I know you hate this!

When you were younger, you built a house of your own design with your own hands for your family.  In later years, I watched in awe as you rebuilt the kitchen, and I questioned how you knew how to do it.  You answered all of my numerous questions, you always did. When I was a small child, you built us a go-cart out of plywood and pushed my brother and I around the back patio until we, not you, tired.  You used to let us sit on your back while you swam countless laps in the pool.  You taught me advanced algebra when I was in junior high school. You were my young, healthy grandparent.  You seemed invincible to me.

In more recent years, you showed me an article on the 50 worldwide destinations an avid traveler should go to. You had been to 36 of them.  You told me stories of each. You recounted the numerous books you had read and why you enjoyed them. A few months ago, we sat around your most recent large jigsaw puzzle and you told me about going to the Chicago World Fair on your way out to Annapolis to start at the Naval Academy.  You told me about dropping out of the Naval Academy to marry the love of your life.  You’ve told me other stories too. You have lived a long and adventurous life.

Yesterday I visited you in a hospital room, you can barely move, you can’t speak, but you held my hand.  You opened your once beautiful, clear blue eyes that are now cloudy and unfocused.  You didn’t see me, but I saw you. You probably don’t know what has happened to you. You who have always been so proud and strong willed, lie in a hospital bed.  My heart aches to see you like this. I know you hate it too.

To me you will always be the Johnny of my childhood.  I love you!

Why I went to Kidspace

I voluntarily went to a children’s museum last week.  There is either something wrong with me, or I have a reason.  Trust me,  I have a reason!

My godson is 4 years old.  I want him to know that we have a special relationship that I am one of the few adults outside of his family that he can count on.  So, last year I decided that for his birthday he needs nothing material, but I want him to have childhood memories of our relationship.  So, I started a tradition of taking him somewhere special for his birthday.  His mom suggested the Noah’s Arc exhibit at the Skirball museum. It was a huge success.

 

So, this year, I stuck with the same plan and offered to take him on another day trip this year to Kidspace.  I picked him up from daycare.  He introduced me to his friends as his Auntie Lisa. I smiled.  He had his happy face on the whole way to Kidspace.  We took pictures when we arrived.

 

He discovered a model of the solar system

He climbed an ant hill

He made music using water guns on drums

He rode around the trail of trikes

 

Then we went to my parents house to get my dog, and we played bingo- he lost he didn’t care

 

 I spent the day with my godson. It was priceless.  

I thought i was doing well

I went swimming this afternoon after hiking this morning.  I am brimming with energy now and so happy to have been active all day and had an awesome lunch with my hiking buddy in between.  Plus, it has been one of those days that has made me take pause and give thanks for my life and where I am physically and emotionally now. Here's why.

Whenever I go swimming I choose my lane carefully.  Trying to avoid the old people who don't swim in straight lines and the young kids who are playing.  When I got to the pool, there was one lane with a guy swimming beautiful clean, easy strokes, at a good clip.  My kind of lane partner.  I joined him and we pushed each other to keep our pace up. He took breaks, I did speed training, he did a long swim, with the styrofoam training thing between his legs (ie. not kicking), and then he got out of the pool.  I was taking a break and noticed him getting out because he carefully raised his body out of the water. He swung his legs over, passively.  Then he hoisted himself into a wheelchair, while saying to me "Nice Swim, see you soon."  "Yeah, you too," I replied, "take care."  I noticed it, I took pause.  I hated being in a wheelchair. I feel so much sympathy when I see someone in them now.  Especially, someone so young and vital and strong.  

 I feel like I have made such great strides in the two years since I was allowed to start walking again, but this guy.  I know nothing of his story. I have no idea how long this has been his lot. I don't even know his name, but he made an impression on me. I hope he is well.  I hope this is temporary and that his happy face isn't just a mask.  I hope I see him swimming again.  

Good Luck, Mr. Swimming Man.  Thanks for making me appreciate things.

Reflections on New Intern Week

It is new intern week in teaching hospitals all over the country. The bright, shiny faces of brand new doctors who have their degree but only limited practical experience enter into the world of their real medical education and in some cases indentured servitude. The past week I have watched the new interns being toured around my hospital, appearing in the cafeteria en masse all tanned and relaxed appearing. New intern week doesn't effect me too much because we don't let the interns anywhere near our unit. Still seeing them around reminds me of that time 12 years ago when I was one of those bright, smiling faces in a different hospital, but the same deal.

