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.

The Man That Scares Me and The Man I Love

Republished at: https://www.kevinmd.com/blog/2018/10/the-man-that-scares-me-and-the-man-i-love.html

There is a man. He is in my house. I don’t know where he came from. But he just came into my house. And now he is living there. And I am afraid of him. I do not know who he is. There is a man in my house. I am so scared. I don’t know why he came. But he is there. And he tells people he is my husband. And he is not! He is not! And no one believes me. Do you believe me? He is not my husband. I am so scared. Do you believe me? I am a good person. I have seven children. I am an honest person. There is something wrong. I know there is. I know there is.

 My patient. Age 68. She perseverates about this man. She is insistent. She was found wandering in the hospital parking lot. No one is with her. She wants to let out her fear in screams, but her voice is thin and frail. She is so frightened.

 They told me she has early onset Alzheimer’s dementia a year and a half ago. Last week I found her standing outside in the rain. A few days ago she had walked down to the neighbor’s house three doors down at 11 o’clock at night without a coat on. Today, she had an accident in the bathroom. She hollered for me to come to the bathroom and then hurried me away because she said she was going to clean it up. I went to check on her and she was gone. She had taken the car and left. She drove herself here.

 My patient’s husband. He is soft-spoken. His left hand tremors as he stands. His face is slightly glossy and his expressions are muted. I explain that she currently is confused. She thinks he is not who he is. She may be frightened to see him.

Sometimes she gets like that. She yells at me. “Get out! Get out! You don’t love me! You don’t love me! You son of a bitch! Get out!” It hurts my feelings. It does. It really hurts my feelings. And then sometimes she tells me she loves me. She thanks me for being her husband.

He speaks with a hollow, flat voice. He stares at me with foggy, pale blue eyes. His sadness and defeat lean into me. He tells me to wait for his son. His son is arranging for her to go to a center. He’ll have the details to tell me.

We’ve been married 44 years. We have seven children. And 16 grandchildren! She is my world. Can I go in?

 We stand outside her room, and his eyes fall on the closed door handle. I tell him that she seems frightened at the moment, but he knows best. If he thinks she will be comforted by the sight of him, he is more than welcome to go into her room. If he thinks it may make matters worse, he is welcome to wait in the waiting room. Whatever he thinks would be best for her.

Well. I think I’ll try, Doc. If she shouts and hollers and shoos me away, I’ll go outside. But if I go in quietly, sometimes I can talk to her and she is okay with me staying there. And then sometimes she warms up to me. I’m going to try.

 He is soft spoken but resolute. I peer through the crack he leaves in the door as he slowly inches in. He leans over the railing of the bed. He straightens her white crisp hospital sheet. She looks at him and I can’t hear their conversation, but that is relieving. He settles into the seat next to her side.

The next time I enter the room, the husband has left with family to rest and the patient’s son sits at the bedside. He loves his parents and he tells me that they are arranging for her to go to a memory care center.

He won’t be far behind her. He can barely take care of himself, let alone her. It’s just been too much for him, you know?

 The last ten days has been draining on their family. This seems like a quicksand downhill plunge. They have been in and out of hospitals. She was at her neurologist’s three days ago and there is nothing to do. Maybe these new medications will help. They will take time. In the mean time, they are chasing her in the rain.

I come back when the work-up is finished. I am relieved. She has a urinary tract infection. I am not relieved there is something wrong with her but I am relieved there is something fixable. You see, urinary tract infections can make you more confused than normal. Confusion can be the absolute only sign that you have an infection. And there it was. The last ten days of rapidly losing this adored wife, this beloved mom, this treasured grandmother, explained with a urinary tract infection. IV antibiotics were started and I admitted her to the hospital where she would not wander into the rain and she would get better.

I am not saying this is the end of their battle, that it won’t still be a declining slope, but I am saying that maybe they haven’t completely lost her the way they had thought.

I go back into the room to tell them. She is no longer tense and tearful. She is relaxed and loved and safe next to her son. I tell them about all the things I have done. Laboratory studies, CT scan, and that she has a urinary tract infection that is very treatable. She laughs out loud and all sense of that frightened woman I had met before seem to be drowned right out. She holds her hand up high in the air to give me a high-five.

Wow! Good job, Doctor!  So thorough! Thank you!  

She laughs joyously like I have just uncovered the eighth wonder of the world for her to see. I thank her for the first high-five of my day. We all chuckle together like old friends and it feels good.

There it was. A glimpse of her real self. All the charisma, all the spunk, all the warmth. There was the woman he has loved for 44 years. There is the woman that raised seven children with all the strength in the world. I see her now. I can see why this is so hard. To see her, then lose her, then see her. It would hurt my feelings too.

Hold close to those you love. Remember all you love about them. Tell them often. Let what you love imprint itself onto you, because you never know which way life may turn.



The Audition

The hoops to being an “on-top-of-it” parent are endless. Remember to pack a lunch every day. Check their homework every night. Help them brush their teeth two times a day. Cook dinner for an entire family. Orchestrate on time after school pick-ups and drop-offs with accompanying sports equipment, water bottles and snacks. Remember to pay the monthly daycare bill. Sheepishly solicit uncles, aunts, grandparents and neighbors to donate to the current fundraiser. Check to make sure they remember their winter hat and gloves on the first cold day of the season. Check to see if they need new boots and coats. It is exhaustingly endless. But somehow we scramble and hustle and keep the barreling train moving forward. Sometimes, the wheels rattle and sometimes they screech and sometimes we wonder if they are falling off, but somehow, we keep things moving forward.

Last week was just like every other stretch of hurling myself over each hurdle of the 100-meter sprint to the end of the next 7-day stretch. It was Sunday night and I was bracing myself for a week of having an out-of-town husband-teammate. I was rallying to keep myself afloat by studying our family Google calendar as if prepping plays for the Saturday morning football game. My eyes flitted onto the upcoming Sunday. “Auditions” it said. My heart took a freefall down the cliff to my stomach. You see, I have a bad habit of burying anxiety-ridden thoughts to be searched for later, and I had done exactly that a few weeks ago.

My seven-year-old daughter had been asking since the start of the school year about auditioning for a “specialty dance” at her dance studio. My seven-year-old daughter—my quiet, thoughtful, unwavering-as-steel little girl wanted to audition for a small group dance. Who was I to deny her of her greatest ambition to date? You go girl, I enthusiastically fist-pumped, in my best she-is-fierce-hear-her-roar impersonation. That is, until I got the instructions for auditions. “Choreograph 6 – 8 8 counts of dance, any style, any music. We can’t wait to see your creativity!” it read. I was horrified.

First of all—for point of reference—you should know something about me. I have no sense of coordination. Here are a few facts about me:

1. I am the person who sprains her ankle walking on flat ground. Routinely.

2. I once fell from standing height while standing still at a wedding because I had put on heels for the first time after spending my entire intern year in residency working, eating, and practically sleeping in sneakers and scrubs.

Do you get what I am saying? To say that I have never been much of a dancer is to let me down gently. I certainly have never learned a piece of choreographed moves to a beat, let alone know the first thing about choreographing a number myself. My anxiety dug a hole in that mud pile in my brain where I hide unwanted terrifying thoughts and snuck this bit of palpitation-inducing information deep into its trenches.

I carried on week by week, just trying to be that scraping-by parent I was so seasoned at being. But now here I was, 7 days from The Audition. I DON’T EVEN KNOW WHAT AN 8 COUNT IS. My panicked brain screamed at me. I frantically searched for a reputable life-line. I asked my daughter, “What is an 8 count?” “A what?” She looked at me blankly. “What is an 8 count in dance? Like, do you count to 8? What is it?” She looked back at me as if I was speaking in Klingon. “An 8 count. Do you know what I am talking about? What is it?” I quickly realized this was leading nowhere fast. I set it aside, and busied myself on the train. We pushed forward with the bedtime routine. Homework, baths, teeth brushing, pajamas, bedtime stories. Two more bedtime stories. And just one more bedtime story. And just one more bedtime story. And by that time, I was ready to put myself to bed. So, the kids went to bed, and I’d love to say I had a productive night of learning about 8 counts, but let’s be honest. I went to bed.

Monday morning. 6 days till game time. WHAT IS AN 8 COUNT??? Brush teeth, put on school clothes, breakfast, check backpacks for weekend homework, library books, get your coats, gloves, hats—don’t forget your coat. Your snacks are still on the counter. Put your snacks in your backpack! Where is your coat? Do you have your gloves? Shoes. Wait, why don’t you ever come downstairs with socks? Get socks!!! You need to go potty? Take your gloves off. Where did you put your gloves? You just had them! Here. Here are a different pair. You want your Frozen gloves? Well, I’m sorry. You just lost them. Seriously, though. You just had them! Never mind. Hurry! We are late! Get in the car!

9 hours later, I have finished a shift in the emergency department. I have emergently sent someone to cardiac catheterization lab for a heart attack. I have put a chest tube into a patient with a collapsed lung. I have diagnosed appendicitis in a patient with abdominal pain. I have put a broken arm in a splint. Guess what.  I still do not know what an 8 count of dance is.

My husband is out of town. My daycare provider is on her honeymoon. My nanny is in Kentucky. My friend, part of my life-line team, and second mom to my kids has picked them up from the bus stop, and is feeding them dinner before taking my daughter to dance. I get off work in time to meet her for dinner, and finally, finally—someone who knows what an 8 count is. She educates me and I feel like she has given me the map to finding something as profound as the fountain of youth. I KNOW WHAT AN 8 COUNT IS. Thank you friend. Thank you for picking up my kids. Thank you for feeding them. Thank you for not laughing at me when I asked you what an 8 count is. Thank you for offering to help your super dance-challenged friend choreograph a piece. Thank you a million times over.

Monday evening comes around. I am armed with my knowledge. I still have no beat and do not know the first thing about dance moves. I watch old clips of dance studio numbers. I get swept up in how good the dancers are and forget to pay attention to what will work for choreographing a dance for my daughter. I have no idea what I am doing. I am in a frenzy. My husband gets home from Philadelphia or Sarasota or wherever his out-of-town trip was this time—I seriously cannot keep track. I thrust my arms in the air and dramatically groan. “I give up! You need to do this! I can’t do this!” before he has a minute to put down his carry-on luggage and take off his shoes. I am passing the buck, because truly, my husband can stand without spraining his ankle and can pick up choreography and help our daughter with her dances in a much more effective way than I have ever been able to. He has officially and involuntarily been promoted to choreographer. He is startled or maybe frightened by this seemingly hasty but unwavering promotion I have bestowed upon him.

