you’ve got a friend (in me).

As many of you know from the rest of my social media presence, my youngest graduated from PreK this week.  It was all the gloriousness you would imagine.  There were caps and gowns, diplomas, pictures, refreshments.  For part of the program her class sang the song “You’ve got a friend in me” from the movie Toy Story®.  It was, as you can imagine, adorable.  And then the big one had her first acting gig in the church musical.  She nailed it. And back to the little’s ballet recital.  Killed it.  And now we ready ourselves for the last week of school. Of course, you can’t go through this time of year, full of its transitions, without some reflection on the months that have passed.

It was a little over a year ago.  I was listening to some music on a run and for some reason I started thinking about what it meant to be merciful. I was quick to realize that I didn’t really have any idea how to describe or understand or even think about mercy. This, of course, was disconcerting to me having been married to the Pastor for almost 15 years at that point. I was at a loss.  So I decided I would spend some time trying to figure out what mercy was, where it was present, how it happened.  And turns out, mercy showed up in all sorts of places. What I discovered is that mercy might be hard to understand because it is that sneaky thing that is always around but not obvious.  But when you start looking for it, when you take the time to seek it out, you will find it’s all around. In the last year I have been enveloped in mercy.

Mercy is your best friend from long ago and also today getting up before the sun does to go to the YMCA with you.  Even though she could go later…because you can’t.  It is a new friend who came along just at the right time and always tells the truth even when it’s not nice.  And reminds you they are there to stick through the best of times and the worst of times. You can feel it when you sit for coffee with someone who has been in your shoes and nods their head in understanding.  You feel it when that call or text arrives at the exact perfect moment from someone you don’t often get to see but the friendship remains none the less.

Mercy shows up in a big blue van driven by a teensy twenty something year old who picks up kids, who look nothing like mine, after school and nourishes them with food, education and love four days a week.  It’s there when those same kids are on stage at your church next to your own reciting lines in the cheesy kids musical that makes you tear up because you know that this demonstration of inclusion and unity is what God intended. And soon those kids aren’t those kids at all.  They are just kids like mine and yours, showing up every week.

Mercy happens when that person who thought she’d never have a baby sees that face on the ultrasound, or even better, holds that person in their arms. But it is also there when you hold someone’s hand as you give them bad news or grieve with them in the losses great and small.

Mercy happens when the Pastor does a funeral for what can only be described as a tragedy and reminds us that the gospel is an unconventional story and we have an unconventional Savior.  And so is mercy.  It’s there in the loud and in the quiet.  In the wins and in the losses.  It’s wherever we show up and remind each other that there’s mercy enough for each of us.

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thanks a lot internet.

The Pastor and I were having dinner with a young couple that is getting married soon. Along with all the (fantastic) unsolicited advice we gave them, we discussed the enormous amounts of ideas and information available to plan a wedding.  When the Pastor and I got married half a million years ago there was no Pinterest, no wedding websites, no Instagram.  In fact, I can’t really even remember what we used the internet for except doing homework.

Our access to a huge amount of information has been wonderful…and terrible. Never before has one been able to see what every single person you went to high school with is eating for lunch or how your grandmother’s diabetes is doing on a weekly basis.  And while the world wide webs have allowed me to continue my search for the best snocone in the city, how many teaspoons in a tablespoon and to connect with other physicians nationwide for support and resources, let’s be honest.  The internet has ruined a lot of things.

Holidays. Let me apologize to all of you who have lost a mother or a child, who long to be a mother but have not become one and will have to endure the onslaught of mother’s day pics and posts.  And not just that. We can now all see what intricate decorations and party favors are made for children’s birthdays and what everyone is having for dessert on their anniversary along with Christmas morning and on and on.  It’s exhausting.

Compliments and complaints. It used to be that if you wanted to complain about something or somebody, you called up your friend or went to the office next door and spilled your heart out.  And if you wanted to compliment someone you would find them and tell them or send them a note or an email or a text.  Now everything on the internet IMG_4733is either the absolute best or the absolute worst.  I feel like nothing is ever just fine anymore.  That when your hamburger comes out with mustard instead of ketchup the whole world must know of the trauma you have endured. In the same way all things good or great are now “I die” and “Gah.”  New hairstyles, vacation photos, work events, your dog’s haircut.  It’s all over the top.

