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!

Fictions:
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.

Facts:
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.

Game of Thrones

Well, you know you haven’t been contributing to your blog enough when you aren’t even getting spam comments (such as “I love your blog post! Check out my site for discounts on Viagra). Apparently, I have fallen totally off of the blog grid. It has been a month or more since I have written anything for my blog. I can hear you judging me so you should know that I have been writing other stuff. My writing energies lately seem to be spent on my medical passions of preventive care (please, everyone out there, get your vaccinations) and physician wellness. However, I do admit that my attentions are also drawn toward non-literary pursuits…. Damn you, Game of Thrones.

Whomever wrote and produced this series obviously just didn’t want anyone to get anything done. My husband and I are watching it on DVD and there have been many a day where I want to do nothing else but see what Daenerys Targaryen is going to do with her wayward dragon children or how Arya Stark is going to track down and kill every last person on her bedtime kill list. By the way, has anyone else noticed how the women of Game of Thrones are kicking ass and taking names? You go girls! And then there’s John Snow. He’s yummy.

You know your Game of Thrones addiction has gotten out of hand when your children are complaining that you never spend time with them in the evenings and that you are always kicking them out of the room so you can watch said TV show. I feel kinda bad about this. But obviously not too bad because I continue to do it.

Does anyone else also worry that their neighbors are going to look in their window and think that they are watching porn? We have this big picture window in our family room and I have to draw the curtains sometimes because of all the nudity happening on the screen. Maybe I’m a little prudish but I don’t want people getting the wrong idea.

In younger days, before kids, my husband and I would spend hours binge watching 24, convincing each other that we could stay up for “just one more” and not be too tired the next day. Now, it is one and done. I must be getting older. In my heart of hearts I am young enough to stay up until midnight watching multiple episodes but, in reality, I have to get up at 5 AM and it ain’t pretty around my house if momma doesn’t get her sleep. So, it is taking us a while to get through the series.

We are finishing up season four and I can’t wait to see what happens next! If you are caught up to present day, please don’t give away any secrets. But, I am praying to the Gods, to the old and the new, that Jaime Lannister will fall out of love with his witch of a sister and find love with Brienne of Tarth and that Arya’s Needle will find its way into the hearts of her foes and that The Mother of Dragons and John Snow will rule over the Seven Kingdoms together. Do you see what you are missing if you are not watching this show? But, beware. Start it and your sleep, your relationships with your children, and your ability to get anything done may suffer.

Looking Out The Window

My sister and I sat in the back seat of our giant boat of a car, our mom at the wheel.

This was before shoulder belts. All we had were lap belts and if we loosened them just enough, we could turn and face each other, our backs against the doors, feet sneaking their way, inch by inch, to the other person’s side of the seat.

“Mom,” one of us would yell. “She’s touching me! Her feet are touching me!” Our legs flew in kicks and shoves. Luckily, there was an unspoken rule that no shoes would be worn in such conflicts as this truly could have done damage to one’s shins.

This was also before all cars had air conditioning and it was the middle of a Georgia July. We were driving to the beach, to a little old house on Hunting Island, South Carolina called Mosquito Haven.

It was hot and we were cranky.

A hand reached around from the front seat, waving wildly in search of legs to smack. “Stop it, girls! Leave each other alone and stop complaining! I don’t want to hear another word. Look out the window!”

This was always Mom’s answer to any car ride dispute. “Look out the window.” As if what was out the window was so fascinating, it would instantly distract us from whatever perceived slight had begun the melee.

I looked out the window at the highway passing by. The grass on the strip of land between the two sides of the road was brown and dry. Little patches of red Georgia clay peeked through, cracked and yearning for rain.

Trucks zoomed by; big freight trucks carrying heavy loads, creating a wind tunnel effect, pulling our car to one side as they passed, always with a “How’s my driving” sticker on the back; little pickup trucks, invariably with a hound dog hanging out one side, catching the breeze in its jowls; caravans of military trucks, their passengers in full fatigues, windows down, looking very serious on their way to somewhere important.

