Friday, September 17, 2010
Friendship and Female Physicians II
Thursday, May 28, 2009
Friendship and Female Physicians
Saturday, May 9, 2009
MiM celebrates one year: Anesthesioboist
Anesthesioboist joined Mothers in Medicine last fall. Since then, we've been graced with her phenomenal writing - a true aesthetic purist (hope I'm not putting too much pressure on her with that).
I think my two favorites would have to be "Code Indigo" and "Mom's Apple Pie."
T., thank you for making us routinely swoon from the beauty of your words and insight.
Friday, April 10, 2009
Love and Wonder in a Carcass
Monday, March 23, 2009
Mom's Apple Pie
Wednesday, February 11, 2009
What is a Mentor, and Where Can I Find One?
But of course the word mentor doesn't come from such a derivation at all. Mentor was the guardian of Telemachus, son of Odysseus, and in The Odyssey the goddess of wisdom assumed Mentor's form to aid Telemachus, one of her favorites among mortals (as well as to escape notice by Penelope's suitors).
Homer's Mentor is a mere minor character, however, without all the attributes of the "experienced and trusted advisor" the Oxford English Dictionary leads us to believe such a figure should have. Where do we get the archetype of a wise teacher who cares about, nurtures, and encourages the learner - who builds up the learner's intellect rather than doing the opposite, sucking out the student's soul, as J.K. Rowling's DE-mentors do?
For that sort of character we have François Fénelon to thank, whose enormously popular book Les Aventures de Télémaque, published in 1699, was "a continuation of The Odyssey from an educational vista," according to author Andy Roberts. It brought Mentor to the forefront as a major character with tremendous influence over the story's hero. "It is Fénelon," Roberts continues, "not Homer, who endows his Mentor with the qualities, abilities, and attributes that have come to be incorporated into the action of modern day mentoring." The word mentor came into modern usage in English in 1750.
I am rambling on about these literary and historic niceties because I enjoy them. But I am also having a hard time writing about an actual mentor. From what I can gather from my own experience and from other people, finding a mentor in medicine usually happens by a great stroke of luck; it's not automatic. You'd think that in a profession supposedly built on compassion and learning, mentors would abound. The word doctor, in fact, means teacher in Latin. But it's not that easy to find good mentors. It may be harder still for those who long for a mentor who is a woman.
I do have a couple of people who always come to mind whenever I hear the word mentor: my med school anatomy professor, Dr. Matthew Pravetz, who also baptized my youngest child; and from my days in pediatrics, Dr. Indira Dasgupta, a woman whose dignity, intelligence, compassion, and humor I hold in my heart to this day. There have been few people in my career who have helped me believe - as they did and as every mentor should help his or her "telemachus" believe - "You can do this. You are good. Your work will make a difference. I'll be there for you if you need me." Even the most independent-minded and confident person needs guidance at one point or another, or loses faith, or needs help. Mentors ultimately stoke the fire and help keep the faith. Happy are those who are blessed with some good ones
Sunday, November 30, 2008
"Attention all personnel. Attention all personnel. Code Indigo, third floor. Code Indigo, third floor."
I look at the nurses. "Indigo? Which one's that one again?"
Every hospital has coded security alerts for unusual events - emergency room on diversion, airway crisis or cardiac arrest, infant abduction, bomb threat, unruly patient or family member, etc. I don't recall having heard a Code Indigo* recently.
"Missing patient," says one of the nurses.
"Probably just went out for a smoke," says another.
I go to do post-op rounds. The all-clear sounds overhead for the Code Indigo. But when I get to the post-partum ward, a nurse there tells me as I leaf through a patient's chart, "Don't bother. You won't find that patient."
"No. Just gone. That was the Code Indigo."
"Oh! I thought I heard an all-clear a while back."
"Yeah, because the patient's definitively gone. Baby's still here, though. Wanna see?"
She lifts a swaddled bundle of warm, sleepy perfection out of a bassinette. The baby starts drinking formula from a small bottle the nurse is holding.
I start to think of another baby, a patient I had had to discharge to a foster parent during my internship. The baby had been hospitalized with bilateral spiral femur fractures. Yet every time I approached his crib to examine him, his face would light up with a bright smile that held nothing but joy. After I turned him over to foster care, I went into the call room, called my husband, and sobbed on the phone to him, utterly disconsolate.
My mind starts churning around my current situation, trying to figure out if there's some way we could take care of this baby ourselves. But of course we're not at all prepared for a decision like that right now; all I can do is call the social worker and make sure she's on top of what needs to be done to get this child into a suitable pre-adoptive home. It seems like such a small, ineffective measure to take.
