- Be present at work. Be present at home.
- Dream, plan, create—but savor these years of youth & the beauty of your children at this age.
- Stop working—in every sense of the word—when it is time. Stop working to seek approval. Stop working toward worldly updates on Facebook or the Nightly News. Stop looking for eye-candy; stop searching the outside world for self-worth.
- Work because I can and because I love it, but remember why God gave me that work to begin with. Don’t let the red tape become the Red Sea, partible only by miraculous intervention.
Monday, May 09, 2016
I’m lucky enough to love my job. Sure, there are politics—red tape, entitlement, insurance muck to slosh through. But most days, I leave the office genuinely thankful that I’m able to do this.
I have big dreams for my patients. B.I.G. (hopefully ending better than the one & only Notorious). But I also have a family that I adore. The truth is that the smiles may come from my patients, but the substance comes from my family.
My age is a touchy subject in my line of work. I feel it my responsibility to seem mature, knowledgeable. But then again, certifications, letters-after-my-name, & ALL THE SCHOOL LOANS kind of prove those things. I get asked a lot. Apparently some think that I graduated from high school at age 11.
When the question is asked, though, I reassure them that I am old enough to have completed my training. The truth is that I want to throw my hands up & prompt a pop quiz about the first line antibiotic for pneumonia or the molecular pathology of diabetes. I am more comfortable there, in the land of blissful academia. I am more comfortable where someone asks the question and, if I did the work, I know the answer. I’ll write you an essay, draw you a picture, or make you the best goddamned color-coded notecard you’ve ever seen. I’ll even use sparkly gel pens if you ask.
But ask me to hold your hand & sit in awkward silence because you just found out your marriage is broken or your father has cancer or your grandmother is suffering? That is the hard part for me.
I realized, not too long after starting work in the “real world”, the post-residency world where neurosurgeon’s call you by your first name & medical students cower in fear of your evaluation, that I was bad at the in-between. I love this job because I get to solve problems; I struggle when I have to sit through them with you.
The hard truth for me is that both aspects are part of my job—the solving & the sitting. The former is the science. The latter is the art.
I’m slowly learning the brush strokes, the color-mixing, the medium to work on. I’m slowly learning the hand-hold to console, to lean into the emotion instead of pushing it away.
And perhaps the most important part of what I am learning is to leave work at work. To close the office door & shut the laptop to just be done. The science is easy to leave, the sentiment drags behind like muddied footprints on a clean floor.
They say our visual memory is like a rolodex of cards—ready to be accessed, spun, at any time. Every so-often a smell, a look, a sense will trigger a memory of a patient or experience. Most are pleasant & evoke feelings of bravery & peace. Some are not, though; some are bitter & course, grating away at the joy that hangs just overhead.
We’ve discovered the difficulty in the constant grating recently. My husband switched jobs, which is what prompted our move. New field, new perspective, new hope.
We are taught that our jobs matter almost as much as our lives in this country. And as an unfortunate consequence, the lowly janitor (who is really not so lowly at all) feels like his life is worth nothing because of his title.
In Mrs. Hays fourth grade class, as part of our Medieval Social Studies unit, we held a royal knighting ceremony. Our parents made food & set out crockpots & snack trays on top of the paper tablecloths we handcrafted. We made a crown, a scepter, & a long purple cape. And, when the time came, the knight of our school walked in, ready to be given what was royally due. Our Janitor got royal treatment that day. He already knew each of us by name--& from thenceforth we got to call him “Sir”. He was a knight in shining (paper) armor, after all.
The symbolism was lost on me in fourth grade. It now brings me to tears.
So the last will be first, and the first will be last. (Matthew 20:16)
The irony does not escape me that my mind is most comfortable in the pretentious world of academia & my heart is brought to tears at the very thought of it.
As much as hand-holding & sitting through it is part of my job, as much as the diagnostics & the competency is part of my job, learning who I am holds an equal place of priority. Who I am to my patients. Who I am for the unacknowledged important. Who I am with my family.
Sparkly gel pens, pharmacology, & ambitious dreams aside, work for me needs to be something in which I can recognize the value of people & help make them better. It is also a tool with which I can teach my kids about the world. So that they can make it better, too.