I go to bed that night irrationally assured and unequivocally certain that I will awaken in the morning to a choreographed, adorable number that my husband has masterfully slapped together. He is literally good at everything (except completing a full load of laundry from start to finish—blogpost for another day). But this. Oh, this he will excel at. I know. I just know. Because, well, we truly have no other option.

The morning alarm hurls its horrible short sirens through our peaceful slumber. We fall out of bed, time to get ready, time to get the kids ready, more than half-asleep, we are already late, I’m sure. My husband breaks the news. He spent a harrowing 60 minutes last night trying and came to the conclusion that it is in fact impossible to choreograph 6 – 8 8 counts of dance moves to create an audition piece. We can’t. He says. We just can’t.

Okay. Let’s take a minute. If there is one thing that makes me know I CAN is someone telling me I CANNOT. The fire has been lit and I am the woman for the job. I demote him from his title, and re-promote myself. The buck stops here.

So, I do it. I truly can’t even explain how it came to be. I just DID. I choreographed 8 8 counts of dance moves to a beautiful song called “Superman” picked by my strong-as-steel seven-year-old daughter. It is Tuesday, and she has an audition piece. She is beyond thrilled. I see the excitement shiver up from her toes to the sparkle in her eyes. She practices on repeat each day. She is in love with her audition piece.

Fast-forward 6 days and it is Sunday morning. It is the day of her audition. She picks her audition outfit. She performs for her brother, sister, mom and dad. My insides are weeping with pride. She is beautiful. She is brave, she is powerful, she is IT. She walks into her audition with not a nerve in her clean, long lines, and she let’s them know: She is strong-as-steel.

We have yet to know if she will do a specialty dance. That will be announced in the following weeks, but wow. I’m not sure that part of this story truly even matters.

This head-strong, quiet, seven-year-old of mine gave me my greatest challenge to date, and I gave it right back to her. If I didn’t realize it before, I realize it now. This is the building of a strong, fearless girl. I am up for the challenge. We beat down that audition. Regardless of the outcome, deep down, I wholeheartedly know we have already nailed it.

Therapeutic Tears

Also published: https://www.kevinmd.com/blog/2018/05/a-doctor-cries-therapeutic-tears-with-her-patient.html

He wasn’t particularly likable on first encounter. He wasn’t apt to answer questions asked. He had a long pause and a long drawl and a tangential, winded story–and back story–all of which he was bound and determined to tell to its detailed completion. With an irregular heart rate in the 170’s and a respiratory rate in the 30’s, I tried to steer him in the direction of concise answers so I could obtain as much information as possible and do my job. This is an emergency. He is an emergency. An emergency who had waited until the last possible millisecond; we did not have the luxury of time.

But he was not to be rushed. My mind raced around his long pauses. My hands flitted around. Feeling his pulse, feeling his distended abdomen. Feeling the smoldering, red, hot cancer that took over his right thigh. I had never seen anything like it. It took my breath away and chilled me with impending fear of the extent of disease yet to be uncovered.

I tried to redirect him, but each interruption was met with a pause, and an indignant return to where he had left off in his storytelling.

It had been three years since he found out. Then, it was just a small bump. They told him it was cancer. It was easily covered up with clothing and easy to deny. He muffled it’s pervading presence with his stubbornness. He was indignant. This wasn’t happening. But it continued to happen. With or without his permission. It grew and grew and grew. And now, it was an undeniable monster. Growing on his thigh, in his liver, in his lungs. Filling up all his space, causing him to take staccato, labored breaths. Fighting to steal some room for oxygen every moment of his days.

His heart medications had gotten mixed up, confused, or refused. It was hard to completely tease out what had happened, as he wasn’t ready to be completely forthcoming. His stories took us farther away with every follow-up question asked. Now his heart worked in an overloaded chaotic state.

Infection had found its window of opportunity and seeped its way in to make sickness sicker—his organs on the cusp of failing.

His last name ended in an “-er”, like “Tyler” or “Kramer”. I brought the consent form for the procedure, he turned his head sharply towards me; we were practically nose to nose, as I had leaned in close so he could hear me in his good ear. “That’s not me. My name has no ‘S’” he said. I looked at the name I had written a top the consent form. I had mistakenly added an “S” to the end of the “-er”, like “Tylers” or “Kramers”. “You’re right”, I said. He gave me a gruff, indignant grunt.

We did what we could to stabilize him. I prepared for a procedure. “Have you done this before, Doc?” He looked suspicious. “No.” I said resolutely. “But I just looked it up on YouTube, and it looked really easy.” He was startled and appalled. I winked and smiled. “Oh, you got me. You got me good. That was good.” He let out a bellowing laugh like a man with all of his breath and strength. It filled the room. We both needed to share that.

I spent my time in Room 7 with him. Fluids, antibiotics, labs, imaging, procedures, talking. I softened. I grew to see his heart. His light. And I grew to like him very much.

I ultimately admitted him to the hospital. He may not have too much more time.

The next day was a day off clinical work, but I was at the hospital for meetings. My mind settled time and time again on Mr. “-er” with no “s”. I wandered between meetings up to his hospital room.

It took him a second to register who I was. My hair was down, and I wore normal clothes, not scrubs. “Oh hi Doc. Well, what are you doing here?” He asked breathlessly.

“I was just thinking I wanted to see how you were doing.”

“You want an update? Well, I can’t says it’s looking good Doc.”

He recounted his last 24 hours.

“I think I waited too long, Doc. And now my wife, you know. She’s home. She needs someone to take care of her. So, you know. We have to figure out how to tell her. My son was here, you know. He slept here last night. You just missed him.”

We sat for a long time. I watched his monitor. An irregular fast heart rate still in the 140’s. I listened to the rapid jagged, sharp breaths he sucked in and out.

“This must be tough. You have to remove yourself. You can’t let yourself feel. You see terrible things. All the time. But you have to Do, not Feel. It must wear on you.” In a moment about him, he made it about me.

“Well,” I said. “I just want you to know you have touched my heart.”

We cried. That awful stifling cry where so much needs to come out of what feels like a pinhole. I gripped his forearm with its weathered, dry skin. My finger scraped the edge of the medical tape that held his IV in place. He patted my hand with his other hand until the blood pressure cycled and forced him to straighten it out.

“Oh Doc. Thank you. For your therapeutic tears. They are warming. You worked last night, and now here you are. Right next to me. What a doc you are. What a doc you are.”

He lay with his eyes closed. Tired. Silent. Just his labored breathing.

Mr. “-er”, no “-s”, you are on my mind. Know that I’ll be here. Right next to you.

How Was Your Shift?

Also published: https://www.kevinmd.com/blog/2018/03/emergency-physicians-shift-really-went.html

She is 61 and she can’t help but smack her lips together repetitively. She has no teeth and the curvature of her spine makes her a miniature version of what she once was. Her frizzy hair is a purple-gray tone, and there are dark particles of something in the knots alongside her left temple. Her clothes are too loose and there are food stains on her shirt. The ambulance arrived at her home and there were pills strewn all over her floor and scattered pill bottles. She tells me that it wasn’t her. That someone had been in her apartment. That they were putting different pills in those bottles that weren’t hers. That pills were showing up on her floor. She was being followed when she went places. Her lips smacked harder as her anxiety mounted. She had to flush all the pills down the toilet because they weren’t her pills and so she didn’t have her own to take.   I ask if there is family I may call.  She stares back at me with hollowed eyes and does not respond.  She had just been released from the hospital a week ago for paranoid thoughts, but it is clear she will need to come back in.

He is 70 and his anxiety is like a storm cloud exploding in the room. He is overwhelmed because he cannot pay the bills and someone has stolen his identity. His furnace is broken and he is afraid the pipes will explode. He is concerned there is a carbon monoxide leak in their home and they are all being poisoned. At times he cannot speak because he is so overcome with his panic. He stutters and spits and cannot get the words out. I hold his hand and rock it back and forth as if to relieve the tremors that riddle his body.  I tell him it is okay over and over as I hold on; at times he appears momentarily calmed and is again able to speak until the next wave of emotions takes prey over him. His family arrives, and there are tears of fear, pain and love filling their eyes. None of this is real. No one has stolen his identity.  There are no broken furnaces and no carbon monoxide leaks. He paces at home and cannot eat or sleep. They have even called the fire department to the house to prove to him that there is no carbon monoxide leak. But it has not helped. These delusions have become his reality.

He is 57 and drinks every day and lives on the streets. He comes in one to two times a week for pain. Sometimes, he says his pain is so bad he wants to shoot himself. He says he has guns at his son’s house. This time he said he fell and his hip hurts. I help him take his pants off and he smells of urine and stool. Where can he go to take a shower? There are no bruises, scrapes, or cuts, but I x-ray his hip and there are no fractures. He says he won’t actually shoot himself if he can have a sandwich and bus tokens to go. He asks for a sandwich and bus tokens with every visit. He says his pain is 10 out of 10 and immediately falls asleep. It is the warmest and quietest place he will sleep until he comes back next week.

He is 20 and he overdosed on heroin. He was not breathing when the ambulance arrived. They gave him medication and resuscitated him and now his heart is racing and he looks bewildered as if he is on fire with anger. He says he knows it is dangerous. He has seen his friend dead in a car from a heroin overdose with the needle still in his arm. Maybe this is his rock bottom. I ask him if he is ready for me to help him get help so he doesn’t die too. He was really close this time. He says he understands what I am saying and he appreciates it. He says he is ready to stop, but he just doesn’t need help today.

These were four people I met on my evening shift last night. There are endless more stories like theirs. I don’t know where they were before they got to here, but I know life has not handed them anything. Their days are constant, steep uphill climbs. It may be addiction. It may be mental illness. It may be violence. It may be homelessness. It clasps its grip around them and won’t let them go. Day to day it swallows them and pulls them back down deep. There is little voice that advocates for and represents them. There is endless judgment that looks down upon them.

Friends and family will ask me how my shift went. I often don’t know what to say. Sometimes I feel I can help and do great things. Sometimes it is a vat of endless hopeless stories in a system with limited resources that continually seems to fail in one way or another. We will keep showing up and keep doing what we can, but it certainly is not enough.

The MIA Parent

Also published: https://www.scarymommy.com/want-people-know-about-absent-parents/

In hushed voices, I heard them. The seven-year-old boy stood, still in full practice hockey gear, hockey helmet pressed against the window of the double doors, waiting for an adult to arrive. “His mom is never here, poor thing.” came one hushed whisper. “If I knew which bag was his, I’d help him change myself!” came the hushed response back.