The snow has turned into something a little wetter and clumpier. It's dark by midafternoon on days like this. I've turned on a mix of Christmas music - a little Nutcracker, some Kathleen Battle, a little Boston Pops and Leroy Anderson. I go back up to the nursery to hold the baby. The nurses welcome the break.
"Here, Dr. T - have a seat right here."
The baby sleeps in my arms. His cheeks bulge out like rosy little fruits. He is totally at peace. He has no idea that either nobody loves him at all, or someone loves him so much that she felt she had to set him free. He is blissfully unaware that he is alone in the world. Abandoned.
"At least she didn't try to flush him down the toilet, like the kid we got last week."
Thank heaven for small blessings.
Advent starts today: the liturgical prelude to the Christmas season, and the new beginning of the liturgical year. There's something in the baby's given name that conjures up images of light. Light, on this grey, darkening day.
"The people who walked in darkness have seen a great light." I wish, I wish, I wish.
I start humming the baby a lullaby. My favorite song of the season, half ancient chant, half carol for a newborn.
O Come, O Come Emmanuel
and ransom captive Israel
that mourns in lonely exile here
until the Son of God appear.
Rejoice! Rejoice -
Emmanuel shall come to thee,
I hope this baby gets his Christmas wish, the wish all babies are born with: a wish for love, for a life that matters, and for a world of hope to be cradled in.
*(Not the actual alert used.)
Cross-posted at Notes of an Anesthesioboist.
Tuesday, October 28, 2008
"You did it! CONGRATULATIONS! World's Best Cup of Coffee! Great job everybody! It's great to be here." -Will Ferrell as Buddy the Elf in Elf
One thing's certain: I won't be getting any "World's Best Mom" awards any time soon. "World's Most Embarrassing Mom," maybe - we're getting to that age.
Some people might even wonder - ESPECIALLY if you scour the American Academy of Pediatrics recommendations, or talk to parenting-book authors/readers - how conscientious I could possibly be as a physician when one considers that I have, at various times in the past,
-occasionally co-slept with my kids when they were babies (right in line, I must interject, with, like, 90% of the rest of the world's cultures)
-used Disney's Fantasia and the like as a babysitter when I had to cook dinner
-let my kids jump on backyard trampolines
-let my kids eat raw cookie dough
-skipped back-to-school night
-let them eat apple pie for breakfast (just once - and it was homemade and yummy and we all did it)
-made them memorize their times tables BEFORE explaining multiplication conceptually
-been physically and emotionally unavailable to them due to an excess of call
-let their father take them through a carnival house-of-horrors when they were WAY too little to laugh it off
-been way too permissive about TV-watching and video games/Wii playing
-missed some performances / special days
-failed to nurse at least one of them for the recommended period of time
-used phrases like "Because I said so" and "Don't do that"
-taken them out of school for trips
-required them to stick with certain academic or extracurricular activities against their wishes
-been impatient and snappish when tired or preoccupied
-let them eat a sickening amount of Halloween candy all at once.
Then I think, all those nitpicky little recommendations in the books and guidelines are nice, but they're not gonna make or break our parenting "success." I was sitting around comparing notes on the subject with some colleagues once when I was a resident.
"I watched TV all the time when I was a kid, " said one. "Violent stuff, too - martial arts movies and everything."
"We didn't even own a TV," said another
"We only ate food from local growers."
"We subsisted on chips and soda."
"I read TONS when I was younger."
"I barely read anything before college."
"And look - we all ended up in the same place, with 'M.D.' after our names, being fairly good people, for the most part, right?" someone finally pointed out.
That one conversation enabled me to avoid beating myself up too hard for all my faults and failings. Here's my bottom line: my kids are happy. They are healthy. They are curious. They have a sense of wonder. In general, they are kind. They read lots. They ask lots of questions. They know we expect them to work hard for their learning, to do not just "good enough" work but their best work always, and to accept the fact that they can't have every material thing they want. They have an abundance of what they need, and much more besides.
Most important, when they see our faces greeting theirs, they see us light up at the sight of them. They know they are immeasurably loved. They know we intend to be there for them no matter what.
And despite all those years of medical training, we have family memories to cherish. A brass band concert heard from a picnic blanket one balmy July night. Making s'mores in the wood stove one New Year's Eve. Dressing up as a medieval family with a Power Ranger to trick-or-treat one Halloween. Stolen moments, when I was either post-call or, miracle of miracles, actually off duty. Precious, warm, treasured moments.
