Monday, July 28, 2014

You Are Not Alone

A friend of mine once told me a story.  Her surgeon husband was working overnight in the hospital, and she was home alone with her infant daughter and two-year old son.  Not only was the baby particularly fussy that night, but her two-year old had broken out in total body hives and was miserable.  She was going to give him some Benadryl, when she realized that she didn’t have any in the house.  Exhausted, sitting on the floor between two crying children, weighing the options of bundling everyone and leaving the house in the middle of the night or calling someone to help her, “it was the first time I felt really alone,” my friend told me.

After having my own two-kid moment of feeling alone this past weekend, now I understand what she was talking about.  After I was done wallowing just a bit in self-pity, it really got me thinking: what is about the parenting of young children that makes mothers feel so alone sometimes?  (And also likely fathers; however, I haven’t discussed parenting experiences with very many fathers).  Loneliness and isolation, these are themes that recur in my every day conversations with other mothers.  I read about them online.  I hear my patients’ mothers tell me about them, often without even realizing that’s what they are talking about.  I see them in the blank stares and half-smiles of other moms at the grocery and playground: we are all inhabiting our own individual spheres of Motherhood: separate, orbiting around but sealed off from one another.

The reasons for this are probably many: fatigue, time, frustration, our own inability to recognize when we need help and then ask for it.  And it’s usually not a feeling that is a poor reflection on the support we receive from our partners (though it often comes across that way).  It’s just… different, being a mother, which is about the best I can explain it.  Our bodies experience monumental changes in the gestation, delivery, and feeding of our babies, and I sometimes think that the recovery from that alone can take years.  And even then some things are never the same.  And yes, our own mothers, grandmothers, aunts, mentors, bosses, they are all supportive in their own way, but there is just something about having a community of other mothers of small children, who are in the trenches too, who are living the same challenges and frustrations at the same time, that is so important.

We all have our own reasons that we feel alone, different in every day and every moment.  It doesn’t really matter why, all of this is just to say, to my fellow mothers, when you have those moments, those experiences, those days when you just feel totally and utterly alone: you’re not.  While our individual parenting narratives are all unique, they are constructed around the same themes.  Whatever you’re dealing with, chances are at some point, we’ve all been there.

When you are so utterly exhausted that it’s physically painful: We’ve all been there.

When it seems impossible how much you can love but not like someone sometimes: We’ve all been there.

When the monumental task of caring entirely for another human being threatens to overwhelm you: We’ve all been there.

When all you want is 20 minutes to not be responsible for anyone but yourself: We’ve all been there.

When you don’t know how you can both love and hate breastfeeding so much: We’ve all been there.

When the accumulating piles: of laundry, of unopened mail, of anxiety, of responsibility, of love, start to feel like a crushing weight: We’ve all been there.

When someone has been touching you all day and you reach the nighttime breaking point: We’ve all been there.

When your head finally hits the pillow after the 2AM feeding and you hear your toddler call out for you: We’ve all been there.

When everyone is finally sleeping, and you toss and turn for hours: We’ve all been there.

When you can’t remember the last time you took a proper shower: We’ve all been there.

When your caloric intake for the day consists of string cheese, coffee, three fig newtons, and a banana: We’ve all been there.

When the pile of laundry on the floor becomes an undifferentiated slurry of clean, dirty, and otherwise, and you realize you don’t really care as long as you’re not naked when the UPS man shows up: We’ve all been there.

When you struggle with the fact that someone – your kids, your spouse, your dog, your job, your friends, your family, yourself – gets the short end of the stick every day: We’ve all been there.

When you’re not sure if it’s poop or chocolate: We’ve all been there.

When you wake up every day vowing to be the best possible version of yourself and you go to bed every night thinking of all the ways you failed: We’ve all been there.

In all of those times and in all of the others, fellow intrepid mothers, you are not alone.  So I tell you what I told my friend: Call me.  Call your friends with small children and just vent for ten minutes.  Or email or text or visit or take your babies and meet up for coffee or whatever.  So what if it’s the middle of the night?  Chances are we’re all awake anyway.  This mothering thing is damn hard and it is so important that we realize we are all sort of in it together.  In this post-modern world of child-rearing, we have lost the village that it takes to raise a child, and we mothers, we parents, need this village so desperately.  We need to reconstruct the village, to create a meaningful and supportive community that exists behind our closed doors and within our sterile suburbs.  Let’s be each other’s village.  Let’s realize that we are not alone.

