Dinner on the porch to celebrate Boards

T passed his Boards!

Thank you, Jesus.

Such a monumental occasion merits a night out to celebrate.

Unless you find out the news at 5:30pm on your way home with four tired kids 

and no babysitter is available.  

In that case, you go to plan B: put tired kids to bed early and get Indian take-out.

Hang a few porch lights, light a few candles, buy a few Izzes,

spring for the palak paneer AND the tandoori chicken,

and you have a veritable feast fit for ANY super special occasion.

After all, we've hoped for and looked forward to this day for years.

What a wonderful way to celebrate.

Congratulations, T.  

He's Done! The Boards of July

Forget the Ides of March.

We've been wary of this month for several years now.

This week, T took his final Board exam for his specialty.

Oral exams are intimidating.  This one is down right spine tingling.

But today, thanks be to God, he is finished.

We won't know the results of the exam for several months.  Even so, there is plenty to reflect on this experience that we have weathered together.  I asked myself so many times over the past few months, 'how can I show love to T as this exam looms?'   T is so cool calm and collected, and leading up to the exam, he rarely complained.  Even so, the preparation for this one was burdensome and exhausting for both of us.  I am always tempted to misread exhaustion as disinterest.  My best plan and surest defense was to keep 1 Corinthians 13 at the ready.  I had to constantly remember that love is patient and kind.  My love must bear all things, believe all things and hope all things.   I could bless his longest preparation days by going the extra mile, lavishing patience and understanding and creating a welcoming, relaxing haven for his arrival home.  If my day had been crazy, it was just all the more opportunity to accomplish these things out of love.  

Exams are hard; so is love.

In the life that T and I have chosen, we must pass the exams. 

But we must excel at love above everything else.

Congratulations, T.  I love you and I am so proud of you.

One year of work for T!

I am thinking...that today is the one year anniversary of T working at his practice.  What a blessing the past year has been for our family!  After so many years of training, we have been so grateful to see the other side of residency and fellowship.  There are certainly challenges in the first year of a medical practice.  But, T has weathered each of them with his signature calm and poise.  When we look back on this first year, I can assure you we won't remember the challenges, but instead the blessings we have received.  T has been home some mornings for breakfast, we enjoy a new norm of family dinners together, T is able to attend school and family events and we enjoy greater free time together on the weekends.  I am also thankful for the way that T enjoys his work with his patients and comes home so happy.  We are grateful for the friends we have made through his practice, the hardworking team members that help him everyday, and the support and mentorship of his partners.  May God continue to bless this path!

Called to spread the Gospel of Life

Although I am not currently practicing medicine, the profession of medicine, and especially the specialty of obstetrics and gynecology, is something I think about on a daily basis.  Not surprisingly, I read with great interest Pope Francis' comments before an international conference of obstetrician/gynecologists at the Vatican today.

I so deeply admire Pope Francis.  I admire the way that he has exhorted Christians to be messengers of healing and mercy, reject a culture of waste, and adopt a simpler life of love in harmony with the richness of Christ's Gospel.

I also care deeply for my friends, former teachers and colleagues who are working as obstetricians.  I appreciate the struggles of the profession, including the responsibility of maintaining a balance of compassionate leadership and faithful service to their patients.

The Pope's loving, encouraging remarks are words that I want to remember.  I want to be prepared to share similar exhortations in the future with friends who need encouragement in their walk within obstetrics.

The full translation of Pope Francis' address can be read here.

"...We witness today a paradoxical situation, regarding the medical profession. On one hand we see – and we thank God – for the advances in medicine, thanks to the work of scientists who, with passion and without sparing themselves, are dedicated to research of new cures. On the other, however, we also verify the danger that the doctor loses his identity of servant of life. The cultural disorientation has affected an ambit that seemed unassailable: yours, medicine! Although being by their nature at the service of life, the health professions are induced sometimes not to respect life itself. Instead, as the encyclical Caritas in veritate reminds us, openness to life is at the center of true development. If  personal and social sensibility is lost to welcoming a new life, other forms of reception useful to social life are hardened. The reception of life tempers moral energies and makes possible mutual help. The paradoxical situation is seen in the fact that, while new rights are attributed to the person, sometimes even presumed, life is not always protected as primary value and primordial right of every man. The ultimate end of medical action always remains the defense and promotion of life.

