Return on investment

December 30, 2017

“Own your mistakes; lend your successes. They will come back with interest. And remember to call your mom – then put the phone down,” said Jason Zweig of The Wall Street Journal.

Own your mistakes.

I currently live in a world and work in a profession in which admitting my failures and mistakes is taboo. Keep up pretenses at all cost.

I recently failed to match to fellowship.

It has taken me the better part of working these long cold December nights to pick up the broken pieces of my ego, reconcile the outcome, and acknowledge my failure reflected back to me. There are a million reasons I could make up to frost the truth; none of which allow the vulnerability of my bared soul.

Lend your successes.

I ran varsity cross country in high school, graduated with a 4.2 and in the top 1% of my class. I got an BA in Humanities and mastered French. I have skied mountains and mastered the slalom water ski; I have sailed the 13 foot boat in the great northerly afternoon wind, and surfed the Nicaraguan coast. I am a doctor and a pilot. I lead committees and have won teaching awards.

I’d take credit for those things, except I had substantial help along the way with luck sprinkled on top. While those titles may come after my name, there is a list of credits that rolls at the end of those accomplishments. It is the conversation in the middle of the night that often inspires and redirects me, one that requires the investment of others in my journey.

Put the phone down.

I keep searching my social media apps for the answers to the questions in my soul or opportunities to fill the pending void. My battery wears out quickly and I miss the world around me as I desperately seek something better in the glass screen.

They will come back with interest.

Investing is risky and not without the possibility of losing big. To love at all is to risk one’s life which has the potential to be the costliest mistake of all. Perhaps Mr. Zweig is correct: reward comes with BOTH acknowledging mistakes and bestowing recognition with achievements.

With a new year is at my threshold, I seek to own my mistakes, lend my successes, and await that return on human investment.

we lament

August 13, 2017

We lament.

After a long, hot, southern, summer August turned bloody. Discourse flirted with violence. Festering systemic racism boiled over into the heresy of shouting voices, creating a cacophony of confusion and a wake of destruction.

And violence came; thrown heavy with thick clubs and parking garage levers. Violence came preceded by a flag symbolic of freedom. Violence came with torches in the night. Violence came with a speeding car into a crowd: a lynching.

A town birthed by a Founding Father has survived the two wars: one for a nation’s independence and the other over Lincoln’s “A House Divided:” political, economical, and moral division. Steeped in complex, tumultuous, sometimes ignoble history, remembrances and relics placed around town tell the storied passage of time. More recently known for its sophistication, education, and opportunity, it has enjoyed its isolated bubble, which burst on a bright Saturday afternoon revealing wounds that run deep.

Is it just the statue or the ground beneath where it sits? Does it matter where it rests or does it matter what it means? How do we remember without recreating? How do we honor without condoning? How do we keep fighting this civil discord?

The talking heads flocked (after reaching for a map) giving myopic commentary framed by their camera lens and their interpretation of history and symbolism. They will soon pack up and leave town, on to the next catastrophic headline. And in the wake battered and bruised, we are left to pick up the pieces.

In the midst of chaos and violence those sworn to protect the residents presented an immovable force. State and local police, with the backing of the National Guard, stood in the gap while the surgeons and physicians absorbed the injured; treating the patient in front of them. 

I am baffled by the phenomenal trust that, in the stupidity of inciting violence, law enforcement will sacrifice to protect you, first responders will be there to transport you, and medical professionals will be there to save you; regardless of your ideology, your skin color, or your heritage.

As a privileged, single, white, woman from the west coast - an outsider – I have attempted, over these past three years, to understand the history I never learned, and the culture I never experienced. I have found a people longing to love their neighbor and a community working to cross the divide. We did not seek nor incite the heresy and violence that slithered in.

And yet hope rises from the ashes. Hope that this will be the last civil discord we fight. Hope that tomorrow we remember.

We hope.

the middle space

June 5 2017

A brief reprieve last night; no new patients needing the intensive care unit. Initially I did not know what to do with myself as the past three weeks have been like racing the Indy 500; unrelenting laps around the unit at high speeds tending to the critical needs of desperately ill patients. In the midst of the chaos I found comfort in the chime of the monitors and the whir of the ventilators.

As the sleepy sun rose behind saturated clouds dropping ribbons of rain to the well-trodden earth, the quite morning was sliced through with the sharp screech of the pager directing my next steps to a patient’s room where he had stopped breathing and was without a pulse. Despite a well-run code, he ultimately passed away; my third death in 48 hours.

