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.

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!

To all my loyal followers, I apologize for my extended absence after my debut post. 7 years does seem a bit excessive for writer’s block, but more on that later…

I’m sitting here on the couch, it’s the somethingth of March (I think it’s still March) and I’m, like I’m sure many of you are, trying to make sense of what is happening in the world right now. Unprecedented is the word I keep seeing…seems pretty accurate.

What also may be unprecedented is the way we are all feeling about it, coping with it, trying to find our “new normal”…something we tend to do when life altering events occur. Except now we have the additional challenge of doing it with social distancing and curfews. So, I thought I would share some of my recent thoughts to see if they rang true with anyone else, just in case.

• Netflix. Need I say more?
• OK…maybe just a little more…I want to personally thank Jim Gaffigan, Tom Segura, Jimmy Carr, Joe Exotic, Marty Byrde and the cast of Love is Blind (in no particular order) for helping me shelter in place.
• I keep getting thrown when I look out the window because typically when we are in this situation we are incapacitated with 1/8 inch of snow.
• I now have no doubt that I could survive on sandwiches and frozen pizzas.
• It’s probably a really good thing that we can’t get alcohol delivery in Birmingham.
• Remember when that Sandra Bullock movie The Net came out in 1995? And I thought how ridiculous it was to think you get through life without having physical contact with anyone? I’m feeling a bit Angela Bennett-ish.
• The news is not a great thing to have on in the background these days, especially when you can tend to get anxious at baseline.
• I have always had the upmost respect for the people I work with, but watching what my colleagues across the nation and the world are doing right now is downright inspiring. And I’m not talking about the physicians.
• This is scary. I’m afraid. I have cancelled going for a walk with my best friends 3 times in the past 2 weeks because I am afraid to leave my house to do anything but go to work. I am afraid of unknowingly passing the virus to someone…I’m worried about my 92 year old mother…I’m afraid of getting sick myself because, as I have been reminded, I’m too old for ECMO. I am afraid and anxious at some point every day.
• Somedays I struggle to remain hopeful. I have always known that I have a healthy fear of the unknown and this is no different, but I especially miss seeing that light at the end of the tunnel. Hearing all the conflicting “facts” and seeing the lack of joining together and fighting this as a team at the highest levels can only be described as disheartening. I feel hopeless at some point every day.
• Despite the fear and hopelessness that seems to come in waves, I feel very fortunate. Fortunate to have a job I love and fortunate to be surrounded at work by people I love and respect and owe my sanity (and my life) to. The team of co-workers in the emergency department at Children’s of Alabama are like no other and I wouldn’t want to face what we see every day (pandemic or otherwise) with anyone else. Every single day you continue to amaze me with your strength, your compassion, and your humor. Thank you for being my front line every day. Despite everything, I feel fortunate at some point every single day.

One of my favorite signs from a previous time in my life I think works well now:

Just when the caterpillar thought the world was over, she became a butterfly.

I have it in a place where I can see it when I first wake up in the morning. I use this to remind me to stay hopeful. Hopeful that my sweet boyfriend will stop trying to “cheer my up” by watching Monty Python. Hopeful that my amazing friends from medical school and I can reschedule our much needed annual trip. Hopeful that my tribe knows I am here if they need me. And hopeful that my friends don’t give up on me when I let the fear get the best of me. I do know we will get through this, and I know we will only get through this together. And, for the first time today, that gives me hope.

Thank you for taking the time to read this…I just wanted to share some of my thoughts, because some of you might have some of the same.

Just in case…

It’s hard to believe that I have been the Assistant Dean for Students for almost six months now. Time really does fly…especially the older I get. As I reflect, I realize that I haven’t been on a learning curve this steep since my intern year. So, for my first blog attempt, I am going to share with you the top ten things I’ve learned.

(Disclaimer Alert: I guess I should also mention that the opinions expressed in the following paragraphs are just that…my opinions. And in no way do they even attempt to represent the views of Medical Student Services, the Associate Deans Office, or the UASOM.)