Thursday, January 23, 2014

An open letter to Speaker Bosma and the Indiana Legislature:

My husband and I have these two good friends.  Well, best friends really.  Casey and Annie are they types of friends most married couples probably have; the kind who will watch your kids in an emergency, pick you up when your car won't start, or bring you meals when you have a baby.  We've taken vacations together, we laugh, play games, go to movies, debate religion and politics; all in all the types of things that most people do with their friends.

I have known Annie for a long time.  She and I went to medical school together, completed our internship and residency in pediatrics together, and even worked together in the same pediatric practice for a year.  Annie is currently completing additional training in pediatric critical care, spending long hours, nights, and weekends in the ICU to compassionately care for the very sickest children and their overwhelmed families.  She's really good at it.  She is the epitome of the physician you would want taking care of YOUR critically ill child should tragedy strike.  You could not quantify the number of families in Indiana who have benefitted from Annie's care.  This is just a small example of what makes Annie the type of person she is.  She never has a mean or negative thing to say about anyone.  She loves children.  She loves animals.  She's creative, kind, and funny.  She is that friend we all have who seems to make friends out of everyone she meets.  She demonstrates no external judgements about anyone, and is able to immediately find and bring out the best in everyone.  In short, she is a wonderful person, someone who has formed an essential part of my community and extended family here in Indiana.

Casey and Annie were married a few years ago.  They spent the majority of their initial relationship apart, as Casey is in the Army and was working in Cuba at the time.  This was, of course, after an active duty tour overseas, serving our country honorably in Afghanistan.  Over the years, Casey has also become a very good friend of ours.

Casey and Annie live in Indianapolis.  They have two dogs, jobs, and a house.  They want to become foster parents.  They want to have kids someday.  If you met them you wouldn't think they were different from anyone else.  Except, maybe you would, because Casey also happens to be a woman.

I grew up in Indiana, attended medical school here.  I work here, I live here, I choose to raise my children here.  Despite the good-natured ribbing that I take from my coastal friends about living in "back-woods" Indiana, my husband and I have chosen to live our lives here and have been happy with our decision.  But, in all my years as a Hoosier, yesterday was the first day I was truly ashamed to call this state home.  Speaker Bosma's political wrangling of HJR-3 is beyond reproach.  Yesterday I honestly wished I could sit him in a naughty chair like I do with my spirited toddler and have him "think about what he's done."

How ironic that HJR-3 comes to a vote just days after we celebrated the life of one of the greatest men and Civil Rights proponents of all time.  What would Dr. King have to say about Indiana entrenching legislative discrimination in the name of religion?  Lest we forget, the church, in addition to being a driving force behind the Civil Rights movement, was also one of the biggest opponents AGAINST Civil Rights for decades.  Slavery has been preached from the pulpit.  Oppression of women, abuse of children has been actively played out in so-called Christian congregations.  The Bible has been used to defend, for decades, some of our most heinous cultural institutions.  The most vocal proponents of HJR-3, what would they have said against Dr. King and his contemporaries had they been campaining back then?  What offensive racial epithets would they have hurled, what discriminatory beliefs would they have espoused, what would they have publicly preached in the name of supposed "morality" against Dr. King -- the same man who only days ago they lauded and celebrated?

If your religion and your upbringing inform you that same-sex marriage is wrong, and that homosexuality is a sin, to that I say, good for you, feel free to live and preach your beliefs.  We could debate that point until the end of days and probably not come to an accord.  But here's the thing.  HJR-3 is not, actually, a religious issue, despite what you may so strongly believe.  HJR-3 IS A CIVIL RIGHTS ISSUE.  We are all, all of us, every single one of us, afforded the exact same rights and protections under the law according to the U.S. Constitution.  Religion may discriminate, and in fact it does so freely and willingly, but the law cannot discriminate.  If you want to fight tooth and nail against your church or your denomination performing same-sex marriages, then wonderful, please, go ahead.  But, under the law, you CANNOT deny rights to one group of citizens that are afforded to other citizens.  There is a reason that Lady Justice is blind, though this seems to have been forgotten or even willfully ignored in Indiana.