This parent thing is a hustle, isn’t it? Making it on time to this hockey practice, to this football game, to gymnastics practice. Remembering to pack a cardboard cereal box for the next school project, remembering to buy Valentine’s cards for the school Valentine’s party. Remembering to sign permission slips and pay for the school party. RSVP’ing to your son’s school friend’s birthday party, then hurrying to the store the day before to buy a birthday gift. Not forgetting to pack the mid-morning school snack when packing the lunch you made last night. Buying the right dance shoes for your daughter’s dance competitions. Getting new skates for your son’s growing feet. New snow pants for your seven-year-old daughter that has been squeezing into too tight pants for an embarrassingly long amount of time. Having dinner ready. Making sure your kids have their shoes and boots for school. And a hat. And gloves. Lining up all drop-offs and pick-ups so your kids are never the late ones or the last ones to get picked up.

Maybe your hustle looks different than my hustle, but it is all in the wizadry of scheduling and mental notes floating in our minds when it all falls into place day after day after day.

Listening to those moms at that hockey practice, I felt a pang in my heart. I felt a pang in my heart for the multitude of times I was that MIA mom. When I am that mom that cannot drop off and pick up my daughter at dance practice. When I cannot stay and watch my son play football. When I cannot be the one to pick them up or drop them off at school. When I could not be there at their 1st grade winter party. That time I almost missed my 3-year-old’s first daycare program and nearly broke my back figuring out a way to make it there.

That MIA mom has been me time and time again. But I do want to make one thing clear. I am not always there, but I am always there. I packed the snack in my daughter’s dance bag, I counted her shoes to make sure she had her jazz, ballet, tap shoes. I laid out those dance clothes you see her wearing. I made sure my son had his mouth guard, full water bottle, and flag football jersey and all flags accounted for and laid out on his bed before I left for work. I pre-prepare dinner for my kids, even when I cannot be there to eat with them. I laid out their boots, coats, hats, gloves in front of the garage door, I fastened their snowpants to their backpacks. I packed my daughter’s daycare pillow and blanket for naptime and hung it on the door. I hunted down the school library books in the darkness and jammed it into my son’s bookbag all before I hurried out the door for work at 6 am. You may not always see me, but I am always there.

My physical absence has no correlation with how much I care about my children. No matter where I am, my presence and heart are always with my family. All of our families look different. But the bottom line is that we cannot compare or judge one another by our outer appearances. We all have different capacities and priorities come in all different forms. They come in the form of work, in the form of aging parents, in the form of friends, in the form of spouses or single parenting, or other siblings. Everyone’s circus is made differently.

Two weeks ago, I was in Whistler, Canada with my husband. He was the chair of a conference, and I, along with friends, were along for the ski adventures that laid on those gorgeous mountains. I ran into a friend who asked me if this was the first time I had left my children behind for an extended period of time. It was not. I explained to her that while it was not without its flurry of emotions of guilt, anxiety, sadness to leave my children at home, it was also with excitement, happiness, and anticipation that I looked forward to dedicating undivided attention to my husband and friends. I explained that I felt it was healthy for my kids to realize that the world did not revolve around them. That I loved them intensely and loved spending as much time with them as possible, but I am also committed to tending to the other parts of my life that make my life full and make me a whole person. She tilted her head, mind blown, and said, “I’ve never thought about it that way.”

Sometimes it is out of our control. I have to go to work when I have to go to work. But sometimes, a night out or a weekend away is something worth prioritizing. The bottom line is my life revolves around my kids, but it also revolves around showing them the strength of who I am as an individual and reminding them that they are one part of a greater world around them.

I believe that we all want to be there for our kids, the best we can. The best we can sometimes means we are late to pick them up from hockey practice because their younger sibling has gymnastics practice across town that consistently runs late. The best we can might mean we have a baby-sitter take them to dance practice when I work predominately evenings. The best we can might mean we spend a weekend away with our spouse to care for our marriage. The best we can might mean clearing our day to volunteer at their 1st grade Valentine’s Day party. The best we can might mean saying no to a work meeting to be there for our daughter’s first dance competition.

Being the MIA mom does not mean you are not doing the best you can. I know that better than anyone. So, to that MIA hockey mom or dad. I see you and your presence in your son’s well-fitting hockey helmet, jersey, and skates. I know you are present and the best you can do with your circus is absolute perfection to me.

Grandpa by Claire

Grandpa hasn’t picked us up in a long time. When he gets done in the hospital I’m going to show him something. I wish it hasn’t been a long time.

These are the words my three-year-old said out of the blue tonight when I was tucking her in. A wave came over me; I sunk my face farther into her Lightning McQueen pillow and let my tears disappear into the red fabric underneath my cheek. I was thankful we were snuggling in the dark, crammed together in her toddler bed.

11 months ago when my father-in-law died, one of the things that brought me the greatest grief was the thought that my children’s memories of him would fade with time. Especially my youngest that adored her grandpa so much. My heart ached thinking that these memories of what Grandpa looked like, how Grandpa laughed, how Grandpa hugged would become blurrier and blurrier with time. As if with each year, we would lose more of him as the memories became more faint.

Out of the blue tonight, my youngest reminded me that Grandpa is still alive through her. The grief resurfaced from the undercurrents of the daily bustle. The waves stopped crashing and the wind settled, and the hollow that he left burned like fire.

I listened to her musings. The shadow of her face cast against the column of light that spilled through her cracked bedroom door. She looked so thoughtful as she pondered how long it had been since she had seen Grandpa. I wondered for a second if I should ask her what she was going to show Grandpa. But it was too beautiful and too heartbreaking of a moment; I decided to let my big-hearted three-year-old have that special moment with her grandpa to herself.

The holidays are nearing, and by nearing, I mean that we will be smacking face-first into them here as we turn the corner. It is a time when everything about the people you love is heightened. You are thrust together in a haphazardly coordinated fashion. You have idealistic expectations while simultaneously bracing yourself for the worst. You are excited to celebrate the best time of year with those that mean the most to you all the while knowing that they will likely get under your skin in 7 seconds flat. You have an idea which of your inadequacies will be immediately brought to your attention under the guise of “we’re just worried about you.” You will try to dart behind the children for distraction. Unless parenting is one of the points of criticism you are trying to deflect.

All cynicism and family dynamics aside, the holidays are a time of magic. Of festive lights brightening common, everyday fixtures. Of holiday stories, decorative cookies, and yearly traditions. It is a time to come together and celebrate and show with our own touch how we love those that we love most.

Unless someone we love most is no longer here. Then holidays become harder. Especially that first holiday without them. A void we never anticipated being part of the holidays sits loudly in the center of the room and throbs in our hearts. We see the joy of the holidays through a lens of aching—part of us remaining idly empty.   We move through the motions and we daydream about rewinding time to last holiday when the greatest stressor was what your inappropriate uncle was going to say in front of your kids. You crave being able to fret about the petty things that had occupied your thoughts, because that meant there were no waves of hollowness widely sweeping over you and making you gasp for air like there are now.

It is hard to feel festive when loneliness so definitively puts its arm around your shoulder. It is hard to let the excitement and joy win.

Tonight, I learned from my three-year-old. The best way to keep my father-in-law a part of our lives is to flood these holidays with his memories. To make him an integral part of our celebrations. To make sure he doesn’t fade in the eyes of our kids. To create new memories with the memories of him. This holiday, we won’t let the loneliness sidle up to us. We’ll inch it out with his presence in our hearts and in our traditions. Grandpa will be with us. And we will show him something over the holidays so it will not have been so long since we last saw him.


There was a moment three nights ago when I was plunging the kids bathroom toilet with all kinds of odors swirling around and splashes of unpleasantries splattering on my arms. I was still in my work scrubs. I had three little kids with wet, dripping, just-bathed hair half-dressed in pajamas, mesmerized by the grossness of what was unfolding, occasionally yelping at the top of their lungs when their feet got a drop of the “YUUUUCK!!!!!”  “Get back”, I mustered to meekly say to them.  That was the moment three nights ago that I just felt ready to collapse.  It was the moment of the day.  “You can’t do this.  You need to go to sleep.”  Is what my brain and body ached and pleaded.  But I was the one for the job, and by the one–I mean, the only one.  So I unclogged the toilet, helped dry my kids’ hair, and got them ready and in bed.  I was ready for bed myself, but Laundry.

There was a moment four nights ago when a patient was unresponsive and I wasn’t sure she was going to make it.  Another patient was on the brink of going into liver failure and was refusing life-saving medications.  Another patient had an infection spreading up his above the knee amputation and was at risk for losing more of his leg.  Along with all other patients in the department that had been impatiently and patiently waiting for hours.  It was the moment of the day.  I was the one for the job.  So I worked with my team to stabilize my patient, I talked to my other patient about the importance of continuing her medications, I started my third patient on antibiotics, and I kept moving as fast as possible.

There was a moment two nights ago when I had gotten home from work–I was so relieved to finally have my husband back in town after his week of travel and ready to finally have a day off.  It was the last night my parents were in town, and all I wanted to do was enjoy a night of nothing but just being together with everyone I loved most in my life.  And then I got the message that I was needed the next day on my day off to cover a morning shift.  My husband saw the sleepless stress brimming in my eyes, and quickly said he would take care of the kids and take my parents to the airport.  There was a pit in my stomach as we moved through the rest of our night.  I wasn’t ready to say good-bye to my parents just yet.  And then there was the moment. Except this time, I just couldn’t anymore. There we were, brushing the kids teeth and putting on pajamas–“I got this”, I cheerleaded myself. But then the tears started in my gut and like unstoppable soldiers marching steadily to battle, they rose in my chest, into my throat, and poured out.  My husband held me, and I just couldn’t stop.  My 6-year-olds slowed their teeth brushing strokes, and my 3-year-old instinctively walked between my legs and hugged me, “It’s okay, mommy.” I heard her say.  I’m not sure she has seen me cry before.

There was a moment last night. I had been on call and had therefore scheduled a baby-sitter to help with the kids in case I got called in. I had yet to be called in and my husband had come home early for a dentist appointment. We decided to have a night to ourselves; I packed our work bags and our work-out bags and planned for a productive night of getting work done while just spending some uninterrupted time together. My husband picked me up and as we drove away, he asked me if instead, I wanted to go somewhere and watch the post-season Cubs baseball game, already in progress. Yes. This was for sure the more attractive option. So we drove to a local sports bar, ordered fried and cheesy appetizers and cheered, cheered for the Cubbies. No one else at the bar appeared to be a Cubs fan. So it was just the two of us, hooting, and hollering, yelling and high-fiving as the Cubs went on to win against the Nationals. It was a close game which made the victory that much sweeter. This was the moment. The moment when despite the rush, the pull, the overwhelming, we pushed it all aside for just a night cheering for our favorite team. We got home just in time to tuck the kids into bed. It was the highs of a perfectly ordinary night–the Reset that I needed.

