this day.

Seventeen years ago today I got engaged. 17! It was the Pastor’s birthday so of course I had no suspicion because who does something besides bask in the celebration of themselves on their birthday? We were in the mountains of Idaho on vacation.  He proposed on the beach.  There were lots of tears.  Finally, we went to the local gas station and used a pay phone to call my parents.

Seriously!  A pay phone…at a gas station. My kids don’t even know what a pay phone is!

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Less than a year later we were married. I was in medical school and the Pastor was finishing his undergrad degree.  We lived off 99cent frozen pizza and 49cent cornbread from a box. We took almost all of our cash from wedding gifts and went out and purchased the most amazing piece of technology known to us at the time.  A DVD player.  We are talking HUNDREDS of dollars. It was enough that we had to save up again to rent DVDs to watch on it.  Well, within the last year we needed to purchase a new DVD player. So, of course, I went to my best buddy Amazon.com.

Guys…you can buy a DVD player on Amazon.com for $25 and get it at your house in 2 days.  2 days!

Fast forward 12 more years and it’s the Pastor’s birthday again.  I’m 38 plus weeks pregnant with baby #2.  The baby spent 3 years in the making and the one who seems larger than life when just a week earlier our state had the hottest day since 1936.  ONE HUNDRED AND THIRTEEN degrees, people.  So, I send him off to have a great day with friends while I take big sister to school and then am off to work.  Only baby BK decides it’s her day to come. Despite my insistence at my coworkers (read: screaming) that I was not going into labor, it was happening.  When my first child was born I didn’t even have a Facebook account! 6 months after my second child was born she was the subject of my first Instagram post.

Imagine a world with no FB and no Insta…that same world had pay phones at gas stations and $250 DVD players.

In the last 17 years we have seen many changes. Most of them for the better.  But some

IMG_6535.JPG.jpegthings stay the same.  Kids still love their birthdays and daddy is a five and ten year old’s best friend.  For 17 years the Pastor has put our family and his church above his own interests.  For 17 years the Pastor has created space for friendship and hospitality better than anyone I know. So, on this day, we celebrate the Pastor and my favorite 5 year old. This day we reflect on what it means to live in a rapidly changing world while finding time to celebrate the things that never change.

 

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we hold these truths.

The Pastor and I don’t have many absolutes in our lives.  At our house you can count on things never being the same.  Our schedules are always changing.  One of us is likely to get called away in the middle of an event or have to rush off to work.  But there is one thing you can count on.  One thing that always remains the same. We cannot, I mean CANNOT, watch America’s Got Talent without both ending up in tears. EVERY. SINGLE. TIME. I mean, there is the kid that used to be blind; the girl who lost her hearing; the 9 year old who is getting a little sister and for goodness sake a sweet girl from my home state and her puppet.  On stage stands someone who is probably in one of the most vulnerable moments of their lives.  Sitting across from them are those whose job it is to pass judgement. These people muster up all the guts they can find in their body and get on stage and hope and pray that they will find success.  And then, when they are finished, the most wonderful thing happens.  The words are spoken.

If you’ve seen the show you know what I’m talking about.   It’s more than just telling these performers they were excellent.  The power of the words they speak is life changing. Because of the enormous weight with which they are delivered, the words “you are a winner” or “you have a gift” or even “you are beautiful” seem to penetrate into the very heart and soul of those on stage. You can see it in their eyes. It’s as if all the sudden they believe in the person they have always been.

And cue the tears.

Over the past few weeks the Pastor has been teaching our girls about the Sh’ma. It’s an Old Testament Scripture or prayer that contains the Greatest Commandment.  And then goes on to remind God’s people to bind the words onto their hands, their foreheads, their hearts.  To recite it morning and night. To never forget those important words.

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It is not lost on me that the lesson in all of this is that words matter. And as someone who likes to blog and helps keep both the post office and her local Hallmark® store in business, I am a big believer in the power of the written word. But a spoken word is different.  It seems to be more weighty, more full.

I hope someday I have the opportunity to speak the truth into someone’s life and change them for the better.  Even more I hope someone does the same for both my girls.   And I hope they learn the Sh’ma and I hope they know their own words matter. That in a digital world full of memes and gifs and over the top OMGs, that you and I and even they, will have the opportunity to look someone in the eye and tell them how incredible they are and how much they are loved.  I hope none of us miss the opportunity.

be safe this summer ladies.