I did a pediatric residency, because I wanted to be a neonatologist. I am unusual like that. I didn't much like general peds, but it was a necessary step. Anyway, as I knew what I wanted to do, I wasn't too scared when I got my schedule and saw that I would start in the NICU. My two colleagues were petrified. I was excited. Even more so because I'd be on call that very first night as an intern. We got oriented, we did our work. We had almost no idea how to do anything, but our chief resident and fellow were very helpful and supportive. We all got through the day, my new friends left, and I stayed behind to take my first call. A very brief time later, I attended my first ever delivery of a 25 week, 500 something gram baby. My fellow did most of the work, but she taught me what needed to be done and how to do several new (to me) procedures that night. That little boy became my patient, my teacher. He taught me so many of the fundamentals that I still use today. I followed him all month and then when he was ready to go home, I became his general pediatrician. He actually made it through his course of being a 25 weeker without any signfiicant complications and by the time, I left residency he was 3 and doing remarkably well. He was the last patient I ever saw in a general pediatric clinic.  I still get letters from his mom every so often. I will think of him celebrating his 12th birthday this week. I hope he is well.

This morning watching the new interns at breakfast, I was reminded of that long ago night, and that little boy. I was also reminded of who I was all those years ago. I hope that I haven't totally lost the amazement that I felt in caring for this little tiny baby. Certainly, I know what I'm doing now, and I have been to hundreds of deliveries like his, but he is special to me still. Also, I hope that I will never lose the drive that brought me into this career and that makes it more than just a job. 

My dog has brain damage

 I am convinced my dog, Sadie, has brain damage.

Last night, I was eating with a friend outside, when all of a sudden Sadie is facing a  low lying brick planter wall with her hackles raised, growling.  My generally sweet tempered dog was clearly incensed.  The growling continued and escalated, her ears and tails were down as she pawed at the ground, and then started barking.  As we tried to control our laughter at my dogs stalking of a wall, I went over to asses the danger.  She became frantic that her foe would hurt me.  Turns out the "foe" was a small FEATHER.  Yep, my brain damaged dog thought I was going to be attacked by a feather.

I certainly sleep better at night knowing what a  good guard dog lives in my house.

Who me, I didn't do anything.

Destination: The Far East

I've done my share of travelling. I've done my share of medical volunteer work, locally and abroad. I've been to Nicaragua several times and had to cancel a trip when I got sick. Ever since then, I've been searching for opportunitites to get back in touch with that side of me that is fueled by being involved in something so much bigger than yourself. I have had many opportunities presented to me over the last year, but for one reason or another none worked out. However, a few weeks ago I was contacted to join CHLA's trip to Mongolia as they wanted to focus on some more maternal- fetal- neonatal health issues this trip. The trip works with my schedule, works with my plans and so I'm in. Plane tickets are reserved and will be paid for by the end of the day. I've never been to Asia, I'm a little nervous, but I'm really excited.

One of the big issues with this kind of work is to find a way to make sustainable differences in the healthcare in developing nations.  This is a huge topic and used to be a source of much dialogue amongst the Nicaraguan group.  Certainly they need supplies, but also standards and education.  The thing I really like about the approach of the CHLA Mongolia mission is their appreciation of those issues and the dedication to going there in order to provide not only education and support during the time that we are there, but also working with the health ministry to establish some standards for continuing education for physicians in Mongolia. Also, there is some effort being spent on extablishing internet based education and support materials for the doctors and nurses there.  I had lunch with the organizers yesterday, and got quite excited about what they're doing.  So now I'm trying to convince a few others to join me. Either way it is a great opportunity.

After spending a little over a week in Mongolia, I am going to continue on to Bali for some vacation while I am on the other side of the world.  I can't wait.  More to follow...

Something Good from Swine Flu

I happened to enter my hospital through the main entrance for the first time in weeks and walked straight into several signs warning everyone about extra precautions due to swine flu. Signs remarkably like this one.


Reading, don't visit if you have fevers, aches, chills, cough etc. Further, as staff of the hospital we have gotten multiple emails saying that if you have any of the above symptoms, you are to go to employee health and get swabbed to see if you have swine flu before you can work. The staying away from work if you have a cough, cold, chills etc., I get. The idea that we are to get screened and if it isn't swine flu you can work. That I don't get. But alas, baby steps right. baby steps.

I have made it clear that I find all of this swine flu hysteria a litte rediculous, but there may be some good messages coming out of it. I work at a Children's Hospital taking care of critically ill babies. Viruses that cause the common cold in adults and healthy, older children can be deadly to my patients. It seems like almost every year, we have some parent visit their child with a runny nose and wind up spreading their virus to their child and others. These same viruses that can cause severe respiratory issues and can be deadly to former preterm babies, babies with congenital heart disease, etc. and not even to mention all of the patients in this hospital getting chemotherapy. There are a hundred reasons to screen visitors before allowing them to come into the hospital and if swine flu is what has finally gotten this done. I'm OK with that. I just hope that people will continue to be vigilant when this hysteria has passed and realize how much broader the threat is to medically fragile babies and children.

Please think about these things before visiting the medically fragile, whether in the hospital or not. Thanks