Liberal Helping of Cranberry Pecan Pie

_dsc0140Do you want to know the BEST part of my job?  Truthfully?  I’m not even going to try to lie and say some bullshit like helping people.  Nope.  It’s not that.  It’s the food.

Lord, help me, it’s the food!

My practice is nestled at the corners of 3 “cities.”  Extending outward from this vantage point are rolling hills, lake communities, and vast stretches of farmland.  Interspersed here and there are the furniture factories that have survived the exodus of such businesses overseas for cheaper labor.  This is the epitome of rural America.  Mostly white.  Mostly Christian.  Mostly living paycheck to paycheck.  About 12 months ago, Trump signs sprung up in the lawns like wild dandelions, pretty little yellow flowers that will choke the shit out of your grass if you let them.

Some people think I’m a yankee.  Where you from?  You from around here?  They already know the answer.  I look like I could be from around here, but my nondescript accent says otherwise. I’m technically a southerner, too, if you define southernness by geographical and not cultural standards.  South Florida is just about as south as you can get without falling into the ocean and as far away from southern culture as if I left the country altogether.  I’m not a yankee, but I’m not a southerner, either.

It’s easy to think that anyone who would support Trump would be crazy, racist, fascist, sexist, even the devil incarnate, but I guess it’s like anything else, when you face the monsters everyday, you start to understand the motivation.  They don’t seem like monsters anymore.  In fact, you realize, they are not monsters at all.  They are doing the best they can.  They are scared.  They work hard.  They just want their own piece of the pie.  Just like the rest of us.

Don’t get me wrong.  There are monsters.  Everywhere.  Liberal.  Conservative.  Christian.  Atheist.  We all have the potential.  We have all been monsters.  We all have the capacity.

I found myself contemplating my role in such a community between mouthfuls of cranberry pecan pie on my ride home from work the other day.  One of my patients brought me a piece.  Homemade.  I tried to wait the 40 minute care ride home, but it beckoned me from it’s place on the passenger seat.  It was useless to resist.  At 70mph on the interstate, I pealed back the aluminum foil covering and tore it apart piece by piece, shoving the sweet tartness into my mouth with my bare fingers.

I found the bitter cranberries to be a sharp contrast to the buttery cakey deliciousness that enveloped them.  Equal parts moist and flaky, sour and savory.  The red cranberries bled purple streaks and pools, lines and intersections.  Occasionally my teeth would hit the speed bumps of pecans, slowing me down, and changing the landscape.

With each bite, my taste buds searched for the sweetness around the bitterness, and then the bitterness around the sweetness, never actually being able to separate them.  They were juxtaposed and married to each other.  They were inseparable, like siamese twins sharing different sides of the same heart.

I could joke around and say that like that cranberry pecan pie, the community in which I practice is full of sweet people with an underlying bitterness and the occasional nut, but it is so much more than that.  But you know what, I think I’ll just leave it at that.

 

 

 

 

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Feed Me

fullsizeoutput_1fbeThe worst part about motherhood is not the lack of sleep.  It’s not the complete and unending exhaustion.

It isn’t the relentless breastfeeding, sore nipples, sore back, that deep and unfulfilled desire to move except you are tethered to another person providing life giving sustenance for an entire year (I gave up after 8 and 3 months respectively).

It isn’t the endless babble, the spontaneous and shocking ear-piercing noises, or incoherent stories as if told by your drunk uncle over holiday dinners.  Children love to talk, scream, laugh, cry, basically just make a shit load of noise.  It is incredibly distracting from the quiet spaces in the mind that produce thought.  Thinking is almost impossible with children around, but that doesn’t even bother me much.

It doesn’t even bother me that I didn’t watch an entire movie for 5 years.  I couldn’t get into any series for lack of actually hearing any of the dialogue.  I missed all of The Walking Dead and American Horror Story because the kids could not even accidentally walk in on me watching them without creating months of nightly awakenings from nightmares.