There are moments that we barrel through because we are tough and we are strong and we can do it all.  There are moments when it all topples and no deep breathing can make it less overwhelming. There are moments when we remember that beneath it all, there is so much for which we are thankful. We are trying our best to do it all, but it is not easy and we just may be balancing between doing it all, hitting our breaking point, and finding the joy sprinkled through all of it.

Anytime anyone comments on how they think I have it all together, it makes me want to take a nap.  It is with every last fiber of muscle, every last brain cell, every last particle of stamina in my body that I try to pull and hold together this life of career and family and home.  And I know I do not stand alone.  That all you capable, multi-tasking parents out there are on my team.

The next time you are standing in your kids’ bathroom, whispering sweet nothings to plead your kids’ clogged toilet to flush, know that we stand together in willing for that sudden gush and swirl of the water in that toilet bowl so you can put that chapter behind you. Know that in that moment of nothing great, there will be moments of sheer happiness that will follow, and Reset us, until that toilet clogs again.

The Secret to Our Marriage

“What is the secret?  I feel like we are already failing.”

A close friend of mine that recently had her first born asked me what was the secret. What was the secret to getting through these tough years with a young family and coming out whole on the other side? How was it possible to maintain some semblance of your identity and maintain this relationship you had with your husband before these small, yet all-consuming little beings enveloped our lives? I sat for awhile, stumped by this question. I couldn’t fathom why she would be asking me. I felt I was still trying to pull myself out of the knee-deep sinkhole of parenthood, marriage, career, and just standing upright to do life every day. What was the secret. Was there a secret? For the first time in a very long while, I felt speechless. We walked away from the conversation, me feeling astounded that I didn’t have some know-it-all response, and my friend feeling defeated that I had no feel-good, sisterhood pep-talk to fill her hopeless vat of newborn, sleepless despair.

It’s such a cliche question, “What is the secret to marriage?” With so many knee-jerk cliche answers. “Never go to bed angry.” “She is always right.” “Happy wife, happy life.” “Communication.” Sure, sure. In the ideal world. All of these are the answers we should live by. But unfortunately, none of us live in this picture-perfect, well-rested ideal world we so easily tout about. We live in a world where our patience is worn down, our frustrations and irritations are threatening to erupt out of the running bath of bubbles, and we never feel quite on top of everything that demands our attention. It is exponentially easier to promise to “never go to bed angry” amidst the warm glow of a candle-lit wedding reception, sitting on satin-covered chairs, eating square pieces of marble cake with fluffy icing, than in the midst of real life with kids and careers and communities where it becomes much easier to stray from these words of cliche wisdom.

My husband and I fell in love when we were two college kids with nothing on our minds but finals and future dreams. We studied abroad together and followed one another around Barcelona. We studied in the library on campus and ate pop-tarts out of the package and ramen out of styrofoam bowls. We had great aspirations and all the time we wanted to dedicate to them. I remember being in graduate school on a warm, sunny day and driving the three and a half hours to New York City where my husband was in graduate school. I remember spending a Saturday in the longest post office line just waiting to deliver some boxes. I vividly remember that feeling that something so mundane and seemingly irritating was in fact enjoyable because here at my side was the person I loved.  I felt so lucky.

Fast forward through the years. We checked off college, then graduate school, then residency, then finding jobs, then saying “I do”, then buying a house, then starting our family. We would soon realize that through all of the obstacles, all of the setbacks, all of the losses, disappointments, proud moments, the most intense would be the raising of a family. There was absolutely nothing quite like taking care of twin newborns through days upon weeks of sleep deprivation. No 30 hour shift in residency, no marathon all-nighter studying in graduate school could compare. No, the sleep deprivation of newborns was epically unparalleled. We stumbled our way through it. We took turns, we did it together, we stepped up when the other was crumbling. There was no science, there was no set of rules to follow. We just took it as it came and barreled through. And somehow, we came out on the other side still a team.

Fast forward every day of every year since we had our twins, then our third child, and it has been much of the same–though I am happy to report, the increments of sleep have become appreciably greater. Every day, every week seems like a two person relay where we alternate sprinting legs of the race and work so insanely hard at optimizing a seamless transfer of the baton that doesn’t end in a falter, a loss of stride, or worse, a drop of the baton or disqualification. The load becomes greater with each year. We add demanding careers, community responsibilities, kids’ school obligations, kids’ activities, taking care of extended family, the maintaining of a house, and the weight of the load becomes harder to toss between the two of us. The mere organizing of a week of schedules–who needs to be where when, who is working, who is out-of-town, who will be picking up/dropping off/staying with our kids feels like the putting together of a 1,000 piece jigsaw puzzle that needs putting together week after week. We scramble to organize the chaos and stay on top of it, but it seeps at the seams and sifts through our fingertips.

We are so tirelessly tired. We often feel like hollowed-out shells of those two lovebirds that followed one another around Barcelona. But as we find ourselves still knee-deep in these trenches, we do as we always do. We pass it back and forth. We lean on one another.  We do it together. We do it with respect and with humor. We stand strong when the other falters. We take on one another’s priorities as our own. We remember that the emotions that resound at times when we lack sleep, when we are stretched our thinnest, when we are at our most stressed are not the emotions that are truly beneath it all.  We appreciate one another and know we are both giving it our all.

This past weekend was my husband’s birthday. I packed the weekend full of birthday celebrations. In the middle of it all, I planned a dinner for the two of us and an overnight stay away from home. In that short, less than 24 hours away, we were reminded of us. We let those daily strains and stretches slough to the side and just remembered that at the real center of it all is still just the two of us. And while we stood in that bustling line waiting to order our coffee on that Sunday morning, I was transported back to that long post office line. Here I still was, enjoying a mundane wait in line, because here at my side, was still this person I loved. I feel so lucky.

I can’t say I know the secret to marriage. Those that have been married 25 years, 35 years, 45 years may hold the secret, but all I know is what has carried us through these tough first years as a young family of five. We stick together. We stick together in our unified voice as parents. We stick together in taking care of our family and friends. We stick together in how we prioritize our careers, families, and each other. We are an eternal team. And while we are never perfect, and are still at the beginning of this long relay run, we will keep passing the baton back and forth the best we can.

Raising of Human Beings

It started with a lanky 6-year-old that had no interest in learning to swing. He sat on the swing and his legs dangled like two lackadaisical twigs in the stagnant humidity of summer. His twin sister next to him pumped her legs and swang high into the sky, back and forth, higher and higher, her long brown hair whipping behind her and across her face. I couldn’t quite put my finger on it. I wasn’t sure if he truly just couldn’t figure out how to swing or if he just had no interest. Both my husband and I would both go through painfully detailed tutorials with him: you lean back, you straighten out your legs, you lean forward, you pull your legs back . . . He kicked and flitted, and remained dangling upright. He’d quickly lose interest and tackle the next adventure.

I suppose it was okay when he was four. And five. But now it was summer and he was six. It should be part of the 6-year-old experience to feel that wind whirling by your ears, that weightless tingling sensation in your stomach as the swing swung low, the lightness of flight as the swing swung high.  While this certainly wasn’t the end all be all milestone of a 6-year-old, it was time to try a different angle. This is how we came up with the ingenious idea of making it a competition. Our kids, and let’s be honest, my husband and Ihave a bit of a competitive fire in our hearts. Make something into a competition, and we will roll up our sleeves and dive in.

Here were the terms we set forth at the beginning of the summer:
By the end of the summer, my son needed to learn to swing and I needed to learn to do a headstand. Best one to complete their goal got to plan the date of their choice for the two of us.
My husband and 6-year-old daughter made a similar bet. They both needed to learn to braid hair. Best hair braided at the end of the summer got to plan the date.

The competition was on. All summer, it was a fun, energetic banter as we “competed” to perfect our end goals. By the end of the summer, my son was soaring high on the swing and both my husband and daughter had mastered the art of the braid. My headstand was a little shaky, but my feet were up in the air and that was good enough for me.

We allowed my parents to judge our competitions and I should have known their grandparent-biased would throw the results. Both my son and daughter won the competition. It was a clean sweep by the 6-year-olds.

The summer was over well before a blink of anyone’s eye, and the grand prize of an end-of-summer date never happened before we rolled into the school year. We promised them up and down that the first Friday after school started would be our date night. It was in fact the only free weekend night we had for the month of September.  That entire first week of school, they could hardly contain themselves, planning their dates, changing their minds over and over. My relentless persistence even paid off as my son carved a stop at Starbucks into our date night. Friday came and that morning started with every light switch in the house seemingly flipped on. “Happy Date Friday, Mommy!!!” The kids bounced about their morning in anticipation for the end of the school day.

Two hours into their school day, I got a message that my mother-in-law was feeling short of breath. She was going to the emergency department. I was car-less at the moment–my parents were visiting and out buying every bulk package at Costco they could possibly fit in my minivan. My husband had left work and was on the way to the hospital to make sure my mother-in-law was okay. Ultimately, my mother-in-law was admitted to the hospital. I thought about the rest of our weekend. I worked the rest of the weekend evenings, and the mornings were inundated with kids’ activities. Every slot of time was spoken for. I thought about how it was important for us to go visit my mother-in-law and important for the kids to go visit her and show their support and love for her. I thought about this sacred Friday night that was the culmination of a summer’s worth of teasing, afternoons spent practicing swinging, and mornings spent biting my lip as my daughter doused my hair in water and pulled and knotted it into braids. I thought about their little bodies buzzing with anticipation. I thought about their longing for alone time with their parents.

As a parent, a piece of your heart aches deeply when your child experiences disappointment. Your natural instinct is to shield them with bubble wrap to protect them from the crash. Your natural instinct is to leap forward onto that mud hole so they don’t stumble and land face first in wet, cold, sticky dirt. Your natural instinct is to try to hold up the dam and patch the holes before the big cartoon tears start to spurt out of the corners of their eyes. But what do we do when we shield them from disappointment? We raise children that miss an opportunity to learn to cope. To learn to encounter deflation and devastation and realize that on the other side of that is healing and acceptance. We raise children with the attitude that everything goes “right” and will easily fall into place with no understanding of the brick walls that will hit them in the face even when they do everything they are supposed to do and swing as high as they can and braid as nicely as they have been practicing to do.

