Stay the F^#@ Home

ciubaluUTFGvki9mErM9egI have been at home for the past 4 days with my family. I go back to work tomorrow. I am actually looking forward to the routine of a work day, although even the work day is not routine. I have little to no one on my schedule. I will be on the phone or computer “seeing” patients, mostly reassuring them, encouraging them to provide medical care for themselves at home. The last 4 days have been disorienting. It reminds me of being on maternity leave. Both of my children were born around flu season. I was petrified to take them out in public during those first few weeks after birth. I basically sequestered myself and the babies at home. It didn’t take long to become unaware of time of day or day of the week.

I tried my best to keep a routine. I got up every morning, showered and dressed before my husband went to work. I never once stayed in my PJ’s. I think that’s key to not losing one’s mind. Try to keep some semblance of routine during your quarantine.

It is important to take small moments to just breathe. I steal these moments often throughout the day. If I don’t, I feel the tension rising inside my chest, a feeling of panic that comes from nowhere and everywhere at the same time. I stop and breathe. I take a moment to be grateful for the breath, for life, for the ability to help even if it means staying in my house and limiting the spread of COVID 19. There are all kinds of heroes during this pandemic, both those that are leaving the house to provide essential services and those that sit their asses at home.

We needed chicken food yesterday. The local feed store was business as usual. Me and the kids stayed in the car and my husband went inside for the food. I observed the comings and goings of the patrons buying cow manure, garden plants, and mulch. It didn’t anger me. I just kind of shook my head. Humans are funny creatures. None of those purchases were necessities during a pandemic. They were just going about their yearly spring routine. The sun was shining, the birds were chirping, and it was time to get the garden started, I mean think of those fresh from the garden tomato and mayo sandwiches come summer time!! Perhaps chicken food is not a necessity either, but I think our chickens may disagree. Bless those 2 little chickens in our backyard. Right around the time this virus really started to uptick, they started laying eggs again after a long and tedious winter. I suppose they, too, are doing their part.

It is hard to break old habits. It is near impossible to get everyone to understand the importance of staying home. Yesterday was such a beautiful spring day in the Carolina’s that it almost seemed like nothing was wrong, nothing had changed. I wish we could stay in this place, but it’s too late now. It is past time to do our part. We have to stay home, we have to avoid the spread of COVID 19. The sooner we get it together, the faster this will be over and we can get back to our gardens, our restaurants, our jobs, schools, life as we know it. I don’t want to do this a day longer than I have to so my advice is….

Stay the fuck home.

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Crown of Thorns

UnknownThe coronavirus is named because under an electron microscope, the group of viruses appear to wear a crown. I can’t help but compare that to the crown of thorns that adorned the head of Jesus Christ while he hung on a cross. I don’t know exactly where I’m going with this illustration, I just keep thinking about it.

Today I am home. I’ve worked the past 3 days. I haven’t seen an influx of patients, but mostly I’m triaging on the phone. I rescheduled everyone that did not need to be there, gave lab results on the phone, discussed any concerns patients were having, refilled their meds, answered questions, gave advise. It felt good to be of some use. I still lack the ability to test anyone other than the most ill, healthcare workers, or those that have travelled, have had contact with a person with COVID 19 or symptoms associated with the illness. It’s frustrating because I can’t be sure that some mild cases have come and gone and I’m none the wiser.

It dawned on me this morning that I’m likely not going to be able to see my dad in person for a while. I’m too much of a risk to be near him. He’s elderly with chronic medical conditions and he’s all alone. My kids and my husband are equally dangerous to him. My husband works in healthcare, too, and kids are just walking Petri dishes. I have asked my facebook friends to help by sending him messages. Hopefully, the collective attention will keep his spirits up and he won’t feel so scared and isolated. We were supposed to be driving to the VA this morning to have his cataracts removed, but like everything else, it was cancelled until further notice. I decided to take the day off anyway and tomorrow, too. My plan is to rest up, relax, spend time with my family, stay hydrated, take my vitamins, and see what next week brings.