10.  Medical school has changed vastly since I graduated…but also not at all.

Anatomy, physiology, pathology…not too much has changed over the last several decades. And, the things that I worried about when I was a student are still the same concerns people come to talk with me about: Am I ever going to be able to pay back these student loans? What do I want to be when I grow up? What if I don’t match? Some things don’t change.

But one thing has changed, and that’s who is sitting in the seats, who is doing the clerkships, and who is going through the match. You’ve heard it before…learners are different now. And, that has made the experience of medical school immeasurably different. As I was sitting in the LCME meeting last week and heard one of the fourth year students say that they really don’t spend the night in the hospital anymore, it really hit home. Of course the age of the 36 hour call has gone by the wayside in residency as well, so maybe it’s a natural transition. Is it better this way? I’m not sure I can say. And I think my generational gap might get in the way a little. I can say that it is different. The rest, in my opinion, remains to be seen.

9.  The steps to Volker Hall are really steep. And slippery.

No joke. Be careful.

8.  No one is responsible for opening or closing the umbrellas on the plaza.

Just an observation…not volunteering. I’m too short to do it anyway.

7.  Open communication is vital to success.

No matter what career path you choose, the way you communicate can make or break you. And, I don’t just mean the words you choose.

I can’t imagine that I am the only person who has ever opened an e-mail…read it…cried…read it again…stormed off in anger…came back and read it again…drafted fifteen response e-mails (all of which got deleted)…read it again…turned off the computer in anger and went and had a handful of thin mints. OK, so maybe you haven’t done that exact sequence (maybe samoas are more your speed), but attempting to interpret tone in a written statement can be a very dangerous thing. So, perhaps the lesson should be to pick up the phone if there is even a question. It will save you a lot of time (and tears…or, cookies) in the long run.

6.  The seats in lecture room B are really uncomfortable.

Seriously.

5.  Balance is important.

All work and no play makes Annalise a dull girl. But, all play and no work makes Annalise a horrible assistant dean and physician. Balance is imperative. Working weekends is part of the role of the emergency physician…and part of the role of the assistant dean as well. It’s very easy for the hours to get away from you and all of a sudden you look back and realize you haven’t been to the gym in six months (even though it’s less than 100 yards from your office). Don’t feel too sorry for me…I manage to make time for other (guiltier) pleasures such as Blazer basketball, The Following, and Impractical Jokers. But sometimes, I wish I had learned the art of balance much earlier in my career. Vacations are important. Sleeping in every once in a while is nice. And, working holidays is not the end of the world. It’s life. Welcome to it.

4.  Even when you are an assistant dean, your mom still gets mad when you don’t call regularly enough.

Especially when she is Italian and Catholic.

3.  It’s important to have people in your corner that you can count on.

And you need to be able to be counted on. It’s a two way street. But, it’s narrow, and there is no room for alternate agendas, empty promises, or unkind words that serve no purpose.

I grew up on teams…mostly sports, but other types as well. The essence of teamwork is that no one person is more important than the whole. I am very fortunate, because currently I am a part of two very high functioning teams…Pediatric Emergency Medicine and Medical Student Services. And, not surprisingly, there is an amazing amount of overlap between the two. Both teams put tremendous effort toward helping others succeed without a hidden agenda. Both teams make me want to work harder and be better because they believe I can. And, both teams do what they think is in the best interest of the people they serve, whether it be the child, the parent, or the student.

Probably most importantly, I know they have my back. And, I have theirs.

2.  I don’t like reality T.V. much.

This doesn’t have anything to do with the new job…just a temporally related realization on my part.

1.  Hands down, the students are the absolute best part of this job.

Even though it’s only been six months, one thing has emerged as the most rewarding part of this job, and that is getting to work with the students. Some make me laugh. A few make me cry. Some make me lose sleep. Some drive me to eat lots of thin mints. But, I have loved (almost) every single moment. I can’t wait to watch my first match day, to participate in my first UASOM commencement, and to watch this class of 2013 go out into the world armed with the resources that we have given them to be physicians, leaders, and pioneers.

Yes, it’s only been six months. But I have already developed loyalty for my team, pride in my students, and hope for the future. I think we’re in good hands.