Disappointment is just a part of reality. And it hit me that perhaps I was approaching this all wrong. All this time, I have been working so hard to raise these children. All this time, I have been trying to create fun and memories and hit milestones. What I really want, is to raise human beings. Human beings that put fun and prizes aside to be there for their family when they are needed. Who learn the importance of dropping everything and seeing their grandma in the hospital when she is sick. Even if it is just to sit at her bedside and eat a meal with her. That even though, this Friday date was the culmination of summer and the most important thing they had in their 6-year-old lives, there is absolutely nothing more important than family and being there for one another.

I thought about how to address this when I picked them up from school. I knew that they would be enveloped in the heaviness of disappointment that made my every maternal instinct cramp. But facing and coping with disappointment is also part of the raising of a human being.

We set down our backpacks and sat on the family room floor. I have something to talk to you about. I said. Grandma was having a hard time breathing today, so she went to the hospital and they decided to keep her there tonight so they could help her breathe better. We talked about being sick and how that felt. We talked about being alone and sick and how that must feel. We talked about being sick, alone, and in a hospital bed and how that must feel. We talked about how if they were sick, they probably wouldn’t want everyone in their family to leave them by themselves in a foreign place and go out and have a really great time. We talked about the importance of being there for family and putting everything else aside. We talked about putting our date on hold and going to see grandma in the hospital.

My daughter looked at me. Her face fell for a transient second. You probably wouldn’t even catch her reaction if you didn’t look closely because it was quickly replaced with a bright smile and a nod. This is how she responds. My son broke out into immediate tears. His cheeks got flushed. His whole body became hot and sweaty, and he crumbled into me with large heaves. This is disappointment, and this is how my 6-year-olds express it differently. We talked through their feelings. Their reactions. That disappointments are tough and both their reactions are valid. We talked about how each setback and how we react and move forward will help us the next time.

I allowed them their time to process. And when they felt better, they both knew that it really just came down to family.

That night, we spent in a hospital room. The kids ate their dinners with french fries with full kid-energy and kid-joy. They bounced around grandma’s big hospital room. They gave her hugs, lifted her spirits, and they let us tickle them until they were full on squealing. We left after a full night of being together and the night ended the same as if we had gone one our date nights—with exhausted kids asleep in the van from another full night.

And that’s how I came to realize that in the day-to-day choices we make in raising our children, we are ultimately raising human beings.

Imagine Her Story

Imagine being 31. Imagine being diagnosed with cancer. Imagine it spreading and taking over your body. Imagine going to one of the best hospitals in the nation filled with hope. Trying one chemotherapy regimen. And then the next. And then the next. And then the next. Imagine your body and your cancer rejecting all of them and running out of options. Imagine your doctors—experts in their field and your final hope—telling you that the medicine is making you too sick and isn’t working. The cancer is progressing. Imagine having fought enough battles for a lifetime. Imagine realizing that the cancer has outrun your race. Imagine knowing that time is running out. Imagine knowing that it is time to count the weeks and hope for months.

Imagine being divorced. Having two kids under the age of 8. Imagine your ex-husband moving to another state. Imagine being the backbone of your family of three.

Imagine being so gripped with pain that you cannot eat. You cannot think. You cannot function. You cannot sleep.

Now imagine it all: Being 31 with lung cancer that has spread all over your body that pulses with pain. Being told that it was time to plan your final days and not knowing how to tell your kids as a single parent.

Can you imagine? It cripples me to do so.

But I opened the door and I didn’t just imagine it, I met her. This was her story. Matter-of-fact. Her eyes steadied on mine. Every muscle relaxed.

She had a plan. In three days, she was flying back to her home country. She was leaving this life before it could leave her. I don’t pretend to know the path she has walked to come to this decision, with her bags packed on the side, ready to step away on these legs that have stood steady when every corner has closed in on her.

I flipped through page after page of medical records. I read about her pain. I read about her decline. I read about the age of her children. I read about her ex-husband living states away. I read about how her parents were deceased. I didn’t ask too many questions. This was not the time for too many questions.

I begged her to stay in the hospital. Her physical pain was too great to handle alone. Her pain was something we could help her with. She couldn’t just step away just yet. It wasn’t time to be alone. I circled back to her room in our Emergency Department three times. The third time, she nodded her head.

Today she should have flown home, leaving her American life behind her. She is still in the hospital. I am another face in hundreds that crossed her path in this final fleeting countdown that no one should have to imagine. I know she won’t have long, but that should not stop us from being her advocate. Every day she continues is another day we continue to treat her however we can. She may be living by the day, but we will be alongside her to re-invision these unimaginable days.

Blink. Reset.

It is one of those nondescript 7 a.m. work days when you feel as if everyone around you is still waking up.  Still with half of their first cup of coffee to drink; the caffeine not quite kick-starting their day just yet.

Yesterday’s loose documents still being filed.  Nurses amidst their morning hand-offs at change of shift.  Morning huddle circles just starting to materialize.

The ambulance phone rings, piercing this morning hum.  78-year-old-man with dizziness.  Vital signs stable.  ETA less than 5 minutes.

He arrives.  He is vague about what brought him to our emergency department ambulance bay, but he is certain of his diagnosis.  This dizziness–just like the vertigo that brought him here 2 years ago.  This left arm pain–just like the pain from the left arm surgery 6 years ago.  This heart burn pain.

“Well, sir, what does your heart burn pain feel like?”  He tells me it is a pressure.  A heaviness sitting on the middle of his chest.  I ask him about the left arm pain.  It is an ache that has made a resurgence after 6 years of not having pain since his left arm surgery.  He describes it as an ache that has become progressively more prominent since its arrival three days ago.

The lackadaisical air of this morning quickly lifts, and I swiftly start undressing my patient.  “EKG.  I need an EKG.”  And the EKG confirms it.  “Well, sir, I am glad you decided to come in today.  You are having a heart attack.”

His wife is now sitting in a chair next to him.  They both look at me, bewildered.  The patient looks as if I have popped out of the closest shrub and startled him, “I am?”  His wife is overcome by an immediate shadow of grief and panic that settles onto her shoulders, gripping her with a paralyzing tremor, the way a strong, unexpected gust of wind shakes a trembling leaf holding tightly onto its last life-line branch.  Tears storm into her eyes, as her breaths become shallow and uneven.

I explain to them next steps.  I describe the commotion that will quickly envelop them, about the events that will unfold before their eyes quicker than it takes to process each and every one.  I assure them that they are in the right place.

They nod.  I linger.  I am confident it will be okay; I want them to feel my confidence.

Minutes fly like hummingbird wings.  Orders are written.  Medications are given, and my patient is ready to be taken to the cardiac suite.  I have no doubt this transfer will happen swiftly and seamlessly.

The emergency department is starting to fill with other patients:  The patient with foot pain in room 6.  The patient with a headache in room 8.  The driver involved in a car accident in room 12.  The patient with nausea and vomiting in room 11.

Between every patient encounter, as I walk from room to room, I finish reviewing the plan of the person I have just seen.  I think about what they just told me, what I felt with my hands, what I observed with my eyes, what I smelled, what I heard, about how their family or friends reacted at the bedside.  I think about every single part and stop between rooms to finalize my orders for that patient.  Then I blink.  I reset.  I introduce my mind to the patient I am now going to see.  I think about the one word descriptor that pops up as to why they are here, I recite his or her name in my mind, I note his or her age; a laundry list of possibilities of what may be going on starts to populate in my mind.  I momentarily let go of the person I have just seen.  It is a quick, brisk walk from room to room, but it is the time I have.  I blink.  I reset.

The man four rooms down having a heart attack will not alter the attention I pay to the woman here who has had foot pain for a year.  The frustration my patient with foot pain relays who has felt bounced from specialist to specialist turns to impatience and anger  when I say I cannot guarantee I will find her answers today.  I will not allow this interaction to affect my patience and compassion for my next patient with a headache in room 8.  The severe pain of the patient with the headache will not make me think less of the neck pain my stoic patient in room 12 reports whose car was T-boned by an SUV going at highway speeds.  The stoicism of my patient in room 12 will not affect my sensitivity for the first time pregnant mom, tearful about her struggle to provide nutrition to her growing baby through her crippling morning sickness.

So, between rooms, I blink.  I reset.

As I move swiftly from my first patient having a heart attack to my patient with foot pain, I see out of the periphery of my vision my patient’s wife.  She is standing as close to the wall as possible as her husband is being transferred to a different bed.  She looks small.  Her eyes brimming with worry.

In that moment, I am transported back to my 17-year-old self.  My dad is back inside from a half-mowed lawn.  He is sweating cold sweat, pale, labored in his breathing.  “Call 911” he tells me.  “Call 911”, says the man who, in my 17 years of life had never complained about an achy joint.  “Call 911”, says the man who, when a cement brick fell on his left big toe, had unceremoniously poured betadine on it, wrapped it with a gauze, and returned to pushing a wheelbarrow full of bricks.

In a blur, the ambulance arrives, and is takes away my dad, lights and sirens.

My mom, our family matriarch, my pillar of strength, is left limp, helpless, frightened, sobbing.

I see my mom in my patient’s wife.  She carries herself differently, but I know there is panic, there is fear of the unknown. So, this time, I don’t blink.  I don’t reset.  I pause.

“He is in the best of hands.  I know it.” I hug her.  My stethoscope digs into my collar-bone, and likely hers too.  But we hold the embrace, we both squeeze a little tighter, and when we let go, she is still heavy-hearted, but there is something lighter in her eyes.  She looks less small.

He made it.  He’s alive.  He’s okay.  I checked in later in the day after his cardiac catheterization to re-open the blocked arteries around his heart.  He’s okay, and so is she.

I have to blink.  I have to reset.  But before I do, I want you to know, I am here for you.  And only you.  As long as you need me.  If you are the one waiting in the next room, please know, I’ll be there as soon as I can be, for as long as you need me too.

At the end of the day, no matter how many times I blink and reset, I’ll gather you all up, and carry you all home with me.  Because at the end of the day, it’s all of you that has made an impact on me.

Our Magical Spring Break

The countdown began about two months ago. Our reservations booked, our plane tickets purchased, our schedules cleared, and all we could do is wait and let the anticipation build. This was our first year experiencing spring break as parents. Our first year with school-aged kids where spring break was actually a thing. We felt compelled to make it special. And there seemed no better way than the magic of a first time Disney cruise. The excitement flickered through their tiny 6 and 2 year-old bodies and exploded in their eyes and in their bouncy legs as the countdown neared the single digits. 9 . . . 8 . . . 7 . . . 6 . . . 5 . . . 4 . . . 3 . . . 2 . . .

