The Rise

Dear Max, Sofia, and Claire,

There is a man name George Floyd. He is an African American man that law enforcement had been called to investigate. The details of this interaction are yet to be clear. But Mr. Floyd was a Black man, and he suffered extreme and unnecessary consequences, and ultimately died. He did not deserve what happened to him. This was not right of the police. This happened because Mr. Floyd was African American. His skin color was different than that of the police. Can you believe that someone can be killed because of their skin color? It is hard to talk about, it is hard to understand, but it is real life. It happens. And as much as I want you to live in your childhood, I also want you to grow up to be adults that see justice and fight for humane and respectful treatment of all people.

Because of the wrongful way Mr. Floyd was treated, our nation is currently undergoing great chaos. It has triggered in citizens of our country great unrest. Because, unfortunately, this is not the first time this has happened. This has happened time and time again to many African American people. Their lives are often in danger because of the color of their skin. Think about your friends at school that are African American. Do you know that many of them have to live with this fear that their life can be in danger if they interact with the police? Can you imagine if your life was in danger every time you encountered the police? What if someone went for an early morning run, like Daddy often does, but his skin was black, so he had to fear for his life because he was running before it was daylight outside and his skin was a different color? Can you imagine if someone pushed you to the ground, punched you in the face, kicked you because of the color of your skin or the color of your hair or the way you talked? Doesn’t that seem wild? But it happens all the time. And this is why people are angry and want our country to change the way people of color are treated.

I know this can be confusing. Police officers are people that are trained to protect others and keep us safe. But all police officers are people of varying beliefs, just like teachers, doctors, nurses, lawyers, mail carriers. Just like neighbors, friends, moms and dads. And among all these different people with different jobs, you will find people with great flaws that allow them to make bad decisions because of their clouded judgment. This does not mean all police officers are bad people. All people make mistakes. But when mistakes become a pattern and puts the lives of others in jeopardy, that needs to stop immediately.

We are living during a time of revolution in our country. As you grow older, you will become familiar with the phrase that sometimes, we have to hit rock bottom before we make progress forward. This feels like our country’s rock bottom in our lifetime. Right now, in our country, there is passion for change. There is anger. There is peaceful protest against the unjust way people of color have been treated for centuries. There is rage that has fueled violence and destruction. There is brokenness and heartache that has brought people together to restore and love through support of one another and our communities. There is fear that has channeled distrust and retaliation. There is persistence, resistance, and standing together.

All of this is happening right now. It is a reminder of our ingrained human imperfections and the need for change to ensure these dark human flaws do not do as they have done time and time again and lead to the unlawful punishment and death of people of color.

Racism is real. Racism is seeing people that look differently than you, act differently than you, have different cultural and religious beliefs as you, as less than you. Feeling as if you have the power to control them, degrade them, or shower hate on them for absolutely no valid reason.

You will, at some point, be the subject of racism. Mom is Asian and Dad is Caucasian. Some people look down upon people of different colors and races being married. They may look down on you, make fun of you, be mean to you because you are an Asian American. How you feel when this happens, is a fraction of how African Americans feel when people are racist towards them. You may feel anger, hurt, small, and sad. But African American people also fear for their lives and the violence that may be inflicted on them. Can you imagine being afraid right now that someone would hurt you because Mom is Asian and you are too? Think about what that feels like, and think about how you can use that to be strong and be strong with other people that feel that and more.

What I want you to do, is open your eyes. Listen with your ears. See how your friends are different than you. See how their hair is different, their skin color is different, their clothes are different, their lunches are different. And see how much you like to play with them because of who they are. These differences don’t make them less your friend. They make them who they are. Every person is someone’s friend. Every person is someone’s son or daughter. Every person has people that love them. That is because of everything that makes them them. Their black hair, their brown eyes, their brown skin, their red hair, their green eyes, their white skin. See the beauty in these differences.

Too often, people are quick to judge the things that they are not familiar with. Things that we are not familiar with often make us uncomfortable. It’s like before you, Claire, try a new food. You scrunch up your face and say “EW”! And Max and Sofia, you know that this food Claire has never tried is delicious and encourage her to try it. Sometimes she does, and then she loves it. Sometimes she never does, and she doesn’t get to enjoy this new thing that you guys love because she has rejected it before ever trying it. We urge her to try it, because it is usually healthy and will provide her body the nutrients it needs to grow, but also, what if it ends up being her favorite food? Sometimes, it is easy to not want things you are uncomfortable with in your life. But just like it is hard for Claire to try new foods, I want you to push yourself outside of your comfort, observe and ask questions about them. Get to know them. Think about the friends you have made. What if you didn’t push yourself to get to know them? What if they weren’t in your life right now? Wouldn’t you be less happy? Connecting and embracing how we are all different is what makes our country thrive. It is what makes our country healthy and allows it to grow. It is this tie-dye mixture that makes our country’s heartbeat colorful and strong.

If you notice someone being pushed aside or made fun of because of their differences, be the one to stand by their side. Be their friend. Be their second voice against someone that doesn’t value their differences. The more voices that stand together, the louder we are. Maybe they will start to make fun of you. Maybe they will push you aside too. People that put you down for that reason will need to face their own flaws. Remove that from your shoulders. It is not your burden to carry. Imagine if you were to stand alone and be made fun of and there was no one to stand by your side. Know that those that stand their ground and help others stand their ground are always the strongest.