I then signed out my pager, walked to my car, and drove to my apartment. Away from the monitors, IV infusions, and vents I become surrounded by the mundane of a broken dishwasher, piles of laundry, and clogged drains. Despite my 30+ years on this earth, I know nothing about an automatic dishwasher except when I turn it on it cleans my dishes. This particular morning I am unsure how to navigate the space between telling a father his son is dead and fixing a dishwasher. How am I supposed to walk these incongruent worlds of managing disease and managing a home?

I recently experienced a challenging day in clinic at the end of which I questioned whether or not I was good enough for this career at which I have been practicing. As I looked back over that chaotic afternoon, drained of any hint of energy, I realized there is not enough of me to meet the needs of patients and nurses and techs and nursing assistants and co residents and attendings and admin staff. I do not know how to button up that 30 minute visit in a nice package with a billing code and follow up directions. I do not know how to put human suffering in a tidy electronic note, signed and cleared from my in box. I do not know how to comprehend my daily experience is not unique, rather is multiplied over thousands of residency programs and other hospitals across the country and hundreds of thousands of medical centers around the world.

There is this hot topic up for debate in the world of medicine regarding wellness and burnout. Some have suggested it can be tempered with a week-long recognition during which there is free ice cream and soda. Others think it can be solved by restricting work hours, and still others hope it can be mitigated by winning points for certain activities followed by bagels and a pat on the back. I would argue these solutions not only fail to improve wellness, they also are counter-productive. How can suffering be licked away with mint chip on an ice cream cone? Points, in my view, only serve to remind me of the long list of things I fail to achieve.  

Perhaps then, “wellness” is found not in free food on a certain day, rather in attention paid to mundane things. Perhaps wellness has more to do with cultivating experiences that provide meaning rather than having it dictated to us. Perhaps wellness is found in that awkward space between disease and the dishwasher.

the legend of St. Valentine

Once I received beautifully gold patterned and rimmed drinking glasses on a random Thursday night; just because. The gesture dwarfed anything I have ever experienced on the designated day of St. Valentine and haunts me on a daily basis.

On this day of recognizing contrived events in the fiction of Geoffrey Chaucer, I sit going through charts, emails, schedules, portfolios, and news articles after a day of sitting with patients: the first of whom was actively miscarrying her second child; her body rejecting the fruit of love. The rest came in one at a time with various complaints of depression, anxiety, obesity, fatigue, and pain; prolonged soliloquies of human suffering.

I walked out of clinic and drove to my apartment, past all the restaurants full of young and old lovers celebrating each other and their sparkling moments together. People often comment their amazement to me that I remain single; as if my academic pedigree culminating in MD with my private pilot certificate, ski skills, extensive travel history, lack of debt, and family associations were the desired dating résumé. I am starting to think, rather, they are my biggest liability. Who wants the always busy-middle-of-the-class-introverted-Jane-Austen-Reading-afraid-of-commitment-terrible-cook-early-morning-running girl? Precious few. And the ones who sometimes hang around I quickly scare off with my habit of ironing the just-cleaned sheets before making the bed.

In a professional world that requires I be “nice” and a culture pushing feminism, I find myself evermore on the fringes unwilling to take on any stereotype that currently exists which plunges me further into singleness seeking solace on my running trials, freshly powdered down hill slopes, or piloting the Cessna 172. Am I really that intimidating, or unattractive or obtuse or undesired?  Maybe so, but what strikes me, of all the February 14’ths that have come before, this legend of a St. Valentine subverts the value of humanity; reducing it to candies and flowers.

the misadventures of a single life

July 24, 2016

There is nothing like spending time with extended family, their spouses and children to drive home my singleness; the price of my independent life.

This particular return trip East, as I dread returning to my obligations, makes for the logical reach for Aziz Ansari’s Modern Romance: a desperate grasp at understanding my perpetual singleness in age of technology and endless opportunity.

So far some of my dating choices call into question any rational decision making process I have. To be sure, I have dated some wonderful guys and left them for some minutia I built into the Great Wall of China of relationship roadblocks and found safety in singleness once again. But others have been more questionable like dating a former cartel member. No, there was not a Cadillac with tinted windows to warn me. Turns out those guys look like everyone else and wear just as much hair gel. And then there was the psychiatry attending while I was a medical student. Red flags galore, but I zoomed past them at 100 miles per hour keeping pace with the warp speed romance because he was hot, could ski and had a dog.