And off we were, carry-on backpacks for all, two suitcases well over the 50-pound weight-limit filled with swimsuits, summer clothes I scrambled to purchase that fit their ever-growing lanky arms and legs, sunscreen, princess dresses, pirate gear, snacks, beach toys, sunglasses, and all. of. it.

Disney definitely knows how to do it up right. We hit the pool immediately upon embarking the ship and the kids were in insta-kid heaven.  From that moment on, our days were jam-packed with dance parties, shows, outdoor movies, indoor movies, character meet and greets, water slides, beach days, and endless ice cream. Everywhere we turned, there was more fun to be had, and more new things to experience. It was happiness, wonder, and excitement on steroids.

As our days filled themselves with kid-magic and sugar, I couldn’t help but hear my own groans, exasperated comments interweaving with the greater cacophony of remarks of all Disney cruise parents surrounding us. There we were, in the “Frozen” spectacular show, when the kindergarten age girl behind me could not control her waterfall of sniffles. I heard her mom say, “use your words, what else could you possibly want? What else?” I turned around, wanting to chime in, “I’m right here with you, mama! That is the mantra of our trip!” but she was elbows deep in child-tantrum, and I wasn’t sure this was the moment she needed my moms-unite cheerleading banter. So I settled back into my seat, and heard my inner thoughts spoken aloud by the mother behind me. “We are about to watch Frozen. Don’t you love Frozen? We are on a Disney cruise. You have popcorn. Juice. You are wearing your favorite Elsa dress. What else do you need???” Preaching to the choir, sister. To the effing choir.

Here’s what I found out on my first kid spring break excursion. It was worthwhile. It was memorable. I am glad we did it. The kids had more than a blast for five consecutive days. But let’s be real. It was also utterly exhausting. It was overstimulating. It was teeth-grittingly exasperating. There were over-tired, over-sugared meltdowns to dodge and diffuse. There were missed nap times that were always a huge mistake. There were uncontrollable tears to try to interpret. There were lines to wait in with fidgety overly excited kids. There was that time we lost my 2 year-old for those eternally long minutes while we had been trying to juggle five plates of food and wiggly kids around our legs through the breakfast buffet. “Where is Claire?” my husband asked. We looked at each other with that frantic, bewildered sinking feeling. No seriously. I am not proud. But it happened. Don’t worry. We found her.

The anticipation, the expectations that we had laid out leading up to this week of spring break made each mini outburst seem exponentially harder to patiently endure as parents that were trying to create that magical family vacation.


If I am being completely honest with you, the best moment of this spring break vacation for me was coming home last night. I found myself on our tiny loveseat couch with my three kids and husband, tangled under a big blanket, listening to my husband read the very first chapter of Harry Potter to our kids. They sat still, captivated by the words of J.K. Rowling. And I thought with each sigh that left my body, that this was it. This was my vacation bliss. Just being still, surrounded by these tiny warm bodies in self-picked out mismatched pajamas. Doing the most exciting yet everyday routine of reading stories at bedtime. This is what I just so love and adore.

Our spring break trip was wonderful. We will have those memories for a lifetime. I will remember how my son’s face lit up when Mickey Mouse signed his autograph book. I will remember how my 6 year-old daughter smiled so big when she twirled in her princess gown. I will remember how my 2 year-old daughter nearly crawled up on the stage to touch a Disney character’s costume during a show. I’ll remember the gorgeous day we spent on the beach, swimming in the ocean and making sand castles in the soft white sand. I will remember with the greatest fondness seeing my parents experience joy with their grandkids. Thankfully, as time goes by, these memories will be the ones that linger and stay with me in pictures and in my memories. I will hopefully have a vague recollection of the meltdowns, of having to sunscreen and re-sunscreen wiggly arms and legs, of all the bulky bags of over-prepared kid emergency items I lugged around with me, of the over-exhausted tired tiny but astonishingly heavy kids that we had to carry back to our room at the end of the night. Honestly, I’ll probably be crazy enough this time next year, to think planning another fantastical spring break trip is a great idea, but for right now, I just want to acknowledge that under all that hype, under all those smiling, sunny, beautiful blue ocean beach photos, there are tears and meltdowns and exhaustion and hard work keeping it all together.

So Spring Break, we’ll fall under your spell again I’m sure, but to all you parents out there, it was tiring for me too.


A Love Story

Most love stories we see in the movies begin with a young man, a young woman, a chance encounter, or these days—maybe a swipe right on an online profile. But the greatest love stories are those that go untold. And this love story—this is one of the greatest I have had the honor to witness, if only for a few hours of their story.

She started with her confusion four months ago. Initially, it started as small things that most would not have noticed. A misplaced purse. Forgetting where the car was parked. Forgetting to mix the eggs into the cake she was baking. Nothing any ordinary person hadn’t done. But soon it turned into something more, he explained.  Getting lost in their apartment. Realizing she had opened the closet door instead of the bathroom door and the shame that followed that he couldn’t shoulder for her. The full out heaves of tears he couldn’t calm when she couldn’t find the bathroom after all. The heart ache of watching her grab armfuls of clothes from the closet and place them on the floor with such purpose, knowing there was only a mass jumble of thoughts and hysteria behind her frantic actions. It was a test of stamina to care for her, to look after her, to help her find the way in this narrowing, dark tunnel of her mind. It tired her too. And she slept. She slept after breakfast, she slept after lunch, she slept after dinner. Her waking hours became so sparse, but when she was awake, it was so filled with hyperactive conviction and activities that were seemingly purposeless. He would spend her sleeping hours placing all her shirts, pants, and dresses back in the closet. Washing stains off her clothes that she had spilled soup on. Salvaging what he could out of the trash of the oranges he bought yesterday that she had thrown away.

And soon, she lost her ability to dress herself. And it angered her. With such frustration, she would pick a dress, throw it on the floor, not knowing how to put it on. She would pick something else out of the closet, throw it on the floor, acting as if it wasn’t that she didn’t know how to put it on, but that she no longer wanted to wear it. Yesterday, she settled after picking a towel, laying it neatly on the ground, and with a satisfied content look, declared that this towel was in fact the dress she had decided to wear that day. He told me this, then fell into silence; keeping his eyes locked on my reaction, as if he couldn’t believe his own words, as if he wanted me to tell him they were not true.

He shared most of these things with me in rapid succession, with the same low, quiet, monotonous voice. His eyes tired but gentle; he spoke with such tenderness and love for his wife. This was a love that had grown over 51 years of marriage. Four months of hardship was worthwhile so long as he still had her.

She lay in the hospital bed with her eyes closed. I talked to her softly as I examined her. He chuckled at me, “you know she is probably stone cold asleep, don’t you?” She awoke when I sat her up to listen to her lungs. “Marty?” She said, startled by my presence. “Yes, May? It’s okay. It’s just the doctor. She is just taking care of you.” “Hm.” she grunted as her shoulders relaxed.

Last night had frightened him. “It scared me the way she was acting.” For the first time, he had seemed to slip from her mind. It had been different when it was the location of her purse, the location of the bathroom, or even how to put on her pants. Last night, she couldn’t remember him. She had asked for her pain medication, and when he gave her only one tablet as prescribed, she had become upset. Looking straight at him, she had said, “I don’t know why Marty wouldn’t give me the whole bottle so I could take what I want. He would only give me one tablet! ONE tablet! Can you believe him?” she had shouted at Marty. She proceeded to ask him to call the police, as there was a man in their home. She tried to leave the apartment without her shoes on with the car keys in hand. “And she doesn’t drive. She’s never been like this. It scared me.”

They met 60 years ago in fifth grade. They spent much of their adolescent years getting to know one another, and at the age of 20, they married. They spent the next 51 years married, 20 of those years married with multiple sclerosis grabbing a hold of her and settling into their marriage with them—an unwanted, dreaded third wheel. There have been good days and bad days, early on the good days outnumbering the bad days and making them tolerable.   These days, the bad days like a storm cloud ravaging all their days. There are days with falls. There are days with anger. There are days with forgetfulness. And every day that slides by, he tenderly holds onto the girl he met all those years ago. His one love.

I walked into room 14 of our emergency department, 4 hours into their visit. I found him sitting still next to her bed holding her hand in silence. The TV off, her eyes closed, the lights dimmed. Her presence—even in these dark days that have consumed them, even when he is losing his ability to care for her in the way he has for 51 years—her presence still his greatest comfort.

Where they go outside of the doors of our emergency department will be a new chapter in their lives. Their story is one of the great love stories that deserves to be told. A love that knows no end.

“Vacation” with Kids

The sound of too-wide-awake and too-energetic children’s voices pierce my dreaming state. The irrepressible groan of frustrated exhaustion shakes me awake. “What time is it?” my body complains. And then I realize, with elated joy, that those sounds are not my kids. My kids are home, safe, with our amazing family friend. And we are in a hotel in Tahoe for a conference, which means one glorious thing–those are someone else’s too-wide-awake kids that I don’t need to make sure are brushing their teeth, getting dressed, and eating breakfast.  
As I winningly snuggle deeper back under the covers, I listen to our hotel neighbors. I listen to our hotel neighbor mom speaking in a continuous 100 decibel tone to her three boys. “Finish your yogurt!” “Take your pants off the floor!” “Put your boots on!” “Don’t fling that at your brother!” I listen to the kids sing and protest and laugh and bicker. I listen to them pound on the bathroom door and their mom yell back, “I’m in the bathroom!!! Stop pounding!” I listen to their endless questions about their day ahead, about what they will eat for lunch, about what they don’t want to eat in their breakfast, about what they want to watch on tv. I listen to them rebel as a united front against the world-altering news that tomorrow is Monday and they will return to school.
The frantic commotion, the never-ending high-pitched commands and urgings. It is all too familiar and understood. I think about what this may seem to an outsider. An outsider who has not experienced the ups and downs of parenthood. I imagine them cringing. I imagine them becoming epically aggravated at the constant ping-pong voices yelling back and forth. I imagine them congratulating themselves for not falling victim to parenthood at this stage in their lives. 
Taking your kids on vacation is always something epic. It is an exciting daydream until you are in the trenches. Then it is too many pieces of luggage and too many fast-moving, squealing little people to keep track of. It is bracing for the spontaneous meltdowns and syncing them with the unpredictable traffic, weather changes, or airline delays of travel. Yes, all things you are in absolute control of. It is managing your kids and willing them to find their zen in noisy crowds and bustling over-stimulated new environments. Come to think about it–fellow parents, are we insane??? Why is vacation with kids ever a good idea???
I’ll tell you why. These are my best memories: My three kids strapped into their life vests, watching the lake water splash against the pontoon boat on a gorgeous blue skies day, fresh wind and waves gently rocking us on the lake, the kids emphatically throwing pieces of bread to the ducks swimming in the water reflecting slivers of sunshine. Campfire s’mores and sleeping bag sleepovers. My daughter at the age of 5, meeting her most beloved Disney princess in Magic Kingdom, mesmerized with awe while Sleeping Beauty spun her in circles and oohed over her dress. Experiencing the pure elation of three kids excited to sleep squished in a hotel room and spend undivided time with my husband and I. Taking them to their first Cubs game at Wrigley Field and witnessing their disbelief turned uninhibited ecstasy when a player threw them a ball. Watching them splash in water parks, giggling maniacally all the way down water slides. Realizing with wide-eyed delight that I was saying yes to that chocolate-iced doughnut with rainbow sprinkles on the breakfast buffet spread. 

