own insecurities of not fully understanding all the details and, therefore, not being able to hold up my end of the discussion. But, I can’t help what I feel. And right now I am welcoming hope.

My feelings do not stem from the actions of one person. This post is not meant to be a political commentary. But as I sit here, lucky enough to have received 2 COVID vaccines, making plans to hopefully return to some “normalcy” (although I’m not sure what that even means anymore), and listening to the hopes and goals of the incoming leadership, the words are filling me with hope. To put it in simpler terms, I feel like we are coming together as a team. Coaches, players, staff…everyone. Together. To support, to advise, and to bring out the best in each other. Fantastical? Naïve? Delusional? Maybe. But I truly don’t think so.

Hennething is possible.

Just One More Episode: Lessons Learned from Pandemic Binge Watching

This year has been a learning experience on so many levels, and that is me trying to put a positive slant on the beginning of the last quarter of 2020. The year that keeps on giving.

One of the biggest differences I noted in people (obviously politics aside) was their approach to the lockdown. To all those people who used that time to deep clean their homes, learn a new language, get into shape, and get to the bottom of their to-do list, I say congratulations. What an inspiring way to spend all those hours isolated from friends and family. I applaud you and your responsible decision making.

I, however, went in a slightly different direction. There was no deep cleaning or new language learning. And, the only part of my body that got a consistent work-out was my liver. But, I did make a substantial dent in my list of “must-see when I have the time” TV shows. And reflecting on it, I seem to have learned a thing or two.

  1. From Ted Lasso: “The happiest animal on earth is the goldfish. They have a 10 second memory.” I could definitely learn a thing or two from the goldfish.
  2. From Hamilton: “Everything is legal in New Jersey.” Enough said.
  3. From The Umbrella Academy: Family is not defined by blood. No matter the circumstances…whether you are brought together by an eccentric bajillionaire or you are lucky enough to cross paths with the people who leave that precious, indelible mark on your life, friends are the family you choose. And also…Life deserves a great soundtrack. Whether it’s The Kinks or Tiffany, music is a key part of every chapter of our lives. You can’t tell me that you don’t have at least one song that immediately takes you back to another time. Sometimes happy, sometimes sad, but always meaningful.
  4. From Space Force: “Someone needs to lead and someone needs to follow but they are both equally on the same team.” More and more I am convinced that life is a team sport. We all have unique abilities that every team needs. Everyone should be comfortable leading, following, delegating, questioning, and trusting. No single part of the team is more important than another, and success depends on remembering that.
  5. From Jeffrey Epstein: Filthy Rich: Money can’t buy happiness. It can buy mansions and islands and private planes, but maybe some of that money should have been earmarked for a therapist.
  6. From The Tiger King: OK. You got me. Nothing learned. Absolutely nothing gained. And I have no idea why I watched it. Twice.
  7. From Schitt’s Creek: Unconditional love. John and Moira not blaming each other when their lives were the most challenging, and instead leaning on the other for strength and support. David and Patrick navigating an unconventional relationship, not perfectly but with mutual respect and unending patience. Alexis and Ted overcoming the obstacles to reunite, only to unselfishly part…not because they didn’t love each other but because they knew it was the best thing for the other person. I aspire to bring even a little of their passion, their dedication, and their unconditional love to the relationships in my life.
  8. From 13 Reasons Why: “You don’t know what goes on in anyone’s life but your own.” “No one knows for certain how much impact they have on the lives of other people.” Working in a pediatric emergency department, I will admit that my first interest in the show was more of a morbid curiosity, wanting to learn more about this series that was rumored to glorify suicide. It is a show that makes you feel uncomfortable because it shines a bright spotlight on issues of mental health that have long been stigmatized or brushed under the carpet. And it didn’t glorify suicide. It showed how one person’s unimaginable pain indelibly impacts so many lives forever. I watched all four seasons and while there are so many great take-aways in relation to bullying, mental health, drug abuse and sexual assault (just to name a few), the point that stuck with me was that you have absolutely no idea what is going on in anyone else’s lives, and there is no place for assumptions or judgment. And every gesture, every word, every text – no matter how seemingly small or insignificant – can have a profound effect on someone. So my goal is to try and make that be a profound positive effect. Be the reason someone smiles. Make someone feel like part of the team. Be better.
  9. From AfterLife: “Hope is everything.” I love the humor of Ricky Gervais. I would be happy if he hosted the Golden Globes forever. Edgy? Yes. Sometimes cringeworthy? Yes. Funny? Always. His dark comedy that follows his character’s journey after losing his wife to cancer shows him at his lowest points and is absolutely heartbreaking at times, but there is an underlying thread of hope that carries you through. Someone once said that laughter through tears is the best emotion (thank you Clairee, Ouiser, and Truvey), and remembering the hope while wiping the tears makes it even better.
  10. From Hamilton: “If you stand for nothing, Burr, what will you fall for?” I’m not proud of the number of times I watched Hamilton after it was released on Disney+, but I loved every minute. And while I could do 10 lessons just from Hamilton, I limited it to just two. I should also confess here that I chose not to watch either of the first two debates. And, in no way is this a political blog (definitely out of my wheelhouse), but if Hamilton taught me anything it is that there is no place for apathy in our country, especially right now. No matter what your views or beliefs are, please vote.

