Hell on Wheels

It’s funny… how a person can be out of their mind scared and wildly, ecstatically excited all at the same time. I suppose it’s a little like the feeling you have just before you get married; committing yourself to something totally new, not knowing where it will take you but knowing that you love it and that you can’t imagine your life without it; feeling on the verge of something bigger. This is how I feel in this moment, first ever article about to be published, heading off to my first writing conference, gingerly starting to call myself a writer. I am stepping outside of my comfort zone. My introvert self is tremulous and queasy. Self-promotion is not something that we are at ease with, she and I. But, I feel a compulsion to go… to stretch myself. I don’t do well with sitting still. I need to push and to grow. I need to write and to share. It is healing for my soul. It allows me to pursue my passions. It allows me to connect with other people and hopefully make a meaningful impact on their lives, even if they are not sitting right in front of me in my exam room.

Perhaps it is genetic, this unease with the status quo, this need to do more. My Grandmother, Helen, was this type of woman and I would like to think that I take after her just a tiny little bit. My grandmother lived life to its fullest. Though, from the outside you might not make this assessment. She did not own expensive dresses or lots of jewelry. She did not attend fancy parties or go on extravagant trips to see the world. But what she did do was get to the edge of her comfort zone and jump and that, in my mind, is what living life is all about. She battled her inner nay sayers, those demons that told her that she shouldn’t, that she couldn’t. She was a homemaker and had four wonderful children but she wanted more. She wanted something for herself.

In her midlife, as her kids grew, my Grandma Helen became an artist. She took lessons, pursuing painting and drawing, and eventually had her own space in an artists’ atelier and showed her pieces at local galleries. Putting your heart and soul onto a canvas and then inviting the world to see and judge your work takes guts. She was one of the bravest women I know. She was also, wonderfully, chock full of spunk. She told me once that, in a fit of frustration, she threw a pan across the room at one of her children. While I think she was giving confession in a moment of guilt (she was a good Catholic after all), I love this image of her; angry and frustrated, throwing parenting caution to the wind, letting skillet fly. I have no doubt that they deserved it, whichever child at which her kitchen weapon was directed. Don’t worry, no one was harmed. Fortunately, her aim was not that good (P.S. – I don’t condone violence and throwing things when you are angry. Though, I don’t judge anyone for the daydream of doing so now and again).

Some of my fondest memories of my grandma happened while playing cards at her kitchen table. Over our games of Gin Rummy, she taught me about life and love and the importance of living your dreams. She taught me that Wham Bam Thank You Ma’am is NOT an appropriate utterance when you beat your grandmother in cards (man, was she angry at me and, for the longest while, I had no idea why). She would talk of her younger days, of moving away from her small-town home in Montana during the war and going to work at the air force base in the big city of Spokane. She spoke of parties and dances and nylons and leg makeup. She spoke of the love of a Jewish boy and her regrets that it didn’t work out. She told me that she wished she had married a man whose last name was Wheels because then her name would be Helen Wheels.

She was a woman who lived and loved with her heart wide open. Towards the end of her life, when one might expect a person to begin their withering retreat into dust, she went and found herself a beau. She fell in love. It was a brief but meaningful romance, her love eventually moving away to be closer to his children. But she was never closed off, and all of those that know her and love her have always felt their place in her heart.

My grandmother is dying and I cannot be with her. While it is not unexpected (she is in her 90s), it is so very sad nonetheless. She has been an AMAZING grandmother and I will miss her terribly. Her body and mind are failing. She is on Hospice to keep her out of pain and to keep the hallucinations at bay. I think of her, in this moment of anticipation, on the precipice of something more, because she was a woman with spirit who lived her life with gumption. Though small and quiet, she was fierce. She had a fire in her belly and a drive to go farther. I hope to be just like her when I grow up.

So, off I go. Headed into a great unknown, excited and nervous, hopeful and scared, channeling my grandmother all the way. I hope that I can push my boundaries and pursue my dreams like she did. I hope to come out on the other end a stronger, more confident, and more engaged and connected me. I hope to be the inspiration in others’ lives that she has been in mine.

I love you so much Grandma and I am so lucky to have had you in my life. I hope I make you proud. You have been a wonderful role model and, to me, you will always be Hell on Wheels.