The sides of the road held patches of dappled shade, respite for birds and other critters seeking refuge from the heat. The trees were overrun by kudzu which was slowly but surely conquering the plants and buildings of the South. I imagine the war may have taken a different turn if General Pickett’s Charge had been as persistent and driven as that of kudzu.

At spots along the road, little stands of peaches and corn and other summer crops could be found. If we were lucky, we would happen upon vats of boiling peanuts, their salty brine permeating the air.

When we passed the giant peach, a water tower painted up to look exactly like a giant peach, we knew we were a little over halfway there.

As looking out the window slowly lost its interest, the hot wind coming through the open windows would lull me to sleep. I slept fitfully, awoken periodically by the sun pouring in the window, making me too hot and causing little rivers of perspiration to run down my back. I drifted in and out, catching the occasional view of bugs that had the misfortune of getting caught up in our travels; spiders climbing along the half open window until swept away on a highway breeze; bees and gnats and other bugs splattered in all their gutsy glory against our front windshield, their innards making a smear as the windshield wipers tried to wash them away.

Eventually, the smells coming through the window would change. A dank, marshy smell – a mixture of fish and sulfur – would waft in, burning the nostrils awake. The ground changed, red clay giving over to sandier soil, blown in little drifts onto the highway. The trees were smaller, scrubbier; more shrubs than trees. Seagulls would appear on the breeze.

We were close.

Looking out the window resumed. Sometimes, on these trips, my sister and I would play games of “That’s my horse.” (But you could substitute “horse” with any other object of desire – house, boat, car). “Horse” was more often reserved for trips to visit our friends who lived in the country. We would keep a keen eye out for anything appealing and try to lay claim to it before the other one did. I’m not sure why this was such a fun game but it sure kept us occupied for a while.

Soon, we passed over long bridges, with salty waterways below. We saw fathers and children hanging fishing lines over the edge, if the water was close. If we were higher up, we would sometimes pass over draw bridges, smaller sailboats and fishing boats passing beneath. If we were unlucky, we would get stuck on one side of a drawn draw bridge, waiting in the stifling heat for a large ship to make its way through.

As we crossed over each little island in the chain, stopping briefly at the Piggly Wiggly and the fish shop to pick up provisions for our week at Mosquito Haven, excitement grew. Passing onto Hunting Island, we would see the lighthouse in the distance and catch glimpses of the ocean through the heavy foliage.

Finally, we would pull into the long sandy drive of Mosquito Haven, a little house on stilts, just steps from the ocean and I would jump out of the car and run to the beach to get the first feel of sand between my toes. The house wasn’t fancy, and it unfortunately lived up to its buggy name, but it was our escape for the summer. It was a place where life was simple and still. It was a place where we would read to pass the time, and then read some more. We would hunt for sand dollars and sharks’ teeth on the beach at low tide. We would play cards and listen to music on the radio. We would collect driftwood. We would eat fresh fish and drink iced tea and would sit outside on the screened porch at night, listening to the hum of the insects.

I don’t think I truly appreciated these summers until later. As kids, we take such things for granted. As a pre-teen, I felt I was being dragged away from more exciting pursuits and would rather have spent time with my friends. But, like my own teen and pre-teen children, though initially feeling captive to these family activities, I ultimately truly enjoyed the adventure. Mosquito Haven is gone now, victim to the swells of the ocean. I am able to revisit her only through the lens of memory and of yellowed photographs in an album. We made our pilgrimage there every summer for many years and, though the journey was long and hot, I took comfort in its familiarity. Now, when life gets hectic, I think back on our travels and I genuinely miss those times – unencumbered by the responsibilities and details of daily life – looking out the window and watching the world go by.

 

Mom, Wife, Doctor, Activist

If you had asked me a year ago if I ever thought I would be active in political discussions, working to effect policy, protesting, and organizing I would have said “Absolutely not!” I don’t like to call attention to myself. I prefer to work behind the scenes and effect change one person at a time. I would rather hide behind my stethoscope and my pen and paper than put myself out there at risk of having to speak for a cause and take on the establishment. But the election of Donald Trump, with his ensuing systematic attempts to dismantle the rights and protections of others as well as to defund organizations that have contributed to the enrichment of our culture, the betterment of our society, and that have worked to advance our understanding of and our respect for the world around us, has turned me into what I am today. In addition to my roles as Mom, Wife, and Doctor, I now also don the hat of Activist. I no longer feel that I can rely on others to ensure protection of my liberties, of our liberties. Look what happened when we assumed that the American voter would make reasonable decisions about who to elect as President of the United States. All Hell broke loose.