I have my worries, but I am also hopeful. Reports from China show no new cases for the first time since the outbreak started in December. This gives me hope. This too shall pass. 3 months. We can do anything for 3 months, right? Stay home, homeschool, delay our social gatherings, shopping, conserve our resources and maybe learn a few lessons about loving our neighbor. So many breakthroughs can happen in that time, new drugs, old drugs used in new ways, maybe (just maybe) a vaccine.

3 months is not a long time, but also an eternity. So many tears and hardship until an end is in sight. Loving our neighbor is imperative. Thinking of the other and not just the self. This is the lesson. Each of our personal survival depends on it.



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I Might Shit My Pants Before its all Over

IMG_6335There’s nothing like a global pandemic to bring Deconstructing Doctor out of semi-retirement. As I write this, the kids are obliviously occupied on their iPads, pretty sure my husband is, too. That Rumba that he bought for Christmas that I did not want is happily purring through the house. In retrospect, I love the Rumba, although this one is actually an off brand. Something generic, something copied. It is truly a worthwhile gadget. Maybe it deserves its own blog post sometime.

I’m getting my spirit ready for what Monday morning will bring in my somewhat small town family practice in North Carolina. If Friday’s dry run is any indication, I better double up on the deodorant and caffeine. It didn’t go so smoothly. No one really knows how a pandemic will go. We are truly flying by the seat of our pants.

Covid-19 only reared its ugly head in December 2019. Three months in and we are stocking up on toilet paper and Lysol, secluded in our houses, every aspect of our American life as we know it disrupted. It gives me the feeling I would have before a hurricane growing up in South Florida. We are prepared. We have battened down the hatches and we wait. It’s eerie.

I worry though that we aren’t really prepared at all. As I go into Monday morning, protocols for testing are still not completely clear. It keeps changing. I have to set aside my Type A-ness and just roll with the punches. I can’t get agitated, question authorities, or lose my cool. I just got to adjust. It’s tough. Patients are going to be calling, coming in, they will want to know if they are infected and to be honest, I’m not sure that we can test everyone with valid symptoms. I’m not sure if there are enough tests to go around.

I worry that we will get sick, too. Healthcare providers are vulnerable. I want to stay well so that I can keep in the fight, I don’t want to tap out too soon. I have been trained for such a time as this, like a soldier posed for battle. I wonder if those brave soldiers in battle have the urge to shit their pants like I do right now.

My nerves go from completely calm and cool, to that “shit the pants” feeling about 4 times a day. I keep checking the news, the CDC/WHO websites, my own company’s and colleague’s emails. I’ve listened to my church’s sermon live-streamed on facebook. I’m even continuing with a Bible study that was started almost 2 months ago. I’m washing clothes and tidying up. I’ve taken 2 baths today and cut my hair. Yeah, that’s weird, but I do cut my hair myself from time to time, especially since I’m not sure when I’ll be able to get a proper haircut at the salon. I’m trying to stay informed and yes, maybe even a little distracted.

Do you recall a surreal moment before your whole life changed? That one moment of clarity and peace until the shit in your pants hit the proverbial fan? This is the moment. I am pecking away calmly on the keys, not wholly sure of what tomorrow will bring, but knowing that it will likely make all the days that follow feel like it will never be the same.

Stay well, blog friends.

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From the Skulls of My Enemies

I have recently taken to the habit of drinking a glass of red wine from a clear glass shaped like a skull.  Not everyday, mind you.  It started after Halloween.  I decided to make a Halloween feast for my family.  Hot dogs carved like fingers, cake that looks like cat litter, with little tootsie roll cat poo half buried below the surface, green colored punch, smoking and smoldering, poured into clear glasses shaped like skulls.  My dad thought the Halloween feast was a lot of fun, the kids still talk about the cat litter cake, and I really liked those clear skull glasses.  I’m the only one.  So I put the other 5 glasses away until next year and kept one out, one that I can drink red wine from when I felt inclined.

Before drinking my wine, I usually announce that I am “drinking wine from the skulls of my enemies.”  My children give me their typical side eye, “mom is crazy” looks, usually followed by, “mom, you’re crazy,” and go about their business.  My husband knows this is par for the course.  Typical of his wife, a little off center, a little eccentric.