Fighting the Clock

Ok.  I am totally cheating.  I am resurrecting a prior post this month because I just have so many other things on my plate.  I am working on getting an article published and am trying to produce some brilliant ideas to pitch for a writing conference that is coming up (Any time you want to show up, brilliant ideas, I am ready for you!). I have totally been feeling my age lately. The skin is dull, the hair is lifeless, I need to work on some rejuvenation and reinvention.  So, this piece feels timely and appropriate.  I hope you enjoy!


I am trying my hardest not to get old, to remain young in body and spirit. Yet, there is incontrovertible proof that, despite my best efforts, nature is still in control. I have begun to do things that only old people do, or at least what my younger self would have thought that only old people do.

I find that I am staring at myself in the mirror more and more often, examining the changing face of the person in front of me. Fight as I may, there are crow’s feet (It’s so much more pleasant to call them laugh lines) forming at the corners of my eyes. These wild and wiry red hairs are emerging amongst my blonde eyebrows, all of whom seem to be growing at a much more rapid pace. I have somehow developed a fine blonde mustache, which my 11 year old likes to point out to me. I am trying to decide if I am the only one who really notices (other than my irritatingly observant son) or if others are just being kind and I need to embark upon a regimen of electrolysis or waxing.

There are things drooping. These are unmentionable things. I will not speak of them… but you can use your imagination.

I have begun to complain more about my bodily concerns. When did I start groaning every time I get up from a seated position? And when did I start saying things like “Oh, my back.”? I have also taken to having a heating pad attached to some place on my body, 24/7. I find that my friends and I discuss the state of our intestinal tracts more often than is probably socially acceptable. We talk of sweats and mood swings and changing hormones. This doesn’t bode well for the continuation of my youthfulness.

I’d like to think I’m not too stuck in my ways but I do find myself opting for the familiar more and more. Why go to a new restaurant, try a new food, or listen to a new song when you have found what you like?

Also, I take off my work clothes as soon as I get home. I remember my parents doing this and thinking, “Why dirty up more clothes? This must be an old person thing.” Non-work clothes are more comfy, that’s why. And when you are a grown up, at the end of a long work day, you want nothing more than to shake off the mantle of the day and the fastest way to do that is to change clothes.

Another thing I said I’d never do when I was a kid, an action I attributed to being older and out of touch with the needs of the younger generation, was to give “Because I said so” as a reason when asked by my child why something has to be done. “I will never do that. I will always explain my reasoning to my children”, I thought to myself. “After all, they will deserve to get a full explanation.” But you know what? It’s exhausting having to explain every little thing. I try to stick to my childhood promise as much as I can but a simple explanation never seems to suffice. There is always an argument (my eldest son has turned arguing into an art form). Eventually, I give up arguing and invoke the old parental standby. Now, as a parent, I see the brilliance in its simplicity.

I suppose it is inevitable, aging. I suppose I should embrace it as it brings with it wisdom and confidence and sense of self. But does anyone really go willingly into that good night? I’m quite certain I’ll be trying to look 60 when I’m 70 and 70 when I’m 80. Time will still have the upper hand, though. I may fight and complain and ask of her in mournful tones, “Why do I have to get older?”, and she will speak to me in a voice that sounds eerily similar to my mother’s and say “Because I said so.”


Steep Canyon Rangers

From a time before hurry up…
When music played on the front porch and children hid under the floorboards, snickering at their daddy drunk on moonshine and their momma kicking up her heels without care.

From a time of not havin’ much…
When music and kinship and the mountain air and the promise of a distant train whistle meant everything.

From a time when life was simple…
When music was joy, sometimes soft and warm like a lover’s kiss and other times hard stomping and frenetic as if God himself was preaching the revival meeting.

Steep Canyon Rangers rolled into town and our musical worlds were opened up and laid bare. This band from Brevard, North Carolina put a smile on the faces and a whoop and a holler on the lips of everyone there and none of us will ever be the same. If only for a few hours, the world of worry vanished and a twinkle and a spark were put back into the eyes and hearts of those of us lucky enough to be on that train with them.