Summer is in full swing and yesterday was the first Sunday of the Pastor’s sabbatical. For as long as we have been married he has worked at our church.  16 years.  For most of those years his weekly day off was my longest day of the work IMG_3307week.  And my days off after being on call overnight were the Pastor’s busiest days.  So this year he gets to take two months off to rest, recover and reconnect.  For the next 8 weeks, Sundays and postcall days will be filled with brunch, swimming, day trips and, hopefully, some other fun adventures as a family.

 

In honor of all things summer….here are the gynecologist’s list of “Summer DOs and DON’Ts”

DON’T go without sunscreen.  Especially you pregnant ladies.  I know what you’re thinking…”sunscreen is for people who look like you and those red headed kids of yours.” WRONG.  Sunscreen is for everyone.  That is, everyone who doesn’t want to get skin cancer or look super wrinkly when they are old.  And, sunscreen is for year round. I thought my dermatologist was going to whack me when she found out I wasn’t using a moisturizer with SPF.  Don’t worry, I do now…every day…I’d like to avoid looking 100 before I retire.  I used to know someone who used hand sanitizer on her kids like a zillion times every day but then those same kids would swim for hours at the peak times of sun exposure turning brown, brown, brown all summer.  Just because you don’t get red doesn’t mean your skin is safe friends.  Tips for everyone: use broad spectrum SPF 30 or higher; reapply every 2 hours; find water resistant formulas.  Pregnant women should opt for oil free (your skin is more prone to break out) and opt for a lotion instead of a spray.  (Never spray anyone’s face…esp your kids and remember sprays make it easier to miss spots!).   And when your baby comes ask your pediatrician about how best to protect that brand new skin from the sun.

DO wear your seatbelt. This seems obvious to me. The Pastor and I took a recent road trip and you’ll be surprised to know that Missouri and Indiana will tell you how many people died in auto accidents that month.  The 10 year old reading road signs alerted us to the number.  Ouch.   But lots of pregnant patients choose to go without.  I wish you could hear how loud I am screaming this at you.  Pregnant ladies!  For the love of all things including your baby!!!  Wear your seatbelts!  Put the lap belt UNDER your belly and the shoulder strap across your chest. Auto accidents are a leading cause of death for pregnant women.  Your uterus, placenta and fetus were not made to sustain direct or indirect trauma from an accident and you can imagine the increase in magnitude if you are thrown from your vehicle because you failed to wear your seatbelt. A quick search of the CDC will tell you that those without a seatbelt are 30 times more likely to be ejected from the car during an accident and 3 out of 4 ejected individuals will die as a result of their injuries.  So let’s all just buckle up, ok friends?

DO use insect repellent. I have no problem with blood and guts.  You know this.  If you follow along, you also know that I think bugs are the worst!  Actual conversation with my dad.  Me: Dad, killed a spider outside.  It was like the size of my face, I promise.  Pastor is out of town, can you spray my house?  Dad:  If it was outside it was one of the good ones. His death will be on your conscience.  But yes, I will come and spray.  (end scene). However, as terrifying as spiders are…mosquitos carry all sorts of diseases including zika virus and west nile virus.  Then there are ticks.  I don’t know if you have seen a tick up close but this image is not for the faint of heart.  Tick borne disease are the ones you learn about in med school that have the cool names and then you learn about them and are terrified. Tips: Use your bug spray with DEET (even you pregnant ladies), cover exposed skin, avoid standing water and if you are out doing some crazy activity like sleeping in a tent (no thank you) make sure you check your skin for ticks.

DON’T overgroom. I’m not even sure overgrooming is a word.  But for today I am making it one and asking you ladies, pregnant or not, to stop it.  Summer is a hassle. Shaving your legs and armpits all the time, wearing a swimsuit; I get it. But let’s not go overboard. Not only are there literally THOUSANDS of grooming related injuries each year, the good Lord gave you pubic hair for a reason.  (I know, commence freaking out that the gynecologist said pubic hair in her blog.  Resume reading when over freak out moment).  And while none of us know the exact reason, it is most likely to keep dirt and other stuff out of your vagina and to reduce irritation of that sensitive skin.  So be swimsuit ready.  But overdoing can result in lots of skin irritation or even infection.