It doesn’t bother me that they are old enough to wipe their own asses, but still insist on yelling across the house, “mommy….I’m done pooooooping!”  Expecting me to stop what I’m doing and run to their side, finding their rear end stuck up in the air for ease of wiping.  To which I reply sarcastically, “It is my greatest joy in life to wipe your booty!”

So what bothers me the most about having kids and being a mother?

I have to feed them.  All the time!

Why so much???  Breakfast, lunch, and dinner?  Snacks, too?  I did not sign up for this.  And why me?  They never ask their dad for food.  It’s the boobs, isn’t it?  Like some kind of billboard for a meal.  I am completely incompetent in the food department.  They never like anything I make.  I really try.  They are so picky.  And it goes on all day.

I’m hungry!  I want something to eat!  Snacks.  Drinks.  Candy.  Chips.  Always arguing over making healthy choices.  I give in sometimes.  I’m not proud.  Just eat the damn chips!  The youngest won’t eat turkey, but loves chicken.  The oldest wants green apples not red.  The oldest will drink milk, but only if it is chocolate milk.  The youngest likes cheese but not string cheese.  It’s insanity and it’s relentless.

Thank God for cereal.  It seems to be the great equalizer.  They both like cereal.  And so far cereal seems to be life-sustaining.  That and a good multivitamin.  The gummy kind not Flintstones.

 

 

 

 

 

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The Doctor Will See You Now

Welcome my friend Amber to Deconstructing Doctor.  Amber is a Neonatologist that I convince to write for my blog from time to time.  She writes so beautifully and lovingly about her patients and her chosen career.  Enjoy her latest post.  To find similar posts by Amber click on Guest Blogger

IMG_1905I see the longing in your eyes every time you tiptoe to the incubator window, willing your son to heal and grow, wishing you could do everything his nurses do for him.  I see your gratitude for how gently they handle him, how softly they croon to him, how expertly they feed him, how they love him.  They’re skilled, responsible, loving substitutes, but it’s just not the same as his mother’s touch…when that touch is possible at all.   

I see the desperation on your face when your tiny child needs her breathing tube put back in after she went so many days without it.  I see the bewildered expressions on your face when we talk about IV fluid ingredients, calories, and amounts in terms like “cc per kilo,” and the panic that you swallow when we describe “spells” on rounds.  I see you fight to remain calm when her heart rate drops and fourteen people swarm to her bedside, because it’s that kind of alarm.  You understand that’s why she’s here and not home in your arms, but the weight of uncertainty is crushing.

I see that you feel helpless to guide your daughter’s journey, this little life you’re now forced to entrust to someone you’ve never even met.  I see you holding back tears as you struggle to accept that sometimes painful things happen to her here, and that it’s not you enveloping her in that strong, safe father’s comfort, because you have a spouse, household expenses, other children, life away from here that needs you, too.

I see you smile when she wriggles himself into the corner of her bed, snuggled into a perfectly round little ball, comfortable and quiet.  I see you ecstatic over that first successful oral feeding, carefully documenting one milestone after another as, one by one, the tubes, lines, and wires fall away.  I see your relief, the first time you get to take her photograph without anything attached to her perfect little face.  I see you amazed by her personality, her personhood.  You’ve learned our language full of confusing acronyms, and gotten used to the daily scrubbings, rules, and protocols.  I see that you want to let your guard down a little, but that the joyful moments come with some pain.  It wasn’t the experience you were expecting or wanted.  You had other plans for her, plans that evaporated instantly as a matter of life and death.

I’ve watched as you prayed incessantly, adapted, cried an ocean, and now feel at once free, yet nervous to be free.  I see your dread that you’re not really done with this, that there might be another bend in the rollercoaster, knowing you will be twisted into knots, then untwisted with dizzying spin.  I see that you want to run as far and as fast as you can from these memories, but that you need to hang on for awhile.  I see, and appreciate, how years later, you have extended yourself to grieve with, and for, other parents.

I can see that you need me to see you.

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Changing Times

class-001You know that the times they are a-changing when you have lunch with your dad and he wants to talk about Malcolm X.

