Stronger

**I'm thinking that with this at the finish line, I could run as long as I needed to. Photo c/o my talented friend, Tabitha.**

I kissed the kiddos goodnight and slipped quickly into my room to tie my running shoes on.  The final rays of a beautiful spring evening were falling, and I wanted to enjoy them.  I told Rockstar where I was headed, then stepped outside to let my feet hit the pavement.

In contrast to the humidity of earlier this week, the lightness of the air felt positively intoxicating.  I took off in a different direction than normal, and quickly found my stride.

My legs pumped as I headed up a long hill, and I noticed how strong they felt as they glided me up towards the top.  The music on my shuffle blended with the gorgeous greenery around me, and created the perfect stage for my thoughts.

I let my mind peruse issues I've been weighing, and noticed that I didn't have to struggle too much against the effort of my muscles to keep my mind focused.

I turned the corner after one hill, and realized that I had more in me.  I wasn't done running yet,
so I looked for a way to extend the run and keep moving, keep moving.

When I finally headed up the final hill of my run, I noticed that my lungs were not collapsing under the weight of that hill as they usually do.

And suddenly it occurred to me.  A simple truth I'll probably be stunned by again and again:

I'm stronger than I was a month ago.

Spurred on by a race my friend organized in April, I'd decided to try out the knee I'd injured last year.  I wanted to feel strong again.  With my knee cooperating, I'd set a modest goal for how often I'd set out to exercise.  And I've kept that goal.

Now, a little over a month later, I am stronger.  My body can handle those hills differently, can exert itself longer, can enjoy things that seemed laborious a few short weeks ago.

There's still so far to go, but I let myself relish the small victory.

And I reminded myself of the broad application of this principle in my life.

It's so often that way: we methodically push through pain and discomfort to find stronger minds, stronger hearts, stronger relationships.

Then in those moments where we glimpse that we have become more capable, we are spurred on to raise the bar again.  To persist in difficulty.  To be further astonished by our ability to grow, change, and conquer life's inclines.

Mother

This is my mother. Isn't she gorgeous? I wouldn't have minded getting a few more of those exotic genes.

Every year I enjoy the chance this holiday provides to ponder the way that her influence has shaped my life. To think about the things I love best about her.

I have become accustomed to hearing talks at church on this day of the year that highlight someone's supermom. They talk about women who made canning, sewing, raising 11 children, and serving the community look effortless.

But as I think about my mother, it is not any supposed idea of perfection that makes me love her so fiercely. It all she has accomplished in spite of human frailty and life's difficulties that make her a hero in my mind.

When her body would fail her as she dealt with chronic illness, she fell to her knees. It didn't look like weakness. It taught me there was power in prayer.

When her past hurts would surface, she'd look to a higher source for healing, and keep loving her family the best way she knew how.

When she came upon questions she didn't know the answers to, she sought them out.

She was always trying, always growing, always evolving. She wasn't perfect, but observing her process of transformation, taught me how to grow myself: how to fill in my own gaps.

When a mother births her first child, she doesn't suddenly become that sainted figure we often hear paid tribute to.

 And thank goodness. It has been watching my mother fight the good fight: watching her try and fail, learn and grow, love and then love better, that has taught me the most crucial lessons of all.

Happy Mothers Day, to a truly beautiful woman.

Happy Easter!

Easter is a wonderful holiday. I love the traditions, love the season, love the meaning behind it.

Wishing everyone a full heart and a full basket on this Sabbath Day.

Finding the Balance--3

I had anticipated making my way through this 'finding the balance' series a little more quickly. But, you know, life has other plans most of the time.

In the last few weeks, I spent a lot of time dealing with this:


That would be Tiny with peri-orbital cellulitis. She ended up requiring a trip to the ER for IV antibiotics when the oral version wasn't cutting it. And my girl did not cry (or even wince!) when they drew blood or placed the IV. She is so my daughter. And she's all better, which is fabulous.


**All better and livin' it up at the Home Depot!**

And I spent a long weekend with some dear friends. I took all these books with me to read, but why did I do that? Because when I'm around my friends, we never stop talking. I still managed to finish two books thanks to my quiet plane rides. I kept feeling like I should be wrangling a little body into their seat, but, nope--just me and my book. I'm sure husband was glad that I got out some of my talkiness (though he would never let on!).

So, anyhoo. I've been playing catch-up. One 'finding the balance' tip before I dive into kelle hampton's new book.

1)Squeeze good into small spaces: Because time spent at the hospital or clinic can be so draining, it's easy to let that suck the life out of the little time you have that's not at the clinic or hospital. Rage against the machine, my friends. Don't let yourself get caught in the trap of putting off all fun until the training road is done. I've always been someone who relished having something to look forward to. Whether it was big or small, I've liked having a little anticipation in my back pocket. It has added color and sparkle to my days.