So there you have it.  Summer safety tips from the gyno.  Oh, and in case you were thinking about blowing off one of your fingers with fireworks, here’s an OBGYN joke just for you…

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Summer of fun.

I’m back!  It has been almost a month since my last post.  In that month I have felt TERRIBLE.  At one point I thought I would never stop coughing and that I would get diabetes from my cough drop consumption.  Don’t worry, I switched to sugar free. But now I’m about 89.32% better and have found the time to write again.  (Which is code for I can stay up late and finish things).  And so here we are.

It’s July.  For most people July represents the middle of summer.  Vacations, lazy days at the pool, short days at work.  In medicine July means ALL THINGS NEW.  As in, all the things are new.  New medical students, new residents, new academic calendar. You see, I work in Academic Medicine.  Which means that I work at an institution of higher education where we train medical students to become competent, caring, ethical physicians and then train physicians to be competent, caring, ethical specialists in their chosen field.  Sounds easy, right?  I will try to briefly introduce you to what the summer is like for those of us insane enough to participate in this great adventure of education.

Medical school is 4 years long and almost exclusively completed after a 4 year bachelors degree is achieved.  In the first 2 years students spend their time in courses learning anatomy, the complexity of each organ system, structure and function of the body and its cellular systems, human behavior and so much more.  They come to class, have small group sessions, read and read and read some more and take lots of exams. By the time they come to the third year they are ready to see how all they have learned can be applied to patients and diseases.  Oh and did I mention they also have to pass the first step of the 3 step medical licensing exam? In the third year our goal for a student is to be able to see a patient, perform a basic physical exam and formulate a differential diagnosis.  What that means is that when they hear a patient’s symptoms and know their history they can think about what diseases they are most at risk for and/or most likely to screen-shot-2016-09-25-at-6-38-08-pmhave.  Only once that is done can we as physicians begin to think about what testing and treatment someone might need.  Medical students don’t do anything without supervision.  Sometimes patients will ask if the medical student is going to perform their surgery or deliver their baby. I can answer that with a resounding NOPE.  What a medical student will do is participate in surgery with me where they will learn the hows and whys of that specific operation.  They will check on their patients in the hospital and often serve as an extra set of eyes, ears or hands to ensure that all the details of patient care are taken care of and nothing has been overlooked in making sure a patient makes it safely home after surgery.  In addition to all this they are reading, going to lectures, taking tests.  At the end of the third year we hope they have chosen a medical specialty.  Then they spend their final year of medical school spending time in areas of their chosen specialty, as well as interviewing for a residency position and taking the 2nd step of that all important medical licensing exam series I mentioned before.  So for me July means making sure the syllabus and all the materials our third year students get and use equip them to learn the most they can about women’s health.  It means making sure those 4th year students who have chosen my specialty have the best opportunity to train at the institution of their choice for residency.

July 1st also marks the day new residents begin their training.  These are recent medical school graduates who have gone through a very competitive process to secure their place in a residency training program. Each specialty in medicine has residency training and each specialty decides how long that training should be.  For example, OBGYN residency is four years long. Neurosurgery residency is 8 years long. (no thank you).  While in residency these doctors have a focused practice where they will learn every detail of their specialty.  It is also the time when they are trained to perform procedures and surgeries all in a supervised environment with the intention that at the end of their training they are ready to care for patients on their own.  In the meantime they will spend up to 80 hours a week in the hospital where supervising physicians will provide guidance, support, and supervision.  At the end of those at least 10,000 hours of training each resident will decide whether to join a private or hospital based practice, become an academic physician or, for those brave/crazy enough, pursue even more specialized training.  One of our greatest privileges is to watch those residents graduate and know that they will provide the kind of patient care you would want for your family and friends.

It’s a long journey into a career as a physician.  It can consume more than a decade of your life.  In truth the learning never stops.  For those in OBGYN we have a written and then oral exam to become board certified after residency.  To maintain our specialty certification we read articles and participate in chart reviews each year. We attend conferences and workshops to learn from one another and maintain and improve our skills. We read articles and travel across the country and collaborate to find the most effective ways to educate our medical students and residents.