I tried to get out of the lunch date, not because I’m some kind of horrible daughter, that’s part of it, but because I felt like I was coming down with something.  How many flu cases had I seen the day before?  Or the day before that?  I lost count.  But it was a lot.  My muscles and joints were achy.  I felt pressure in my sinuses and my throat was a little sore.  I just wanted the few hours I had left before I picked up the kids from school to be spent under the covers and watching tv.

I don’t feel that good, dad.  I don’t want to expose you to anything, maybe we should plan for another day.

He wasn’t having it.  He wanted to have lunch with me and that was that.

“You can get soup.  You need to eat anyway, don’t you?”

He wanted me to take him to Red Lobster.  We settled on Cracker Barrel.

Over lunch that was actually breakfast food, pancakes for both of us, my dad started to talk about the goings on in his life.  He’s remodeling his bathroom, working on his old car, going to church dinners twice a week, his visits to the doctor at the VA, going fishing when the weather warms up.  And Malcolm X (insert record scratch).

I’m pretty sure my dad voted for Trump, although, I can not bring myself to ask him directly.  I just don’t need to know that about him.  Kind of like not knowing about your parents love life.  My soul will be better off if I’m ignorant to those facts.  But I have a feeling he did based on comments like –he really speaks his mind, he could make the VA and Medicare better, he can shake things up. It’s just possible that if he did vote for him, he may be having buyer’s remorse

Because he’s watching movies about Malcolm X.

My dad, who belongs to the NRA.  Who used to drink too much beer, but hasn’t in 13 years.  Who’s southern accent sneaks out in the most unlikely places (wire becomes whau-yer).

He’s reaching out.  He’s learning.  He’s curious.  He knows something’s not right.  He knows that the VA and Medicare are not priorities with this administration.  Things are getting shaken up and it’s chaos.  He’s hearing about Black Lives Matter.  He knows I participated in the Women’s March with his granddaughter.

He watched a movie about a black man in the 60’s who was a Muslim.  A man who stood up against white suppression “by any means necessary.”  A man who was likely murdered because his militant beliefs tempered with time and he sought ways to peacefully create understanding and change.  He changed.  He evolved.  He understood.

And if Malcolm X can do that and my dad can do that, then there’s hope for us all.

 

 

 

 

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Profit or Prophet

img_2431There is a financial pressure to see a lot of patients in a day.  Seeing patients equals revenue.  Revenue equals a paycheck for me and everyone else that I employ.  It also feeds the giant corporate machine to which I now belong.  In all honesty, I haven’t felt specific pressure from the corporate machine because for now, I am flying under the radar.  Plus they are nonprofit.  At least on paper.

I know that this reprieve won’t last for long.  We recently changed computer systems, which if I were a few years older, probably would have forced me into retirement.  It was one of the hardest transitions I have ever endured.  Everything feels like a fight.  There is no one accountable when things go south.  You have to talk to a half dozen people just to get to someone who knows WTF you are talking about.

When I print a prescription, it is going to a Pediatricians office in another city.  Why can’t you fix my printer?  Why can’t my computer print to my printer in my office?  That took like 3 weeks.  Not joking.

For now, they are not giving me too much shit, because they know somewhere in their corporate brains that they can’t push us too much.  Not yet.  Not until we get our footing with this system.  With being part of a big machine.  With trying not to lose our humanity.

I had a conversation with another provider recently who said one of their partners saw more than 50 people a day.

This.  Would.  Kill.  Me.

I seriously contemplated the enormity of this.  My first thought was -Jeez, I must suck, I feel overwhelmed when I see 25.  What’s wrong with me?  What am I doing wrong?  Then, I wondered how they weren’t screwing everything up, missing parts in the chart, forgetting to send someone for a mammogram, misdiagnosing a disease because they were in a rush, working on their charts into the wee hours of the night.  If that’s what it takes to stay in this business, to make money, to be a doctor, count me out.  I’ll just be poor.  Debt-ridden.  And happy.