That can be a powerful thing during medical training. When you're tired, it's easy to want to hang out with your DVR or a book instead of the friends of yours who are meeting up at a restaurant. Because, you know, that would require wearing something other than scrubs, combined with the scarce commodity of energy. And most of that time, I think it's just fine to skip those things. You do need to rest. You do need to be careful about not stretching yourself too thin.

But you also need to remind yourself that there is still fun to be had along the way.


Rockstar and I were celebrating our 2nd anniversary during my intern year. We switch off surprise-planning them, and when baby status allows for it, we try to make it a weekend getaway. It was my year to plan. At first I felt defeated at the thought of trying to plan something fun into such a chaotic schedule. But I reminded myself about the power of anticipation, and the need to keep living my life. So on one of my Golden weekends (a rare bird where you are post-call on Friday, have Sat/Sun off, then return to be on-call on Monday), I planned a New York trip. It was a whirlwind of restaurants, Wicked, and shopping. Even knowing I had to be back to craziness in 48 hours, we ate it up. It's still one of our favorite memories.

I might've been tired, but I felt alive.

Most of my simple joys were on a smaller scale: McDonald's ice cream cones, live music, walks by the local river, trips to the bookstore, phone conversations with old friends, dinner out.


**inexpensive manicures! (Shellac really does last 3 weeks!)**

Such things, for me, were key to maintaining sanity.

Find something that makes you feel alive and try to fit it into small spaces every once in a while. Have something to look forward to. Make it happen even during improbable times. That's not always easy, but the dividends are rich.

Finding the Balance--2

**Balancing toddlerhood and effortless cool.**

*Choose the right partner. I say this partially tongue-in-cheek, but if you know you are going into medicine, be honest about what that might mean with your future spouse. I had a friend in college whose boyfriend was a little worried about what the medical training road looked like. At the time, I thought it was sort of funny how he did a lot of research, and interviewed people who’d been down the road to decide if he was up for it. I mean, when you’re 21, that doesn’t sound very romantic. Love is love, right? Looking back, I realize how smart he was. He found out what the road would entail for both of them, and decided he could commit to it. They got married and have navigated the ensuing road as a team. Also, if you are both pursuing time-intensive careers, communicate honestly about how you plan to merge those paths, or who is going to compromise, and when. Better some upfront discussions and research than down the road bitterness.

*Take care of your spouse: We've established that the partner sacrifices a lot in the pursuit of the medical dream. But it's important not to become so myopic in that intensity, that you forget there are lots of little ways you can pamper your spouse. A love note under the pillow, a quick phone call, a surprise donut pick-up on your way home--things don't need to take a long time to have an impact. Let your spouse know that they aren't unappreciated or forgotten in the long hours and sleep deprivation. Medicine can make you tired, but it doesn't have to make you a narcissist. :)


**You've gotta love a partner who can find the right anniversary card. Rockstar says those boots are the pre-cursor to Uggs. And I'm totally buying him some. Happy Anniversary to the man who has carried me through many a difficult thing!**


Bonus Round: Here's what I love about the people I work with. After a month of my co-workers analyzing the utter insanity of a certain reality TV show, I walked in one morning to find the following on my bulletin board(both relating to said reality show's finale that aired this week).





It definitely had me smiling as I walked into the first room of the day.

**Thanks to those who left comments on my last post--they gave me food for thought as I write these posts!**

The Balancing Act

**I brake for Saturday morning donut runs.**

You can get sick of anything after eating it enough. And as much as I loved the veggie burgers sold at the hospital I trained at, eating them every 4th night pretty well destroyed their appeal. Only one thing made them bearable: the company I kept while eating them. Rockstar came to the hospital every 4th night for my entire intern year. Whether I had a 10 or a 30 minute break, those stolen moments scarfing down a tired sandwich, kept me going.

I’ve never taken my husband’s support of my career for granted. In fact, it still strikes me as this incredible thing: that he bought so fully into a dream that wasn’t his own.

When I meet young couples, one of whom is starting down the medical training road, it’s usually the partner who I feel sorry for. Because I know how this road demands everything a family has to give, and that’s harder for the person who didn’t choose it. I’ve seen relationships fall apart when the spouse wasn’t ‘all in’ and felt like it was all too much.

Last week I wrote the post below on Interruption. I talked about how the weight and joy of the white coat is that when it’s on, it’s really not about me.


