Open Letter to the Medical Field

Dear Medical/Hospital Administrators, Supervisors, and Leadership,

We are human, we are not indestructible, we have feelings and emotions that can get hurt, probably more than the average person based on the careers we have chosen.  Yes, we will pass up on our well being (such as sleep, hygiene, exercise, relationships with family and friends) to be there for our patients.  To receive our critical training to be able to care for others.  This is our sacrifice and we did it knowingly.  We do it because of how much we care.  We do it because for many of us, this is our calling.  We do it because want to help people, we want to make them better.

But here's the thing, we are not made of stone, we cannot withstand abuse and neglect and still give to others in the same capacity.  Yes, we are doctors, but we are human too.

In medicine there is a very malignant environment that is just accepted.  As eager medical students we are only trying to please and learn as much as we can.  And our Attendings (supervising physicians) may sometimes give us  a "good job", when we know the right diagnosis or assist in an appropriate way.  We also get told when we are not doing something right, as we should be told and learn from our mistakes.  As we enter Residency (some being more malignant than others), the kudos slowly disappear and there's an overlying expectation of ALWAYS doing the right thing.  Yes, we can ask questions.  Yes, we are encouraged to learn, BUT if there is an error, which there will be, there is no more sugar coating.  There is no more talking to us in such a manner so we can learn from our mistakes, rather it's shaming us into never wanting to try again.  There is no more good job.  I can take care of 30 patients well, but only ever hear of the one I missed something on.  I wish this were an exaggeration, but it's not.

No, we shouldn't be handing out awards for doing your job,  no we shouldn't say "good job", every time you actually just do your job, but "thank you", "your patient really appreciated your help", "thanks for covering that shift on your day off", "thanks for staying late to take care of...," ....any of these  comments could go a long way before I'm told about the one chart out of a hundred I didn't complete in that one certain way.

Suicide rates for doctors are raising at an alarming rate and the highest for any profession.  Physicians are telling their own children not to go into a field of medicine. We can no longer just name it physician burn out and tell doctors to meditate, or do yoga, or take some personal time for them selves.  None of this is the root of the problem nor will it fix the problem.

We are human, we have feelings, we are here to take care of our patients but who will take care of us?  Because at this rate, there will be less and less people that care and more people that are numb to it all because there is no other way to withstand the malignancy the has permeated our field for too long.  Doctors must be appreciated (not just one day a year), we must feel like our sacrifices mean something to someone or else it's just too hard to keep going.

The Faces of Womanhood

We have a photo wall in my house of black and white pictures from different important stages of our lives.  I love the pictures, I love how the wall looks, and I stare at it often.  It's on a wall between our 3 bedrooms and the laundry room, so let's just say...I pass by it...a lot! Sometimes I take a moment to really look at it, not just fly by, and I usually just look at the kids but the other day I stared at my face in each picture.  No idea what prompted me to do that, I hate looking at myself in general let alone analyzing a photo of myself but each face told a story and this is how it went.

My Wedding Day:
I was ecstatic!!!!! It was hands down the best day of my life.  It started with the usual stresses, but the wedding was immensely fun!  The picture is of me with my husband during our first dance.  I'm beaming with a smile ear to ear...I'm truly happy.  We had no time to choreograph our dance, we were barely in the same city, let alone the same room before we got married.  But I didn't care how lame we looked just holding each other and swaying like teenagers.  I was married to the love of my life and I was the happiest girl in the world!!!!  Plus I felt like a princess in that wedding gown!

The Birth of Thing 1:
It was exactly 7 days after he was born, his Bris (a religious circumcision ceremony).  Probably the most stressful event for a new mom.  In the picture, my husband and I were holding him and kissing the top of his head.  I look terrified! A complete look of self doubt and uncertainty. Am I holding him too tight, too loose, is he okay, will he be okay, what happens if he cries, what happens if he doesn't cry, is he too hot, too cold?  I literally was worried about everything and felt responsible for every single emotion he may be having.  And I was certain I was going to mess it all up!

The Birth of Thing 2:
The pictures were taken 2 weeks after she was born, Thing 1 was 2.5 years old. My husband and I had a house, a mortgage and 2 kids and I felt like a real grown up.  We could actually afford a fancy studio photographer, and fancy birth announcements.  I now had 2 little people counting on me... and I was... exhausted.  In this particular picture of the 4 of us, I looked impatient.  I looked like I had a fake smile and I remember thinking, please everyone just look at the freakin camera...just one decent picture.  Hoping my naked baby does not poop on me. Hoping Thing 1 doesn't tantrum and refuse to be in a picture, hoping we can get the perfect birth announcement.....Thinking:  Just keep it together people....!