Who once said and I paraphrase, If you do what you love, you’ll never work a day in your life?  This work is a labor of love.  I don’t see dollar signs when I look at these people.  I see mothers, fathers, factory workers, waitresses, broken hearts, fear, perseverance, despair.  I see resilience, faith, trust, joy, prosperity, and forgiveness.  I see healing.

I learn their stories.  I want to learn their stories.  That’s why I feel overwhelmed when 25 people come through my rooms.  I can’t give all of them my attention.  I can’t learn their stories.  Oh, I could see a hundred people in a day.  Line them up like an assembly line.  Dole out the antibiotics.  Gloss over their questions.  Send them for tests. Refer them out to someone else to deal with.  Run ’em through  like cattle.  I can’t be that kind of doctor.  I won’t be that kind of doctor.

If you listen carefully enough, the patient will tell you what’s wrong with them.  The diagnosis will be given to you.  The patient will tell you.  If you just listen.

If you are my patient and I don’t know that your dog died last month, or that your grandson has been deployed, that your daughter is getting married, or that you got that job you wanted, then I am not doing my job right.  If I am not listening to your stories, how will I ever find out what ails you?

 

 

Posted in Healthcare Today, Medical Musings | Tagged , , , , , , , , , , , , , , | 18 Comments

Resistance

_dsc0208I have a list of diseases that I hate the most.  I hate them because I have no way to fight them.  I have no power against them.  I push back and push back, but they don’t budge.  They laugh in my face.  They know my weakness and they gloat.  All the while taking the patient’s life an inch at a time.  Slowly.  While I watch.  Helplessly.  I feel the burning stares of the patient and their families.

Why can’t she help me?  Why can’t she fix this?

I know a thing or two about resistance.  Doctors invented it.  We fight and resist against the inevitable.

Death.

People look to us to do the impossible.  Death is coming for us all, there is no way to fight it, but yet we all still resist.  We all want just one more day.  Just one more chance.  We want to be able to fulfill our purpose, to make the moments count, to have made a difference.  When we die, all our work on this planet is over.  We don’t want to be left out. We don’t want to be forgotten.  How can the earth continue to exist without us?

To be forgotten.  As if all the struggle was for nothing.  All the angst, the sacrifice, the sleepless nights, the turmoil, the work.  All for nothing.

I am not sure I believe that.  Sometimes, I’ll look at my children without them realizing it. I wonder who they will become, what will they do with their lives, who will they fall in love with?  Will they make a difference in the world?  I know that the sum total of all of my experiences and life lessons and those of my husband’s are for them.  Everything that I am  and have done are a gift to them.  I offer them my back, they may step on it, and reach  even higher than me.

I resist death for myself and others.  Just one more day, one more week, one more month, one more year, one more decade and on and on to make a difference in the lives of those we love and those that seek our help.  Continue to fulfill my purpose.  To do good work.  To be a force in the world for good.

Resist.

Even when resistance seems pointless.  Even stupid.  Even when others ask, why bother?  You can’t fix it.  You can’t change it.  Just accept it.

On my deathbed, I’ll accept it, but for now, I will continue to resist.

 

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A New Hope

Editor’s note: Shinbone Star staffers have been working so hard that we felt we needed a doctor. So we added one! Not only can she bandage our wounds, but she can write a bit, too! Yes, I stole that title from Star Wars, but that’s what I need right now, a new hope and Star Wars. I don’t have to […]

via A New Hope — THE SHINBONE STAR

Check out my first foray into hard hitting journalism.

Well, they are the journalists, I am the wannabe.

It really is an honor to be a part of the Shinbone Star!  When I read Glenn’s first post about a retired editor and journalists getting back to work, fighting against the attacks on good truthful journalism, I was ecstatic!  What a great idea!  They have nothing to lose!  They can use their collective skills unencumbered by newspaper sales and expectation of unbiased reporting to really dig in and find the truth in a post-truth world.

Consider following the Shinbone Star, you won’t be disappointed!

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