Right now in our state and in our country, people are standing together. They are protesting what happened to Mr. Floyd. Mr. Floyd died because racism is real and because he is a Black man. In no place is this the right thing to have happened. Mr. Floyd is not the first man to die because he is Black. But this should never happen. This should never happen. And now, we have hit our rock bottom with Mr. Floyd’s death. So people are standing by their friend. They are saying this is wrong. They are demanding that no person like Mr. Floyd ever be subject to extreme punishment or death because of the color of their skin. Some people are doing this with peaceful protest. Some people have turned to violence and destruction.

Now, I want to be clear. I never want you to turn to violence and destruction. Violence and destruction, no matter how mad, how angry you are, is never the answer. It is never going to be the right thing to cause more pain, put more people in danger, destroy things that people depend on like food and medications and people’s property and business that provide them shelter and their livelihood. This will never, never be accepted by your mom. Ever.

But I do want you to know that this is the time to open our eyes and stand with those that are standing by Mr. Floyd, Ms. Taylor, Mr. Arbery, Mr. Castile, Mr. Sterling, Mr. Garner, Mr. Scott and all the other people that were treated with brutality because of their color.

Max, Sofia, and Claire. I love you more than anything I can imagine. All these people that have been harmed because of the color of their skin also have moms and dads that love them more than they could imagine. I want you to be part of the good in the world. The healing and the strength, because I need as many moms and dads hearts to be protected as possible.

Our country is at its rock bottom. Let’s be part of the rise. It starts now and it starts with us, my loves.

 

 

 

 

My Thank You to You

Cardiac arrest. I am ready. Infant with a fever and seizing. I know what to do and how to reassure his parents. Unresponsive heroine overdose. I know how to treat her. Arterial bleed from a dialysis fistula. I have done this before. A two year old with an unknown foreign body up her nose. I can get it out. A teenager suffering from depression now with suicidal thoughts. I can help. A belligerent intoxicated patient with a bloodied face. I can manage. A fish hook accidentally caught in the scalp or dog bite to the ear. I can fix it. A mother with ongoing bleeding after giving birth. I can take care of her. No matter the unexpected nature, however things went terribly wrong, I am ready. I got this. I am steady, prepared, and nothing can possibly shake me, because there is a plan for every possible scenario. 

Before I even step foot in a patient’s room, the chief complaint written down at triage has created at least two dozen pathways in my mind. Like a choose-your-own-adventure, of sorts. Within ten seconds of being in the room, that choose-your-own-adventure has been widdled to one pathway with a few minute adjustments. 

This is the world of emergency medicine. Day in, day out. We open our arms wide to the wildly unpredictable open fire hose of anything and everything that comes through our doors. We are prepared for the unexpected. We absorb information, we assess, we create a plan, and we act. All before you finish your initial story of telling us why you are here. 

We are the experts at being prepared for absolutely anything. There is a calm steadiness that allows us to work deftly under pressure, to adapt to absolutely anything, against time with efficiency and precision. 

I do not know how to start to explain how COVID-19 derailed me more than anything has in my over a decade of practice. 

Let me take you back to March. 

A searing pain cuts through my left eye and spears through to the back of my neck. I wince and squint to keep the light out. My head is heavy, throbbing. The pain gives me sweats and makes me sick to my stomach. I want to curl up in my bed and not move, stay in the dark. Stay in the silence. 

This is how the beginning of this pandemic started for me. Sleepless nights leading to crippling migraines. My mind racing long after the house was in a silent slumber. A feeling as if I was on a ship built for a quiet fishing lake in the middle of the thundering ocean watching the looming clouds around me turn that ominous dark gray, bright flashes of muted blinding lightning, the wind starting to pick up, tiny ice cold pelts of rain whipping against my skin. It’s a feeling as if you are trying to stabilize on this tiny rocking ship, ill-equipped, knowing the storm is inevitable, and preparing with the flimsy life jacket and buoy at your side, knowing that this will not be enough, knowing you will soon be gasping to stay afloat. 

There were so many texts and messages from friends, close and distant, asking me how things were. How I was feeling through all of this. I stared at these messages, wondering how to answer. Knowing my voice was reflexively one of reason, one of calm, one of steadiness. But now, I felt undone. I felt unsteady. I felt scared. I felt paralyzed. I did not know where to start to explain what was keeping nights long and the storm untamed. 

That is what it felt like when this went from surreal to reality. 

I am that person that lays down, head hits the pillow, and I’ve long been in a deep sleep ten minutes later. Since this pandemic came to be, this has been far from the case. A million thoughts come alive in my mind and light up behind my closed eyelids as I try to will myself to sleep. But it doesn’t come, and next thing I know, it says 5 am on the clock. I start thinking about my work day ahead and start mentally and emotionally preparing. To distract from my mounting anxiety, I pour over articles, what little research there is, methods and protocols at centers ahead of us in this pandemic. I read as much as I can to learn as much as I can. This is the only way I know how to best prepare right now. 

There is tightness in my chest as I drive to work. It’s a feeling I am not familiar with. Nothing about work gives me anxiety. There is always a path. There is always a method. There is always a way to get from chaos to stability. I have trained for it all. No patient walking through those doors is one I cannot care for. I have always felt well equipped. There is a plan A, plan B, plan C, plan D to every condition. I have a plan for everything. 

But this. This is different. There are guidelines on disaster relief, mass casualty protocols. Every year we manage the influx of seasonal viruses. We manage the surge of influenza illnesses. But a novel pandemic. Where do we begin? 

I am starting with my basic building blocks to create my plan A. I go back to my training and experience. Start from the beginning. I can stabilize any patient, but with what resources? With what action plan? With what first back-up plan, second back-up plan, third back-up plan? What is the best way to resuscitate a patient from this illness? How will I keep my staff safe? How will I keep myself safe? How will I keep my family safe? How do I do this if I don’t even have the equipment I need? The testing I need? Everything is on shortage. How will I ration out in an emergency? This is the fuel to the fire of my anxiety. 