So then I thought what would my current self tell my past self:
On My Wedding Day:
Remember this day and this feeling forever!  The love you have will literally carry you through some dark times.  You will be challenged, beyond the point you think you can endure and you will doubt yourself... a lot. Some days will feel like it's too hard to keep going.  You will walk through fire, sometimes alone, sometimes with your husband by your side, sometimes him holding you and sometimes you holding him.  But you will come out the other side holding each other and completely in love! You are stronger than you think.

The Birth of Thing 1:
You have so many doubts, everything in you is unsure and worried. That's okay, your son doesn't see any of that.  He doesn't care if you nurse him or give him the bottle. He knows you love him with all your heart and loves you right back.  You're his rock, the one he comes to when things go wrong and you figure sh*t out and tell him it will be okay.  And he believes you 'cause you're mom.  You got this, and...You are stronger than you think.

The Birth of Thing 2:
The next couple of years will be tough.  You will feel like you will never have your sh*t together... again...like ever! Your kids will get hurt and you will feel like the worst mom ever.  Sh*t gets real.  But things get better, they always get better.  You walk through fire again...and again...and again, but you get through it, stronger everytime.  You will meet many guardian angels throughout the way. In many different forms, just be open to it, to all of it. Life is messy and unpredictable and so hard for your controlling personality but you gotta let it go girl!  Just let it go and enjoy these fleeting moments.  They don't last.  Be present and don't worry about the perfect picture, the memory behind the picture is so much better....Oh...and you're stronger then you think.

What would your current self tell your previous self? What would your future self tell your current self?

To Each Their Own...Temperament!

When my son was about 8 months old we were at a religious ceremony, a quiet religious ceremony,  and he was just sitting beautifully in my lap; not a peep, no whining, no crying, no squirming.  He was perfect.  As I mentioned before this was his temperament.  He was (and still is) very chill.  So when a family friend, who was sitting behind us, praises me for his behavior I respond "That's just the way he is!"  She assured me that I should take credit because of course I had a part in his behavior.   Well, I have to admit as a new mom, that made me feel kind of good and really made me think, could I take credit for his angelic behavior? What if he was screaming his head off,  what if he had had a bad night, what if he just wouldn't sit still....would I be blamed for his behavior?

I frequently think about this as we, as mothers, often apologize for our kids' behavior.  Starting at a very young age.  If I left my littles with a family member or a sitter I would apologize if my kids were fussy. I would feel horrible,  I would take it personally! Oh and what about when it's your kid that bites or hits another kid at school!!!!  Oh...the shame! You might as well move to a different state where no one knows the horrid event that happened!

Thing 2 was not as easy going as thing 1, don't get me wrong, she's great but her temperament is completely different (see previous post.) She let you know she was there and needed immediate attention (still does).  It was completely apparent from the day they were born...Nature vs. Nurture.
But how much credit (or blame) do I get for their innate personalities?

The topic that is most glaring with this subject is manners.  I truly believe manners are important but I don't think they are THE MOST IMPORTANT things ever!!!!!! I was taught manners more by example, then by actually being told to say please or thank you.  In my culture we refer to everyone older than us in a formal way.  To the point that talking to my teachers in grade school and referring to them as "you" was strange and felt rude to me.   I was taught to be respectful by following examples.  My mother did not withhold food from me until I said please or thank you.  I was painfully shy as a child and if I had to greet every single acquaintance of my mom or dad,  I would have passed out!

So back to my angelic son.  He too is incredibly shy (or "slow to warm up" is the new PC way of phrasing it.)  He would not make eye contact with a single adult for like the first 8 years of his life. He wasn't being rude, he just was not comfortable with looking at an adult in the eyes ( a stranger to him), smile and make conversation.  Ok, that's kind of intimidating to me!!! But I could feel these adults (friends or family members) kinda judge (yup...don't judge me!).  I mean, maybe they weren't but I definitely had times where people would say things to my kids like "Are you going to say Hi? Are you going to look at me?"  UGH!  I can feel the shame creeping up in me now!  My husband and I agonized over this.  We can't have rude children, we can't have other people judge us...G-d forbid! At some point I finally gave up, I did my best, I led by example, I made it a point to be polite and greet everyone when my kids were there.  And then I gave up and decided, people can think what they want.  I think my kids are great and if other people don't then so be it.  And now....  I get compliments about Thing 1 (the same kid that would hide under a table at a party...really) and how polite and considerate he is...I'll take it. And yes I'll take a little credit for it YES I love to hear it!