And Mr. Ansari relays a bon point with his apt analysis of our generation: “we’re in a hallway with millions of doors. That’s a lot of doors. It’s nice to have all those options. But – a hallway with millions of doors? Is that better? Is it terrifying? . . . Today we want a bunch of doors as options and we are very cautious about which one we open.” Yes, Mr. Ansari, a million doors is terrifying.

People tell me I am fun to hang out with and I have friends. I’m highly educated; well, perhaps more aptly, I have spent thousands of dollars on learning, though I venture a guess the jury is still out on how educated I actually am. In all those years spent at academic centers I took for granted the hundreds of people with whom I rubbed shoulders, assuming at some point I would simply run into “the one” and the rest would be history.

Now I spend free time reading journal articles in a desperate attempt to fill knowledge gaps or trying to understand market trends and finance for my obligations associated with my family’s foundation rather than chase after my epic soul mate. Where does that leave me at the end of the day? Too chicken to ask the adorable guy doing the crossword puzzle two seats down from me on this plane for his phone number? Who does a crossword puzzle on a Sunday plane ride across the country? My future husband, that’s who. Alas, we will never meet as the last several years have taught me how to study hard and say very little which now is a practice that seems counter productive.

As the plane touches down and I shuffle off to the next connecting flight, 4 total in this cross country venture, I wonder who might be on that one and what would I say if only this post-modern dating scene wasn’t so terrifying or such a tease.

chasing the moon

April  24, 2016

I chased the moon tonight: across the country, coast to coast. From the Redwoods over the vast farm-lands – those amber waves of grain - to Jefferson country with the battle fields of the British and between our own countrymen. My feet ache from wedding dances while my heart cherishes the hugs of family. A picture is worth a thousand words and it is priceless to be present in them.

I am learning to live in this present moment: to stop my incessant planning and agenda making. I am learning to say yes to an invitation even when I cannot see how the pieces will come together. I am learning, so painfully slowly, in order to have the experience on which to cultivate wisdom, I must first participate in today. 

I’ve had many a conversation with my mentor on what she’s coined the “no agenda” life. It is quite the opposite of this current goal driven culture with its demands on projections, anticipating forward progress, predicting growth, and marking time in 5 or 10 year increments. She advocates in such goal setting this present moment is robbed of its abundance. I hurdle over today in the mad dash for tomorrow and loose the overall race when I come to the finish line a shadow of myself and empty handed – having missed the opportunity to grow in the fullness of each 24 hour cycle.

I am not advocating for throwing out all planning; certainly there is a place for such a discipline. Perhaps, though, as I mark another birthday and look forward to the year ahead of me, I finally lean fully into TODAY and all it has to offer. Perhaps I practice being still in this present moment, rooting deep to grow and flourish such that when tomorrow comes I bring a fullness to bear that was not present before. Perhaps in having no agenda I will find myself once again chasing the moon; thankful I accepted the invitation to be present.

bare soul

My parents divorced and the house is for sale.  The photographs marking the growth of family through the years have left their place on the walls; packed away, forgotten. My mother’s cookbooks no longer lounge on the kitchen bookshelf. The pantry that once fed my siblings and our friends is empty.

In the process my single heart, uprooted, also flaps a for sale sign; casting about to find a home.

Somewhere along the days I have lived thus far I neglected to root elsewhere. Un-tethered and adventurous I had 4 different addresses in the past 4 years. Perhaps I am darting about to avoid committing; fearing I will miss opportunity.  Perhaps if I keep moving, I will out pace the loneliness and avoid its entrapping tentacles. And yet simultaneously my soul longs to be stationary, grounded, to hang my own photos on the walls, year after year, marking time.

How does one live in the space of discomfort: suspended above stability and swaying whatever direction the wind blows? How does one let go of the key that used to let you through the door to your refuge?

And then the still small voice reminds me I am already bought, worth the greatest price. I am whole with the fierce pursuit of my God after my heart; holding me together as the surrounding walls crumble to the ground, the foundation cracked and barred.

And the sun rises again. The trees are gold tipped as dawn breaks. The snaking river glides over the foundational rocks.

I stride into the hospital ready for another day to care for broken and desperate souls that long to find the same belonging as I. We are not that different.