Woody Platt, the lead singer, a younger Johnny Cash if Johnny Cash wore his Sunday goin’ to church suit and played bluegrass, gave smooth sounds and harmony while tearing up the guitar strings. The hands of the mandolin player, Mike Guggino, moved like the wings of an electrified hummingbird, strumming so fast that, at times, the blue lights of the stage bouncing off the sheen of the mandolin made it look like he had lit a spark. The banjo/guitar player and song writer of the group, Graham Sharp, had a booming voice reminiscent of the Oak Ridge Boys and their “oom boppa mow mow”. His soulful baritone grounded this group who might otherwise sprout wings and fly. The stand up base player, Barrett Smith, romanced the strings and moved across the stage with his love as if in a dance. The drummer, Mike Ashworth, who just so happens to also play guitar and sing, was a wonderful surprise of humor and versatility. Could it get any better? Oh, yes. Yes it can. Nicky Sanders, that fiddle player from Boston, so very obviously born in the wrong time and place, was a gale force wind blowing across the stage. A force of nature. He coaxed from his fiddle a plaintive wail and a staccato squeal and every sound in between. In his notes could be heard the music of the old world… of Italy and Ireland and a little Hava Nagila. Could anyone love their work more? It seems hard to imagine. And all of this, backed up by the incomparable Spokane Symphony Orchestra. It was, truly, one of the best concerts I have ever been to.

So, if you ever get the chance to see the Steep Canyon Rangers in concert, do it. Do it without hesitation. Trust me. You need this… this joy, this love, this celebration of life.

Making Dr. Google Work For You!

Just ask any doctor. You’d be hard pressed to find one who hasn’t had a patient bring in a Google search to discuss their potential diagnoses. Got a rash? Check Google images. Weird dizziness? You might just have vertigo, anemia, pregnancy, a brain tumor, or a bite from a Guatemalan rain spider (okay, I made up that last one). Let’s face it. We live in an Information Age and Google is a brilliant source of information. However, without the medical background with which to put all of these potential causes of illness and disease into perspective, Google can often be a confusing and sometimes frightening place. Doctors and other medical providers are then left to pick up the pieces of this information overload. Not only do we need to spend the precious few moments we have with you providing preventive care and treating disease, but now we also have to help you sort through complex and confusing diagnoses, most of which are highly unlikely, and debunk often faulty information gleaned from chat rooms and non-reputable sites. We providers get frustrated. We gnash our teeth. Our ire rises. We curse Dr. Google under our breath. We buy mugs that say “Please do not confuse your Google search with my medical degree”. But I’m going to let you in on a little secret (and I might just get kicked out of the club for this one). Doctors also use Dr. Google. Gasp! Shock and awe!

Come on… Don’t judge. Google is, hands down, the fastest way to find any information we need. Side effects of Hydralazine? Nomogram for an elevated bilirubin? Algorithm for working up adrenal insufficiency? Just search Google and Bam! Two seconds later and the world of science and medicine is at your fingertips. The difference is, and this is an extremely important difference so listen up, doctors know which sites to rely on as reputable and factual, and which to ignore. Did you get that? Out there, in the Googleverse, there are both good sources of information and bad sources of information. You just have to know which ones to trust.

So today, class, we are going to learn how to differentiate reputable from non reputable sites for gathering accurate and well founded medical information. There are just a few basic tenets you need to know.

1. First, look for nationally recognized sources: The Centers for Disease Control (CDC), the National Institutes of Health (NIH), The Mayo Clinic, The Cleveland Clinic, etc. Government funded, not-for-profit, and university sites tend to be trustworthy.

2. In general, disease specific sites are also reputable: The American Cancer Society, The American Diabetes Association, The Alzheimer’s Association, etc.

3. Medical information is constantly changing so make sure to check the date of the article you are reading or the date of most recent update for the site you are using. Look for the most current sources.

4. Research the author. Are they reputable? Do they have a background which allows them to speak with authority or is this merely an opinion piece made to sound scientific? Do they list their sources backing up their claims and can those sources be verified?

5. If the site is trying to sell you something, be skeptical. As much as possible, you want to look for sources that are non biased and don’t have a conflict of interest. If an online medical practitioner or site is trying to sell you their products, they are inherently biased and you need to move on.

6. Please don’t believe everything you read on Facebook (no offense, Facebook). Just because a friend of your mother’s neighbor swears by an essential oil to cure cancer or is claiming that X vaccine has been linked to infertility or that Y supplement is great for weight loss and is totally safe, doesn’t make it true. Before you start that miracle cure or supplement, please talk to your medical provider. Let them help you make sense of all those claims and help keep you safe and healthy.

Well, that’s about it. It’s pretty simple really. Pick your sources wisely and discuss any questions or concerns you have with your medical provider. And, if something sounds too good to be true, it probably is. Google can be an amazing tool for learning, for patients and doctors alike. But, as with any tool, we just have to know how to use it. We, as medical providers, may grumble a little when the Google search shows up during our office visit but we shouldn’t let it frustrate us so much. Our job is to educate and that is what Google is allowing us to do. After all, the origins of the word “doctor” come from the Latin word “docere” which means “to teach”.