I guess what I'm trying to say is, although it's our responsibility as parents to guide our children, to teach them manners, to set an example for them;  ultimately they are their own person.. They are born a certain way and we can only guide them within those parameters.  I've really grown out of my shell and I'm a lot more out going, but you put me in a big crowd and I'm still the quietest one there...I have no desire to be the center of attention...and I'm good with that.

Have you ever been ashamed of your kid's behavior?  Have you been credited for your child's temperament/behavior?  Blamed for it?

Message to My Kids: Push Yourself to Your Limit and Then Push a Little Harder

"The sky's the limit..." I'm sure we've all heard that phase many times. Or a different phrase with a similar idea.  Basically there is no dream, no achievement, no goal out of reach.  It's a great message......especially for kids.  Everyone's "sky" and goals are different but we should all push ourselves out of our comfort zone and into our sky, whatever that may look like.

For me, starting this blog was my sky.  Not that it was the highest thing I could ever achieve, but that it was out of my comfort zone which is exactly why I did it.  I've received great feedback from friends and strangers which I appreciate, some of which has been specifically related to my honest writing of raw emotions.  Things we all think about but don't necessarily share with the world.  But when I decided to share with the world I had to be ready for criticism as well as praise.  That was definitely out of my comfort zone.

The comfort zone is safe, it's nice, it's familiar.  I know what is going to happen, how and when.  But the comfort zone is a plateau, a place of zero growth, no learning or advancement.  It's just so easy to stay in that comfort zone.  And when most of us have a path to choose between easy and hard, we know which we will chose. Even if we know which one is better for us.  So your sky may be much higher, much different from mine and that's ok.  All of our skies should be different, we were not born with all the same abilities or talents.  We do not have the same goals. We do not have the same comfort zone.

How do you know you've pushed yourself hard enough? For me, it's feeling like I'm going to throw up.  Like you're literally nauseated either from butterflies in your stomach or physically from working out too hard. That's a good indication that you're definitely out of your comfort zone.  But you will come out stronger on the other side...like "yeah, I just did that thing that scared the sh*t out of me....I am badass!"

I used to religiously watch the show "The Biggest Loser".  I loved watching the emotional and physical transformations of the contestants.  From the very first episode they are put to work and there's always the one person that vomits or faints from pushing themselves so hard.  The trainers would get totally excited about it.  The contestant pushed him or herself to the point of physical exhaustion!  They reached their "sky!"

So the message I want to leave my kids is push yourself so hard you think you're going to vomit! 

(Words of wisdom from a pediatrician!)  Your sky, your limit is higher than you think, I promise.  Don't settle for easy, don't settle for good enough.  Get uncomfortable, get nauseous and then live to tell about it from the other side.  Your sky is always changing and (hopefully) always getting higher, because as you grow, your sky will grow.  Never be afraid of being uncomfortable, never be afraid of something being hard.  The best things in life are not handed to you, they are earned with hard work and determination.  And if you do actually throw up, I promise to be there to hold your hand and (for my girl) pull your hair back!

What's your sky? How do you push yourself out of your comfort zone?

Mom guilt..just say no!

When my first child was born everything was perfect. He was perfect, my pregnancy (for the most part) was perfect, I worked full time and worked out, breastfeeding was a breeze...It was all perfect; until it wasn't!

First of all, none of it was actually perfect, but I wasn't having any extreme symptoms and was able to stay active during my pregnancy so I was thankful for that, but once he was out of my body that baby kicked my ass!  It was exhausting, even for two physicians who were used to not sleeping and taking call... it was like taking call Every. Single. Night!  Other than the exhaustion (and other post pregnancy related stuff that nobody ever talks about) I thought things were going pretty well. Until his 2 week visit at our pediatrician's office. He wasn't gaining weight, my milk production was low, and I was starving my precious child...everything was NOT perfect! Here it comes, the "mom guilt", in full force. As a pediatrician I knew breast was best and of course that was all my precious baby was getting.  I tried everything, lactation consultants,  drugs, herbs, teas, even guiness beer!   I nursed every 2-3 hours and then I pumped...after every damn feeding to increase my production... I did it all!!!  I finally, begrudgingly, started him on formula when he was a month, he gobbled it down!  I was starving him, my body was failing us and there was nothing I could do about it.  Some members in my family encouraged my nursing only stance, others were ecstatic when I finally started formula, none of them were wrong, but nobody supported me how I needed supporting or maybe there was no way to support me?