So, while I could have taken this time to learn Italian or take a toothbrush to my shower grout, I don’t regret (all of) my choices over the past months. I do feel like I have earned my professional binge-watching badge (don’t feel bad if you’re still amateur status…practice makes perfect), and I feel like I gained some new insight I can use moving forward.

Now, if you will excuse me, I am going to go put up the Christmas tree. Hoping it will make 2021 come quicker. Stay well.

Don’t Forget to Be Kind to Yourself

I was reading this article in the New York Times about Dr. Lorna Breen (https://www.nytimes.com/2020/07/11/nyregion/lorna-breen-suicide-coronavirus.html), and it literally took my breath away. This awful pandemic has claimed so many lives, in so many different ways.

Sadly, it made me think of a medical school classmate of mine who took his own life a few years ago. He arranged for this to post to Facebook the next morning:

I didn’t know Dr. Breen, but I did know Brandon (not his real name). And from what I’ve read and from what I know, it seems they were both forces to be reckoned with. And my thoughts keep going to that final dark moment, when there didn’t seem to be any other option. And it haunts me.

At the time, our ED was struggling with all the usual things…albeit, not pandemics, but all the other things that affect our jobs, and in many ways our lives, on a daily basis. I wrote the following email to my co-workers:

As I have struggled through this week in the ED with difficult patients, challenging consultants, and near record numbers, I think about Brandon and what he must have been going through, the pain he must have felt especially at the time he wrote this post, knowing what he was about to do. And one simple thought came to mind:

I get it.

It doesn’t matter if you have been doing this 2 years or 2 decades…we have stressful jobs. I don’t think people can truly appreciate what we do and how we feel. I don’t think people…even some other physicians…understand that we don’t punch a clock and leave these patients behind when we go home. I am willing to bet that every last one of us has woken up in the middle of the night at least once thinking about “that kid you saw”, wondering if you had done the right thing. Any of you who have been on the receiving end of “hey – remember that kid you saw?” as I have, know that feeling in the pit of your stomach, and are familiar with the cold sweat that breaks out, even in a few seconds. And, any of you who have been involved in a bad outcome as I have, knows that those cases…those families…those children…stay with you forever.

So, as I have gone through my shifts this week, I have dealt with disgruntled families with unrealistic expectations (often times, the result of advice from another physician); I have physically restrained 2 nine year olds and physically pulled the mother off one of them as she was hitting him with her shoe; I have felt belittled by consultants, my approach and management plan questioned; I have given families news they didn’t want to hear, and I have had to repeatedly say “I don’t know”; all with the backdrop of 20-30 patients in the waiting room seemingly at all times, in the back of my mind wondering which of those triage level 4/5 are getting sicker.  I was fortunate that I was not involved in any of the 4 codes that resulted in deaths we had in the department this week. My heart goes out to those of you who were…each one more heartbreaking than the last.

This is my plea to you. We have tough, tough jobs. Few can truly understand our professional lives. But we do.