Professions. All that knowledge out there in the interwebs is awesome. And terrifying. I think we are coaxed into thinking that we can use all that information to master any area of life we would like. Here’s the problem…we can’t. The internet won’t make me into a third grade teacher anymore than it will make you into a gynecologist.  And that’s awesome. The internet should empower us to learn and grow but we should not be mistaken as a replacement for the hard work and training people invest in their careers. So let’s stay away from thinking that a quick search can make you into an electrician or a plumber, a surgeon or a theologian.

In all seriousness, may we use the power of the internet with grace. Celebrate the highs and respect the lows. Think twice before wielding your social media account for vigilante justice. Say a prayer for those who won’t celebrate the events in life that you have the opportunity to celebrate. Make sure the people you love and respect know exactly why that is true. Post a million pictures of your kids, your pets, your food and your drama if you wish. But always remember the power of the internet and that kindness and empathy have a place here too.  And while you’re at it…if you find the best snocone in the city let me know about it, ok?

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this interruption brought to you by…

There are certain things that really help you mark time. It’s easy for me to forget how long it’s been since I was a student or a newlywed, or a brand new mom. But then you get glimpses of how oh so long it’s been.

Yesterday I attended a graduation party. Today I will attend a baby shower.  The graduate and the expectant mom were the ages of my kids are now the first time the Pastor and I watched them while their parents were away.  Which means I’m now the age their parents were back then.  And I’m now the person who can’t use snapchat and has to ask what certain words mean. So the moral of the story is, well, more time has passed than I’d like to admit.  (Insert grandma emoji.) Screen Shot 2017-04-24 at 9.55.24 PM

One of the biggest issues I discuss in my patients who have the benefit of the tincture of time is menopause.  By definition, menopause is the permanent cessation of the menstrual period.  Get it?  Men-opause.  It usually occurs around age 51 and the time just before menopause is referred to the menopausal transition. As has been so famously penned, the menstral cycle “does not go gentle into that good night.”  The menopause transition can be torturous for some.  Up to 80% of women experience bothersome symptoms of menopause.  One of the most common is what is known as the hot flush.  I haven’t been through menopause but I have been pregnant and had some similar hot flushing experiences. Imagine you are sitting at work and someone just moves the surface of the sun about 2 feet from your head. Your head, your face, your neck feels like you have entered the portal to hell for about 3 minutes. They can happen daily and often times women experience hot flushes for 3 or more years. Additionally, as estrogen declines women can experience severe symptoms of vaginal atrophy.  (Sorry friends, you know a gynecologist is going to write the word vagina in her blog at some point right?) The point is that menopause isn’t just the joyful absence of a monthly cycle, it is a transition into a new phase of life that can be, well, painful.

Fear not my faithful reader.  If you have made it this far I have good news for you.  The symptoms associated with the menopausal transition can be managed.  Your doctor can offer you different types of medication along with non-prescription therapy to alleviate your symptoms. We will also talk to you about what to expect during and after the transition and how best to care for your body.  For example, women in menopause are at increased risk for osteoporosis and associated complications so we might gently remind you to take your calcium and vitamin D and get your weight bearing exercise done.

I have big plans for the last stages of my life. Like just telling everyone what I think all the time.  I know some of you are thinking…don’t you do that already?  But really, just let all the thoughts come out.  Pretty sure there is an age at which I can get away with that. The point is that you are not alone in your transition.  Ladies, don’t let the menopausal transition get in the way of your big plans.  See your favorite gynecologist.  Talk about your symptoms.  Listen to what they have to say.  And then get on with your big plans.

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(photo credit to the twitter, the emojis and the someecards who are always full of delightful things)

in plain sight

It was Holy Week.  The week of Easter. The mother of all weeks in the church. There was preparing, cleaning, cooking, shopping, eating, egg hunting and so much more.  Frankly, as fun as it is, it is exhausting.  So I won’t belabor the point today.

This Easter I cannot let go of the words from Luke 24:5.  “…why do you look for the living amongst the dead?”  I think now, more than ever, we are looking for signs of life. We are flooded with images of death and destruction from our own country and around the world.  Mothers and children in war torn countries, live streaming videos of crime or self harm, the dropping of bombs, all the way down to angry emails and rants on social media.  It’s enough to make you feel withered and dry and near dead.