Sunday, April 03, 2016
I’ve been pro-Real Food for a few years now. Not strict. Not biblical about it. I still eat grain. I still engage in the occasional pop tart. But our eating habits have changed drastically since 2011—when I was overly pregnant and reading the book, Real Food.
In her book, Nina Planck beautifully outlines a life that is full of foods sourced locally, prepared lovingly, and eaten slowly. It’s a non-extremist perspective of the art of slow food.
Dr. Alessio Fassano has done ground-breaking research in the world of celiac disease and made monumental discoveries about things like gap cell junctions, IGF-1, and gut microbiota. Without too many boring (but beautiful) scientific details, his discoveries point to the fact that maybe the amount of gluten we are eating isn’t good for us. And maybe our food has a direct bearing on our disease.
Our Small Group before we moved was lovely. We called it a Small Group. But really, it was a large group of dynamic people who were, in all senses, our tribe; spunky, life-filled people who loved the Lord and loved us well. And thankfully, it was also full of people who cared about their health. Best not bring oatmeal cookies to group because they would go untouched. A bowl of kale chips, though? ALL OVER IT.
My CME in December of last year pointed to the fact that for a real perspective on food, we need to look at the Metabolic Disease-free history of our world. The Blue Zone Project followed the eating habits of the places on Earth with the highest concentration of centenarians. Combine their findings with the hearty work of Dr. Ornish and Dr. Hazen, and we are left with a startlingly-clear but gosh dangit hard picture of what we should be eating.
First, our relationship with food needs to be one that looks at food as a positive experience—one of nourishment and sustenance. Aside from true eating disorders, most of us (myself included some of the time) probably have disordered eating. We grab the chocolate instead of the carrots, the French fries instead of the fritter itself. Our coffee is drowning in syrups and whip and although our hips may not feel the difference, our hearts know it. Our genes are smarter than we are & they sense the changes, the unhealthy habits, the molecular balance before we’ve even swallowed.
Second, we need to choose vegetables over every. other. (Gosh dangit.) food that exists. Over meat. Over grain. Over bread. Over fruit. Every Blue Zone had a diet that consisted of at least 60% vegetables.
And third, we need to limit meat. Our ancestors ate it a few times per month—usually in the form of fish. They did not have Type II Diabetes. They rarely died of acquired heart disease. They did not have triple bypasses or suffer lifestyle-induced high blood pressure (on the regular, exceptions are always a guarantee). Obesity was almost non-existent. There were genetic cases of these diseases, no doubt, but genetics instead of nutrition played a much stronger hand in their development. Instead, they chose beans. EVERY DAY THEY CHOSE BEANS.
Gosh dangit. Again. And again. And again.
We have a quarter cow in our freezer as I’m typing this. And to be honest, I was really looking forward to a hamburger.
But as I’ve been reminded time and again by the research, food has incredible power. It is the most powerful medicine or the slowest form of poison. Making good choices for my family means choosing foods that are not as awesome to eat as a Wendy’s frosty with French fries.
“The only way to keep your health is
to eat what you don’t want,
drink what you don’t like,
and do what you’d rather not.”
But this year, I’m counting on it being different. I’m counting on food being part of our lives—in a positive and rewarding way. Thankfully, the changes we’ve made mean we don’t have far to go. The evidence is irrefutable. But like all things in life, I’m committing to taking baby steps. Lots of them. I’ll probably walk backwards half the time. But I’ve got my eye on a goal now.
· Eat 80% plants on 8 out of 10 days.
· Eat more beans, less meat.
· Eat slowly, intentionally.
· Linger at the table longer.
· Make better, more consistent food choices.
· Serve better foods and teach our children to find more balance.
· Source foods locally when possible, organically when not.
· Be more intentional about planning regular, simple meals.
· And be more purposeful in trying new ones a few times per month.
Rid the expectation that meals need to be complex, complicated, perfect. I don’t expect the perfect soufflé or stock. We’ll have a lot of fails. I’ll end up giving my kids rice and apples for dinner. But in the midst of all those could have been better’s, I’m hoping for a few home runs.
Friday, January 15, 2016
I’m not going to lie that I stole this list from Tsh Oxenrider. I started her book on my trip, mostly because I’d downloaded it months ago and had already spent my $10 per month Kindle budget. It was just sitting on my iPad, calling my name.