Yep. I looked that up on Google.


Flu Vaccine 101

So, I feel like I spend hours and hours every day (this may be a slight exaggeration) talking to people about the flu shot. I guess by this time of year, when we are in the full swing of flu season, people who are already convinced of the vaccine’s importance have gotten it and those that I’m seeing in my clinic who haven’t gotten it are either just late to the game or truly need some talking through the facts and fictions about the flu shot. So, in an effort to get the word out more universally, I am going to distill my flu vaccine counseling down into an easy to digest blog. I hope that you enjoy it, find it informative, and will share it with your friends and family. Please spread the word about this life-saving intervention.

First, a little clarification about the Influenza virus. Every day I get folks telling me that they got the flu shot but that they were “sicker that year than ever before”. The flu shot was never meant to be a one stop shop for preventing illness. There are numerous other viruses out there that can cause a flu-like illness that are not the flu. Here is what true Influenza looks like. It comes on suddenly. One day you’re fine. The next day it feels like you were hit by a truck. Your body hurts. Your eyeballs hurt. You have a high fever, cough, headache, sore throat, and fatigue. It lasts, typically… a week. Unless, of course, you have complications of the flu that may linger longer. Also, the “stomach flu” is NOT the flu. This is a viral stomach bug. Only occasionally does a person with the flu have vomiting (maybe a little more common in kids than adults) and diarrhea is not part of the picture. If you’ve got vomiting and diarrhea, you’ve got something else and the flu shot doesn’t help with that – I wish it did. I HATE vomiting!

1. “The flu shot causes the flu.” This, my friends, is false. The flu shot is a killed virus vaccine and, as such, cannot cause the illness it is meant to protect against. Live attenuated virus vaccines can make those with a suppressed immune system ill but not killed virus vaccines like the flu shot. “But I felt so cruddy after the shot”, you say. It is not uncommon to feel a bit under the weather after the flu shot – or any shot, for that matter. A bit of achiness, mild fatigue, even low grade fever is considered a normal response and is just your body’s immune system kicking into gear. It is NOT the flu. Trust me. The flu is much worse. Scenario #2: It takes 2 weeks before the flu shot even works and it is possible to be exposed to and contract the flu in that 2 weeks when you are not yet protected. This is why it is SO important to get your flu shot in the early fall. That way, by the time we see the flu in the winter months, your immune system is ready for the fight.

2. “The flu shot is not that effective. It won’t help me anyway.” Au contraire, mon frere. Even though the flu shot is the “best guess” for what strains will be circulating that year and is not always spot on, it still protects you from serious complications of the flu. The Northern and Southern Hemisphere flu seasons are exactly opposite of each other. We look to the Southern Hemisphere’s flu season to try to predict what is heading our way. Some years’ guesses are better than others but that doesn’t mean the vaccine is not worth getting. We know this from looking at data regarding people who died from the flu. The Centers for Disease Control (CDC) looked at all of the pediatric deaths during the 2012-2013 flu season and found that 90% of these deaths had been in children not vaccinated for the flu. And, since the flu vaccine was introduced in 1933, we have not seen a flu pandemic such as the 1918 Spanish Flu that killed nearly 50 million people. The flu vaccine works. Moving on.

3. “I’m Healthy. I don’t need a flu shot. I’ll get over it.” Well, maybe. But even healthy people have serious complications from the flu like pneumonia, respiratory failure, and death. It is true that those with chronic illness, the elderly, babies, and pregnant women are at greatest risk. But remember those children who died in 2012-2013 from the flu? 40% of those kids had absolutely NO chronic illness or other risks for serious complications. And so what if you are healthy and you do get over it? What about all of those around you? What about those you come into contact with out in the world? Shouldn’t we try to protect each other and keep each other healthy as well? You. Yes, you. You are contagious for approximately 2 days before you even have one symptom. And there you are, out there in the world touching things, shaking people’s hands, and spreading germs that you don’t even know you have.

4. “I prefer to get my immunity naturally.” Nope. Doesn’t work that way with the flu. The flu strains change each year. Having the flu one year does not prevent you from getting the flu the next year.