I am not a big drinker.  I drink one glass, but it’s enough.  I am thoroughly pleased with myself as I empty the clear glass skull of my enemies.  Who are these enemies?  That’s a hard question to answer.  In my 43 years, I can barely name an enemy, but the longer I live, I suppose, the chances of lengthening that list increase.  It seems there are people that I have touched in this world with my presence who do not like me.  I will call them my enemies.  I will also call those that have manipulated me or hurt me or tried to destroy me my enemies.  Those that have deceived me or worst of all betrayed me, I think it’s a fair assumption to call these people my enemies.

I would guess that having enemies then requires one to feel immense anger towards them, anger driving rage followed by thoughts of revenge.  Enemies and hate go hand in hand, but I don’t feel hate. This new habit of mine does not feel tinged with ill will, I am not angry with these enemies.  I do not wish them death or destruction.  I think it is a way to come to terms with them.  It is my way of finding forgiveness, of sharing a toast, having a simple drink in their honor and in their skulls.  It’s my way of telling the universe, these people do not have power over me.

Do I drink other things from my skull glass?  Well, milk just seemed wrong.  I once had a little bit of Coke in it, but somehow, it wasn’t as satisfying.  I think the liquid should be red.  Red is anger, red is powerful, red is life giving.  Now that I have enjoyed this clear skull glass so much, I ordered a skull coffee mug from Amazon.  A hot cup of tea from the skulls of my enemies, now that sounds like good therapy.

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The War of Christmas

Creepy-Christmas-2It was a typical Monday morning, I got the kids up and ready for school, dropped them off before the bell, and headed off to work.  Halloween was still fresh in our minds, the candy piled high on the kitchen table, costumes laying clumped in piles in the kids’ rooms, skeleton decorations still hanging on the front porch.

As I drove into the small town that I work in, a glaring reminder that the holidays are upon us struck me like a slap across the cheek.  A giant red glittery, metallic, shimmering “Merry Christmas” was strung across the entire street.  Overhead, it glittered and shimmered overwhelmingly in the morning sun, almost blindingly.  It was huge.  Is it wrong that it felt like an assault?  Not an assault like a gunman barging into a bar and spraying bullets into the crowd kind of assault.  More like an assault of the senses, an assault on anyone who doesn’t celebrate Christmas.

I celebrate Christmas, I am a Christian, but even I don’t understand this war-like stance that Christians take about this holiday.  This garish sign across the street heading into town might have well read, “Merry fucking Christmas” or “Merry Christmas, motherfuckers” or “If you don’t celebrate Christmas, then get the fuck out.”  Yet, in this same small town, one might hear people sitting in the diner complaining about immigrants coming into our country, or how our taxes support all these lazy people on welfare, or how they support a man that tells it like it is, even when he says he grabs women by the pussy or degrades fellow Americans with disabilities.  You can’t have your “Merry Christmas” sign and spew hate or support those that do.

The first Christmas was spent on the floor of a barn amongst the sights and smells of the beasts of burden.  Immigrants traveling and not being welcome, a man and a woman in need of shelter, a human baby born without the comforts our humanity can provide.  His birth, ultimately leading to his death for all of us, despite our depravity, ignorance, greed, jealousy, hatred, sin.  The first Christmas was void of red, glittery, metallic signs.  It was dark, cold, and dangerous.

Today’s Christmas is an assault.  The quiet, solemn moment of the Christ child’s birth and the subsequent story of Jesus as savior is overwhelmed and outshined by the jolly round Santa, flashing lights, piles of presents that no one really needs, the bustling crowds selfishly hoarding their baubles amid immigrants seeking asylum, children living in poverty, and veterans living on the streets.

If someone doesn’t tell me “Merry Christmas” it does not anger me.  I am not proud of what Christmas has morphed into.  People wear bracelets that read “WWJD (What would Jesus do)” and I wonder what would Jesus think of what the celebration of his birth has become.

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Endlessly Forever

BLUEThere are times when silence is necessary.  Quiet reflection, stillness, exhalation.  I found myself in a state of mind consistent with floating on the stillness of the ocean, buoyed by the salinity, the sun peaking in and out behind the clouds, shadows flickering behind my closed eyelids.  It is absolutely blissful, however, not as conducive to angsty curse-filled blog accounts of the unfairness of a doctor mom’s life.  I reached steady state.  How does one rail against such peace and calm?  One doesn’t.  One just floats.