She’s a smart lady, that Tsh. A culturally aware, spiritually rooted, local-food loving mama in Central Oregon. I think we’d get along swimmingly.
It never ceases to amaze me that in my quest toward the movement for slowness, I keep finding more things to add to my list to be a simpler person living a slower life. The irony is not lost on me, folks.
Adopt a cleaning routine.
Have a weekly meeting for budget review and scheduling.
Work out three times per week, walk or get outside the other days.
Make craft activities for the kids.
Look into sign language or Spanish classes for the kids .
Keep the house clean.
Keep the car clean.
Keep your heart clean.
It seems that, in my quest to be better, I automatically equate it with the need to do more. Logic tells me that it is precisely the opposite. The journey in-between, however, is where I struggle.
She wrote this list on page 22 of her book. I wanted to mark it with a flashing beacon and paint it on my pillow. Maybe osmosis will make things happen if I’m not disciplined enough to do it on my own.
One thing was apparent: going with the flow and living like everyone else does not automatically guarentte a slower life. My nudge from God was true; living slower requires living with intention. And to live with intention means to make little daily choices that resonate deeply in our souls—that make sense deep in our being and ring true…
These five slices represented the major categories of our family’s daily decisions:
I’ve adapted it for our own family. Knowing myself, I’ll probably forget I wrote it in May and rediscover it again in November, only to attempt reimplementation in 2017 (by the way, how the heck did it get to be 2016, yesterday it was 1993). But nonetheless, I’m really going to try this time. I’m feeling all sorts of giddy at the power of togetherness we will be forced to have in this new environment. The possibilities are endless and all I want this time around is limits. Intentional choices. Mindful eating. Purposeful spending. Quality time. Margin.
I know we don’t need to move to Costa Rica for that.
(First FOOD, coming soon)
Sunday, January 10, 2016
I’d guess we are about 30,000 feet above the ground now. I’m here, in my pleather seat, plucking away on the laptop keys—just as I would be sitting at my dining room table at home. The fact that I was catapulted into the sky, enclosed in a metal object with wings is totally lost on me.
I’m not sure why I’m writing, actually. It used to be cathartic for me—a release of sorts. I used to find solace in the words, the familiar pecks of the keyboard, the glow of the computer screen after the house was quiet.
It has become something else though: foreign.
As much as I hate to admit it, I just don’t have the drive to write anymore. Which is honestly odd because I have sentences & paragraphs, stories to be told swirling in my head all day. But at the end of the day, when the children are nestled & the floors are wiped (or not, lets be honest) & the dinner is fixed & the lunches are packed, most of the time I feel like I don’t have much more to give—to God, to my husband, to my home, to myself.
It’s what this is, you know—the giving of myself. But it is also for myself—something I oft forget in the bustle of the day. Encapsulated in the drive to get things done is also a desperate echo to slow down. And, as I’ve keenly noticed after packing up our millions of belongings into two mobile storage containers, the drive to have more on a daily basis (I look at Pinterest too, you guys), oddly results in the desire to own less.
This crux—the junction in the road where either something has to change or something else will give—its where I’m at.
We moved—did you know that? We packed up our stuff & drove 130 miles south to Wine Country (in the desert). We are not completely settled (those two mobile storage containers still hold 95% of our belongings), but we are working on it. Housing is more expensive, preschools are more expensive. They say the school districts are better. My pessimism tells me that better schools doesn’t mean the kids are better or brighter or more Spiritually successful. That’s home-grown, I think. And plus, the sunsets are prettier here.
Honestly, I was a bit embarrassed about how much stuff we discovered we had when we moved. Old houses are awesome, except when the full unfinished basement acts as a storage-dumping ground. I could pretend we were put-together upstairs; but it always felt like an episode of Hoarders was fixin’ to be filmed in our basement. Somehow, the pleasure in buying kept overriding the logic that we have enough—in our home, in each other, in our faith. Funny how that happens. Its like Black Friday every day at the Dollar Tree or Target or Goodwill—wanting more & buying more & getting the deals & saving money (but not really because you are still buying)—shortly after expressing sentimental thanks for what you already have. I’m guilty, too.