A widespread mentality of the useful, the “throw away culture” which today enslaves the hearts and intelligences of so many, has a very high cost: it requires eliminating human beings, especially if physically or socially weaker. Our answer to this mentality is a decisive and unhesitant “yes” to life. The first right of a human person is his/her life. He/she has other goods and some of them are more precious; but life is the fundamental good, condition for all the others.  Things have a price and are saleable, but persons have a dignity, they are worth more than things and they have no price. Because of this, attention to human life in its totality has become in recent times a real and proper priority of the Magisterium of the Church, particularly for life which is largely defenseless, namely, that of the disabled, the sick, the unborn, children, the elderly.

Each one of us is called to recognize in the fragile human being the face of the Lord, who in his human flesh experienced indifference and loneliness to which we often condemn the poorest, be it in developing countries, be it in well-off societies. Every unborn child, condemned unjustly to being aborted, has the face of the Lord, who before being born, and then when he was just born, experienced the rejection of the world. And every elderly person, even if he/she is sick or at the end of his/her days, bears in him/herself the face of Christ. They cannot be discarded!

...Be witnesses and propagators of this “culture of life.”...

...Dear doctor friends, you who are called to take care of human life in its initial phase, all of you must remember with facts and words, that this is always, in all its phases and at every age, sacred and is always of quality. And not because of a discourse of faith, but of reason and science! There is no human life that is more sacred than another, as there is no human life that is qualitatively more significant than another. The credibility of a health care system is not measured only by efficiency but above all by the care and love of persons, whose life is always sacred and inviolable."

~Pope Francis, September 20th, 2013

Audience with the International Federation of Catholic Medical Associations

PASS!

Thank you, Jesus,

I passed the last Step of my licensing Board exam!

This afternoon we toasted with pear juice after I got the email.

A toast to the Boards passed!

This was the third and final exam, and after taking all three while pregnant,

I am glad that I won't have to do any of them again.

I have to thank T for his constant encouragement, 

Nana, MoMo and Papa and the many friends who offered up abundant prayers,

little J-Bear for putting up with all the butterflies in my tummy during the two day exam,

Buddy Bear for the practical testing of throwing up on me as I walked in from my first exam day,

and G-Bear and E-Bear for sticking with me through thick and thin, not only during medical school, but everyday since.

Most of all, thank you, Lord, for helping me leap this last testing hurdle. 

Test Week

This week I am taking the last step of the board exam for medicine.   This Lenten season has required a lot of disciple on my part to study, as well as plenty of prayer to keep myself from worrying.  Finishing strong takes on a special meaning for me this week, as I look forward to completing the test right before  Holy Week.

We have been blessed by the support and prayers of Nana, MoMo, Papa and so many others.  Even G-Bear and E-Bear said prayers for the test last night.  When I come home exhausted at the end of each test day, I am extra thankful for T, who has been through this before me and has a hug at the ready.

The Doctor is IN

Remember this guy?

T's first day of residency.

Today, T has been at his new job for two weeks.  Hallelujah!  Sometimes we have to pinch ourselves.  We are so thankful to be entering this post-residency phase of life.

Belated, here is our front step photo from his first day.  I told him he looked very trustworthy, definitely someone to whom I would recommend patients. :)  

As our kids grow up and have their own first day jitters, it will be fun to pull out these pictures, and others like them, and remind our bears in real terms that "we can relate!  We've been there!"

So far, the beginner jitters have been manageable, as T has a great work environment and supportive co-workers.  I have a feeling he'll be hitting his stride sooner than he thinks.