 When vacation ends, and the dust settles, and I ask my kids what they loved about our trip, I’ll never forget their favorite reply, “Being with my family”. When I ask them at the beginning of summer what they most look forward to and they remember with such excitement their last summer adventures and they yell, “cabin week!” “Chicago!” These are the ways I know that all the stress, all the chaos, all the unenjoyable corralling, mishaps, sideway glances from other travelers was well worth our energy. All of it. And I’ll do it all over again . . . after I lay motionless on the couch for awhile catching my breath.
I remind myself how amazingly lucky my husband and I are to still be at the stage of life where our kids would rather be nowhere else but glued to our sides. My heart aches knowing this will pass, and so I swallow the urge to growl as I nearly trip over them milling at my legs as I make dinner and I pick up my big six year old babies when they ask to be picked up like their little sister.   
I know it’s hard to understand why this is worth it when you aren’t in the trenches of parenthood, but to my hotel neighbor mom, I salute you and your never wavering 100 decibel voice. You and I know this is all worth it.  

Life Preserves 

In day to day life, you learn what makes your friends tick. How they may simultaneously cringe and gasp with laughter at that awkward moment you had at work. How they might react to the car that cuts in front of you in traffic. What they might say to that rude teenager loitering at the mall by the “No Loitering” sign. How they will listen and reassure you on a particularly frustrating day.
This is the day to day, and reacting to day to day is easy. We’ve all done it before. Most of us, 365 days a year, excluding leap year. No big deal. Your friends are your friends because you have grown accustomed to and like the way they react to the day to day. It’s all very relatable–often comically amusing–this day to day.
Until it’s not about the day to day. Until it’s about what stops our day to day. Something that unexpectedly takes your breath away in a way you were always too afraid to even dare imagine. A miscarriage. A divorce. A death. A terminal illness.  
This is not the day to day. It is an upheaval. A make-your-world-spin despair. A hollowing of your every comfort and warmth.  
What happens when this day to day is replaced by suddenness? The intensity of pain from the inside out?
Everything and everyone you touch whirls with you. 
“I don’t know what to say.”

“I don’t know what to do.”
Friends stand dumbfounded in the smoke cloud that erupts around you.  
Some avalanche forward, too carried by the momentum of their own day to day, forgetting to stop and notice that you have fallen out of stride.
Some slow down to see the roadside crash with a sympathetic sideways glance, perhaps mouth, “Are you okay?” as they slow but never stop.
Some come to a simultaneous, sudden hault. Everything they are carrying falls out of their grip, and they rearrange to make room to help carry what has fallen out of your grip. They may not entirely be sure what needs to be carried or even what to say, but they open their arms with the utmost certainty. They are alongside you with purpose. As present as if it was another day to day. Your detour is their detour and they patiently wait.
As they ease in alongside you during this crowded, chaotic time, you wish there was more than thank you. They may feel awkward. They may feel it isn’t enough, but it is more than enough. In fact, exactly what they have to offer is exactly what you need. Because all you need at this very moment is those you care about being the people you love, right there by your side, as you try to pivot through the darkness. They are there to steady you. To remind you that the day to day will carry you along when it feels a lifetime away and today feels heavy and breakable. 
As we move from our lowest points back above water, these loved ones are our human life preserves.
It doesn’t have to be much–a card in the mail, a text message to show you are on their minds, a thoughtful delivery showing support, an offer of cooking a meal–these keep you lifted at a time of grief.  
As I try to find my way back to the day to day, it is these friends that have stopped to be alongside–my human life preserves–that keep me afloat.  
Thank you is entirely not enough. 


He was a Russian exchange student that had come to our high school at the beginning of the year. He had a tough time assimilating and most of us didn’t make it any easier. With his thick Russian accent, his style that was different than the trends at that time, and his general different understanding of cultural norms, he was just different. He walked an uphill path, making few friends, encountering more students that made fun of and bullied him. I wish I could say I was among the brave few that stood by his side and befriended him. I was not. I was one of the students that stood aside, my heart silently breaking for him.

I didn’t know much about him. I’m not sure I had any classes with him, but I knew he was one of the kids that just didn’t have it easy our senior year. When it came time to announce the homecoming court, it was the usual suspects. The girls and guys that you knew were the most popular. Except one. The Russian exchange student. He had been nominated. As a joke.

It put a pit in my stomach. I couldn’t believe that we could come together as a student body and unite to show our mean streak. Our ugly side. I felt helpless and in disbelief at the same time. How could we team up against one struggling student? But who was I to do anything about it? What could I do anyway?

It seemed to unfold before my eyes in slow motion. Was this really happening? It was really happening. How could the star students of our high school stand behind this? Think this up? Think it was funny? My heart silently broke more and more.

What I will never forget is how he responded to this cruelty and bullying towards him. Someone asked him if he was going to go through with it. He asked why he would not. “You know it’s a joke, don’t you?” “I know it’s a joke. It’s a joke to them, but not to me. But what did I do? Nothing. I’m going to live it up.” He accepted the nomination. He held his head high. And he joined in all the court activities, with his head raised high, standing firmly on the ground he deserved.

I can’t remember who ultimately won the title of Homecoming King. I remember how a class of students rallied and showed their snarling teeth. I remember the ache of feeling his isolation. But worst of all, I remember my silence.

This was a story of how one single exchange student was bullied. But he was not the weak one. He was never the weak one. He showed us all that he was better than all of us with his bravery, with his grace, with his head held high. We were the weak ones. We, that rallied behind a mean-spirited joke. We, that stood in herds, silent to it all.

What could I do anyway? How could I have stood up to something I knew was so wrong? I was just me, and I was no one to be known. But now I realize that I was wrong. There are so many things I could have done. Now, I realize that not everyone has to react in the same way. Some may publicly and loudly protest. Some may engage in heated discourse with those with whom they disagree. Some may work more quietly, befriending and standing by the side of those that need it most. Some may commit to public service. Showing solidarity in all forms from all perspectives is necessary. It is desperately needed. I know that now more than ever.

I regret and apologize for my silence when I could have been so much better; when I could have held my head high and stood alongside another human being that mattered.

I move forward knowing that it is my responsibility to challenge myself the way I didn’t challenge myself then. To show up. To be present. To stand up. I’ll do it in my own way. I hope you’ll find your way too.


Summer Cabin Week

There is one week of the summer that is the best week of our lives. Summer cabin week. We rent a cabin up north in Minnesota like Minnesotans do, and we, as a family of five, unplug from the world, spend long days on the shore of the lake, in the water, on a boat, eat s’mores and egg my husband on to make a better “World’s Best Toasted Marshmallow” than the last. In the evenings, my husband and I kick back with a glass of wine, cheese, and admire the lake or let our inner competitive natures take us to a different level in a cut throat game of Scrabble. Even rainy days can’t get us down. We watch morning cartoons, make bracelets, color drawings, and build legos. It is our week of complete togetherness and pure fun. It is the one week I look forward to the most all year long. Summer cabin week. The best week of our family’s year.

Except this past summer. It had been a grueling fall turned winter turned spring. It was a blurry concoction of muddy distress and gasping for air. I won’t get into the details, but my endurance had been my whimpering crutch to lean on through a difficult season of life. Our weeklong summer vacation was the horizon that I daydreamed about and when I took deep breaths, I imagined smelling the lake air that was just around the corner. But as the week drew closer, my husband and I both knew that we would not be out of the woods of our hard year that was wearing us both down in the worst of ways. And soon, we went from panic to surrendering that our magical summer week would be edged out by my husband’s work demands. Determined to still go, we went through the motions of packing, driving up north and settling into our cozy cabin with the sparkling reflections of the gorgeous lake taunting us from our cabin window. The week of vacation was filled with long, full work days for my husband and full, effortful days for me of trying to preserve the magic of the lake and cabin for my kids. From my kids’ perspective, it was still the best week of the summer. And while I will admit, I still enjoyed the joy of my kids as they laughed and buried one another in the sand, it ground at my patience that here I was, still leaning, trying to stay upright and keep together the fabrics of my family. I tried to hold on to the fact that all things considered, we were lucky to have this trip at all and that the bottom line was that my kids’ memories of our summer week would still be ones filled with happiness. But it was freakin’ hard.

My husband and I are always surprised when people comment on how we “have it all.” Handing off the baton stealthily as we pass one another during all hours of the days and weeks. Him out of town. Me working a string of overnights. Him working long hours. Me working the weirdest of hours. We still choose to manage our kids’ hockey team. I still choose to participate in the PTO at both our kids’ schools. He is on the board of a non-profit charity that helps provide support for legal representation for foster children. I like to bake goods for his office on days off. He trucks the kids along to their various activities on weekends I am working. I love to write on the side. He gets honored with awards and makes national lists of awesome lawyers I disgruntling agree to not share on social media. We plan big parties for our kids’ birthdays. We host evenings with friends. We plan date nights and sneak long weekends away to ski, to our favorite retreats, to Napa, to spend with friends. We plan week-long summer vacations for our family. We make crazy choices to train together for half marathons.

How do we do it all.

I will be the first to laugh maniacally and flail my arms like a rabid animal that we are hardly capable of “doing it all.” Except, most of the time, I’m too tired to flail my arms at anything. If you asked me, we are scrambling to “have it all”, one day at a time, with nothing truly figured out. Our priorities tug and pull at us and bicker with one another to edge out their competition.  We get stuck in the middle feeling like we are watching the construction of an overambitious house made of cards that might blow over at any given moment if one flimsy card is misplaced.

This is something we never trained for when we said “I do.” While I thought I knew when we were dating that my husband would be a good father and partner, I truly and foolishly had no idea what gave me that impression. He could have turned into the worst. So, first and foremost, I am thankful that did not happen.