In the end, this letter may not matter at all.  You have probably already made up your minds how you will vote today, and certainly mine is not the first "gay people are just like the rest of us" story you have heard in the past few weeks and months.  But I don't think I'm really writing this for you anyway.  I'm writing this for them, for Annie and Casey, and the countless other same sex couples in Indiana and beyond who today are feeling the sting of discrimination, hatred, and legisltative injustice.  What a morally reproachable state of affairs that an American soldier who risked her life in Afghanistan and a pediatric critical care doctor cannot even obtain a mortgage or file their taxes together.

The thing is, Casey and Annie aren't our "best gay friends."  They are our best friends who also happen to be gay, which happens to not matter to us.  And it shouldn't matter to you.

Make no mistake, universal same-sex marriage WILL be achieved in this country, and I hope, pray, and believe it will happen in my lifetime.  Now it's a question of how Indiana will be viewed through the lens of history.  Will we be the protagonists of our own story?  Or will we live up to the rest of the country's general beliefs about a state like Indiana?

The choice is up to you.

Tuesday, December 31, 2013

The Things We Gained

If you are reading this, it is probably no surprise to you that 2013 was… challenging… for our family.  I  suppose I should have just settled myself in for 12 months of turmoil when the year started out with our little asthmatic being admitted on only the 5th day of the year, though I distinctly remember thinking to myself, “well, at least we got the worst out of the way early!”  “ha ha” said 2013.

While the “Things 2013 Took” list is far too long to write about, I can’t sit here on December 31st and not contemplate the worst of the year.  We lost a Grandfather.  We lost an Aunt.  We lost sleep, health, a car, and some sanity.  We lost money.  We lost jobs.  We lost many more inconsequential things: a garage door, a shower, a sink, and some dishes.  I personally lost about 4 weeks’ total time at work because I was physically unable to be there.  We lost a great many things, and if I try to consider the enormity of a few and the sum total of them all, it’s not a very happy place to be.

But, in reflecting on The Year That Was, I also find myself thinking about the things we gained in 2013.  Some weight and more than a few gray hairs to be sure, but also, most importantly, we gained Perspective.  Perspective on what is truly, most fundamentally important in life.  We gained appreciation: for our parents, our siblings, our families, our friends, and for each other.  We gained appreciation for our supportive co-workers, flexible jobs, and the excellent education(s) that helped us arrive at this privileged place.

We gained love.  We gained togetherness.  We gained communication.  We gained confidence.  We gained courage.  And oddly, we gained the gift of time.  Between my confinement in bed, Husband’s between-job status, and holiday vacation days recently, the great gift Mike and I have gained has been time together.  What a rare and valuable gift for two full time working parents of a young child.

The people we lost we will remember fondly as the years roll on.  And the rest of it is just stuff.  Stuff that’s either not important and/or replaceable, and let’s be honest, “retirement” isn’t even a word in our lexicon with 10+ years of student loans still to pay off.  So we give thanks that we have the means to fix what needs fixing and appreciation for the perspective to know what we can do without.

So for all of you who have prayed for us, thought of us, sang for us, emailed us, texted us, laughed with us, cried with us, cooked for us, distracted us, and otherwise just been there, we say Thank You.

In the end, I think 2013 was truly a mixed bag.  There was some really great parts, some not so great parts, and other parts, well…. Let us never speak of them again.  There are some things I will truly miss about this year, but I must say I am mostly glad to put it in the rear view mirror.

Happy 2014 everyone.

Monday, September 2, 2013

Stand Up

The vast majorityoif people in this world are decent, normal people who want nothing more than a peaceful and stable life for themselves and their families.
I will say it again.
The vast majority of people in this world are decent, normal people who want nothing more than a peaceful and stable life for themselves and their families.

If you can accept this premise, there may be something of further interest to you in this post.  If you cannot, then I thank you for your honesty and wish you well as you journey to your next internet destination.

I don’t normally make political posts.  In fact, I think one of the things that is destroying civil politics as we know it is the internet.  However, I have become so increasingly disturbed by the situation in Syria that I finally felt compelled to put a few thoughts to paper.

I suppose another premise that I must also ask you to accept is that we all have biases.  Biases based on upbringing, politics, religion, friends, and so forth.  And in the interest of full disclosure, I will first share my biases with you.

