the things that linger.

For a long time people asked me about why I became a doctor.  The reality is that I had no good answer for them.  It bothered me a lot. I felt like I should have this great answer about how I had this transformative experience where some giant ray of light broke through the clouds and I knew what I was destined to do. But there was no transformative moment or ray of light.

The truth is I wasn’t great at that many things. I was good at school, a below average athlete, well below average on the cuteness and popularity scale.  I was good at organizing and prioritizing which, if you didn’t know, aren’t skills widely praised in the high school arena. I think mostly what I was looking for when people asked me about my future was to give them an answer that would seem like something great.  Turns out, I said it enough that I really believed it, and, well, here I am today.

I was reminded this week of the things that linger from when we are young.  I think most days I can still feel the shadow of those thoughts that I might never measure up to those around me. For most of us, we have these small things that are difficult to grow out of. I can recall the moments in my past that are the reasons I still don’t like to be teased in public or get the feeling I am being left out. I spent time with a friend this week who remembers the feeling of never really having enough; the feeling lingers in his life today despite proof of the opposite. How do we move beyond the insecurities of our youth? How do we get past those things that always seem to linger?

I’m not sure letting them completely go is the answer. There’s no shame in wanting to do something great. What I had to do is convince myself that being great wasn’t about gaining approval from some person who I was sure didn’t think I measured up. Doing great things was about pushing myself beyond what I initially thought I was capable of doing or accomplishing. I’m fairly convinced that I push myself to write another research proposal or figure out how to improve our educational curriculum because I don’t ever want that lingering feeling that “I can’t” to take hold of me.  I believe that small voice that continues to whisper that you might be left out is pushed further into the background every time you practice inclusion. When you live a life of generosity with others you squelch the fears of scarcity just a bit more.  In a few months I will turn 39. Last summer one of my best church girls told me that my 38th year could be one of my best. And it has. I think this year, more than any other, I have discovered what it means to consciously shake the insecurities that bind me and learn what it means to find the joy that is discovering true friendship and fellowship with others.  And I’ve only figured out how to do it about half the time.

In the evenings I am reading Richard Rohr’s book “Falling Upward.” It’s about the second half of life. Fr. Rohr reminds us that if we never move beyond the first half of life we risk missing out on the best that God has to offer us.  I am reminded each night that although there was no transformative moment marking my decision to become a physician that daily I am transformed into a physician, and a person, who uses those lingering things from the first half of my life to liberate myself as well as others.

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May each of us, friends, shed the insecurities and disappointments of our youth just enough to move forward, but not so much that we can’t use them to transform our own lives as well as the lives of those around us in meaningful ways.

 

despair and disparities.

“Lord I have seen your goodness and I know the way You are.  Give me eyes to see you in the dark.” – Christy Nockels, Revive Me.

Those words have haunted me today.

About 1/3 of women in this country are a member of a racial or ethnic minority group. Healthcare providers have become increasingly aware of disparities in access to care as well as health care outcomes for women who belong to these minority groups. Our job as care providers is two fold.  One, we should appropriately document a patient’s race/ethnicity so that information collected on healthcare issues for these women is accurate.  Second, we should attempt, collectively, to identify and address factors that contribute to these differences.  We cannot fix what we fail to recognize.   Black women have an increased risk of stillbirth and preterm birth. Native American women are less likely to receive prenatal care in the first trimester.  Despite having an equal or lower rate of breast cancer, black women are more likely to die from their disease. Minority women are more likely to report their health as poor and less likely to have health insurance coverage.  These women are less likely to get their mammogram or Pap test at the recommended interval and a quarter report having no personal physician.

Disparities in health vary among each state. However, in those states where there are fewer disparities it is most likely because both white AND minority women are in poor health and have less access to healthcare resources.  We must recognize that there are many barriers to good health for minorities, especially women of color. Poverty, lack of education, gender wage gap and single parent households all contribute to poor health. Health disparities are not simple problems to solve and they are not simple to correct. And the truth is there is not a set of winners and losers in healthcare.  When we fail to correct these healthcare disparities, healthcare costs for all increase and our overall health as a community suffers. More than those reasons above I think we should all be concerned when the most vulnerable among us aren’t being made whole.  If you have worked in healthcare long enough you will encounter the despair in these disparities.  You will feel the despair when one of your patients, who happens to be a woman of color, dies from her cancer.  You will ache with despair when a minority woman presents to your office after the death of her infant.  You will notice the ones that don’t come for many of their doctors visits.