I noticed an odd pattern, actually; probably akin to dropping spinning plates. Or maybe better: If you give a mouse a cookie. I would let dust bunnies accumulate & intentionally ignore the toys on the floor. It birthed a disappointment with our space, so I would feel the need to leave the house. Leaving the house took me to the coffee shop (I had coffee at home), the grocery store (we had a full fridge), a thrift store (what could I possibly need?), or the Dollar Spot (it’s only a dollar! Right!? …right?!!!????). Then, by some stupid miracle or severe lack of willpower, I would come home with another bag of stuff—snacks or pastries or stacking bins for which I had no purpose. …and having snacks around meant that I would eat them. Following, I would feel bad about eating them, then lazy…& I would let the dust bunnies accumulate & intentionally ignore the toys on the floor.
…Something has to change or something else will give.
And all this rambling finally gets me to January 1. I’ve never been one for “New Years Resolutions”. I think they are corny, actually. I mean, really, every day is a new day. But this year, with all the changes in our lives, I’m feeling a bit sentimental about 2016. It just dawned on me that had we continued our pattern of babies, I would be bursting with pregnancy right now. And for as much as I’m loving having my body back from growing & feeding those babes, I’m a little torn about what is next for us. This move was a big decision. And for the first time in years, there are no major life changes planned. Medical education is over (except for yearly CME, but that’s a treat). Jon is done with higher education. New jobs are settling. No new family members on the immediate horizon.
Maybe this time, “just hanging in the balance”, is purposefully placed right here. Right about the time that something has to change or something else will give we are handed the golden opportunity to make that change. To re-evaulate, re-locate, re-think decisions for our family & our daily lives. And maybe most of all, in a way, to re-define ourselves. Not to abandon who we were before (in lots of ways I liked that version of us), but to recalculate the trajectory we are on, check our proverbial parachutes, & take the faith-based jump into the unknown & the uncomfortable free fall that awaits.
Actually, come to think of it, parachutes & free-falling probably aren’t the best analogies to use when I’m stuck inside a metal tube flying at 30,000 feet.
New Year, here we come.
Friday, February 06, 2015
It took me 11 years and 8 months to get two extra letters after my name. That’s 4,179 days and almost $200,000 to earn the title of “doctor” and get one of those fancy pen stamps that represents the most-used tool for those of us in the order-signing practice of medicine.
I tend to be on the “granola” side of the large gray line in my profession. If we took a not-so-equal split and divided all the healthcare providers into two sides, I’d fall on the “less is more” category that favors conservatism, supplements, nutrition, and risk assessment (instead of the more statistically brained, medication- favoring other group). I tell my patients to eat grass fed beef and sip sparkling water instead of soda. Half of them don’t listen and balk at my insistence that their nourishment actually makes a difference in their health. But I tell them anyway. And I sign off on lab results that show borderline lipid levels because I know that pharmaceuticals cannot change lives and levels as much as healthy habits for most patients.
This week I spent two days with my young kids at home wiping snotty noses and changing poopy diapers. And I also spent three days in my office; I saw over 65 patients and signed my name-with-two-extra-letters more than I’d care to remember.
A beautiful 43 year old with jet black hair and flawless skin sat in front of me with a furrowed brow and concerned look and asked me about her cholesterol. A 58 year old female with advancing osteoporosis wanted to know why she had brittle bones despite her lifetime of activity and healthy eating. I saw a 2 year old and a 92 year old, representing the range of life and lifestyle and living.
In most respects I am a well-trained, well-read, well-educated Family Physician. I subscribe to nationally recommended guidelines in my practice. I use motivational interviewing techniques. I discuss risk assessment and polypharmacy with almost every patient. I believe in intervention when it’s needed and a hands-off approach when it’s not. I believe in the marvels of modern medicine and the old-fashioned art of patient exams. I believe in cardiac stents, laminectomies, and radical mastectomies. I believe in genetics, in research, in bettering the good that we’ve already got in Western medicine. And deep down I truly believe that, just like Loretta Lynn sang in her southern drawl, we’ve come a long way, baby.
Which is why I surprised myself when I didn’t want to vaccinate our kid.
I know about statistics. And I know about disease. And epidemiology. And modern vaccinations. I know about thimerosal (and that it is no longer in preparations). And autism (and the concern over its link to vaccination). And adverse effects. And I know what it is like to see a 4 month old with Pertussis he caught from his grandmother. And what it is like to see a 4 year old lose her ability to walk because she was one of the (very very) few with post-vaccination Guillain-Barre Syndrome.