As we round the two week mark, we remember to give a big "Thank You!" to all of our family, loved ones, supporters and educators who have helped our family get to this point.  Thanks to the love and support of so many, T is off to a great start!

A Good Pediatrician

Baby Bear is almost 4 months old, which has me thinking about his four month well-child check.  I reflexively reach for my phone to make an appointment with our clinic in Minnesota, then I remember it would be a bit of a drive and, quite a kick in the pants, it would be an out-of-network visit for our new insurance.  Shoot.


I have only had one pediatrician since becoming a mother.  Janelle Dailey has seen all of my kids since G-Bear was born.  She couldn't get a higher recommendation for me.  As a mom I have learned how important it is to trust and have a good relationship with your child's doctor.

She saw the kids through developmental milestones, cheered me on through parenting and medical school, gave us plenty of tips along the way and tolerated our idiosyncrasies.  Because she knew my kids so well, if one of them was sick, she could tell just by walking into the room.   When they were feeling well, they would light up when she came in the room, and I would too.



One of our last outings before leaving Minnesota was to take Baby Bear to see her for his two month visit (besides doubling his age, he has come a long way since then!).   It says a lot about how we feel about Dr. Dailey that we would all pile in the car for the visit.  After Baby Bear wowed us all, there were plenty of hugs, stickers and snoopy bandaids for everyone.

This week my project is to find a new pediatrician.  There will probably be stickers and bandaids and crayons at our new clinic, but there won't be Dr. Dailey.  Fortunately from her care, I have learned the irreplaceable value of a pediatrician I trust.  That's one thing our new clinic will certainly have.

The Decline Effect

"The decline effect is troubling because it reminds us how difficult it is to prove anything. We like to pretend that our experiments define the truth for us. But that’s often not the case. Just because an idea is true doesn’t mean it can be proved. And just because an idea can be proved doesn’t mean it’s true. When the experiments are done, we still have to choose what to believe."

~ "The Decline Effect and the Scientific Method," by Jonah Lehrer

The New Yorker, December 13th 2011

Have you ever heard of the "decline effect?"  It's a phenomenon that doesn't have an official name, but it is a new, touchy subject in the scientific community and the subject of the above-cited and fascinating New Yorker article.  For us as medical trainees, awash in the realms of evidence-based medicine and scolded so long with the stick of the scientific method, this article was fascinating.  The article tackles a recent baffling trend within science and medicine, in which "all sorts of well-established, multiply confirmed findings have started to look increasingly uncertain," in a way, attacking the veracity of reproducibility and the scientific method itself.  

I know, the article is 7 pages long.  Still, it's worth a late-night read or a long trip to the Powder Room.  Read it, think about it, then come over for dinner and wax philosophic (or not so much) with us about it.  T and I live a good bit of our professional lives in a world where evidence-based, double-blind, statistically-proven science is king.  The decline effect resonates with us because it suggests anew that whether scientific or not, we are all taking leaps of faith, it just depends on where we place our faith.

Hard Days: The Choice

What do you do when someone you love falls on a string of bad days?

We can relate.  This seems to happen often in medical training.

What do you do when your husband hasn't slept more than 5 hours for the past 4 nights?

When he hasn't seen the kids in three days?

When co-workers ask in jest if his wife is jealous of them?

When he gets off work at 10:00pm, his car battery is dead in the 20 degree cold, and the car alarm won't stop alarming after AAA comes to jump the car?

When his alarm goes of at 4:05am the next morning and he still isn't home at midnight that night?

What happens?

Are you resentful when the dinner you made is cold on the stove?

Do you grow weary of parenting as the night grows long?

Do you resent the work, the schedule, the people who keep your loved one away?

Do you let questions creep in and doubt that you're loved?

Do you pity 'why me' and forget how you're blessed?

Or

Do you welcome your loved one and warm up a meal,

and make a safe haven for brief comfort and rest?