1. You are more likely to have serious consequences from the flu than from the other infections for which we more readily vaccinate. In 2015 we had our first measles-related death in over a decade. By contrast, the CDC estimates that the average number of influenza-related deaths in the 2011-2012 and 2012-2013 flu seasons ranged from 12,000-56,000 annually in the US (250,000-500,000 worldwide). Statistically speaking, you should absolutely get your flu shot. PS – Please don’t use this as reason not to vaccinate for measles or other infections. Vaccination is the reason we don’t have the number of deaths from these illnesses that we used to have.

2. This year, there are two different circulating strains of the flu. If you had the flu before you had a chance to get the flu shot, you should still get the flu shot to protect you from getting the other strain that is out there.

3. There is NO mercury in the flu shot unless you are getting a vaccine drawn from a multi dose vial. And if you are getting your vaccine from a multi dose vial, the amount in one pediatric dose is equivalent to eating one 3 oz can of tuna fish. Not so scary is it? Also, the type of mercury in that multi dose vial is Ethyl mercury (like my sweet aunt Ethyl, not dangerous at all) which is cleared much more rapidly and is less harmful than Methyl mercury (the kind found more commonly in that can of tuna).

4. Everyone needs a flu shot – to protect themselves and their loved ones and to protect those more vulnerable in our community. The flu shot can be given as early as 6 months of age (at which time the vaccine is actually given in two doses spread apart by a month, after that it is one dose per year).

5. In an ideal world, everyone gets the flu shot by Halloween. But it’s not too late to get the shot now. Flu season typically lasts into the spring, some years running as late as May.

So, please protect yourself and those around you. Get your flu shot. And if you have more questions or concerns… ask your provider. Don’t let misinformation and misunderstandings keep you from being healthy and safe!

Mastering The Art of the To Do List

This morning I rose early (early for a Saturday) to get my work done that I had been unable to complete last night because of my son’s basketball game. As luck would have it, I would spend the next 40 minutes trying unsuccessfully to log into our electronic medical record. Following refresh attempt after refresh attempt (intervening time killed by reading emails and scrolling through Facebook), I finally called our IT department to discover that the “system is down” and that they were “working on it.” Hopefully, it would be up later in the day. Now, I don’t know about you but I am the sort of person who is unsettled by things left undone. Having 12 incomplete charts out there, memory of exam findings and assessments and plans fading by the moment, just gets me nervous and feeling like things are a bit out of control. I know, this sounds like a personal issue and I really need to learn to let go. Nonetheless, I was left feeling on edge.

So, in an effort to regain some semblance of control over my world, I reached for my old friend, my trusted assistant. “Okay!”, I said to my husband who was trying to enjoy quietly reading the paper. “Do you know what will make me feel better about this? What will make me feel a bit more in charge?” And he nonchalantly, as if he knows me or something, said, “Of course! You will write a To Do list. And it will start with #1 – work, #2 – exercise, #3 – brush teeth, #4 – get dressed…. It’s the same To Do list every time.”

“Nuh-uh”, I said in my wittiest comeback ever. “I don’t put things like ‘brush teeth’ on my To Do list!” I wasn’t going to let him shame me for my To Do list habit. To Do lists are the foundation of a highly successful life, or so I’ve said to myself during conversations with me.

This got me thinking. Why not set my To Do lists up to ensure success? When life gets overwhelming and the number of responsibilities are piled high on my proverbial plate, I gain comfort and confidence by breaking tasks down into measurable, accomplishable actions. I do not get as granular as my husband proposed, but I do plan out my day, step by step, so that things don’t get missed. I mean, how else is a person supposed to remember everything that needs to get done?

So, I am now planning, and I won’t let you make me feel silly for doing so, to start each To Do list with “#1 – Write To Do list”. Why, you ask? Because in making my To Do list, I have already accomplished my first task! I am winning at my day already! First thing on the list, crossed off! (This is a very satisfying feeling, by the way, crossing something off your to do list. You should really try it.) Success is mine from the moment my day begins. Don’t you think this is a good way to start each day? Why start the day with a dauntingly long list of tasks – especially when #1 (ok, work is always my #1 on the To Do list) is not achievable because stupid technology fails? Now, #1 will always be achievable.

Some may read this and think, “She’s crazy!” But, that’s ok. I don’t mind. I own and cherish my crazies. They make me uniquely me. And, in this case, crazy gets the job done! Now, off to make my To Do list of To Do Lists I Need To Make.