I also know that needles hurt. And that post-vaccination fevers are no fun. I know sleep deprivation and the mind-numbing exhaustion that comes with crying babies after shots. I know the concern over injecting something irreversible into a clean, pure, breastfed kid. And I know the anxiety that comes with injecting six-somethings AT ONE TIME into an innocent little baby. I know that we live in a country where school aged children don’t die from measles, the County Fair is (usually) an okay place to take your 6 month old, and polio is a thing of the past. I know that, for me, taking the advice of a large governing body (i.e., the Center for Disease Control) is sometimes harder than listening to our own doctor. And I know that my own fears about Ebola and parasite-infested drinking water are piqued more by the pretty newscasters at night than they are from my 13-pound medical textbooks.
I know these things because I am a trained physician…and I am a mom.
My generation of physicians has been spoiled. My generation of mom’s has been spoiled. And the truth is that I have been spoiled, too. We’ve been falsely lead to believe that our own opinions about medicine trump the research, that our own fears about side effects might make them come true, and that the advice of those large governing bodies are filled with conspiracy and ill intent. We’ve been subconsciously convinced that feeding our kids the wrong type of baby food might make them fail kindergarten (it won’t), a cold lasting more than 7 days needs antibiotics (it doesn’t), and leaving your children in the car for 3 minutes while you return your shopping cart might get you arrested (who knows). I’ll readily admit that despite my training and my experience, despite those two extra letters after my name that make me authorized to give solid evidence-based advice to my patients, despite all the studying I’ve done, I still cringe when it comes to shots.
I told my patient with slightly elevated lipids to come back in a year. She doesn’t need the risk associated with medication right now. Lifestyle and nutrition changes might not make a giant dent in her lab results, but it is the best option we’ve got. I told my patient with osteoporosis that we have medication that might help her bones. The medicine is designed to halt the progression of disease. They aren’t perfect medications and they are fraught with potential side effects, but they are the best option we’ve got.
And THIS IS THE TRUTH: When it comes to foods, garden is best, organic is good, fresh is fine. Buy the baby food that is on sale and take your kid to a juice bar with the saved money. Nourish your child.
Put your phone away, get off WebMD, stop reading Jenny McCarthy’s books; engage your kid, play dress up, toot some trains around the house. Invest in your child.
And despite everything floating around the media, vaccinations are good. They are backed in research, statistical success, and positive epidemiological transformation unlike any other public health movement (aside from using toilets, but I think we are beyond that…). I won’t deny the side effects. Or the post-vaccination fever. Or the screaming that comes when your kid is poked. So protect your child.
We vaccinated our kids.
The truth is that most of this argument isn’t about vaccines at all. It is about kids. And health. And very real disease (that has recently made a comeback). And it is about parents doing what they think is best for their kids.
Maybe it is time we all stand in that gray area together. The physicians losing a bit of our objectivity and looking concerned parents in the eye, recognizing that vaccines can be scary stuff. The parents giving up a bit of our subjectivity and listening to educated professionals who care about our kids, recognizing that vaccines are lifesaving miracles…sometimes with side effects. And in the best world, both sides coming together to admit that, although vaccines aren’t perfect, they are the best option we’ve got.
Tuesday, December 16, 2014
I was asked by the Children's Pastor at church to reflect on JOY in Christmas. I had the opportunity to share my thoughts before our annual Children's Program, appropriately titled A Super Christmas where all the little people donned facemasks, crowns, & muscle suits (& sometimes a combination of all three) & sang about our ultimate Superhero, Jesus.
The season seems rushed this year, doesn't it? Thanksgiving was yesterday & now this: Frenzied shoppers, thick traffic, Yuletide Greetings on recorded repeat that narrate the tree trimming & turkey basting; it feels so chaotic.
The season seems rushed this year, doesn't it? Thanksgiving was yesterday & now this: Frenzied shoppers, thick traffic, Yuletide Greetings on recorded repeat that narrate the tree trimming & turkey basting; it feels so chaotic.
I tried to plan Christmastime activities for our two-year-old this year. His favorites are the Chocolate advent calendar & moment of wonder at the first tree-lighting. He is terrified of the Abominable Snowmonster, thinks candy canes are “disgusting”, & can suck our joy up with a straw when his famed bedtime habits have us waking & pacing at all hours of the night.