Where are signs of life?  I think it’s tempting to say that we will find them in our beautiful pictures on social media of our well dressed slightly less well behaving children on Easter or in our waxing on about our job, house, or whatever new or exciting thing has come our way.  I would argue that there isn’t true life found here. Where then, will we find signs of life? For me it’s in those text messages from friends far and near who understand the daily struggle to balance all things work and church and home.  It’s sending a note to remind someone that they are loved and prayed for.  It should be obvious to those of us who have spent most of our lives wandering in and out of the church doors.  If you lose your life you gain it.  We find signs of life when we extend ourselves to another.

I sent a giving key to a fellow pastor’s wife.  One of the tribe.  If you don’t know about giving keys they are necklaces, with a key on them, and a word inscribed in the key. Someone who tak51412342510__07BB8511-CA17-4486-9560-2002B6474851.JPGes the time to remind me to breathe and relax sent me one. The word I sent was “hope.” It was a promise to hold out hope for my friend on the days where it didn’t seem like hope was possible. When the problems in life, the problems in church, the problems in the world seem too much.

So when you find yourself overwhelmed by all the death and deathly news that surrounds you, give away part of yourself. Make a phone call, write a note, sit down for coffee, send a token of care. Find signs of life and share them with those around you.

i’m not making this up.

A few months ago I was at dinner with friends, one of whom is pregnant. The topic of drinking in pregnancy came up and someone said to me “you just tell people not to drink because you have to, not because it’s really harmful right?” Um…I made that face. That face.  You know. The one where  you couldn’t possibly believe what you heard but, then again, you heard it.  The one where your eyes are big and your mouth is open.  After a pregnant pause I explained that national and now international guidelines recommend against any alcohol consumption in pregnancy.

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We all know that you are never going to get more unsolicited advice than when you are pregnant.  What you can and can’t do including raising your hands above your head or eating peanut butter in the bathtub along with what your baby should eat, how it should sleep, what it should wear and where it should go to college.  Whether or not you should consume alcohol in pregnancy is among that advice.  However, drinking during pregnancy is the most common cause of birth defects in the United States. And while these birth defects are most common among women who drink heavily, there is no safe amount of alcohol consumption for a pregnant woman.  Alcohol use in pregnancy is associated with low birth weight, preterm birth, birth defects and developmental disabilities.  Health care providers are encouraged to discuss discontinuation of alcohol for women who are pregnant and those actively trying to get pregnant.

April is alcohol awareness month. It was established to reduce the stigma associated with alcoholism and increase awareness about alcohol abuse, treatment and recovery.  Excess alcohol use costs the United States about 250 billion dollars per year.  About 5 billion of that is related to alcohol use in pregnancy.  So no, as gynecologists we don’t just say these things because “we have to.”  We say them because we truly want the best outcome for you and your baby.  So if you should find yourself with two lines on that pregnancy test, congrats!  It’s time to take a break from alcohol.  If you are already pregnant and haven’t stopped drinking I would urge you to do so now.  You can tell your grandmother, your best friend, the lady at the grocery store and the dude at the gas station that you are doing everything you can to take care of yourself and your baby.  Really.  We’re not making this up.

to my friends in white.

Thursday was Doctor’s day. It has been celebrated since the 1930’s when handwritten notes were mailed to physicians and flowers were placed on the graves of doctors who had passed. Today Doctor’s day is usually celebrated with free breakfast in the hospital and snacks and cards from office staff.

I have the privilege of helping to educate medical students and residents.  Doctors to be and doctors in training. When you’re in medical school or residency I think you try to keep your eyes forward, always looking toward the next step, the next goal.  Don’t think about the mountain you are climbing, just put one foot in front of the other. Looking back, for me, it would have seemed insurmountable to approach it in any other way. There is more to learn, more work to do, more complicated patients to care for today than ever before. The long hours and hard work don’t stop. The struggle to balance education, work, family and your own health never ends.