What makes us functional is our uncanny awareness of one another. We both carry an internal stress barometer for the other. And when the other’s stress is ticking into the red, our ability to take over expands. When the other’s frustration and mood takes a nosedive for the worse, the other is their to lay out the trampoline so when we fall, we bounce and don’t hit the ground. When these safe measures are too late and we do crumple into the ground, we snatch up the super glue and mend one another the best we can with the fiercest devotion to one another.

This is how we make it doable. The to-do’s, should-do’s, already-late-but-still-have-to-do’s catch up and cripple us at times. Those seconds during the day that we are passing the baton are wobbly, we often both come close to dropping the hand-off or colliding, and our legs buckle as we try to run in stride with one another.  But somehow, we pull it together, for one more task of the day, week, month.

It is not easy. Oh man, it is not easy. Our days are infiltrated with irritability, disappointments, resentments, frustrations, misses, falling asleep on date nights. There are demands, setbacks, things we say yes to, many things we have to say no to–however much it pains us to say goodbye to new opportunities in our careers–but we remind ourselves that this is about our family. That this is our ultimate goal. The raising of a family. A marriage, kids, the preservation of love. All this that we are doing, it is about this core unit that we uphold over everything. If the baton is a little wobbly today, and even if we flat out drop it somewhere along the way and have to run back and pick it up, our team efforts will ultimately keep us in forward motion.

All things considered, we make it work because we carry the same vision and ultimate goal: to protect the best part of all of this—our family. We may have seemingly insurmountable days, outright failed days, and make all sorts of wrong choices along the way, but as we pass this family baton back and forth, we will fervently protect it with what we can and shoulder one another the best we can. Cabin week last summer is one I don’t care to replay–in fact, last year in its overall entirety is one I am okay to leave behind–but we are already planning for our cabin week this summer; the kids could not be more excited.

It Started With a Eulogy

It started with a eulogy, as things never start. I listened as my husband spoke about his stepdad. I listened as his daughter spoke about her father. I remember the words that came to me and filled the pages as I wrote about my father-in-law. The same theme resonated: our greatest admiration and adoration of him was his commitment to his family. He gave love to his family, to his friends, to his community with the greatest generosity. It was about his loyalty. It was about his steady support and “I’ll be there for you no matter what” way of living. It was that he would offer you a roof over your head if you needed one, better yet, he would build one for you. And as I wept alone and wept publically at this great man we have lost, I also came to an eye-opening conclusion.

When we honor one another at the biggest events of our lives–weddings, anniversaries, birthdays, baby showers, and yes, even funerals, we honor the person. We honor their character, their connection to us, how they love us, how they fill our lives, whether they make us laugh, whether they challenge us, whether they support us, whether they take care of us. We honor them through our memories that have brought us closer and how they make us feel. We may touch on their accomplishments, their accolades; we may be impressed by what they have done in their lifetime, but this is not why we love them. This is not what they mean to us. To us, they are not a walking resume of achievements, but the soul that beats and fills our lives in whichever unique way that might be.

This has opened my eyes. So much of my life has been about striving. Striving to achieve. To get good grades. To reach my career goals. To always be in the top percentiles. It has always been about the climb, the achievements. I have sought the tangible accolades of degrees, position titles, awards, to prove myself and my worth.

Somewhere along this climb, I stopped myself. I thought about where I was going in this lifetime and why. I made a vow to myself that once I got to my goal of where I wanted to be with my career, it was time to change the course of how I dedicated my time and energy. It would be time to devote myself to maintaining my career goals, and shift my efforts towards what was truly my greatest aspiration and passion. And that is to be a mom, wife, and the greatest center force of my family. A close second to this is to be a loyal and present friend in the lives of those I love like family.

This was no easy shift. Why couldn’t I do it all? All those years in college and medical school, I had been told, “You can do it all. You can have it all. You can have success in your career and you can have success in your family.” I believed it. I believed every word. But as reality has shown me, when you dive into something such as a demanding career, you better give it your all to be the best. And when you give your all to one thing, where is the rest of you to give to “doing it all”? You may have a family, but you also have the support that becomes more and more essential to “having it all.” A supportive husband, supportive parents, a supportive care provider by your side, partnering in this raising of a family. These extensions of you become more dominant, they become a greater and greater force in those aspects of your life that need supporting, until you become the supporting role behind the real presence. And is that okay? Of course it is okay. Every family is a blended family of different pillars, different roles; that is how we have successful, dominating career oriented females and males in our society that we so greatly admire.

For me, this just couldn’t be the story of my life. I had to take a step back. I had to think about the repercussions of saying yes to this committee, to the added honor of accepting a promotion, writing a book chapter for a medical textbook, or a position of more responsibility. When you say yes to something, you are taking away from something. There is not an infinite amount of you to give.

This was tough for me at first, and if I am being honest, it is still something I struggle with to this day. Being entrenched in an environment that encourages you to strive for more, to reach higher, to produce greater things, to ultimately be better in your career and dedicate yourself to the pursuit of excelling, this is what I defined as success. Career success was life success. Life success was the sum of all your achievements. As I watched friends continue down that path, I felt pangs of envy, of resentment towards myself. Why aren’t you doing what they are doing? You could do that too you know. Are you lazy? Are you not good enough? Why are you giving up?

These questions haunted me heavily for years, and at times, still float to the surface and taunt me. But somewhere along the line, I acknowledged what I have known is the core of who I am. What matters to me above all else is not my career, but my family. My husband. My kids. They are my everything. My friends. Devoting my life to being present for them is a very conscious and very active decision I have made. By not “having it all”, I have intentionally created space and time to let my family know that they are what matters. Whether it be by making home-cooked meals, being home to pick the kids up from school and hear about their day, deciding to set up for a surprise, spontaneous fort-making extravaganza after school, baking zucchini bread for lazy weekend morning brunches, bringing homemade cupcakes to my husband’s office, or bringing a home-cooked meal to a friend’s family at her time of need, these are the things that matter.

This is my success story and I define success as prioritizing the people that matter most to me. Being involved in two PTO’s, managing my kids’ hockey team, these are the commitments that I invest in, because by investing in these things, I am showing my kids that they matter. That they matter to me more than any hospital committee or council I could be on.

This is not to say that I believe the opposite is true.  If your path is to to pursue that high-powered career, this certainly does not mean you are any less dedicated to your kids and certainly means nothing about how much you love your kids.  You make the ends meet the way it works for your family, showing them the importance of work ethic and showing them the tremendous value of commitment to your career and your life passions.

I do recognize that when I actively say yes to one activity, I passively agree to take time away from another. I therefore choose my career-oriented responsibilities with greater scrutiny. And the things I can most easily take away from are the ones with the smallest voices, that may not even realize their needs, and those are from my children and even from my husband. They are the ones that won’t provide me with another title to add to my resume, but it is these intangibles that I find my greatest responsibilities.

I won’t lie, some days still get me down and are hard. Surrounded by the high-functioning overachievers that define success that very way I had for so many years when I was achieving right along side them, I can see it in their eyes–they know they are leaving me in the dust. That my success story is a fading one. I have come to realize, this is far from the case. My success story is a blazing one.

My worth is defined by my intentional presence in the life and lives that matters to me most. This may sound morbid, but when those that love me sit down to write my eulogy, I want it to be about my fierce dedication to loving them, about my love and pride for the family my husband and I raised, and how devoted I was to always being present and there for them.

I have sought to re-define life success. Career success is not synonymous with life success. Career success is only a small fraction of what truly matters. My priorities are in order, and I can proudly say, my husband, my kids, my family and friends, will always be my greatest definition of success.

Dear Byron

What I’ll remember most is this uncanny relationship you built with your two-year-old granddaughter. I’ll remember how she would run to you, her full head of flouncy blonde hair, whipping behind her and collapse across your legs, burying her flushed, chubby cheeks in her hands and head into your lap. You were her safety. You were her rock.  
That two-year-old. She is a smart one. Because that’s how we all felt. You were our safety. You were our rock. We all buried our heads in your lap in our own ways. For me, it was knowing every time we had a crisis with the kids–this kid had a fever and needed to be picked up from school when both Joe and I were working, that kid was vomiting and couldn’t go to school today, or someone needed to stay at our house because Joe was suddenly going out of town and I was working overnight, or we simply needed a night out–you were there. Drop everything. No questions asked. I would look at you with desperate appreciation, and you would look back at me firmly, “that’s why we’re here. Stay out longer. You guys need the time.” And I would sigh and breathe and want to cry, knowing you were there to lean on, time and time again, letting me know that being there for us was all you wanted in return.  
What I loved most of all, was that there was no questioning that your number one priority was always family. And most of all, your wife–the love of your life. At the core of it all, you lived your life to love your wife and family and to protect and take care of us all. Every ounce of everything you were went into taking care of us. I remember how when you became too weak to walk across a soccer field, you would drive your wife to her grandkids’ soccer practice and wait for her in the car. I’ll remember how you would rather be out of breath carrying bags than consider having someone else carry the burden. I’ll remember how you shooed me away from washing the dishes every time you saw my shoulders slump in exhaustion after a long day. I’ll remember how you acknowledged what an amazing dad my husband is for stopping what he was doing to help our son build a lego set he was struggling with. I’ll remember how every time without fail, you would put down your fork, and say, “My Doctor told me to stop eating when I was full”, with a wink and a nudge in my direction. I’ll remember how nothing lit you up the way talking about your kids coming to visit did, and how you were looking forward to walking around the hardware store with your son, checking out new gadgets, just like you two used to do. I’ll remember the afternoons we spent on the lake with you–always the driver of the boat–while the rest of us enjoyed a carefree summer day of sun, water balloon fights, and stops at the ice cream shop.  I’ll remember those pork chops you slow cooked over a bed of hot coals–your famous hot chops.  Oh, we’ll all remember your hot chops.  I’m so sorry if you never had Byron’s hot chops.  

You were never one to want a lot. Just your family. Just to feel useful and needed. Just to be able to provide. Just to see your family happy and comfortable. You spoke loudly with your actions what you seldom said with words: I am here for you. Always, no matter what, because this is how I love you–with everything I can offer.  
You have been the ultimate fixture in our lives. Always steady, always there, never wavering. We all leaned on you.  
Our two-year-old continues to ask, “Where is Abba-abba?” And I will continue to tell her, that you are right here in our hearts. Our permanent fixture.  
Byron, you are truly one-of-a-kind. We all miss you greatly. But you have emblazoned your love into each of our hearts.  
Thank you for being here for us, even in these days when you have gone.  
We will continue to love you the way you loved us–with everything we’ve got.