Before we have babies we all have a certain image of the way things should be,  images of doing yoga while we connect with our child, of the birthing plan that's perfectly planned out down to what song is playing while we "naturally" birth our child, and breastfeeding our baby as we stare into each others' eyes and bond and then he naturally weans himself  off when he's ready.....ummm, yeah, sure, that's all totally realistic!

Where does this all come from?  These images and pressures we put on ourselves, on each other? Too much to live up to, too much guilt to be had.  No, no, no!  I was the product of being formula fed, because at that time, that was best, better than breast milk, so why bother with nursing? But, you know what, I turned out okay.  I love my mom (I talk to her daily) and I graduated from med school! The bottom line is we all do the best we can.  We care for our kids and only want what's best for them but it should not come at the cost of our sanity.

It breaks my heart to tell a mother they need to add formula to help their baby gain weight, because it broke my heart when I had to do it.  But Thing 1 also turned out okay, he's now 10 and so far so good! And breastfeeding was my downfall, but there's unfortunately so many ways we can feel like failures; there's the mom who is so nauseous that she can't even get out of bed, let alone work out! Or the mom that had her heart set on a natural delivery but instead she had to have an epidural and c-section. Or maybe you had all of this down, but you couldn't get your baby to sleep through the night and convinced yourself you did something wrong...!?!?

There's countless examples of mom guilt, the list is endless.  It's partly society, magazine images, even medical professionals,  but ultimately for me it was just me!  I had to accept that I couldn't only nurse, realize I had a healthy baby and move on.

I drove myself (and my family) crazy with my nazi-like pumping ritual!  It had to stop! I wasn't enjoying my baby and getting more emotionally attached to that pump than my baby (that dreaded pump!) It's not easy but we all have to find ways to let go of mom guilt, it serves no purpose, and in the end what we usually end up with is a healthy baby (thank G-d) that really doesn't care about you birth plan, whether his next meal comes from a bottle or a boob, or if he came out of your tummy or the other way!  Or if he didn't come out of you at all! It's all good!!!!!! None of it really matters. And it doesn't stop at the baby stage...oh no...the guilt never ends!  We work too much or don't work enough, we missed the school performance or we miss our sanity!  It keeps going, and going....and going!

SO let it go, let it all go and just love your babies (big or small).  Your babies will love you back and know that you are the most important person in their lives because you give them love, not a whole lot else matters after you cover all the basic needs!

What's your mom guilt?  Have you been able to let it go? How?

Don't Judge Me...

I think of myself as pretty non-judgmental.  I listen to my friends with an open mind and an open heart.  I know I don't do it all perfect (or anywhere close to perfect) and have no expectations of anyone else doing it perfect.  I actually make a conscience effort not to judge.  BUT my subconscious on the other hand, that's a different story! 

I find myself waiting in line at the supermarket judging how people dress, peek into their carts to see what they're buying.  I judge people when I'm driving and they are speeding, honking, cutting me off (like I've never done that...)  I judge people in a split second, literally.  But I'm trying to make those unconscious judgments conscious and stop them.  I know nothing about those people, nothing, and yet I have the gall to judge anything about them. 

And knowing someone does not make it any better.  It could be your best friend in the whole world, your kids, your spouse.  You really can't judge their behavior or their feelings or their actions.  We really don't know what's going on in anyone else's life.  Even the people closest to us sometimes have things that we just don't know about. Or feel something that they aren't sharing with us.

My first child completely spoiled me, he literally only cried when he was hungry or tired.  And the first month he cried a bit more because I was starving him (blog about mom guilt in a future post).

Once we added formula he was angelic.  My daughter on the hand was a screamer...naturally. And of course after having Thing 1, Thing 2 had a hard act to follow.  So there were times that I wanted to launch her out of the window. I could picture the whole thing happening in my head.  I just wanted it to stop.  I was exhausted and not running on all cylinders....

But I would never act on it and I knew I would never actually do it.  At one point I even said I could understand child abuse, NOT CONDONE IT, but understand it. (I'm an advocate for the little people, child abuse is NEVER acceptable!) 