My youngest loves to sing. She can learn the words to most songs pretty quickly. Which means you can’t let her listen to anything you don’t want repeated.  That being said today she was singing songs from the Disney movie “Moana” at the top of her lungs in the car. “and the call isn’t out there at all it’s inside me…like the tide always falling and rising.”  Every time she sings the words they stick with me. Medicine is a calling. Yes, while it is often exciting, intellectually stimulating and on most days rewarding, none of those extrinsic things will be enough to keep you in it long term.  It seems like it should be, I know. But the pressure, the paperwork, the volume, the hours add up to some grueling days. We know that physician burnout rates are more than 50%. We lose the equivalent of a class of medical students to suicide every year. Conferences for physician educators are now filled with sessions on how to increase resilience in our trainees. We have committees on how to promote wellness in our profession. We desperately are seeking ways to make medicine meaningful again and redeem what has been lost in our profession.

So for my friends in white coats both short and long, in wrinkled scrubs, sitting behind books and laptops and electronic medical records and paperwork of all kinds. For you, every day is doctor’s day. You will get up early and pour yourself into your work and the lives of your patients, your coworkers, your students. Remember to be kind to yourself. Some days the call to medicine will feel far away and you will struggle to remember how and why you got here and why you should stay.  Other days you will celebrate the work you did, the people you met, the things you accomplished and the calling will be close to your heart. But never forget that your white coat does not ultimately define who you are. Last week I had the opportunity to hear Friar Richard Rohr speak at a conference the Pastor hosted.  He will tell you that in the second half of life you really only learn anything from your suffering and from love; not from your successes. I have come to agree with him. I know more about who I am by listening to those who love me and experiencing the suffering that life brings.

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When I think about how to foster wellness and resilience for my friends in white, I think maybe we can do best by reminding them, reminding ourselves, that while your work is meaningful and important…that YOU are meaningful and important. Without your white coat, without the initials behind your name. Medicine will be a huge part of who you are. But it will not be who you are. You are more than medicine.

find the big spoon.

About a week or so ago I was talking to some girlfriends about work. The subject came up about how long I would work and if medicine would be my only career. It got me thinking about what I might do when they stop letting me show up at the hospital every day. The short version is, I’d make spaghetti.

It’s March. In Oklahoma that means we are getting our first look at severe weather warnings, hours and hours of live shot cloud formations and lightning strikes and reports on damage from such severe weather. Unfortunately, Oklahomans are all too familiar with the aftermath of tornadoes and other severe weather events. Damage, destruction, deaths, Screen Shot 2015-07-19 at 10.05.19 PMdevastation.  But that’s not all that comes in the aftermath.  What also arrives are people and organizations. People and organizations who bring trucks and tools and supplies and food and hands and grace and love. One of the most recognized organizations in disaster response is the American Red Cross.

And that’s where the spaghetti comes in. For as long as I can remember I enjoyed making food in large quantities.  I’d get out a big pot or pan and chop and stir and boil and whatever until a great big amount of something was made. It’s problematic when you are a household of 2. So in the first years of our marriage our condo would be full of hungry college students or hungry medical students who would eat and eat and then take food home. Over the years I have learned to taper down and not make enough food to feed the neighborhood. March is Red Cross month. Buildings across the US will be lit up with red lights to honor the 300,000 volunteers who respond to over 60,000 disasters and bring with them life saving food and water. The Red Cross supplies about 40% of the nation’s blood supply. And almost everyone who serves with the Red Cross is a volunteer. Can you believe that?

I can remember being a kid and seeing news coverage of tornado damage in my state. And I remember the trucks.  The trucks with a big red cross on the side. And in my mind I would imagine all the volunteers unloading those big pots and pans and making big pots of spaghetti or soup and sandwiches and all I wanted to do was go and stir something with a giant spoon.

Let’s take a moment to honor and support the thousands and thousands and thousands of people who make the American Red Cross go. Maybe they love making giant quantities of food.  Maybe they feel a call to make a tangible difference when people are at their most vulnerable point of need. Whatever it is, they have chosen to serve in a disastrous time. So donate blood. Give money. Volunteer. Take a class to learn how to help. Do something now. Don’t wait for a second career.

What will I do when I stop being a gynecologist? I hope whatever it is the Pastor and I are doing we will be serving people in need. And that just might mean climbing out of a big truck and stirring a pot of spaghetti.