And I am not alone. In fact, the Trump presidency has created the greatest generation of activists that this country has seen in a long time. Never before have we seen so many people organized around a cause. Perhaps this will be his only positive lasting legacy. The large majority of Americans, whether they would admit to it in public or not, are nervous about what is happening in our Government right now. Trump is taking aim at some of the very institutions that have made this nation great. He is doing the opposite of what his campaign slogan promised. He is making America dangerous, intolerant, hateful, and the laughing stock of the international community. He is setting back the advances we have seen in race relations, gender equality, LGBTQ rights, health care, international relations, environmental protections, and the list goes on. He forgets that we are the United States of America. Every time he removes freedoms from one of us, it threatens the safety of all. Every time he takes aim at social programs for one group, it weakens the societal safety net of all Americans. And I, we, cannot stand by and let him unravel this beautiful patchwork quilt of diversity and liberty that is our great nation.

It is as if he is trying to cross off a check list, one item at a time; trying to undo every measure or bill put in place by the Obama administration, just to say he lived up to a campaign promise. Never mind the fact that he and his sycophantic cabinet offer no realistic or reasonable alternatives or replacements. And the American people are becoming wise to his game. He is a figurehead only, and a very poor one at that. And for all the obstructionist tactics the Republican Party has used over the last eight years of Obama’s presidency and for all the talk of bridging the party divide, he is making no efforts to bring Democrats and Republicans together to develop solutions. Instead, he is ramming presidential order after presidential order down our throats like he’s in some race to the finish line. Perhaps he sees that his tenure in the White House is coming to an end and this is a frantic dash to do something, anything that he promised on the campaign trail. Otherwise, his presidency would be an unmitigated failure and he himself would be a national embarrassment. Well, Mr. President. It is too late for that.

The March for Science is coming up on April 22. In contrast to the dozens of people that showed up to the Anti-vaccine movement’s March for Truth yesterday in Washington, DC, the nation is again going to witness the huge outpouring of support that the world has for its fellow citizens, its planet, and for reason and fact. The March for Science will bring tens of thousands, perhaps hundreds of thousands, of people from around the world to speak out against Trump’s anti-health, anti-environment, and anti-intellectual agenda.

Without the Environmental Protection Agency, we would have many more deaths due to poor air quality, many more children poisoned by lead in their drinking water, many more species on the verge of extinction, many more instances of severe and damaging weather. Without Planned Parenthood, we would have even higher numbers of pregnancy terminations (since more accidental pregnancies would occur without access to birth control), greater numbers of sexually transmitted infections, and higher rates of cervical and penile cancers. With the doubt and fear mongering that Trump plans to disseminate in questioning the efficacy and safety of vaccinations, he would set public health advances back to the 1700s when we saw millions of people die from vaccine-preventable illness. Does he even know how many organizations (both government funded and private) are already devoted to monitoring the safety of vaccines? I count at least eight and there are undoubtedly more. Yet he would have us believe that 220 years of vaccine science is false, inadequate and needs to be redone. And who’s going to pay for that?

If we love this country and we want to preserve the rights and dignities of all Americans, we must stand up and let our voices be heard. If we stand for truth and justice and equal opportunity for all, we must stand against Trump and his administration. His policies may not directly affect you or your loved ones now but, if we allow tyranny and prejudice to stand, who’s to say what group he will target next. His words and actions are not Christian (nor are they consistent with the messages of love and tolerance that are central to the teachings of all of the major religions), they are not American, they are not even Human. Most of us are born with an innate instinct to show care and compassion for our fellow humans. This moral compass seems to be lacking in president Trump.

So, I hope that you will join me at the upcoming March for Science rally on April 22. Let your activist flag fly.  Speak up for that which you believe. Help bring this reign of absurdity to an end.