So when the kids run to the door exclaiming "Mommy!" and throw their arms around me in big bear hugs every time I arrive home from work, or come home after a long night of call, I take heart. I may not be the world's best mom, or the world's best doc, for that matter, but I've had more than my share of the world's best moments.
Friday, September 26, 2008
I talked to her of our good fortune: we are women in a society in which we are free to choose to be wives or not, mothers or not, with opportunities to educate ourselves, vote for our leaders, work at professions of our own choosing.
Sunday, September 7, 2008
"Doctors Wanted - No Women Need Apply" - NOT!
Any time I get a little discouraged or feel a little fatigued about working my two jobs - nine or more hours in the O.R., followed by a commute home directly into the next task, food preparation for the evening meal and after-dinner homework/music/general kid-help - I look up stories of women who had it MUCH HARDER than I do and try to give myself a little wake-up call. I stop whining right away.
Here are just a few of the many amazing stories that have inspired me:
Dr. Susan La Fleche Picotte, born in 1865, was the first Native American woman in the United States to receive a medical degree. She was 24 years old. She was also the first person to receive federal aid for professional education. The M.D. program at the Women's Medical College of Pennsylvania was a three-year program; she graduated after two years at the top of her class. She had been inspired as a child to study medicine by the death of a Native American woman after the local white doctor refused to provide care for her. In 1894 she married Henry Picotte; they had two sons. She had a busy general practice serving both white and non-white patients. Two years before her death in 1913 she opened a hospital in the reservation town of Walthill, Nebraska, achieving a lifelong dream.
Dr. Elizabeth D. A. Magnus Cohen was the first woman licensed to practice medicine in Louisiana. The NLM site relates, "While she was still in medical school, a New Orleans Bee editorial on July 3, 1853, had labeled the idea of a female physician treating male patients as incongruous and improper. In 1898, an editorial in the Journal of the American Medical Association blamed women physicians for the declines in salaries and prestige of the medical profession. Eventually, medical schools began refusing to admit women." Dr. Cohen recounts that as a surgeon she was called at least once or twice every single night before dawn during her thirty-year practice from 1857-1887. Other doctors apparently referred to her as a "lucky hand" in tough cases. She was married and had five children, though only one lived to adulthood.
Dr. Sarah Read Adamson Dolley was the first woman to complete a hospital intership, in 1852. Her interest in medicine was sparked by a physiology book given to her by her teacher, Graceanna Lewis, to read at home. She practiced OB/gyn and ran a medical practice with her husband, with whom she had two children, one of whom died in childhood. "Her vivid correspondence documents her success in creating a solo practice after the death of her practice partner—her husband. They also reveal her anguish over how to support her son, pay for his education (he, too, became a physician), and how to overcome the resistance of her male colleagues. But her letters reveal that in her rise to success, nothing was easy, especially without a role model to guide her."
Dr. Halle Tanner Dillon Johnson was the first woman of any ethnicity to be a board-certified physician in the state of Alabama. She was already married and a mother when she began her medical studies and in 1891 earned her medical degree from the Women's Medical College of Pennsylvania with honors. While "southern newspapers had scoffed at the idea of a black woman even applying to take the [board] exam," in that same year the New York Times took note of her success in passing the grueling ten-day Alabama State Medical Examination. Alas, her career was brief. She died of childbirth complications on April 26, 1901.
Finally, though I don't think she was a mother as well as a physician, I want to honor Dr. Elizabeth Ann Grier, the first African-American woman licensed to practice medicine in Georgia. She was an emancipated slave who alternated every year of her medical education with a year of picking cotton in order to pay for her training. "When I saw colored women doing all the work in cases of accouchement [childbirth]," she said, "and all the fee going to some white doctor who merely looked on, I asked myself why should I not get the fee myself. For this purpose I have qualified. I went to Philadelphia, studied medicine hard, procured my degree, and have come back to Atlanta, where I have lived all my life, to practice my profession." Sadly, she died in 1902 after practicing for only a few years.
It's stories like these that let help keep me going, putting one foot in front the other and telling myself, "You can do this. You totally can." I think we have to keep passing on stories like these - to our students, our colleagues, our children, ourselves.
Wednesday, September 3, 2008
Girl Bonding 101: Moving Beyond Netter
I just looked over at my 10-year-old daughter (soon to be 11), and for a second I saw a young woman sitting in the armchair. Or at least, a young pre-woman. Ack.
She has shot up several inches and a couple of shoe sizes this year. I feel like she goes up one Tanner stage every week or so. Her face has gradually acquired subtle, more mature angles, and let’s not even talk about the rest…
She builds sand castles at the beach and sleeps with her teddy bear. But she also notices attractive young actors or singers, and her comprehension of the nuances of flirtation is accelerating at an alarming rate. She is bubbly and all smiles and hugs one moment, irate and scowling the next, at the slightest provocation. She can still enjoy Sponge Bob, but she can also start to discuss American politics and social issues. I am amazed and thrilled and in awe and totally distressed.