If reading that last paragraph made you queasy or made you want to report ME for child abuse, I'm telling you now, we can't be friends.  When I was feeling those feelings I needed my mom friends to say, I hear you, I'm here for you, and what you're feeling is ok...hopefully while we are drinking a glass of wine.  There are so many things that we all do and don't do, that we should do and shouldn't do, that we want to do but can't do, that we don't want to do, but can't stop.  I don't need a lecture, and I usually don't even need advice....I just need someone to listen and say; I hear ya sister...we've all been there!

So don't judge me, I know I'm not perfect, not even close.  I know I have things that I can improve on and I'm  working really hard on trying to fix them (I really am) but I don't need more mom guilt (I have enough).   The concept of judging favorably comes from the original self help book, the Bible.  (And if you're not religious, that's ok, because it's really not about religion, it's about living our best life!) I have attended a number of lectures on this topic (Lori Palatnik, Adrienne Gold, Sharon Shenker) and one of my favorite quotes is; "You are meeting this person in chapter 3, you don't know what happened in chapters 1 and 2." We can't judge anyone if we are not walking in their shoes. And although you may know everything that's happened with your kids or spouse, you don't know their feelings, their interpretation of each situation and therefor you can't judge their response.

If you need to vent about your kids driving you crazy, dreaming about running away to tropical Island, need to let off some steam about a fight you had with your spouse, even if you want to launch your baby out of a window.... come over, have a glass of wine and tell me about it...I won't judge!

Do you feel like you get judged by others? In what circumstances?  Do you (consciously or unconsciously) judge? (No need to answer that, just something we all need to think about!)

Attitude of Gratitude

I have the privilege of being a doctor,  I have the distinct honor of taking care of people, little (very cute) people to be precise.  I don't take this task lightly but much of what I do is run of the mill colds and flus, earaches and throat aches.  I work with a population which, for the most part, is healthy and I'm happy about that. But that doesn't mean I don't see my share of badness. Bad things happen to good people, bad things happen to little people.  Babies and young children that live and unfortunately die in hospitals.  As a doctor, we sometimes have to develop these hard shells to deal with it, to be able to keep going, to see another patient and then go home and hug our families. A recent visit melted my shell and shook me to the core.

 The patient was a newborn baby boy and he was doing just fine.  His mother, on the other hand, was a young mother of 2 boys with a new diagnosis of terminal cancer, she was diagnosed only one month before giving birth to her second son.  A son she may never see walk or talk.  As she told me her story, she started crying and tears sprang to my eyes as well.  My shell was gone and in its place was fear, anger, sadness, hope and most of all gratitude.  Gratitude was my first thought as she shared her diagnosis.

I was doing a home visit and felt so fortunate that I could have the time to spend with her, that she didn't have to sit in a waiting room full of germs, that I didn't have to rush her because I had a roomful of patients waiting.  All I had to give her was my time and support and my prayers.

So why does it take this tremendous tragedy to make me feel gratitude? I wake up every morning (wishing I could go back to bed) checking my Facebook/Instagram and email (see previous post),  thinking about my day ahead, my errands, my schedule, my kids' schedule, who needs to be where and when and how I'm going to get them there,  what am I making for dinner and whether I had time to sneak in a nap (I never do but I like to dream I do).  Of all those thoughts I have first thing in the morning, none of them are thoughts of gratitude.

First I should be grateful to be awake, that I have another day to live, to dream, to be,  to love. Then I could list 100 or  more things I should be grateful for on a daily basis (don't worry, I won't).  But if you are reading this then that means your list will be pretty long too!

I get so bogged down every day with mundane things and even get angry about them, why?  Because I'm human, because this is my world and sometimes I need to feel the petty things and then I need to let go of the petty things.  I'm working on the second part.

I told this mother that she was doing a great job, she had a beautiful healthy baby boy and she was instrumental in bringing him into this world.  She said to me she is blessed to have supportive family around her.  Let me repeat that, she said she is BLESSED to have supportive family.  At that moment, I was in awe, in her darkest times this women was able to see her life as blessed.  I stayed for a while and answered her questions, reassured her of how wonderful of a job she was doing, and left with a heavy heart and only one thought in my head, gratitude.

This does not mean I will now forever wakeup with only thoughts of gratitude, I wish it would, but I'm human.  I still get mad, sad, angry and frustrated even about the petty stuff. But I will strive everyday to live in gratitude. I will strive to always feel blessed as this courageous woman did.
How do you stay in gratitude?  How do you deal with the petty things?