1)I have an interest in global health, particularly refugee health.  I think the monumental task of triaging, treating, and housing/re-settling refugees is one of the greatest public health challenges of our time.  The UNHCR recently estimated that of the 2 million Syrian refugees now living in neighboring countries, half are children; the majority of which are under the age of 11.
2)I subscribe to the MSF (Doctors Without Borders) field bulletins.  I love MSF.  They are a gutsy, apolitical organization that works where literally no one else will go.  Frequently overwhelmed, constantly undersupplied, often in mortal danger, their doctors, nurses, and field personnel are among the bravest human beings on the planet.
MSF recently released a statement that on August 21st, three of its Damascus-area supported hospitals had treated approximately 3600 patients presenting with neurotoxic symptoms in a three-hour time period.  Read the original press release here.
3)As a medical student rotating through the ER, I was involved in the stabilization and treatment of a patient with organophosphate (pesticide) poisoning, the symptoms of which are essentially identical to those of someone exposed to a chemical nerve agent such as sarin gas. To the point, it was horrible.  Extreme respiratory distress, inability to control bowel and bladder functions, extreme salivation, seizures, coma… I will never forget the experience.  It was watching someone die in the most gruesome way possible right in front of my eyes.  And this was just one patient.  I can’t imagine the horror of a hospital full of patients in such distress.  Like Hell on Earth.
4)Since 2004, I have been privileged to work in an academic medical setting, which by its very nature is diverse, even in Indiana.  I have coworkers, acquaintances, and friends of friends who are either Syrian or of Syrian descent.  Hopefully it won’t surprise you to know that they are decent, normal people, wonderful physicians, and unimaginably sick at heart at what has been happening in Syria since 2011.