**Spring is here-happy, happy day.**

Reader, Aurora, who is starting out her journey in medicine, made the following comment:

“The thing I struggle with is this: How do I be okay with taking that time away from my son and husband and (essentially) acknowledge, "It's not about me... OR you." It's so hard sacrificing family time for patients on my child's behalf. I see so many children of physicians resent the time their dad missed a baseball game to repair an aortic aneurism or counsel a patient. Where do you draw the line and how do you reconcile that boundary, emotionally?”

These are great and important questions to consider.

The tricky thing about medicine is that for better or worse, it does require a relinquishing of self that not many other professional training roads do. It’s not that other training roads aren’t as or more rigorous than medicine, but medicine is one of the most iconic service professions. There are expectations that go along with that, and they live alongside the reality that lives are always hanging in the balance.

So, what is the trick to balancing family and medicine? I’ve seen it done a lot of different ways. Over the next week or so, I’ll be stopping in to share what I’ve learned along the way. I'll start with medical school and work my way up to attending-hood (what, you didn't know that was a word?)

Here’s one before I hit the sack:

*During those first two years of medical school, be physically present as much as you can. With so much lecture material available in notesets or in textbooks, many students in my med school class skipped some lectures in lieu of reading the material on their own. Depending on what kind of learner you are, this can be an effective use of time, and free up more time with your family. The last two years of med school don’t allow a lot of flexibility in terms of location and schedule, so use that flexibility while you have it. Of course the ideal is to be home physically and mentally. But your physical presence still matters, even when your mind is on pharmacology. Some people can’t study well at home, and I get that. Sometimes my friends and I would study at Barnes and Nobles on Friday nights. We knew it wasn’t as good as library time, but we were getting through some material and also preserving our sanity by feeling like we weren’t locked away at school all the time on weekends. Especially if you have kids, think of studying at home in the same way. Not perfect, but yielding important benefits.



**Shoot for the stars, baby. And when you fall short, that's okay too.**

Interruption

**Target is dangerous. I saw a heart shaped miniature pie-press,and wham-o! How could I not have a Valentine's tea party for Tiny and a couple of her friends?**

Among the many things that can interrupt the mojo of an afternoon of patient care, are fire alarms.

Yep, fire alarms.

Take this week, for example. My patient was all set up for her IUD placement, and my nurse and I were at the ready. I sat down to begin, when I heard a strange buzzing.

"What's that sound?" I asked my nurse.

"I'm not sure--should I check?"

"Yes, just in case it's a fire alarm."



**I think Rockstar's alarm bells go off everytime I walk by the dollar bins. Because suddenly I'm in a haze of, 'it's pink and miniature and ONLY A DOLLAR!' Seriously, though, thanks for the cute straws and party bags, Target.**


Well, whaddya know, it was! My patient was gracious about her sudden, albeit temporary, reprieve from the scheduled procedure. My nurse and I waited outside for her to get dressed. Several people passed us while we waited, and advised us to get a move on. We advised them that it seemed in poor taste to leave without our customer.

We walked out into the (mercifully mild) weather, and observed an enormous group of people--staff, doctors, nurses, patient's--standing together in the parking lot. Commenting on the cold, checking smart phones, wondering if this was 'real'.

I wondered how I was going to come back from what ultimately ended up being an almost 40 minute evacuation (!!!).

Miraculously, things went incredibly smooth once we got back into our office. Patients were understanding, visits were fairly straightforward, and a normal departure time looked not at all unlikely.

My last patient was a nice woman who I've been taking care of for a while. In the course of our conversation, she mentioned some chest pain that she'd had recently. She seemed almost embarrassed to bring it up. "I know I shouldn't even say that word in a doctor's office," she said.


**Say the word 'jewlerybox' to four little girls, and you've suddenly got their undivided attention! Again, thank you to the dollar bins.**


After discussing it, I knew we needed to do an EKG. Since we were down in a satellite office that afternoon, it would take the nurse some additional time to get the machine brought over and set-up. I mentioned to the patient that I wanted to proceed with doing the EKG and she said, 'But you guys have families that you need to get home to! Are you sure?'

I laughed it off and said, "I promise you that I don't base my clinical decision making on what time I want to leave the office.

I left the room and waited for the EKG to be done, feeling grateful for my nurse. She didn't even bat an eye at the delay.

Here's the thing: I'm not going to lie and tell you that there was no passing disappointment when I realized that my family would be waiting an extra half hour for my arrival home.

But the weight and joy of this white coat is that when it's on, it's just really not about me.

And that is the thing that ultimately keeps me going. Because when it's the right cause, giving more of yourself than you sometimes want to give means pushing through to something better. It means fighting fatigue and being flexible to land in that place of satisfied exhaustion that fills you up and lets you know that maybe your efforts are adding up to something bigger after all.


**My girl loves nothing better than to take pieces of this, and bits of that, and turn it into something bigger. In fact, I think she could do it all day long.**