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So if you see a medical student or a resident, give them a hug or a handshake or a pat on the back.  During a time when there is a lot of uncertainty in healthcare they have made the choice to commit their lives to the service of others. When no one can seem to agree who should have access to care or who will pay for that care, they have dedicated a huge chunk of their lives to ensure that care is available no matter what.  Now if you’ll excuse me, it’s July so I need a nap.

 

zero is my hero.

Today is my 39th birthday.  Birthdays are always a little strange for me.  I spend most of my day caring for the needs of others and have worked hard for a long time to be able to care for my own needs.  I love a crowd.  I love a party.  But a day to celebrate myself honestly makes me just a little uncomfortable.  So in today’s post I will tell you about some lessons I have learned this year from one of the greatest.

Russell Westbrook averaged a triple double in the NBA this year.  A feat not done for the last 50 years.  He also recorded more triple doubles in a single NBA season than any other player has done in history.  And the Pastor and I got to see it.  This alone could be the reason why number 0 is my hero.  But it’s not.  Here are the reasons why.

  • With the right attitude you can pull off almost any outfit.  Overalls. Floral shirts. Ripped jeans. Camo. Glasses.  Russell breaks the rules with most of his fashion statements and wins.
  • Work hard and then work harder. Russell doesn’t shoot well in a game?  You’ll find him putting up shots afterwards in the practice gym.  Be the first to arrive and the last to leave.
  • Smile at your critics.  If you follow along with number zero enough you will start to notice this great big smile he carries around with him when he’s not staring down his competition on the court.  It’s as if he knows those famous words from Teddy Rosevelt, made famous again by Brene Brown: “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again,because there is no effort without error and shortcoming.”  Keep smiling Russ.
  • You’re nothing without your team. At the end of the 2017 season losing in the first round of the playoffs Russell was asked about why teams did so much better against them when he wasn’t playing.  His answer?  Don’t try and split us up.  NEXT QUESTION.  I figure Russell asks everyone on that squad to play their best, to get better every day.  That’s all that matters.  No one can do it alone.
  • Always give back. From countless elementary school reading rooms, serving a hot meal at Thanksgiving to those without, to helping at-risk youth.  Westbrook quietly and consistently gives away from himself with joy.
  • WHY NOT? If you’re unfamiliar with the #whynot hashtag then you must be unfamiliar with RW. It is attached to everything he posts, everywhere he is, everything he does.  It’s not about the why we can’t, it’s about the why we CAN.

In year 39 I will continue to wear the pink heels with the coral skirt, the striped shirt with the patterned pants.  I will work harder this year than I have in the past.  I will smile at my critics and continue to step into the arena.  I will increase my empathy.  And most importantly, when the voices in the room say “we can’t” I will be the voice to say, “why not?”

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(di)stressed.

April showers bring May flowers.  And what does May bring? Well, as we approach the end of this month it seems that May 2017 has brought with it a heaviness. May brought with it a multitude of tragedies.  May was sad.  So I find it utterly appropriate that May is mental health awareness month. Did you know that 1 in 5 adults in the US will experience a mental health condition at some point in their lifetime?

Our culture seems to treat physical and mental health in very different ways. I find myself often talking with my patients about how best to prevent things like cancer, heart disease, bone loss and other physical ailments. As physicians we often forget to remind our patients to take care of their own mental health.  In fact, I would dare to say that for most of us our mental health takes a back seat to all other areas of our lives. We are so busy caring for the needs of others, worrying about the world around us, and so on and so forth, that we forget to stop and reorient ourselves towards health for both our body and our minds.

So in the same way that we should prepare our bodies for long term health and wellness, let us prepare our minds.  It means taking time to rest our minds, find peace in our heart and extend kindness to our minds. So on the last day of this month full of distress, take time to create some new mental health habits. Find your support system.  Those people who will check on you when the days are long and hope runs thin. Take some slow, deep breaths when life seems to be moving fast. Take a walk, preferably in the warm sunshine. Do something just for yourself like reading a book, attending a yoga class, writing something in a journal.

And finally, if you need us, we are here.  Physicians. We care about your mental health. We are ready to listen, to provide empathy, to give resources and to remind you that you are not alone and that there is help.  So say goodbye to May, but say hello to better mental health my friends.

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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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