Chemical weapons were used against civilians in Syria.  This is no longer conjecture, but an undeniable fact.  I cannot say for certain by whom they were used, though increasingly the U.S./Kerry camp asserts evidence that they were used by Assad against rebels and civilians. 
Why is this such a big deal, you might ask?  Because chemical weapons are a horrific weapon of mass murder that affect any and all in their path (similar to all other classes of WMDs).  They kill indiscriminately, brutally, and not always quickly.  They are relatively easy to conceal, disperse; and compared to other WMDs, also relatively easy to manufacture.  Those who survive will often have permanent deficits.  They are truly terrible, some of the worst products of human ingenuity.  We are, of course, not the first generation to realize this, which is why a prohibition against the use of any and all chemical weapons was established at the 1925 Geneva Convention.
What about the other tens of thousands of Syrians killed by more “conventional” means?  Assad has been brutally murdering his own citizens since early 2011, he’s now just added a more vicious weapon to his dictator arsenal, right?  This is a fair point.  However, this is how I look at it: As a pediatrician, I frequently find myself counseling parents regarding discipline as such – “pick your battles.”  The small, or even sometimes moderate transgressions can be overlooked, but there comes a time in every household where a line is crossed.  In my opinion, Syria’s use of banned chemical weapons against citizens is like your teenager stealing your wallet, your car, and staying out until 4AM drinking and smoking with his friends.  In most households, this would not simply be ignored.
Which brings us to the heart of the matter.  Use of chemical weapons, cannot stand.  It MUST NOT be allowed to happen unchecked.  The consequences for the future are too horrible to contemplate.  I have been disappointed, yet unsurprised at the unwillingness of the UN and western allies to take action on the situation.  In their defense, there are exactly zero good options.  Become embroiled in yet another impossibly complex religious geopolitical war in the Middle East? I don’t think so.  Send arms and support to jihadist- backed rebel groups so Syria can be the next Afghanistan in 20 years?  Bad idea.  Diplomacy? Impotent and ineffective (see also: Russia).  Bomb the daylights out of the whole country? Inhumane and probably also ineffective.  So-called “tactical strikes” against military installations? Maybe, but with a high probability of either being too much or too little.  Embargo? Again, maybe, but with the knowledge that that embargos universally make living conditions even worse for civilians in war-torn countries.
Any action undertaken by the U.S. and its allies will have serious, far-reaching political consequences; both foreseen and unforeseen; immediate and long-term.  But to me, personally, these consequences are more palatable that the consequences of doing nothing.  It is said that those who do not study history are doomed to repeat it; should we then ignore the edict of our forefathers, fresh from the horrors of World War I, that chemical weapons have no place in modern warfare?  To me the answer is unequivocally no.
So what to do about Syria? In his speech yesterday, President Obama surprisingly, but I think perhaps wisely punted the question back to Congress.  Any action taken in such a complex situation with potentially widespread consequences cannot and should not be decided unilaterally.  Political, diplomatic, and military voices should all have the chance to weigh in.  And even more importantly, the voice of the people.  U.S. citizens deserve, and have been given, the chance to help decide what our country will do about Syria.  It may very well be that I hold the minority opinion that the U.S. should take any action at all, and that's ok.  If any action or inaction that we undertake as a nation is driven by the wishes of the majority, I can accept it even if it runs contrary to my own.  Is this not the point of democracy?  If the U.S. is to move forward into the quagmire, it must be by majority consent.  We must share in the decision, for we will surely share in the consequences.
So stand up.  Speak up.  Be counted.  Let your Senator or Representative know what YOU think should be done about Syria.  Do not say “I haven’t been following closely enough,” “I don’t have an opinion,” or “I didn’t get around to it.”  We have a week before Congress is back in session, which is enough time to read and form an opinion. (And please do not use this post as your only source of information.  My favorite article on Syria so far is here; the New York Times has had a good series of reporting on Syria, as well as CNN and The Huffington Post).
Even saying “I care, but I have no idea what to do” is a viable opinion to express.  Our elected leaders need to know that we are paying attention, lest they forget the gravity of the decision they have been tasked to make.  And, who knows?  America is full of smart people, maybe someone out there has a workable idea that hasn’t been discussed yet.
But for the love of mercy and human decency, do not remain silent.  Or know that if you do, you relinquish any future claims on complaining, lamenting, or criticizing the inevitable political fallout whatever our action or inaction.  Do not say “we should have done something” if you will not say it now.  Do not say “we should have stayed out of it” if it’s not important enough to say now.
For many of us this is a long holiday weekend, time to spend with family, friends, and loved ones celebrating the end of summer.  I hope you enjoy the weekend, but I also hope you will take some time to think about Syria and consider… What if you, your loved ones, your friends had the simple chance or (mis)fortune of being born in a different country?  What if you were as you are now, a decent, normal human being who wanted nothing more than a peaceful and stable life for you and your family?  What if you suddenly found yourself the subject of a brutal dictator, the citizen of a country embroiled in civil war, the parent who must choose between fleeing to abject conditions in an alien refugee camp or risk your lives staying where you are?  Imagine, that for the past two years your life had been utter hell and horror, worse than you could have ever believed… and then you watched as your family, your friends, your neighbors, your parents, even your children, were brutally murdered by guns, bombs, and then one of the worst weapons of warfare known to man?  What if you were counting on strangers halfway around the world to decide if there would be any sort of justice for you and your loved ones?  What would you have them decide?
I pray to a merciful God that we will never have to know such things, but we cannot ignore that this is a reality for many of our fellow human beings.  Other people who, while far away, we might find are not so different from us.

Friday, June 14, 2013


As parents, we constantly think about how we are raising our children; how we are imparting our values, beliefs, and experience to the next generation.  As parents, we are constantly asking ourselves: How can I teach the lessons I want my child to learn?  How can I impart the best aspects of myself/my partner while omitting the worst?  And most importantly, how can I not totally screw this up?

Lately though I've been wondering, what can I learn from my child?  Certainly she is much closer to the formative years of childhood (and their inherent, inevitable, invaluable lessons) than I.  So, what can she teach me?  We spend so much time as parents trying to make our children more like us, that we fail to see that perhaps it should be the other way around.  How can I be more like my miniature little force of nature?

My daughter...
...loves to laugh
...sings all day
...knows what she wants not afraid to express her opinion
...values her friends
...dances at will
...loves her grandparents happy when she goes to bed
...wakes with joy
...reads lots of books
...eats her vegetables
...washes her hands
...would spend all day outside if she could
...plays with our pets
...loves animals in awe of nature
...wants to learn everything
...seeks every adventure
...cherishes every day daring brave silly fun smart forgiving trusting sweet patient with her tired and cranky parents
...stops to smell the roses