I want to tell her pituitary axis: whoa! Slow down! Childhood’s short enough! But it’s useless.
It’s time to have THE TALK.
No, not that talk. We had that talk when she was eight, because the kids at school were already disseminating all sorts of sketchy information about reproduction and childbirth. I told her I was okay with her discussing reproduction and childbirth but I wanted her to have the right information – and who better than her doctor-mom to provide it, right?
Now, I am sure there are lots of people out there who can describe the “right way” and “wrong way” to handle sex education. I myself got “educated” in a bit of an unusual way. I was in a book store when I was five and saw a book entitled Where Babies Come From, or something like that, illustrated with some cartoon-like illustrations. I had been reading for about a year. I picked up the book, learned the facts of life, and, bored out of my mind, put the book back on the shelf. My mom was a little surprised, I think, when, after she expressed doubt that I actually knew about intercourse, I explained the process to her fairly accurately. It was only later that the more abstract concepts came within reach.
When my daughter asked me where babies come from, I said, “Cells, of course. Remember how I told you all our bodies are made of little, tiny things called cells? Babies start out as little clumps of cells inside their mothers and grow bigger and bigger with time. The parts of the body develop as our cells make more cells.”
That explanation satisfied her for a while, but then the inevitable came: “How do the cells get inside the mommy? And is it true that mommies push the baby out through where they pee?” That was the part the kids at school were talking about.
That was the part that made me thankful I'd hung on to my Netter Atlas of Anatomy from medical school. I sat my daughter down between my husband and me and we explained the relevant mechanics of reproduction step by step. I explained a little bit about menstrual cycles. I drew simple diagrams of female internal organs and used Netter as a supplement. Last but not least, my husband and I both expressed our personal values regarding the place of sexuality in the context of human relationships. As our daughter listened I felt proud, because she seemed to be listening so thoughtfully.
Lately, though, now that she’s a little older, she has acquired a kind of embarrassed reluctance to discuss “woman stuff.” When she was eight we could almost sense a certain pride in her at being entrusted with these more “adult” concepts. Today, however, she’d really rather not talk about them. But I feel I have to get us talking about them, not only to reinforce the idea that it’s okay for us to talk and for her to have questions, but also to make sure she doesn’t feel anxious or uncertain or ill-informed. Sometimes it seems like it's almost easier to get patients to open up about personal things.
I wanted to have the talk about menarche. I think it’s imminent at this point. But how to create a level of comfort about the subject? And to make sure we’re prepared, together, before the moment arrives? I want her to feel good about growing up, to celebrate each milestone instead of dreading or being unpleasantly surprised by it.
The other night an opportunity arose. I don’t quite remember how. But the subject came up, and I asked her if she had any questions about periods.
“No,” she answered emphatically, casting her eyes down. I could almost hear her mortified mental voice asking me, Please don’t give me an awkward, long-winded lecture; please don’t start looking for “ins;” and please, whatever you do, don’t ask me if I’m sure about not having any questions.
“Are you sure?” I asked, stupidly. So predictable.
Then I started to babble. I told her she could always come to me if she felt unsure or worried about something. I told her it wasn’t at all scary to get a period if you knew what to expect. I told her I would go with her to the drug store when the time came to look at the options in terms of supplies.
Then it happened. I got my “in.”
“Actually, that’s the part I wasn’t sure about,” she said, looking up again.
“What’s that, honey?”
“The supplies part. I don’t exactly understand how they work.”
Relief! She had given me a concrete way to nurture and support her! Hallelujah! I launched into an enthused discussion - not, I hoped, an awkward, long-winded lecture - about the pros and cons of various types of supplies, demystifying the “anatomy” and mechanics of each with appropriate exhibits. I explained what I liked and didn’t like about each option.
Sometimes, whether it’s a patient or a beloved child, it can be so tough to talk about so-called “sensitive” issues. And somehow it can be much easier to be direct with total strangers. “Are you sexually active?” we ask during a comprehensive medical history. “With one partner or more than one? Male or female?” I can do all that "doctor stuff" without batting an eyelash, but somehow when it comes to the mother-stuff of making sure my daughter’s emotionally okay, or figuring out if I’m asking too much or too little, saying too much or too little, I feel much less certain that I’m doing an adequate job. There’s no Netter Atlas of Parenting, after all.
I guess I just have to take my cues from her.