We have all taken varied roads to get here, but now we are together. We are a large, sometimes dysfunctional family, and everyone has their individual struggles and frustrations. I am the first one to say that I have let those struggles and frustrations get in my way at times. We don’t always get along or see eye to eye, but I know that if I were at the point that Brandon was last week, this group would drag me out of the dark place I was in and make sure I was safe and knew I was supported. I know that because it has happened to me.

We don’t have to love each other…we don’t even have to like each other. But, we do have to support each other. No matter what. There are plenty of people out there that are willing to Monday morning quarterback what we do, and if we don’t have each other’s backs, I truly worry about our longevity, our happiness, and our well-being.

I apologize for the length, and for the gravity of this email. Again, do with it what you will…take it to heart, delete it, whatever. But one thing I have learned after being here for 20 years is that if we don’t stand together, we will slowly fall apart.

So, as I read about Dr. Breen, saddened by the fact that we have been robbed of yet another young, promising, motivated physician, I am reminded that as bad as this pandemic is…and truly believe it is awful…when it gets better (and I have to believe that it will), we can’t forget. Because all the other things that have always been there but got shoved to the back burner by COVID will be there again. And no matter what kind of medicine you practice, there will be unique (and some not-so-unique) stressors.

We are always expected to be kind to our patients. But my plea to you is to be kind to each other and, more importantly, yourself. You’re worth it. And I promise there is someone out there who understands what you are going through.

Sometimes you just have to ask.

Subject Line: Sad News

No matter what kind of day you are having, when you open up your email and see that subject line, it takes your breath away. While it could be a notice that Jeni’s is out of salted caramel ice cream, you know that’s not likely the topic. So, you take a deep breath and you open it…

Ten days ago, I woke up with a fever, sore throat and couldn’t smell anything. I knew deep down what was going on, but there’s always that little voice saying, “It could just be strep…or some other virus, NOS.” So, when I filled out my daily symptoms update with the new developments, it was impressive how quickly I got a call from employee health…seriously within ten minutes of submitting, and I had my testing appointment for the next day.

I had heard the agony that was associated with getting the actual test…one friend told me they thought they had a CSF leak afterward. So, when the nice woman in the UAB drive through testing site told me that I “could not grab her hand or the swab”, I felt it best for me to sit on my hands. Just in case.

The test was actually quite tolerable, but I’m not sure it could have been as bad as I had made it out to be in my head. I rolled my window back up and drove home and waited for the news I knew was inevitable. The call came from the sweet employee health nurse the next morning, and I passed the info along to everyone who needed to know and prepared to hunker down for the ten day quarantine. So thankful for ibuprofen, Hamilton, and friends who left me an endless supply of magazines, cheez-its, ice cream and fudge stripes on my front porch. Oh and DoorDash…can’t forget DoorDash. And Shipt.

Fast forward ten days. I am fever free for three days, tired but no breathing problems, still can’t really smell anything (but that may not be a bad thing after being stuck inside for ten days). Every day I have been blessed by so many people texting and checking on me, making sure I’m ok. I’ve always known I work with the best people in the world, and seeing them volunteer to cover my shifts has given me one less thing to worry about and one more thing to make my heart warm.

Before I start to watch the next episode of Sherlock Holmes (I’ve already watched Hamilton once today), I check my email and see a subject line that reads: sad news. It’s an “Official Message from UAB” and it tells of the heartbreaking death of UAB Police Sergeant Parnell Guyton. I had followed his story as he was diagnosed with COVID-19 several months ago and spent weeks in the ICU. He was recently released and able to go home, only to require readmission to the ICU yesterday. His death was confirmed this evening.

I didn’t know Sergeant Guyton personally, but I almost feel like I did. His son went to school and was friends with the son of one of my closest friends. From all descriptions, he sounds like a gentle giant, with a heart to match. He trick-or-treated, he protected his family just as he protected UAB. And somehow he contracted this elusive and confusing disease. And bravely he fought for weeks and months. And sadly he lost his battle today.

My friend, who is one of the best human beings I know, was trying to explain to her son what had happened and she felt like she was struggling and not doing a good job. In the midst of all this, this amazing human stopped and asked me how I was doing. How I was feeling. How I was managing.