1. To Do – Make To Do list of To Do lists
2. To Do – What to pack for the lake
3. To Do – Lists of writing ideas
4. To Do – How to keep child #2 focused and on task  (encourage use of To Do lists)

The Church of Sunday Morning

Some people look forward to Sundays as a time of communion with the Lord. They get gussied up to greet God and their neighbors, they enjoy a bond with fellow parishioners, and they find peace and solace in bowing for prayer and gratitude. Don’t get me wrong. I look forward to these things as well (though in my house “gussied” is all relative – if I can get my kids to wear a pair of pants without holes in them, it’s a success). I do truly cherish that hour of quiet reflection that church offers. But what I really look forward to on the Lord’s day, what brings me joy and hope and restores my faith in humanity, is the news show Sunday Morning.

Now, if you don’t already know about Sunday Morning on CBS, then listen up! It is one of the best news shows around. It has been on the air since January of 1979 and I figure I’ve been watching it almost since the beginning. Growing up, my family did not go to church so our Sunday morning ritual became turning on the TV and watching the estimable Charles Kuralt take us through homespun and national news stories. He guided me through some of the most historic events of my lifetime with honesty, integrity, and humor. While the nightly news was always full of doom and gloom, enough to make a child wary of the world, Sunday Morning never failed to bring brightness and hope.

Perhaps it is the fact that it is airs on Sunday, a day set aside for rest and appreciation of God’s gifts. Perhaps it is its ever-changing sun, the symbol of Sunday Morning, that offers light in the darkness. Whatever it is, Sunday Morning brings us something special. And even as hosts have changed over the years, Charles Osgood and now Jane Pauley taking the reigns, the essence of the show is unwavering. It seeks to educate and to celebrate. It offers us weekly glimpses into the arts, culture, and the kindness in people’s hearts. It seeks to discuss the issues of the day in an open and unbiased way. And it always ends, with what has become my favorite closing act to any show, in a moment of nature. One moment of serene beauty where you can hear the birds sing, hear the wind blow, hear the rush of a mountain stream or the bellowing of a bull moose. And there you are, in that grassy prairie or on that mountaintop, in the middle of God’s most beautiful chapel.

My children now watch with me on Sunday mornings. We curl up together on the couch, still in our PJs, before it’s time to start getting ready for church. We watch stories of hope and love and passion and faith. My heart is always full at the end of the show and I have usually shed a happy tear. In a world where we are constantly bombarded with the negative, Sunday Morning is a glass half full.

Thank you Sunday Morning.

A Hidden Epidemic

In my first job out of residency, I worked with another new physician.  Let’s call him Bill.  Bill was a warm, caring and generous, but highly anxious, person. He worried about everything: every patient he took on, every decision he made, every lab that was even remotely out of range.   My partners and I also suspected there were things going on in his personal life that were troubling him but we wanted to remain professional.  We didn’t want to pry or to make him feel uncomfortable.  We figured he was just like many of us… trying to sort out his new role as physician, finding a way to make it fit into his life.  Then one day Bill didn’t show up for work.  We contacted his family, who lived out of state, and they hadn’t heard from him.  Later that day, Bill’s body was discovered in the river.

In our last all provider meeting, we discussed the new regulations requiring health care providers to have a certain number of hours of training regarding suicide.  As the requirements and options for training were being laid out, I couldn’t help but think of Bill and of our medical profession as a whole.  The figures are frightening.  The equivalent of nearly 2-3 medical school classes of physicians die by suicide each year.  Male physicians are about 1.5 times and female physicians about 2.5 times more likely to die by suicide than the average person.  Not only do we need to undergo training for suicide risk detection and prevention for our patients, but, it seems, we desperately need it for ourselves as well.

The role we have chosen for ourselves is difficult.  It has many rewards, of course, but it also can take its toll on self and family.  As a group, we tend to be harder on ourselves than we are on others.  We hold ourselves to sometimes unrealistic and unhealthy standards.  We are excellent at delayed gratification and dedication to others before self.  We want to please and have a hard time saying no.  We put our lives and families and finances on hold to complete our training and to build a practice, only to be met with what sometimes feels like a lack of appreciation for our efforts.  And the ultimate goal of our calling, the development of a close and caring relationship between doctor and patient, is eroded by the seemingly endless administrative duties which are taking over our day-to-day lives.  And if we do ultimately feel like medicine is not the right place for us, we often feel stuck  – without other skills, saddled with huge debt, and lacking time to pursue other options.

