Why I love College Football- Or how a friendship began!

So, unless you've been living under a rock or don't know me at all, you know that I'm a sports fan.  I love my Lakers.  I'm a Kings fan.  I kind of like soccer, especially the World Cup. But I love college football and my Fighting Irish!




I've loved college football since I was a kid and grew up going to USC games because my family had season tickets (mom's an alum).  Those 6 or 7 Saturdays every fall are great childhood memories.  Mom would make us my favorite sandwiches, ham, provolone, and pepperoni- no mayo for me thank you very much.  We'd picnic on the lawn in front of the Natural History Museum on SC's campus.  My brother and I'd throw the football around.  We'd go to the games.  Cheering for SC with everyone else.  Even as a little girl though I refused the whole "Fight On" thing.


Still when I started thinking about choosing a college, I felt no affection towards USC. Those days were separate.  Starting in high school, I used to always think that the other fans were classier, their cheerleaders better, more collegiate somehow.  My senior year in high school, Rocket scorched the SC defense as the Irish destroyed the Trojans en route to their last national championship.  I'd already decided to apply to Notre Dame by then, but I remember observing the crowed watching the game. I cheered for ND for the first time that day.


Then my college years started and a fall football season at Notre Dame is like no other experience.  Sure I love the game, but its about the loyalty and rivalries that people feel for their schools. That is what I loved, still love.  I was hooked.


As an adult, I still love college football, it reminds me of my days in college, good memories of those football Saturdays bakc int he day.  A few years ago, I took care of the son of a guy who played for one of ND's rivals.  He told me about playing against Montana.  As our game approached we placed a friendsly wager of $5.  His son, now 5 is thankfully healthy, and every year the bet is renewed.  This is why I love college football.  Sure our schools are rivals, but there is a respect for the traditions.


 When I joined twitter, on those days that I'd watch ND games on my own.  I'd live-tweet them.  I noticed others doing the same.  One woman stood out.  She clearly loved her team, but she appreciated others who loved their teams.  Thus,  a "friendship" was born.  Initially I didn't even know that Jen lived in Los Angeles.  She was just a football fan I twittered away with on Saturdays.  I have many sports fans like that.  Mostly Lakers fans, but I appreciate them nonetheless.


Then last New Years Day, I met Jen for the first time at my friend Kim's New Years party. A friendship grew.  We respect each others love of college football and our teams.  So when the god of bowl games decided to have our teams play each other for the first time since we were in college.  The idea of a roadtrip took oh about 20 seconds to blossom.


Therefore, I am going to drive to El Paso with Canes fan Jennifer Vides and we're going to love every moment.  If you wanna follow these two crazy football fans from rival schools travel together, check out Football-Loving-Women!


Go Irish Beat the Canes!!!

Waiting....

I walked around the unit the other nigth and paid attention to the look of anxiety on some of the parents faces.  I'd stop and chat with them and listen to their concerns.  More than one parent was anxiously awaiting some sort of test result on their baby.  Being the end of Thanksgiving weekend the wait was slightly longer than average as routine tests and procedures don't usually happen over the holidays.

I feel for these parents waiting anxiously.  One dad in particular was so frustrated.  I know that the info he is waiting for isn't going to change anything in our treatment of his baby, but I still understand the anxt.  I made one of the only promises I ever make to parents to him.  "As soon as I know, you'll know."  There are only 3 promises I ever make to the parents of my patients and that is one of them.

It has always been something that has been important to me.  This sharing of information, or results as soon as I know them.  I strongly believe that as physicians we must be in partnership with our patients and their families.  It is their baby who's care is entrusted to us; thererfore, they must be given information as soon as possible after it becomes available.  We must help them to make informed decisions when those decisions come up.

As a patient, I understand that waiting game.  I am waiting right now.  I should hear soon about what the plan is for my surgeries.  A few weeks ago, I was waiting for the phone to ring to give me my results. I hate waiting.   Still, I feel a combination of wanting to know and a little fear at the answer.  Somehow it has been easier to deal with since I knew for sure that I have a recurrence.  Reality is so much easier than fantasy or fear.

So, I wait....  I hope that my time on this side of the doctor-patient relationship will continue to make me a better physician in the future, that I will conitnue to grow through my experience.  That would be a good thing!

My Promise

You grasp my finger with your tiny hand.  My finger that is bigger than your arm.  You who are impossibly small, but perfect and feisty. You sometimes kick and cry.  Your little arms and legs stretching out into the world around you. I examine you every day and promise you that I will do the best that I can to help you grow.


Your mom looks at me with fear in her eyes.  I promise her that we will do everything we can.  That we'll be with her every step of the way.  We say having a preemie is a roller coaster ride.  I hope that she knows we'll support her on this trip.