My only response was that I was feeling extremely fortunate. I have read more about this disease that I have wanted. I have thought more about this virus than I have wanted. And I am tired of thinking about it and worrying about it and being scared of it. But I cannot even imagine what Sergeant Guyton’s family, as well as so many others who have experienced the loss caused by this awful pandemic, are going through and will now have to face the uncertainty of the future missing an adored member of their family. I don’t know what they had planned for 2020, but I know this wasn’t it.

I don’t claim to know the right answers or the absolute right thing to do. But I know that I have had COVID and it sucks. And mine was mild. As we move forward, please think not just of ourselves but of others and their families. It’s up to us to protect ourselves and our loved ones. It’s up to us to do what we can to make it so other mother’s and father’s don’t have to teach their eight and ten year olds about life without their protectors…their heroes. About death that may have been able to be prevented.

Please. If you won’t do it for yourself or for the guy next door or because of the conspiracy theorist down the street, do it for the children whose lives are forever altered, and for the parents who are left to rebuild a future they never deserved to experience.

Those Who Stand for Nothing Fall for Everything

Fireworks over Robin Lake, Callaway Gardens; July 4, 2020

On June 26th, Thomas Blanton died in prison at age 82 of natural causes. While his name didn’t mean anything to me, the headline caught my eye. He was the last remaining living klansman convicted in the 1963 bombing of the 16th Street Baptist Church. The brutal attack that took the lives of four young girls, and left a fifth with scars she carries every day.

I have lived in Birmingham for over two decades, and it’s one of only two places I have called home. I am very proud of my city and of the growth and progress I’ve witnessed especially over recent years. Every city…community…person…has things from their past that contain painful memories. And, ideally, you take these life events and learn from them. And, to borrow a phrase used for other acts that have altered the world we live in every day, never forget.

To say that Thomas Blanton’s death closes a chapter in Birmingham’s history wouldn’t be fair. That chapter will never close for the people that were involved. Sure, there won’t need to be any more parole hearings or other proceedings and maybe that will help in some small way. But it does mark a point on the timeline. And that typically comes with an opportunity to reflect…was this occurrence used as an opportunity for growth? On a personal level? On a community level? On a national level?

So, as I was reading this article, I thought about what we could tell those four young girls. Could we tell them that although it took 37 years to hold the parties responsible for this merciless action, we have traveled an incredible societal distance since 1963? Could we tell them that this vicious act that cut their lives far too short had been used as an example of how not to act for people in 2020? Does Sarah Collins Rudolph, the “fifth little girl”, feel that this senseless attack and the tremendous loss and disability that accompanied it, has helped make people realize that the color of a person’s skin is not an indicator of their worth?

And that is when the myriad of emotions I had been experiencing bubbled to the surface. First and foremost, overwhelming sadness. All the names that had been filling all of our newsfeeds over the past several weeks…Ahmaud Arbery, Breonna Taylor, George Floyd…and those were just the ones that made the news. Lives cut short. Victims…not of a church bombing, but of acts seemingly fueled by the same ignorance and refusal to accept the basic tenet that all men are created equal. Sadness coupled with hopelessness, that if the pointless deaths of four young girls can’t be the example that changes our actions, what will?

Intermingled with the sadness came shame. Or possibly guilt. Probably a combination of the two. I am a middle-aged, divorced, professional white female. While the Catholic upbringing may explain the guilt, I was still left with the question…could I have done more? And where do I go from here? But, I have plenty of African-American friends! Isn’t that what I am supposed to say to make myself feel better? But what do I say to my friends who go out every day and have to know that their mere appearance has already caused some people to make an assumption about what kind of person they are? How do I address the fear that has become a permanent part of their daily routine, for themselves or for their family members? What do I do about the shame I feel because of the color of my skin?

This weekend, we celebrated our country’s independence. And, like many many others, I took advantage of the opportunity to watch Hamilton. I had heard the music, read the reviews, but never had the chance to see it. And I was absolutely blown away, for so many reasons. Here was an extremely talented group of racially diverse people telling me the story of my beloved country, the best country in the world. And it seems so obvious…our founding fathers came together to create a new democracy. States that would be united, a more perfect union to be exact. There is no illusion that these men agreed with each other about everything, but they came together to make something better…more perfect. Not perfect. And while I know that those rooms were filled with white haired Caucasian men, the story I was told through Hamilton seemed…right.