I stand tall, I move with purpose, but inside, there is a small rocking ship bracing for a storm it is not equipped for. 

This was a little over two months ago. It’s hard to believe how far we have come in a little over two months. With immediacy, but with what felt like the energy it would take for a thinly assembled group of people to move a heavy piece of machinery from a locked position, all hands came together, and pushed forward—straining, using every muscle, demanding forward movement. We scrambled to gather information. We scrambled to understand as much as we could about this new illness, about how to manage it, how to treat patients inflicted with it, how to protect and keep ourselves healthy so we could keep working. We scrambled to understand the magnitude of its affect on our country and on the world. We scrambled to know how to best prepare our emergency departments, our hospitals, our community, ourselves. 

Every day, protocols change. Every day, new information is learned. Every day, protocols and management of patients is developing and becoming more streamlined. We realize what resources and equipment is needed, and we are procuring, stocking up, making ourselves as well equipped as possible and ready for every possible circumstance. We are troubleshooting and fine-tuning. We were fortunate enough to have the ability to do these things, rather than being overwhelmed by volumes of acutely ill patients. 

Every day, we learn more about this virus. We are learning, unfortunately from those that have been undone by it before us. We are learning how it affects the lungs, the immune system, the cardiovascular system, and all other organs. We are seeing what therapies and management strategies have been most effective. We are building our best practice, our best protocols. There may be some trial and error. But with our unquestionable commitment, our unwavering dedication to what we do, we are steadily starting to put down the brick pathways that we can walk on safely. We are accumulating knowledge, resources, safety equipment, plans of action.  

All of this has been made possible by the guidelines set forth by our state government encouraging social distancing, staying at home, discouraging gatherings. This has given us time to build an infrastructure that allows us to care for all of you. I know it has been beyond challenging. It has been hard to keep away from the people you love. The people that make your life whole. It has been hard to give up all the daily little things that bring us joy. But in doing so, you have given us—your medical community—the time we need to develop the best and safest way to take care of you, should you need it. This gift of time has been invaluable.

I will continue to go into work with my colleagues by my side. We will continue to dedicate our time and efforts to you. But now, I will do it with far less anxiety, better rested, better protected, and with a plan, a back-up plan, and a back-up, back-up plan to do the best I can for you. 

What I came here to say, is thank you. Thank you for every sacrifice you have made to help you and I and our family and loved ones stay as safe and as healthy as we can. We may still have a long way to go, but I want you to know your sacrifices have not gone unnoticed. You have allowed us to make large strides in managing this pandemic. Regardless of who we are, we are in this together.

Revolving Worlds

My twins were two years old. My husband and I were leaving for the first time for an extended trip. I can’t remember the details of where we were going or why. What I do remember is the deep ache that ballooned in my chest as we rolled our luggage to the garage door. Their little faces with red-rimmed eyes and Rudolph the reindeer noses, tears smeared across flushed cheeks as they wiped them on our pant legs. Sticky hands grabbing at our hips begging to be clutched tight and not let go. My heart pounding and willing the rest of me to protect them from their heartbreak.

Since then, I’ve realized that those instincts to shield them from hurt and that unraveling that starts in my chest and billows through to my toes as I see them in pain will always be a part of how I mother, but even back then, I knew that leaving them to honor other commitments was part of parenting. A good part of parenting.

As parents, our greatest desire is to ensure our kids know we love them. That we are here for them. That we are present and we support them. In this world that goes a mile a minute, it is hard to feel as if we are giving them our undivided selves, because that is simply not reality. We are divided. We are divided with our professional careers, with upkeep of our homes, upkeep of our daily lives with groceries and meal-planning, with upkeep of our relationships with extended family and friends. Like an elastic toy, we are stretched to extremes, each corner pulling us hard in every direction. Our hearts tethered in the middle like the mid-section of a well-worn tug-a-war rope. 

But this is okay. This is truly okay. This is better than okay. This is what we should be showing our kids. I remind myself to let go of the guilt of being a mom with multiple shoes to fill. I’ve allowed myself to invite my kids into my world rather than living in their world.

I allow them to see how dedicated I am to the things that color my life and make it full. I show them that I am one hundred percent committed to my profession. I tell them about my patients, about what I did during the day. About what was hard, about what broke my heart, about what was exciting or astonishing, and what made me proud of what I did at work. I tell them when I am excited to take a trip with their dad or go on a date night. I tell them when I am having a girls night with friends and how girls nights with my friends are just as fun as when they have play dates with their friends. I bring them along when we drop off things for someone in need and tell them how important it is for us to not only show up for each other but also for our community. I let them know when I am going to exercise and remind them that this is time when I need my complete space to just help my body stay strong and healthy.

In each and every one of these moments, I am taking time away from my kids and giving it to another part of my life. What I want them to see is that I love them and despite them being my greatest priority, my life does not revolve solely around them. That this world does not revolve around them. There is a world outside of them, starting with the world their very own mom lives. And outside of that, there is a greater community thriving and breathing. I want them to see the importance of independence, self-sufficiency, and working hard. I want them to realize I will always be here for them. I will be their safety, their net. That I am their greatest support, but I am also so many other things to so much else in this world. They are the most enriching part of my life, but there is so much more that fills it up and makes it whole.

And this is okay. This is better than okay. 