This is why I do my job. My goal every day is to do my best for you and all the other babies in my care. You who are the size of my hand, may I be up to the task.  This is my wish!

Magic- Lessons from Plants

I have this plant on my porch.  Its a desert succulent called a Night Blooming Cereus.  I've written about it before, but typically this plant has one bloom a year.  Each flower lasts for only one night.  It opens after darkness falls, and the bloom is dead with the rising sun.

For those few hours while the bloom is open it sends the sweetest aroma wafting through the air.  You can't stick your nose in the bloom and drink in the smell like a rose, you have to sit 5-20 feet away and slowly breathe.  The rewards amazing!  This smell is not to be bottled, not to be sold, but savored and enjoyed as you take a few moments break.

In the summers of my youth, my dad would sometimes wake my brother and I late at night so that we could experience a moment of this flower's brief life.  He told us that the night that the plant blooms is an auspicious one and given its fleeting nature, we should make a wish.  Some kids wished upon a shooting star or a fallen penny, but I wished upon a flower who would only grace the world for a precious short time.

Therefore, I always feel a special sense of something: nostalgia, hope, dreams on the night that the plant blooms.  I've been known to cancel plans to just sit on the porch and drink in the aroma.  I feel cheated when I miss the flower.

Some years, crazy weather patterns will allow the plant to bloom twice.  Then it is that much more special, that much rarer.  When I came home from work this morning after an exhausting, trying night, I immediately smelled it.  The plant had bloomed!

I poured my coffee and sat on my porch and took in aroma and felt that sense of hope and peace.  I pray that the second bloom of the Night Blooming Cereus grant us all good luck and fortune!

Malibu Triathlon

Last Sunday was race day!  The Nautica Malibu Triathlon to benefit Childrens Hospital Los Angeles.

I've been training for a few months, I did my best to taper the week leading up to the race.  Saturday night found me with pent up nervous energy from tapering, ready to do this thing, but feeling anxious about my prep.  Nonetheles, my calmer side prevailed.  I knew that I was as ready as i was goign to be. So, I managed an early evening to bed and a blissful sleep until 3:45 when my alarm went off.

The first thought as my alarm blurted out Indigo Girls music was I need a new hobby!  Still it was race day, so I got up.  Stretched, made breakfast changed and drove to the beach as what still an hour before Oh Dark 30, the freeways were empty.

I made it to Zuma dealt with the parking mess, got my stuff to the transition area and got my stuff arranged for the feat to be done.  I got myself into my wetsuit and headed out to the beach to wait for my wave to start.

As we all gathered on the beach the prerace meeting, the energy in the crowd was palpable.  They announced that we had raised over a million dollars for cancer research at CHLA, amazing!

Then began the long wait to start my race.  I was in one of the last waves to race, so I was standing on the cold beach for over an hour.  My foot, never a fan of the cold with its poor radiated nerves, was so cold and numb.  I started to worry, once my foot goes numb it usually stays that way.  This could go poorly.  However, I couldn't focus on that I had the ocean to contend with.

Finally it was time for my group to enter the water.  We ran into the surf that was blissfully not too violent this year.  I did my best to just focus on my swim, but I really don't like getting kicked and hit while in the water.  There is just no way to make me feel comfortable wtih that.  Each time someone ran into me, I'd lose my rhythm.  Oh well, I was able to keep going.  I rounded the last bouey and was able to catch a wave partially into the shore.  0.5 mile ocean swim 20 minutes.  I'll take it.

Into the transition area I ran, now painfully aware that my foot was completely numb.  I managed to get out of my wetsuit, into my bike stuff and out of the transition area in just over 6 minutes.  Oh well, I haven't really practiced fast transitions.

The 18 mile ride along PCH was beautiful.  There was one scary moment when the woman in front of my crashed getting onto the little ganglplank to go over the flooded underpass, but other than that the bike was a nice recovery.  My numb foot didn't hinder me too much. I was able to eat some food and drink some water.  Kept to my rhythm, I kept to my pace.  It was good.  18 mile ride along PCH 1:05.  My goal was to do the ride in about 1 hour. OK, i was a few minutes over.

Back into the transition area, this foot thing was a problem.  I could barely manage to get completely numb foot into my shoe.  I tried stretching briefly, no improvement.  Undaunted, i headed out.  Each step felt like little needles coming up through my leg, but I carried on.  I was encouraged by all the people lining the rae course cheering on the CHLA team.  The few peopel I knew cheering me on. It helped to keep me going.  I made a quick pitstop and kept running.  There was no way my will would allow me to stop.