We need to begin to care for ourselves as we care for our patients.  We would never suggest that our patients work 60-80 hour weeks, skip meals, get too little sleep, defer family time for more hours at work, take only a few weeks of maternity or paternity leave, etc.  This is not a humane way of living and it is unsustainable.  We need to support each other as coworkers and in an organizational capacity in pursuing quality of life in the workplace and at home.  Our emotions – all of our emotions – are not weaknesses.  They are part of what makes us human.  We need to acknowledge this as a profession and work to get rid of the stigma that surrounds mental health issues in healthcare providers.  And, finally, we need to be there for each other if one of us is struggling.

Some of us worry that reaching out for help would be an admission of weakness or would signal to others an inability to practice in the best interest and safety of our patients.  So we don’t reach out.  Many of us have long office hours and spend more hours after work completing charting and don’t see a time to be able to attend counseling sessions.  So we don’t reach out.  But we have to find a way to break down these barriers to care.  Below are some of the resources available to us that are confidential and will work around our hectic schedules, we just have to be willing to get started.

None of us can travel this road alone.  If you are struggling, please reach out and let someone help you.  After all, wouldn’t you do the same for another in need?

·        The Spokane County Medical Society (SCMS) Foundation offers a Wellness Program which is staffed by psychiatrists who specialize in treating medical professionals.  There is complete privacy and confidentiality (providers are referenced by number only and providers can either choose to go to the psychiatrist’s office or there is a separate room with a separate entrance at the SCMS offices that facilitates anonymity).  For SCMS members, the  1st 8 sessions are free.  Sessions are contracted at lower rates for non-members.  Mental health providers are available 24/7 by pager and can be reached at 509-720-6000 (if not immediately available, a message can be left which the recording states will be returned within 10 minutes).  You can find out more about the SCMS Foundation programs at www.spcms.org.


This Is Me

This is me.

I am Doctor, Mother, Wife, and More.

I am Confidence Keeper, Amateur Counselor, Health Promoter and Sickness Healer.                       I am Patient Protector, Part-time Teacher, Dream Inspirer and a Sometimes Friend.

I am Meal Maker, Homework Helper, Heart Healer and Expert Worrier.                                             I am Story Teller, Back Rubber, Booboo Kisser and a Tucker in Bed.

I am Travel Planner, Errand Runner, Special Maker and Photo Taker.                                                   I am Memory Maker, Party Planner, Love Giver and the Keeper of Kin.

I am Shower Singer, Daydreamer, Nature Lover and Wannabe Writer.                                                 I am Cause Fighter, Alone Time Hoarder, Age Defier, and the Fiercest of Friends.

This is me.

And who are you?

I Rise Early

I rise early, hoping to steal some time alone with my thoughts.  It’s quiet at the lake in the morning… except for the symphony of sound.  The honking of geese miles away bounces off the mountains.  Squirrels titter in the trees.  There are high-pitched squeaks and guttural whale-like sounds, forced from adjacent docks as they rise and fall with the lapping of the lake water.  The bees begin their gentle hum.  In the distance, a bird calls but there is no answer.  A car engine breaks the silence, then quickly fades away.  Even in the stillness there is motion. Nature is an early riser, just like me.

The lake smells of smoke this morning; like a thousand campfires left smoldering to ash.  Yet past the smoke, or maybe underneath it, there is a freshness, a clean smell; something subtle that you can’t quite put your finger on.  Had I a better nose, I might smell the sweetness of flowers growing in the planters below or the piney scent from the surrounding trees.  But the only thing wafting my way this morning is the smell of coffee.  Lights are on in the cabin. Someone has turned on the coffee pot.  My youngest son, now awake, snuggles up on the couch in a cozy blanket as I grab the few remaining moments of quiet… before the rest of the world awakes.

Even now the light is rising, as if on a dimmer switch in reverse.  The mountains become clearer on the horizon.  Smoke from distant fires layers across the treetops and blankets the sky.  A slight breeze picks up, creating tiny ripples on the water.  A lake otter swims alone along the shoreline.  Boats begin their journey across the lake, white tails of water trailing behind; fishermen in search of that perfect secluded spot to catch their prize.

As my senses are gently coaxed awake, I wonder…. Do night owls, late to bed and late to rise, find the same quiet and peace in the nighttime?  When they wake, in the height of the day, do they wake to an assault on the senses?  I cherish these early mornings and their treasures of sight and sound – these moments with Mother Nature, before our busy days begin.