Do you speak to your children, when questions of absence arise, 

of daddy's great virtue,

 the great needs of others 

and how working late provides for both family and neighbors?

Do you remember how hard your loved one is working, 

and respect that Good Purpose can be found in the labor?

Do you banish all doubt and resolve to love deeply, 

past the depth of emotion, convenience, exhaustion?

Do you remember the suffering of others, far greater,

are you humbled by Sacrifice for your own failures?

Lord, help me, I will make the better choice.

Tonight, tomorrow,  

for him,  

for me,

  for us,
for them,

  for our witness.

Happily Ever,

Queen B

No Joking

I am on a GYN oncology rotation right now, meeting women facing cancer diagnoses and chemotherapy.  There are many challenging aspects of the field.  I especially find that it difficult to know how to support a patient through such a sentinel life experience, and I am soaking up every good example and role model I can find among the physicians I am working with.

T was telling me that he has worked with a physician who never jokes with his patients.  This physician is an amazingly compassionate, gentle-spirited man and has great relationships with his patients.  The reason he doesn't joke with patients, however, is that he wants them to always be able to instantly trust what he tells them.

This sounded like a good approach to me, but I wonder what others think.  Would this be an approach that you would appreciate in a physician?  Help me become a better doctor! Let me know what you would appreciate.

Pesticides and ADHD...We're buying organic

I buy a lot of organic produce for my family.  The latest issue of Pediatrics just gave me another reason to justify the extra effort and $ it takes me to buy organic produce.

A study just published in the journal found  that children age 8-15 with higher levels of organophosphate metabolites in their urine were significantly more likely to be diagnosed as having ADHD.  You can read the study as published in Pediatrics here.  What are organophosphates?  They are neurotoxic chemicals used as pesticides on many fruits and vegetables sold in the US (also in some residential pesticides).  As stated in the intro of the study, the major exposure to pesticides for infants and children is diet, and children are considered to be at greatest risk to these chemicals because their developing brain is more susceptible to neurotoxins and the dose of pesticides per body weight is likely to be larger.

Does this study conclusively say that pesticide exposure causes ADHD?  No.  More specific studies are needed to establish whether this association is causal and not just an association.  However, the findings do suggest that organophosphate exposure, at levels common among kids in the US, may contribute to ADHD prevalence.

So what can we do about this?  DON'T STOP FEEDING KIDS FRUITS and VEGGIES!  Organic produce is grown without the use of pesticides and is available in many of the grocery stores we buy from anyway.  Plus, the more we as consumers DEMAND organic produce, the more grocery stores will carry fruits and veggies grown this way!  Also, as summer approaches, farmer's markets are a great place to buy produce because many of local farmers do not use pesticides (just ask!).

Do you have to start buying ALL organic?  Probably not.  Some fruits and veggies are (on average) more contaminated than others.  You can learn more at Foodnews.org, the website of the Environmental Working Group or just click here for their handy shopper's guide  (I carry it with me to the grocery store so I know what to splurge on and what to buy regular):

What are the drawbacks of organic produce? 

1. It may cost more  

2. There may be less of a selection of out-of-season produce at various times during the year 

3. You may have to hunt for the good organic produce suppliers in your area.  

I have decided these are small prices to pay for healthier food, and I have also found that by doing a little investigating, I can find the organic produce products I need at very good prices at a few trusty stores in the city.  My favorite places to buy great quality, cheap(er) organic produce:

*Produce Exchange at Midtown Global Market  (they have AWESOME weekly deals)
*Sam's Club!  (Who would have guessed--the best prices on organic salad, spinach, and carrots in the city....now if I could just get them to expand their selection!)
*Rainbow Foods (believe it or not, their organic line is great and very inexpensive)
*Trader Joe's
*Minneapolis Farmer's Market (Open everyday now--be sure to ask about pesticides, then, go get those veggies!)