Now, more than ever, the mom-guilt can be crippling. So many of us are working from home and having to divide ourselves without the help of physical space to have our kids in school and us in our work buildings. Now more than ever, we are aware that our kids are in need of our attention with home-schooling and being all ever present at home. We are having to tell them to wait their turn as we focus on other obligations. The glare of our inability to provide them with undivided attention is fierce. The shadow that this guilt casts on us inevitably grows taller and more pervasive. I definitely have found myself more irritable, brisk, and wild-eyed at my kids on a more frequent basis, but I try to remind myself that it’s okay to ask my kids to be patient and to let them see that there are other priorities that matter.

They will always be my number one, but that doesn’t mean I can drop everything to cater to them with their every desire. You are here. You will always be here for them. But let them see you in all your color and life. They are watching, and they will learn from this. They will see that you are strong, self-sufficient, and upholding your value as your own self, your value in your family, and your community. As their mom, they see you as one of the strongest presence in their life. What a beautiful thing for them to see you as the whole person you are.

I know there is guilt. I am right along you with the daily ugly mom-moments that we criticize ourselves harshly for. But your kids know you are the foundation of love that underlies all of this daily noise. They know you are theirs and them yours. Even on your lowest days and hardest moments. Give yourself grace to work through this day by day, and know that there is tremendous strength and beauty in letting them into your world and not just revolving around theirs.

This New Path

The alarm pierces our slumber. We step into our starting blocks, leaning into the fire that is about to burn in our muscles as we sprint into the day. Round and round the track we’ll go. Get kids ready for school. Breakfast. Homework. Lunches. Gloves, boots, snowpants. Backpacks. And did you brush your teeth??? Out the door to the bus stop.

During the day, we continue around the track, whether it be at work or at home. The kids get home and it’s a snack, our cackling voices rushing them along, hurrying and getting them ready for this activity and that activity,out the door, picking up this neighbor for carpool, remembering your daughter’s water bottle and favorite stuffed panda, your son’s baseball glove, bat and helmet, your other daughter’s dance shoes or choir book.

On Friday night, maybe there is an occasional date night. Maybe a family grill out with close friends. Maybe your daughter’s hockey game to sit in the stands and hoot and holler for your team with all the other fellow parents. Sunday brunch at your favorite bustling spot. Sunday night, you ready for another push through the week. Pack bags, homework done, and then all over again.

We heave and we push, and around the track we sprint. It seems the pace never slows, and it is seemingly never ending, doesn’t it?

It seemed never ending, didn’t?

Now. Now we settle. We scramble to figure out this new homebound life. We blink hard, take a deep breath, and adjust.

School is cancelled. Activities are cancelled. Commuting to work in an office building is cancelled. Social events are cancelled. Sporting events are cancelled. Choir concerts are cancelled. Our sense of physical social togetherness and community is cancelled.

Our anxiety heightens as we watch daily reports of illness rise. The death tolls rise. We worry about grandparents. We worry about are loved ones far away. We worry about those that are less equipped for illness, for this financial crisis.

As if in a dream-like state. Is this real? Are we truly on this ledge, scampering for resources to prop ourselves up? Desperately trying to keep ourselves protected and from losing our balance and tipping over?

We count the days, the hours, the minutes. They change as quickly as they arrive.

I feel undeniably thankful for the role I have been given in all of this. To love and protect my family and friends. To extend support to my community. To care for people in need. At times, these exact privileges overwhelm me with great anxiety and exhaustion. At times, I am beyond grateful for this life my husband and I are so lucky to live. At times, I count down the minutes to the end of the day and break down in tears because I don’t know how else to process my emotions. At times, I feel ashamed and guilty about my own reactions, feeling what I am doing is largely not enough. That there are people struggling with so much greater than my anxiety, like where their next meal will come from or how they will continue to provide a sustainable life for their families.

I share all of this with you to let you know that you are not alone. It is okay if we all have moments big and small. High and low. It is okay if you suddenly have tears in your eyes and feel like you don’t have it all together. We have all been there. It is also okay if you are secretly happy to slow down with no one to rush, to enjoy your family at home, and stay in your pajamas all day.

None of us have ever done this before and there is no wrong way. Give when you can, support your community as you can, reach out for all those exact things when you need them too.

Most of all, be gentle with yourself and allow yourself grace.

As my family and I step off the track and put the starting blocks aside to walk down this much slower, open path that is yet to be paved, I am overcome with all the emotions. The joy, the peace, the anxiety, the wearing of my patience, the exhaustion, all of it. Some days are better than others and some days are a revolving kaleidoscope of all the feelings.

Let’s support one another. Does your friend mama have a color-coded home school schedule complete with solar system diorama and clay ceramic-making art class? Like what. That’s freaking amazing. Did your other friend mama splurge and subscribe to Disney plus and three new video games to occupy her kids? Awesome! How much fun for them.

Let’s allow one another to do what we can as we try to find our new footing. Let’s acknowledge that we will feel how we feel and let it be okay and enough. Let’s meet each other where we are and gently, steadily, with so much love, we will get through this.

Dance Moms

Dance Moms. Just that simple two-word title triggers guttural reactions in most.  It stirs up connotations of a middle-aged woman with frumpy hair and stretchy pants.  A coffee in one hand and an extra-large can of extreme-hold hairspray in the other.  It stirs up connotations of a once-was, or even worse, a never-was dancer way past her prime beaming on stage left, clapping emphatically and slightly maniacally for her daughter. It stirs up images of this shiny, bedazzled daughter of hers in a starch-stiff tutu adorned with silver sequins, hair in a high bun matted concretely to her head with an entire squeeze bottle of gel and bright pink lipstick outlining bright white teeth.