I’ve been told in the past that perfect is the enemy of good. And while I have always applied that to my career, I think it fits well in all facets of life. Our country isn’t perfect. Americans aren’t perfect. And we never will be. But, maybe we should just try being good. Especially to each other.

It is Favorable to liberty. Freedom can exist only in the society of knowledge. Without learning, men are incapable of knowing their rights, and where learning is confined to a few people, liberty can be neither equal nor universal.

Benjamin Rush, Founding Father; 1786

Daddy’s Girl

My dad died 11 years ago today. I remember it like it was yesterday. I hadn’t been gone from the hospital long, my brothers were with him. I have absolutely no doubt that he waited until my mom, my sister and I left to let go. He protected me until the very end.

I also vividly remember, as I was on my way back to the hospital early that morning, realizing that my dad died on tax day. And that there had to be a joke in there…somewhere. Death and taxes. The only guarantees in life. And once again, he made me smile.

My dad wasn’t a big man…5’8″ is probably generous. But he had an infectious laugh, a booming voice, and his “just wait until I get you home” look could stop you in your tracks. He remains one of the hardest working people I have ever met. A pipefitter by trade, he was fiercely loyal to his family, his friends, his church and his beliefs. I was raised with a healthy fear of touching the thermostat and crossing picket lines and being taught that hard work is paramount.

He had terrible dad jokes (for example: What did the fish say when he swam into the wall? Dam. *groans*), but also had a string of sayings that I refer to as Frank-isms. A few of my favorites include:

  • It’s easier to keep up than to catch up. (So so true…hoping to figure out how to do that very soon.)
  • If you tell the truth, you don’t have to remember anything. (Truer words were never spoken.)
  • Nothing good happens after midnight. (Again…truer words…)
  • If you leave hungry, it’s your own fault. (A holiday favorite)

There are so many more, but I’ll save those for another time.

I have been a daddy’s girl for as long as I can remember. My parents did not plan to have a 4th child. To be honest, I’m pretty sure I was the result of a weekend trip to Vegas and the rhythm method. I remember going to the grocery store with him every Saturday morning and the people at the store would ask him, “Is that your granddaughter, Frank?” And he would always reply, “Nope, just a little girl I picked up on the side of the road.” And everyone would laugh (although I’m not sure how that would go over these days…). He retired when I was still in grade school and had his first heart attack in his late 50’s. The day after his hospitalization, he gave all the unhealthy stuff up cold turkey. He watched his diet like a hawk (sometimes annoyingly so), never smoked again (not even the occasional cigar that he used to enjoy), did everything the doctor told him to do to the letter, exercised religiously. At the time I didn’t truly appreciate it, but having been in medicine for awhile now, I realize that it was his discipline and sacrifices that gave me all those extra years with him.

I said goodbye to my dad when I was 38 and he was 88, eleven years ago today. He was not a perfect man, but he gave me some perfect examples of how to live my life. Do I agree with everything he did or said? Do I even understand why he did some of his decisions? No, but I have learned to appreciate why he did and said the things he did. And that was one of the biggest gifts he gave me. I am proud of the woman I have become (most days), and thankful that he always encouraged me to be the best I could be. Through that, he taught me to be an independent thinker and in charge of my own life. Sometimes right, sometimes wrong, but hopefully always true to myself.

And while I still have never crossed a picket line, I love having control of the thermostat.

One of my most favorite pictures of me and Dad…and yes, those are footie pajamas and plastic slipcovers. #growingupItalianinthe70’s

Dealing with feedback

I’m no stranger to negative feedback and rejection. I’ve dealt with it all my life, in all different formats. I’ve received it in all forms, ranging from not seeing my name on the list of players that made the team to being told no over the phone when I asked someone to prom (don’t judge too much…I went to an all girls’ school so we had to do the asking) to getting my rejection letter from Stanford (dream school) in the mail. Remember when we had to fill out all those paper applications with a typewriter??

In the age of cell phones and social media, the possibilities of where the feedback and/or rejection may come from exploded, and I am proud to say that I have been rejected on the best of dating apps. I’m not proud…calling them “growing opportunities”. Or something. Anyhoooo…

I have been known to possibly, completely unintentionally of course, over-, under-, or just flat out mis-interpret an email or text. I find I have a hard time trying to “hear” the tone intended. I don’t think I’m the only one suffering from this affliction…in fact, I’m pretty sure there is an ICD-10 code assigned to it: ABC.90210…abdominal pain caused by overthinking a received text or email, initial encounter. Luckily, over the years I have developed a bit of a thicker skin, so that helps while trying to sort things out.