Big producers of baby food are also providing organic pureed foods now that are generally available at big stores, or I would make my own purees for my kids with organic apples, peaches, pears that I bought from the store.

We can make a difference.  Remember, we vote 3 times everyday with the food we buy and eat.

Delighting in the Simple Things

"And if anyone gives a cup of cold water to one of these little ones because he is my disciple, I tell you the truth, he will certainly not lose his reward." ~Mattthew 10:42


There are so many little details to tend to when caring for young children.  Sometimes it is hard not to feel like the day has been lost in those little details.  Little meals require lots of little preparations, little diapers requiring lots of changes (E-Bear! How did you poop AGAIN?!  I just finished changing your third poopy of the day, and it isn't even naptime!), little hands need lots of holding, little games need lots of clean-up, little fights need lots of patience.....so many little details of the day!

I confess there are days when I sigh at the seeming insignificance of what "little" I have accomplished in the day because of the little details I had to attend to.  It is interesting that the little details that are so import to my children don't always feel very important to me.  Do these things really require my attention?  Wouldn't my talents be better spent doing bigger, more "important" things?

Ironically, I find myself asking myself the same questions some days at the hospital.  Physicians spend hundreds of thousands of dollars and decades of our lives trying to learn the deepest scientific intricacies about lab tests, drugs, treatments, and procedures to help heal patients.  In the midst of trying to provide these healing measures, I have found that many of my patients are most concerned with details that I could have fulfilled for them well even before my pre-med years---feeling cold and needing another blanket, hungry because the hospital food didn't come, thirsty because of the medications they received, lonely because their family is gone for the day, sad because they are in pain.  Do these things really require my attention when I am trying to provide more complex treatments my patients need?  Sure they do.  They matter to my patients.  Because mysteriously, the importance of a detail isn't measured in its uniqueness, its complexity or how much we paid to learn it.  The simple details are important because that is where we spend most of our lives.

One of the hardest things to understand about God is how He can, on the one hand, rule the mighty Universe with infinite power and still keep account of the tiniest of details, like the number of hairs on our heads or what the sparrows will eat tomorrow. Our Lord is, at the same time, capable of the mightiest work, yet cares intimately about my hurt pride, a stubbed toe, or what happened to my neighbor's lost cat.  Yet, because of my lack of faith and perspective,  I can have trouble seeing the significance of the little details of life--I have trouble believing that I will be rewarded for taking time for seemingly "small" services in caring for my children and patients.

So, today let my perspective be different. Jesus, teach me to delight in the simple things.  As I strive to do everything with love, grant me the wisdom to see the significance of the little things and care for them with the same exquisite tenderness that you have for them.

"Do you aspire great things?  Begin with little ones.  You desire to erect a very high building?  Then think first of the foundation of humility."  

~Augustine

Finding other moms in medicine

T found a great new blog for me today: Mothers in Medicine. You can also find it on our "Sites We Like" page.

By far one of the hardest things for me to reconcile in my life right now is my medical path with my life as a mother.  Being E-Bear and G-Bear's mom is the most important job I could have ever imagined, and even better, I love it.  So, how do I mix my medical path with my love of being present for every bruised knee, cooking every bite of homemade mac n' cheese, and mitigating every tussle that ensues between my babes?  I know I am not the only medical mom who struggles with questions like this, but for me, because I am ahead of most of my female peers in terms of family life at this stage of the game, I seem to confront this daily issue head on in a way few of my friends do.  So imagine my delight when T sent me this blog today.  I am already enjoying the diversity of opinions as well as the similar sentiments that I have read on the blog.

This coming year will be full of decisions for us regarding the future of my final stage of medical training--what I like to call the "whether's, where's and when's" of residency for me.  I am sure I will enjoy this blog as I am praying about my decisions.  Even more importantly I am asking God for His guidance and peace, knowing that He not only entrusted my precious children to my care but also knows better than I how much work there is to be done in medicine and how many sick and wounded patients around the world are in need of a loving doctor.  Stay tuned...