I know what you think. I know what you see.  It makes me laugh, because at times, when I’m not paying attention, I could mistakenly see what you see.  Those Dance Moms!  But fortunately, I’ve realized what Dance Moms really are.

My daughter was five when she announced she was ready to join her friends in their rhinestone leotards accessorized with large, bobbing, sparkling hair bow headpieces on that dance stage.  I shrugged my shoulders.  It wasn’t different than anything else we had tried.  A summer camp of basketball here.  A community T-ball season there.  A high school led soccer class there.  Dance?  Sure.  Let’s do it.  I went into it with no idea.  I imagined it would be a class once a week, and an adorable recital at the end of the year.  What’s the harm in that?

I imagine this is how most Dance Moms are created.  Eager moms and dads in this helicopter-parenting era, ready to encourage their sons and daughters in yet another endeavor.  Was I crazy to consider this?  No.  Ha.  I was just a sucker like the rest.

And so it began as I expected.  We signed up for a recreational dance class.  One class once a week.  A recital on the horizon.  My son joined too.  Why not?  But it wasn’t long before my daughter was invited to join the competition world, and my son, wise beyond his years, sniffed that there was something not for him about this place we had been bringing him every Thursday, and graciously bowed out.

Competition dance? Most definitely!  Why not?  My daughter smiled from ear to ear.  It sounded like a fantastic idea.  Slightly more rigorous classes with a couple competition weekends thrown in here or there?  Yes.  She was on board.  I was on board. This sounded like a great idea.

Ha.  Sucker.

I’m not quite sure where to start without diving right in.  Competition dance is not for the faint of heart.  It is for the diligent, the passionate, the committed. Because there isn’t anything that I have done on behalf of my children in these early years as a parent that has defined commitment as much as dance has.  It is a pure labor of love the things I have found myself doing that I never, in a million lives, would have imagined myself doing.

Putting 186 rhinestones on one dance outfit?  Been there.  Sewing appliqués onto sequined tiny tops?  Done that.  Wrangling my seven-year-old daughter’s long, straight hair into two perfectly tight buns on top of her head at 4 in the morning? Yep.  I’m raising my hand.

But here’s the truth. The real truth.  Underneath all those superfluous, flashy distractions you see on the surface is hard work.  So much hard work.  I’ve never seen girls this age work like this.  These girls that commit after school evenings to dance class then practice at home on their days off.  These girls that show up at 6:30 in the morning on a competition day and do not go home until 11:30 at night, only to get up at 6 am the next day, and do it all over again.

I remember one moment last year—my daughter was 7 years old.  She had literally been at a competition going on hour 14.  And there she was, doing cartwheel after cartwheel after cartwheel across the gymnasium practice floor.  Why?  Because she was loving every single minute of it. The early mornings, the late nights, the long days, the dance after dance with costume changes and intricate hair changes, she did it all because she was exactly where she wanted to be.

This past weekend, my daughter, now eight, had a full day of competition, snuck in a six-hour night of sleep, and at 6 am the next day, was up and ready for the next day of competition.  There was no complaint in any of her still-waking-up muscles.  She sat straight as I pulled her hair into a tight high bun.  She proceeded to go on to stretch, practice, and compete, giving it her all.  And every time I witness her in one of these moments, I just know.

This girl.  This girl of mine has grit.  All these dancers have grit.  They have passion. They have so much love for what they are doing. They are determined and strong and have so much bravery to go on that stage with those blinding stage lights and perform.  There is no doubt in my mind, that I am that mom standing on the sidelines, clapping emphatically, and yes, yelling slightly maniacally for my daughter.  For my friends’ daughters.  For my daughters’ friends.  I do this not because I was never a dancer and I am living vicariously through the powerful grace of this gorgeous girl of mine, but because I know what it took for her to get here.  The hours, the commitment, the practice, the right attitude.

I beam and can’t help bubbling over not because I see my life through her, but because I see the life this brings to her. I follow her around with extreme-hold hairspray, because that is the very small part of the competition that I contribute to in this bigger lesson I hope she is learning.  Work hard.  Work so hard.  Don’t forget the details.  Know that effort pays off.  Acknowledge that you are exhausted, but continue to carry yourself with grace and do what needs to get done.  And if your emotions get the best of you, let them come, and then let them go, and then pick yourself up and find your strength again.

This is what it means to be a Dance Mom.  To be the grit behind the grit.  Make no mistake—my daughter and her dance life do not define me, but part of who I am is most certainly Dance Mom. I am the support beam behind a very brave girl that feels empowered to live her passion and most importantly, is learning the importance of work ethic, a good attitude, and where it can get her on that stage and beyond.

To all my Dance Moms. I’ll happily and proudly be called a Dance Mom right alongside you.

And. Make no mistake. I am wearing stretchy pants.

 

 

Bring Your Daughter to Work

It was one of those slippery moments of working mom-hood, when childcare slipped through, back-up childcare slipped through, and I was left at a crossroads.  How do I get myself from point A to point B and what do I do with my four-year-old in need of supervision?  Thankfully, my day of commitments was a day of meetings.  A day of meetings was far more flexible for me than a shift at work seeing patients.  That would have been more of a figure-it-out, you-must-show-up-to-work no-nonsense scenario.  At least with these meetings, I could call-in, though it wasn’t as meaningful to just call-in.  But what other choice did I have?

I sat there, my morning coffee already heading towards its lukewarm destiny.  My four-year-old in her shimmery batman dress and cape, crawling in my lap, the crayon in her hand daring to leave marks on my sierra sand colored couch.  And as I sat there in a silent tantrum, not wanting to miss my department meetings, but feeling as if I had little choice, it dawned on me that there was an alternative.  I could just bring her with me.  I compiled a list of ways to approach this.  I could shoot my boss an email and apologize and let him know I was bringing my daughter.  I could show up with her and apologize and explain how childcare fell through.  Or, I could just show up with my sidekick.