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In the light we see all the good that screening programs and medications and preventative services do. In the light we see all our good outcomes and lives saved and people helped. But in the dark spaces are where the disparities hide. In the dark is where, unless we look closely and carefully and with serious intent, we will miss the most vulnerable among us. We will fail to recognize the despair that awaits if we continue to ignore the women of color that are daughters, sisters, mother and patients just like we are. In the dark is where we need eyes to see, ears to hear and feet to move towards better health for all individuals regardless of race, ethnicity, gender or socioeconomic status. Give us eyes to see.

what the Grammys taught me.

 

Watched the Grammys tonight.  Or as my four year old said, “it’s like a contest with music where they pick the prettiest people.” Not too far off. The show didn’t disappoint. So tonight I will leave you with a short and sweet post about what I learned watching the best music filled beauty pageant of the year.

  1. Hello there Adele. Let us all remember to think about the person on the other side. The other side of the argument, the other side of the text, the other side of the phone call. You get a few do-overs in life but if you will think about the person on the other side then you are more likely to give them, and yourself, a little more grace.
  2. Chance the Rapper. We don’t do anything alone. Thank the people that walked with you through failures until you were a success. Also, I’d like to think that #3 on his hat is reminding women everywhere to get their Pap screening at least every 3 years depending on their age. It’s like that giant 3 sitting atop his head is screaming “let’s keep women healthy!” Chance, gynecologists everywhere would like to say thanks.
  3. You can wear just about anything for your maternity pictures if you’re Beyoncé. I have already challenged someone to replicate that with their first child. No kidding. Beyoncé don’t forget that twins put you at an increased risk of preterm birth and other complications, so you keep those dance moves in check girl.
  4. Resist. Become a blonde in an attempt to resist the gray. Take on a new challenge and resist the temptation to remain in the status quo. Read the literature, find the evidence and resist the pressure to do it “the way it’s always been done.” Life will push you in one direction or another and it’s not always the way you should go. Resist.
  5. Imitation is the sincerest form of flattery. Be the person you hope someone will want to be in 10 years or 20 years. Pay tribute to the ones you imitated in order to achieve your dreams. And when in doubt, channel your inner Prince. You can’t go wrong.
  6. There should be more times in life where you get music to let someone, or yourself, know that it’s time to stop talking. Really. Like right now. Then I would know it’s time to end this post.

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Most of all, the Grammys teach us that we all have a song to sing and a story to tell. Find your stage, find your platform. Your story, your lyrics, the background music will be reason for someone else to believe in themselves or to believe in a better future. Tonight, Chance reminded us How Great is Our God. Tomorrow we can decide what song we will sing.  I hope mine will be more than just “work work work work work.”

(thanks to @von_jet on insta for the meme used at the top of this post).

stay in your own lane people.

We’ve all done it, right?  Veered into another lane of traffic.  Oh, you haven’t?  Yeah right. Anyhoo, moving into another lane of traffic can be no big deal or a giant disaster.  And while I hope we all can agree that we should put down our phones and ignore our children in the backseat and pay attention to the road I’m not really here to discuss actual driving habits.  To stay in your own lane is to stick to what you know.