I’m still floating.  I am enjoying my work, teaching my students, laughing with my patients and fellow healthcare providers.  I am running along pathways in the forest and along the roads, listening to my angsty music.  Occasional songs from my mom’s funeral playlist intermingle and instead of bringing me to tears, it makes me feel close to her again, makes me remember her voice which I haven’t heard in 2 years.  My run doesn’t even skip a beat like it used to.  I’d have to slow down to catch my breath because it got caught somewhere in the ether where she now lives and I couldn’t bring it back.  I couldn’t bring her back.

There is a delightful rhythm to my life.  Morning routines, the unyielding banter of children, letting the dog out and then letting him back in -endlessly forever, the plans for trips that involve running endless miles in strange towns, reading Harry Potter to my kids at night, sleeping again, reaching over and holding my husband’s hand in the night, tapping into new art forms, making something out of nothing -endlessly forever.

I could live in this space forever, endlessly forever, but I know there will be moments to swirl and stir my peaceful ocean.  Waves will come, some small, some like a hurricane with massive flooding, spreading destruction everywhere it touches.  I will have to find some bit of flotsam and jetsam to cling to, some discarded bits that are really gifts from the universe telling me to hang on!  Hold on!  Don’t let go!  No matter how small, appreciate the gifts that the universe, God provides.  Even in the worst possible moments, something will float by that makes the difference between just surviving and truly living.  So much of my work is teaching people how to live their best possible lives, but somehow I forgot to tell myself.  I took a chance.  I saw the blue water, the light dancing on the ripples and I jumped.  I swam around a bit and then I laid back, smiled at the sky, and floated.

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Unmade in America

jewish_refugees_aboard_the_ss_st_louis_in_cubaMy 10th great grandfather and his family boarded a ship in Mannheim, Germany in 1663 bound for America.  They came to Germany by way of Amsterdam and before that France, seeking refuge from religious persecution.  Each new home offered only temporary asylum.  During this time, and for reasons that are not entirely clear to me, the Catholics were persecuting the French Huguenots, murdering and torturing them, causing them to flee to the corners of the world.

David and his wife Marie were among these French Huguenots fleeing certain death toward a new world.  They were refugees.

I have been researching my family lineage.  My mother’s father’s side is rich with history like the story of David and Marie.  David’s offspring fought in the American Revolution, the War of 1812, the Korean War, World War’s I and II, Vietnam, and Desert Storm.  It is fascinating to imagine how my family were some of the first settlers in this new world, shaping the story of American history, living the ideals of freedom, worshiping their God, fighting for their country, and building a future that includes me and my children.

My family included farmers, factory workers, musicians, soldiers, carpenters, seamstresses.  I haven’t found any doctors.  It seems I’m the only one, an anomaly.

My father’s side has been more difficult to research and I’m actually a little nervous to dig too deep.  You see, his mother’s side were white southern farmers.  If I dig too deep, I might find something more sinister, like the vile stench of slavery on the family name.

My father’s father’s side came from Hungary.  I have acquired the death certificates of my great grandparents which lists their parents’ names, but that’s where the trail ends.  My great grandfather’s death certificate does not list his mother, only his father’s name.  Did she come to America with him from Hungary when he was a child?  Or was it just him and his dad?  Were they fleeing persecution?  War?  Certain death?  Did she die trying to escape?

All of these stories led to me, sitting here today, pecking at these keys, occasionally staring out the window, trying to find the right words to convey the emotions that I feel so that you can feel them, too.

David and Marie boarded a ship, knowing full well that it may never make it to shore, it could end up at the bottom of the ocean.  They still got on, fully aware of the dangers that they would face traveling to their new home.  They knew that once they got to America their troubles would not be over.   They needed to find shelter, food, a community that accepted them.