I watched as my four-year-old mimicked my every move.  Sipping her milk and declaring how her coffee was hotter than mine. Drawing a panda version of me, picking my favorite blue color for the panda’s belly.  And at that moment, I decided there was truly no other way to show up than with her at my side.  Unapologetic and with assertion.  Because there was no denying that this is my life: I am a mom and a physician, and I care about both and I will show up for both the best way I can.  And more importantly, this is what I want my four-year-old to see with her little eyes.  I want her to know the unique privilege of being a woman. I want her to see that we can be parents and also contribute to the workforce. It may be a balance to strive for, but we do it the best we can.

The best way I can today means a purple backpack with daffodils stuffed with my iPAD with downloaded Disney movies, pink kid headphones, my daughter’s Leap Pad, a pencil bag of crayons, coloring books, snacks, a rainbow unicorn water bottle, and a stuffed animal.  And my hospital work badge.

So, that’s what I did.  It was a meeting I prioritized and if it meant bringing my daughter, then that is exactly what I would do.  No apologies.  This is how it is.

My little spunky four year-old, sat at my feet, because laying on the ground watching a movie was more fun than sitting at the rectangular shaped tables in stiff conference room chairs.  She watched episodes of Doc McStuffins, part of Sing, she played some preschool app games, she colored, she drew, she ate cereal, she only needed a potty break twice.  And all the time, she knew I was right there part of her world and part of my work world.

It felt like a small victory, but a victory nonetheless.  I chose to bring my daughter to the meeting because the alternative was missing out on important decisions, updates, and discussions.  I brought my daughter to the meeting because daycare is unpredictable.  But mostly I brought my daughter to the meeting because I wanted her to know that this is unapologetically who I am.  A working mom that certainly doesn’t have it all figured out, but is managing the best I know how.  I want my daughter—and all sons and daughters for that matter—to grow up tearing down the judgment and stigma that follows that of a working mom.  We can work, we can raise a family, and we can do it with no less confidence and competence than the next person.

 

Finding Margins

This weekend was like any other.  Kids’ activities, work, home improvement projects, social gatherings to allow ourselves the joy of connecting with other adult human beings.  It was a fluid mix of “I’ll drop off here and meet you there and so-and-so will pick up there.”  All the pieces like well worn, slightly beaten up and bent puzzle pieces. That subtle mix of knowing all the pieces should fit exactly as coordinated with that undercurrent of anxiety that we may get to the end and one piece will have gone missing from the tattered, but structurally sound box of collected pieces.

It seems astounding that every fifteen minutes, ten minutes, five minutes, three minutes counts in this interweaving of a family’s schedules.  There was the moment when I was getting ready for work; my husband was corralling our son and youngest daughter out the door to pick up our other daughter from a birthday party on the way to bring our son to baseball practice.  With thirteen minutes on the clock until the end of the birthday party and twenty-eight minutes until the start of baseball, he pulled out all the ingredients for beef stew to throw into the pressure cooker.  Beef, potatoes, carrots, soup mix.  I looked at him wild-eyed.  “What are you doing??”  “Making dinner” . . . with the kids climbing in the car and thirteen minutes until pick-up.

No. Just no. Go.

So. There are countless moments like that.  The wind tunnel that funnels us mercilessly in forward motion as time lapses quickly and impatiently.

These are not the moments that keep me fueled and running.  No, not these harried punctuated moments of start times and end times.  But instead, all the hidden, quiet in between moments.  The Margins.

It’s peeling myself out of bed twenty minutes before the slumbering haze of morning lifts to make coffee, shaking off the dizziness of sleep and orienting myself towards the day ahead, and maybe even catching a glimpse of the sunrise.  It’s the pain of getting my four-year-old to hockey early on a Saturday morning, only to find myself sitting solo, in silence, with nowhere I’d rather be than on those chilly bleachers, hugging my thermos of caffeine while watching with fireworks of pride as my daughter’s tiny four-year-old body glides across the ice with fierce determination.  It’s the forty-five minutes after lunch and before baseball on Sunday that I chose to sit and read and not scramble and trip over household chores while my two eight-year-olds built Legos.

It’s intentionally clearing space on these tightly organized, highly chaotic days with a myriad of demands.  It’s finding these margins and allowing myself this time to be present.  It was in that brief forty-five minute margin when my eight-year-old son asked me to help him find that one specific blue Lego piece in the sea of Legos.  I was startled by my own reaction.  My usual irritable, impatient, don’t-you-see-I’m-busy self was cast aside, and to my own shock and astonishment, I put down my book and helped him scour all the piles of tiny Legos.  With not even one iota of a mumbling nag of how he needs to keep track of his own things. We searched for a solid handful of minutes.  When we came up empty pile after pile, he finally conceded and said, “That’s okay.  I’ll just use something else.”  He paused pensively, and with sincerity added, “I love you mommy.”

That moment hit me. It confirmed to me that margins matter.  By choosing to create space to allow the impossible finding of a Lego to be my way of seeing my son—that moment mattered as much as, if not more than any other moment.

Margins—the clearing of space and time to allow and acknowledge your presence and the presence of others.  The time to be thankful that when we strip away all the orchestrated to-do’s, must-do’s, should-do’s, scheduled-do’s, that we see each other. That we see ourselves.  That we see our kids.  That we see our friends.  That we see our partners.  That we see those we love.  That we appreciate ourselves not for our busyness, our achievements, our productiveness, but for just being me.  Being you.  Being us.