Having said that, I’m having a bit of a hard time interpreting a recent email rejection I recently received and would love to get some feedback. With my thicker skin has come a likely ill-advised enthusiasm for exploring my previously well-hid love of writing. Which has led to my sharing some of my pieces with people outside of my comfort zone. Which leads to emails such as the following:

Thanks for the submissions, but I’m going to politely decline the pieces.

Reasons may include any of the following:

  • There are too many typos, formatting or grammatical mistakes.
  • The topic has already been discussed.
  • The article promotes a commercial entity by name.
  • The topic is not of interest.
  • I have too many articles in the editorial queue.

Having spent the majority of my adult life in an educational role, I am a firm believer in constructive feedback. If it happens to be positive as well, that helps, but I know that just isn’t realistic. But, I just really am not sure what to do with that response. Of course, I want to believe it’s just because there are too many other things to review. But, what if it really not interesting. Or just plain sucks?

I know it is a bit unfair to be critical, especially when these people have put together such a successful endeavor that people are (possibly) lining up to be included. But, my question to you is what should I do?

Should I:

  • Put it on the shelf and forget about it?
  • Resubmit exactly the same pieces?
  • Edit and resubmit?

In all seriousness, I am using this as a good reminder to myself about the importance of useful and constructive feedback and criticism. These are stressful times for all of us and these times could be game changers, especially for younger physicians. I was working in the ED the other day, and one of the residents who I greatly admire and the fact that he and people like him are in pediatrics gives me absolute hope for the future of the specialty I love, stated basically that if he thought he was putting his family at risk for doing this job, he would drop it in a heartbeat. Those words were very eye opening, a bit sobering and, honestly, more than a little scary. It reminded me that we need to be there to support our trainees and young physicians through common crises, pandemics and life in general. The wrinkles and gray hair I try so hard to hide are, in many ways, scars of battles we have all fought. Some I have won, some I have lost, but all have taught me something, whether I wanted to learn it or not.

So, to my colleagues and trainees…when we get through this (and we will get through this), and we can hang out in public together again, remind me to tell you my stories of when I cried, when I couldn’t get out of bed, and when I almost quit. We’ve all been there, and will probably be there again. I promise to try and do better than “great job” and “read more”. And I promise to listen.

First round is on me.

Every Paper Has A Home…

In these unprecedented times, there have been several calls for research proposals. Those of you who know me know that I am a highly motivated, not to mentioned talented, researcher. So I am just throwing some ideas out there…

1. Provider performance at the beginning of a shift compared to the end as it relates to serum ETOH (increased use of hand sanitizer) and CO2 (never taking your mask off) levels.

2. A descriptive analysis of stupid things kids do when they are quarantined.

3. Will finishing the academic year at home have an impact on parents perceptions on corporal punishment in schools?

4. What percentage of children diagnosed with walking pneumonia are ambulatory? (I know this isn’t really COVID related but still think it needs to be looked at).

5. A descriptive analysis of stupid things kids do when they are quarantined, part 2. Yes, I feel quite strongly that there will be enough data for at least 2 papers…and that’s just from our single institution.

6. With the pending chloroquine shortage, could daily consumption of gin and tonics be the secret COVID-19 cure? (Corollary study: does adding lime have any effect?)

7. Important e-mailed missed because your inbox was full of messages from Bed Bath and Beyond, Petsmart, and Ann Taylor (just a sample of a few) and THEIR response to COVID: a descriptive analysis.

8. NICUs census expected spike in the next 25-30 weeks: a predictive analysis. (Additional outcome evaluated is most common names in 2020 and 2021).

9. Novel ways to survive limited supplies of PPE, hand sanitizer, toilet paper, and tolerance for people who think the rules don’t apply to them.

10. The rise in voyeurism since the arrival of COVID: Does provider removing their clothes before entering the house after a shift cause an increase in binocular sales?

Happy to co-author or help with IRB. Just let me know!