In the midst of the fruitcake & mistletoe, I feel chaotic too—the inside of me, that is. Adding the hustle to an already-bustling life certainly doesn’t feel very merry. But I call out Holiday greetings anyways, & I sing off-key Jingle Bells & enter my name in Secret Santa’s & raffle baskets, & bring my 4 dozen cookies to a sugar-exchange because I think I need more of this in my life. And besides, COOKIES.
We flip the calendar pages, pop out new chocolate shapes each day of December, & it seems the anticipation rises with the numeric date. Like every juxtaposition in life, the Christmas we, as Americans, celebrate tends to spread on the guilt like thick peanut butter. Or maybe Trader Joes Cookie Butter, because, COOKIES. Matching the rise of anticipation is the breaking off of thrill for this thrashed season; each day that passes slicing off small pieces of my Holiday happiness until, just like the December moon, only the tiniest bit is left on December 25th when I give in & exhale my last exultation.
Isn’t it ironic that the Anniversary of anticipation for the dawn of a New Testament leaves me frantic, frenzied, & emptied?
And isn’t it ironic that the very season that feels so rushed, so hectic, & so diluted took many slow centuries of God-making & mixing & matching & molding. The roller coaster of daily chaos aside, the history books point to a very different holiday, sans the cookies & certainly sans the hurried expectation.
You see, the tale woven throughout the shroud of history tells a tale very different from the frenzy that fills my December. The story is slow, stretches across centuries & finds itself on the fringes of foreign lands & families with Aunt Gertrude’s taste for the dramatic; it weaves a colorful tapestry of obedience & simplicity, always showing up on the edges of cultural popularity & always falling back to the promises of God.
From the heartbeat of Moses to the crown of David, straight through to humble Habakkuk & finally landing in the womb of the young blushing girl called Mary, God’s tapestry is painted heavily with slow brushstrokes & missing every hue of hurry.
Habakkuk 3: 17-18 says: Even though the fig trees have no blossoms, and there are no grapes on the vines; even though the olive crop fails, & the fields lie empty & barren; even though the flocks die in the fields, and the cattle barns are empty, yet I will rejoice in the Lord! I will be JOYFUL in the God of my salvation!
Your cry might be different this year. You might feel that your health is failing and there are no gifts under the tree. Maybe your scans came back positive; and the bank accounts are empty. Like Abraham’s Sarah maybe your womb is barren. You might be tired of studying & these tests cannot be over soon enough, and the heart-hearth is low & the debt is high and the smiles on our faces are fading and our stress is rising and even though it feels so chaotic, I will rejoice in the Lord! I will be JOYFUL in the God of my salvation!
You see, the golden glue in God’s history book writes love-notes of JOY. JOY in the mundane, the miniscule; in the MERRIEST of all seasons. And of course, God’s history book sings a slow song of JOY in the simple mantle & the humble Manger.
He converts our chaos, relieves our rush, & gently nudges in the expanse of stars & the expense of Starbucks that He is who He has always been: a God of reprieve who fastens miracles to dysfunctional family trees & sends smiles and salvation to YOU, His love.
The forever-song of God, the one floating through Eden and whispered to Jesus, is that of HOPE: hope that He will keep his Isaiah-promise & send a savior to bring slowness & salvation to a broken & bustling world. And it is one of JOY: that in the most unexpected way with unbridled compassion he sent Jesus to be tenderly loved as a child.
In just a moment over 75 little feet will walk out here on stage. There will be cameras & Grandmas & tears & waves and predictably, there will be chaos. But just like the rest of history, each of these little souls is part of the tapestry of Christ. The same God of rest that calls us to slowing for this season also wants to teach us to savor his Creation. Closer to the womb than the World, these little lives are going to sing forever-songs to Jesus.
And although there will be chaos, OH WILL THERE BE JOY.
So this season, one draped in commercialism & immersed in chaos, we invite you to slow for JOY. This season, which for so many is stretching & sorrowful, we invite you to the crux of the God who sends love notes to YOU. And this season, the one that is celebrated & anticipated & filled with so many cookies & the echoing songs of centuries past, we invite you to experience JOY unbridled, unkempt, & uninhibited.
Find JOY in these little voices.