I’ll keep finding margins because they matter.  They help preserve my stability, my sanity, my fuel for the rest of it all.

She’s Back

There is a list of names in every Emergency Department that is well known to each individual that works and fuels that ER. And I’m telling you, it is never a good thing when you are the patient with the name that we immediately recognize upon popping up in our waiting room. For the most part, it indicates that you are chronically sick and chronically in need of emergency healthcare.  This runs the gamut of chronic illness.  You may have a weak heart that frequently gets overloaded and you end up short of breath with fluid filling your lungs.  This may mean you have failing kidneys that cause your electrolytes to go dangerously high as they cannot be filtered through your kidneys. This may mean you are an alcoholic with poorly managed diabetes coming in with abnormally high blood sugars. This may mean that you have mental illness that causes unmanageable panic attacks or leaves you feeling unsafe and suicidal.  This may mean that you have chronic pain and frequent exacerbations of uncontrolled pain.  This may mean you are addicted to narcotics and doctor shop for refills on pain prescriptions. This may mean you look for providers that will give you IV medications to give you the high that some pain medications can provide.  Whatever the reason, a familiar name in the Emergency Department is never a good thing.

On this particular day, I stepped into the chaos of an already bustling Emergency Department.  My colleagues mid-hustle, moving swiftly and deftly about the chaos of a busy day.  And there, waiting to be seen was a name I was all too familiar with. She is a mother, a wife, a member of our community, a person who struggles with mental illness and self-harm.  Triggered by events that send her stress into an insurmountable wall.  I don’t pretend for one second to know what she lives through on a daily basis.  I don’t pretend to understand these uncontrollable urges.  I don’t pretend to understand what it must feel like to come to the same emergency department, see the same healthcare providers, anticipating how they may react, judge, or act. I don’t pretend to comprehend how difficult, how humiliating, or how much courage that must take. What I know is that she comes into our emergency department on a regular basis with undeniable self-inflicted wounds that take a prolonged period to repair.

There was a time when I called for social services every time she came in.  She always gently declined their services.  Even when they came to talk to her anyway, she dodged and ducked out of their way.  She will assert how she has a therapist appointment right around the corner. That her therapist knows she is here.  That she is working through some very hard things.  I’ve called her therapist on occasions and she has corroborated what she has told me.  It is a difficult case, her therapist tells me.  During one instance, she was admitted to the hospital for a more intensive mental health evaluation and management.  It turned out, this only snowballed her mental illness and made her spiral deeper down a dark hole.

I’ve seen her enough to know she means it when she says she is not suicidal.  She often greets me cheerfully.  Talks about the weather, about her day and her week and her kids, as if she wasn’t there for self-inflicted injuries, but just for a regular slip and fall. In the same conversation, she gives instruction and suggestions on how she would like her repairs done.  I slow my breathing and try to wrap my head around how I should act.  This is not normal and I cannot help her normalize this behavior.  On the other hand, she is a mother, a wife, a member of a community that is deserving of basic human courtesies and respect.  She is a human being that is struggling.  Struggling so hard to just live a daily life accepting all the triggers and finding a way to assimilate them in a healthy fashion.

If I am being one hundred percent honest, it can be hard for us with patients we see frequently to not see them through a lens of judgment.  The patient with a weak heart that is on a low salt diet that eats ham and gravy over the holidays with his family.  The patient with failing kidneys that routinely misses one or two rounds of dialysis and is in need of immediate intervention to ensure his heart doesn’t go into a lethal rhythm.  The alcoholic patient that has uncontrolled high sugars and will continue to drink when he is discharged from the hospital.  The young patient with debilitating anxiety convinced he is having a heart attack that comes in monthly to have it checked and is in need of persistent reassurance.  The patient with chronic pain that comes in with abdominal pain regularly and requests large doses of narcotics.  The patient who has been to every Emergency Department in the local vicinity in the last week, accumulating narcotic prescriptions, who yells aggressively when confronted.  My patient who inflicts harm on herself on a regular basis and wants us to do nothing but fix her wounds.

It is easy to make quick judgments. It is easy to feel as if they are less than.  It is easy to push all the fault on their shoulders.  But who are we to judge?  We come from a place without heart failure where we can excitedly enjoy an unrestricted holiday meal when reuinited with our families without worrying about our breathing.  We come from a place without three day a week dialysis, a place where we are sober, a place where we are not crippled with anxiety, a place where chronic pain doesn’t have a vice grip on our lives, a place where we haven’t fallen to the addictive properties of narcotics, a place where we have never experienced or worked through mental illness that urges us to harm ourselves.

Who am I to judge? I am no different. I am a person with my own issues; I am just exceedingly lucky my issues do not lead me to the Emergency Department on a regular basis. So, I’ll work harder to challenge myself.  I am not here for judgment.  I am never here for judgment.  I won’t fault myself for being human, but I will check myself and know the bottom line is that my patients are in need.

They are in need.

Whatever that need may be, in the Emergency Department, we are better equipped to help them navigate it at this moment than they can do by themselves.

That day I took a deep breath.  I checked my judgment.  I repaired all of her injuries.  The Emergency Department outside her room was bursting at the seams, but she deserved my full care like everyone else.  It took me about an hour.  I looked her in the eyes, mother to mother. Wife to wife.  Human being to human being.  I asked her openly if there was anything else I could do for her today.  “No”, she said.  “That is all.”