For the past 3 Sundays I have awoken to the desperate need for a cinnamon roll.  Not the kind you can get at a donut shop on a Sunday morning but a warm iced homemade cinnamon roll.  Guess how many weeks I happened upon said delicious breakfast treat?  ZERO.  So this weekend I decided I would make my own cinnamon rolls.  That’s right. I can perform surgery so certainly I should be able to follow a recipe and make these rolls. With great pride I proceeded to gather all my ingredients from the grocery store along with three other food projects I decided to create for our Super Bowl party.  Yes, you read that correctly.  Not only did I decide to make cinnamon rolls from scratch I figured adding a few img_7732other new recipes in the kitchen certainly wouldn’t add to my angst.  Um, oops.  Moving on, I made those cinnamon rolls.  I mixed up the dough and let it rise and put it in the fridge ready to complete my creation.  It was only then that I noticed the recipe I was using said clearly at the top: “Makes 40-50 Cinnamon Rolls.”  You have got to be kidding me. What am I going to do with 50 cinnamon rolls?  At this point I panicked and frantically phoned one of my best church girls who also happens to whip up homemade cakes and pies and other fancies in her kitchen on a daily basis.  My exact text: “WHAT HAVE I GOTTEN MYSELF IN TO?”  Clearly I had veered from my own lane. Fortunately for me cinnamon rolls can be made ahead of time, they can be frozen and they can be shared with those you are lucky enough to attend Sunday School with.

In this case moving out of my comfort zone, my lane, didn’t turn out so bad. It could have turned out worse.  Sometimes we decide to swiftly move into territory in which we have no education or experience. This has the potential to be disastrous. I won’t be trying my hand at teaching kindergarten, flying a plane or operating any heavy machinery.  Our culture too often tells us we know as much as the experts. And why not? We have access to all sorts of information through the power of the internet. Exactly.  All sorts of information.  The good, the bad, the ugly.  It’s too much. In my arena we use what we call “evidence based medicine” as best we can to direct patient care and research efforts.  We are taught to examine the evidence and decide what the full body of research has concluded, if anything, on a subject. And while I have a good deal of experience reviewing medical literature it doesn’t mean I can easily read the law, interpret scripture or solve complex math problems. At other times knowledge in one area transfers easily to another. Take surgery, for example. When we plan for a gynecologic surgery our team anticipates possible deviations from the norm we might encounter based on the patient’s problem, their medical and surgical history and the procedure being performed.  We create a plan to minimize risk and maximize benefit to the patient.  Does being a gynecologic surgeon mean I should volunteer to operate on your brain or in your nose?  Well, first of all, gross. Secondly, while some principles of surgery carry over from one specialty to another like sterile technique or attempting to minimize blood loss and restore normal anatomy, a gyn surgeon does not have the expert knowledge and experience a neurosurgeon might have. If you ask me the best treatment for say, your eye disease, I’m going to tell you to go to your ophthalmologist, ask some questions about the risks and benefits of each treatment and some others on success rates, etc and then make an informed choice on what to do with the help of your physician.  On the other hand, many more of the techniques used in general surgery would apply in gynecology and vice versa.  So, should natural disaster strike, general surgeons and gynecologists would operate side by side to save life and limb.  But let’s hope it doesn’t come to that.  There are lots of other examples.  Have kids in school?  Swerve into the other lane because you must know how education works!  Voted? Swerve into the other lane because you can run the government.  Been going to church awhile?  You probably know the Bible better than most. The truth is we are all stakeholders in these issues: whether it’s our own health, education, the government or theology.

So what is the best way to change lanes?  Well, we check our blind spot, we put on our signal and then deliberately move over.  Life should be much the same. How do we improve education?  We find our best educators and the best available evidence on education and then create your best practices.  I know exactly who I would approach if I want to figure out how to make low income kids succeed in the classroom.  How about government?  Well, until about 4 months ago I didn’t actually know how the electoral college works.  Or really much else about government.  Who knew those things would matter when I was ignoring them to focus on my science and math classes way back when? So I find those whom I trust who have done their homework and who will, more importantly, discuss all sides of the issue with me. And when it comes to theology, well, I’ve been learning from the Pastor for almost 16 years.  And trust me when I say he knows what he is doing people.  So let’s check our blind spots.  Let’s figure out where we have assumed we know best and admit that we don’t know best.

Here’s another “if you know me” moment.  If you know me, you know I love being right. But I’ve learned that being loud and persistent doesn’t mean you’re right.  So now I’m learning to signal to the people around me and learn about what they have to offer.  So join me in checking our blind spots. Let’s figure out where we have assumed we know best and admit we don’t know best. Otherwise we should just stay in our own lane people.

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