The spirit within them still stirred, compelling them onward despite the dangers, promising them a future even when it looked like there could be none.  They got on the ship.  They leapt into the unknown.  The took a chance with their lives.  The horror that they were fleeing was so overwhelming that escape was the only option no matter what new dangers lie ahead, like jumping out of the window of a burning building 10 floors above the ground.

There are places in this world that are worth escape even if death is the destination.  There are people who still make the journey no matter the cost.  They would die to live the American dream, to be free.  I see the death of the American dream before me.  If there is no promise of freedom for those that seek it, then there is no America.  America has closed it’s doors, shackled it’s heart, barb-wired it’s soul, and stepped on the necks of the oppressed.

David and Marie made the journey for the chance at the American dream.  The pay off, 400 years later, is that I sit here understanding why someone would make the journey.  To be an American, worshipping my God, expressing my opinion, loving who I love, standing up for those who can not speak for themselves, helping others by being their doctor, supporting causes that help the less fortunate, speaking out against hate, calling out hypocrisy, calling out the lies -this is why David and Marie crossed the ocean.

They made me an American.  Because of their sacrifice, I am deeply rooted in the American dream, to never let the quest for individual freedom die, no matter the cost.

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Suicide Dissolution

Trigger warning:  This post discusses suicide, if it is a subject that triggers you, please do not read this post.  If you are suffering from depression, having thoughts of suicide, please seek help by calling the Suicide Prevention Hotline 1-800-273-8255

imagesI only know one person that committed suicide.  He was a patient of mine.  There were plenty of patients over the years that had tried, but all of them were unsuccessful.  Except for him.  Over the years, whenever suicide becomes big news, my mind often goes back to him.  I search all of my recollections of meeting him in the office, talking about his job, his family, his military experience, and I never once suspected that he would take his own life.  Never.  Once.  He never seemed depressed, never admitted to being depressed, never expressed any feelings of desperation, isolation, loneliness, sadness, or rejection.  He was pleasant, likable, even a bit jovial.

Someone in the office saw the headlines in the local paper and told me that he had died.  I couldn’t believe it, I had to see for myself, the article read:  Suicide.  I instantly called his wife.  She was inconsolable, she could barely speak.  I knew there were no words, but I wanted her to know that I was there for her.

I think about him then and now and wonder, was there anything that I could have done to save him?  I knew him well, I was his doctor, and I never once considered the possibility.  There were no clues.  None.  He was the last person in the world that could have done such a thing, but he did it and there was nothing that I could have done to stop it.

I wish there was because I feel like I failed him.

My sweet lovely husband and I have been talking about suicide a lot lately since the recent slew of celebrity deaths.  My husband’s gentle demeanor and upbeat personality can not fathom the spiritual and emotional black hole that sucks the life out of a human being.  He had a lovely childhood, with lovely parents, a warm bed, clean clothes, church 2-3 times a week.  He knew kindness, community, a higher power, gentleness, and comfort.  Not everyone is so lucky.  Not everyone experiences life in these terms.

Life can be hard.  Not just hard, but downright cruel, wrought with evil.  Life can take you to places that undermine your sanity, leave you reeling, wondering, what is this all for?  It can feel like a Godless place, full of despair.  The people that know you, share this life with you, may never even know what you are going through.  That is the saddest part, really.  People that know you, love you, need you, can be kept from the truth.  They can be kept from the chance of saving you. It’s not fair.  Suicide is unfair.

If someone comes into the ER with chest pain, at least I have the chance of saving them.

The only chance we have is to be kind.  To everyone.  All the time.  We have to change the  societal discourse that is willing to encourage the killing of strangers with guns, remove children from foreigners seeking asylum, throw insults anonymously over social media, allow children to go without food or medicine, hate people that don’t think like us, love like us, look like us.

We have to care about each other, the planet, and above all, we have to value life.



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For the love of nurses

nurses-uniformI passed the boards, in case you were wondering.  It’s a relief.  I don’t have to think about that again for 10 years.  Who knows, by then I may be retired.  Or a famous writer.  Or still doing the same thing I’m doing now, the job I love.  I have found a new delightful rhythm in my work.  It feels refreshing instead of draining.  I am on the other side of something sinister.  My steps feel lighter, my laugh less restrained, my love for this work blossoming.  I have my favorite nurse back in a new place and it makes all the difference.