Never How it Should Be

Also published at: https://www.kevinmd.com/blog/2019/02/when-a-baby-arrives-dead-in-your-emergency-department.html

When a baby arrives dead in your emergency department

When a baby arrives dead in your emergency department

When a baby arrives dead in your emergency department

The world stops. You stop breathing. You are gasping for air.

She is limp, she is cool, she is pulseless.

Chest compressions on the tiniest 6 month old I have ever met are done with the finger pads of my index finger and middle finger. Quick, synchronized beats. I look at her blue, blue lips. It should never be like this.

Her eyes are fixed and dilated telling me that she has been like this for quite some time.

We stop and check for a pulse. No pulse. Chest compressions resume, we work to put a tube in her mouth to help her breathe. It is how I imagine a doll’s airway must look like. Stiff, tiny, a small pink flap over the throat.

There is a cool calm, a cool horror, a cool this-is-never-how-it-should-be. We work deftly to bring her back. But she is gone. She was gone before she arrived. She is gone now. She is gone.

There is hysterical sobbing heard by the family. Our insides are gutted. Our hearts, shattered. But the emergency department keeps pulsing, and we need to keep it afloat.

I meet my nice gentleman with the irregular heart beat in the 160’s. I check on my patient with the migraine headache. I discuss at length with my patient with the extraordinary high blood pressure and horrible headache the need to do a lumbar puncture to rule out a head bleed. She ultimately leaves against medical advice despite my coaxing and persuading. I evaluate a diabetic with intractable vomiting and abdominal pain. I see a sweet woman with severe pain who is now wheelchair bound and whose 80-year-old husband can no longer care for her at home. His shoulders relax and his eyes sigh in relief when I tell him I am going to admit her to manage her pain.

Throughout all of this, the weight of a dead 6 month-old suffocates me and holds me captive. My heart is in pain, and I am devastated, and this is too catastrophic to set aside to mourn later, but I do. I do, because this is what I do. This is what we do.

I’ll never forget walking into this. That sweet purple, lifeless, limp 10 pound baby on a huge white stretcher. The tiniest of chest compressions giving her heart an external beat. For those suspended moments in time, she was all of our child. We loved her, we ached for her, we didn’t want anything to harm her. We will all weep in our own ways over the days, weeks, months to come. Not even the usual armor that we constantly garner will keep these feelings at bay. This is one that will rattle us. Keep us jarred.

Because there is nothing natural

When a baby arrives dead in your emergency department

Lessons at the Stadium

Last night we took our son to the big football game between our beloved Minnesota Vikings and our most love-to-hate team, the Green Bay Packers. It was a big night for our son. He is a walking Vikings statistic generator obsessed fan. His love of football is around the clock. It starts in the morning with him putting on yet another Vikings jersey, throwing his football in our foyer, continues at school where he brings his football and football gloves to play a game with his friends at recess, and continues after school with more football playing, and ends at night reading statistics and talking about Sunday football, Monday night football, and Thursday night football with my husband.

He was on cloud nine when we stepped into that Vikings stadium last night. His wide-eyed stare, his toothy smile, his body tingling with excitement. I don’t think he stopped showing his left-sided dimple all night long. He loved every second of those over three hours of heated, edge-of-our-seats game play. He screamed loudly with complete elation with each touchdown. He SKOL-chanted in rhythm with his fellow Vikings fans. “This is the best night ever!” he screamed into my ear.

With every stadium game comes the adult jeerers and nasty comments about the rival team. Multiple times, the Vikings fan behind us made cracks about the opposing team’s quarterback, calling him a homosexual or gay. He yelled, “Why don’t you love your family! They will accept you for who you are!” While sometimes humorous, he crossed the line time and time again. He was so crass and loud, that it was unavoidable. My son turned and stared at him multiple times. There was no judgment in his eyes, only curiosity. As he had never heard those words strewn together and thrown aloud with such force. I heard the fan’s girlfriend lean over and quiet him trying to get him to show consideration for all the kids in the stands. “What?? Hey, don’t bring your kids to a Vikings game if you don’t want to hear the truth!” he drunkenly yelled. I did not see a productive conversation moving forward if we confronted him about this. So, I took note of his words so we could talk about it later. At one point, my always inquisitive and thoughtful son leaned over and asked me why the opposing team’s quarterback didn’t love his family. This was all news to him.

After the game on the drive home, as we came down from the high and exhilaration of a Vikings win; I turned to my son and asked him if he knew what it meant to be a homosexual or gay. He said he did not. We talked about kids that have two dads or two moms. We talked about how people can love whomever they would like, but that there are people that don’t agree with that. That though we know that you can love whomever it is you want, others who are close minded and close hearted will loudly make fun and judge people for decisions they don’t agree with. I told him that everyone is entitled to their opinions but there is a way to be kind and there is a way to open your heart to all kinds of people. I explained that that fan behind us was not one of those people that choose an open heart and kindness, and that there were many people just like him. I told him it was our job to support and show love for all kinds of people and stand up for people and their choices when they cannot themselves.

At the end of the day, I am thankful we were there to hear the truth. The truth is that we cannot shield our kids from other people’s close-minded, hateful rants. What we surely can do, is not brush these experiences under the rug. When the homophobia, racism, sexism, bigotry is loud around us, we need to be louder. I don’t mean yell back and be obnoxious in the stadium louder. I mean address these truths head on. Talk to them about these hard things and equip them with the right tools to process and react to this ever evolving, dynamic world.

We cannot just think that our kids are innocent and will find their way to the best conclusions. They are listening and learning every step of the way from everyone around them–for better or worse. Make this an active process, not a passive process.

The Vikings won. My son opened his eyes to another face of humankind, and because of it, he grew a little bit more into the man he is becoming.