My husband recently said something genius, “you are only as good as your worst nurse,” and he’s so right.  Physicians often feel very alone and isolated, our life and death decisions are made in our own heads, the consequences resting on our shoulders, the burdens felt in our hearts, any bad outcomes solely for our conscience, but I’m never truly alone in my work.  There are so many people that I depend on and need to help me do the best job possible for the patient.  I can’t do it alone.  Being alone is exhausting.  When the people that I need to help me do my job instead work against me, it’s a perfect storm for burnout.

A lot of the time, I get all the credit.  The relationship is built predominately between me and the patient, I am the one they want to talk to on the phone, the one that gets all the accolades when things go right, the one that gets the baked cakes and Christmas cards.  Like my husband said, I’m only as good as my worst nurse, and I have the best nurse, she makes me look good.  She makes me a better doctor.

There have been times that I haven’t given nurses enough credit.  Sure, sometimes they can be annoying, offering their own advise to patients that may not be exactly what I’d say, taking it upon themselves to diagnose an illness (thus taking away my thunder), forming their own special relationships with the patients, offering advise on tests to order, pointing out medication errors, and just plain doing a good job for the patient.  For a doctor, trying to navigate a strange field where our degrees and our licenses allot us great responsibility and great rewards, but come with great sacrifices and great burdens, sometimes it is difficult to allow a nurse to have his/her say.  It is hard to give them the credit that they deserve, to admit how much we need them, or to recognize the depth of knowledge, wisdom, and experience that they possess.

I have the best nurse.  I know this for so many reasons, but recently it was because she showed me she cares for these patients as much as I do.  When one of our patients recently passed away, we both got tears in our eyes and reminisced about him.  He was just as much her patient as mine.  He touched her heart and I discovered that I’m not the only one who carries the burdens of this job.

I trust her implicitly.  She has the best interests of the patient at heart and therefore, my best interests.  She’s my right hand.  Nurses are life saving, not only for the patients, but for the doctors too.  My nurse is the best.  I am so grateful to work with her.



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Be Kind, Unwind

Unknown-1The unwind.  That’s where I find myself right now.  It’s this strange process, like a colon cleanse or some such shit, whereby I untangle myself from the trappings of my job, just briefly, while on vacation.  This unwind doesn’t last. It really never processes to completion, anyway.  In fact, it’s kind of a tease.  I can never truly unwind myself from this work.

On the agenda today, the one and only house cat museum in America and the train wreckage from the movie, The Fugitive.  Both happen to be located in Sylva, NC, about a 2 hour drive from our home.  I’ll drive, the kids will be in the back of the minivan, arguing about movie choices and snacking, contributing to the layers of crumbs that have accumulated on the floorboards.  Which reminds me, I need to find time to vacuum the minivan before I go back to work next week.

Tomorrow, a cat cafe in Charlotte and a train museum in South Carolina.  Do you sense a trend, yet?  Cats and Trains.  This is how I will unwind.  Not because these are my choices, but my kids’.  The youngest likes cats, the oldest likes trains, so I oblige.  They are off for Spring Break and I took the same week off from work so that we could go on adventures together.  If it were up to me, we’d be in Bath, Beaufort, and Ocracoke following the path of the pirate, Blackbeard, as he traipsed through NC, but my kids nixed that idea.  They said it was too scary, so we stayed home taking day trips about cats and trains.  I accidentally mentioned a ghost tour in Beaufort and that was it for them.  Nope.  Don’t want to go.  I wouldn’t have made them do the ghost tour, anyway.  Little turds.

I have already been in my work computer this morning to make sure there weren’t any pressing messages.  So much for the unwind.  12 messages, 15 med refills, 10 lab results, 1 patient email.  Don’t they know I’m on vacation?  It really never ends.  Maybe that will be the worst of it.  Mondays are usually insane, it can only get better from here.

I plan to check my computer every other day, but this part of me, the part wound the tightest can’t rest until I know there is nothing “bad” waiting for me.  I just need to know. I just need to fix it before someone gets hurt.

I know I’m being a bit over dramatic. It’s part of the unwind.  It resists.

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