My timing chip thing didn't work on my exit from T2, so I don't have an official fun time, but it was about 40 min for a 4 mile run.  Slower than my usual pace, but considering my pitstop and the pain from my numb foot I'm good with that.

Total time 2:17.  I called two hours and 15 minutes Friday night and was pretty close to that.

It was a great event, great energy, great comaraderie.  So fun to have gotten to know some of my work colleagues in a different way.  I'm so proud of the community support for CHLA.  It was funning seeing all the other teams out there racing away.  An amazing day!

NICCU Reunion 2010

Every two years, we have a reunion for the graduates from our NICCU.  It is always an amazing event lovingly put together by our nursing staff, and an event that highlights why we all do what we do. I try to never miss a reunion.  I wrote this after the last reunion in 2008.

Therefore, this Saturday afternoon found me at Live Steamers in Griffith Park. Immediately upon arrival I was treated to the sight of a miraculous set of twins who are now 5.  They are beautiful and although still small, they were running around playing together and with some of the other children.  They played like 5 year olds should. Their mom instructed the little boy to hug and thank me, and I choked back the tears. 

Then I saw another family whose now 5 year old daughter is also one of our graduates.  She was off playing with her older sibling.  Happy smiling, talking away, beautiful, precious, as all children are.  Her mom said to me, “We’ve never forgotten the first time you came to her bedside and didn’t hide your smile.  It was the day, we believed our daughter would survive, would come home. Now look at her.”  Now look at her indeed, they photographed us together.  More tears threatened to make their presence knows.

However, I got sidetracked by a 3 year old who ran past me sporting a shirt that declared “Chicks dig scars!”  We all laughed at his parent’s sense of humor. However, knowing that boys story to see him thriving in this way was amazing.  He arrived at our hospital months into his hospitalization for extreme prematurity barely hanging on.  He stayed with us for many more months.  That he is running, talking, playing is amazing.

One family, walked the grounds wearing t-shirts emblazoned with the image of their baby who was in our unit, but didn’t survive.  That they would still come to thank us for the time they had with her speaks volume to what happens in our unit.  Speaks volumes to some of the amazing people whose children we’ve been honored to care for.

Other families, came up to me showing off their children.  Many still bore the signs of their rough beginnings; however, several I had to ask which of their beautiful children spent time with us.  The entire day was an overwhelming blur of emotions.  Working in this field can be exhausting and trying and takes an emotional toll.  However, seeing these children play and the gratitude in their parent’s eyes, is all the thanks I need!

I left the reunion so proud to be a part of this amazing group to get to play an integral role in some of these families lives.  I’m humbled and proud!

Final Triathlon Prep! (AKA: Why they call them Bricks!)

My last weekend of real training for my triathlon on Sunday was a week and a half ago.  I had the weekend scheduled to do back to back bricks.  Saturday- Bike, run!  Sunday- swim, bike!
They call them bricks because when you get off of the bike or out of the ocean your legs fill like bricks when moving to the new discipline.  Therefore, training back to back is essential to prepare for race day without injury.

Saturday's plan was to ride near the race distance and focus on speed since lately I've mostly been doing distance rides.  My goal is to finish the 18 mile ride portion of the race in an hour, totally doable, but it will mean pushing myself.  Therefore, I headed out on a ride I've done routinely to meet that goal.  I rode from my house through Griffith Park, past Forest Lawn cemetary, through Burbank and then back along the LA River ride, 20 miles according to my cat eye. It took me just over an hour.  Therefore, feeling confident I headed out for a 3 mile run.  There is no such thing as a flat run near my house, and that run was agony.  My legs complained every step.  I was soar and tired and could barely make it.  That is why they call them bricks!

Ack, defeated!  I tried to console myself by the fact that I had worked out once or twice a day for the preseedng 3 days.  I did a killer spin class two days early and lots of weight training.  So, I told myself, I'd be OK.  I rested Saturday afternoon, visited my friend with a hottub, stretched, tried to eat right, so that I'd do better on Sunday.

Early Sunday morning found me sitting on Zuma beach ready to practice entry and exit through wves that were towering over my head.  We went in and out to a  starter's siren three times swimming almost the distance of the race, but the hardest part.  Then my friend and I headed off to ride 20 miles along the race route.  We made it in an hour!  Quickly we changed our shoes, locked up our bikes, and then headed to run 3 miles or so down the beach.  Therein I realized the saving grace, the race course is flat! That run was easy!  We made it right on target around 9 min miles!  We finished feeling confident that we were ready!

Race weekend has come upon us.  I've done what I can to prepare and I'm overwhelmed by the generosity of my colleagues, friends and family who have supported me.  I'm buoyed by their faith in me.

I'm ready!  Bring it!

Denial

Denial aint just a river in Egypt!

I read through my tweets from last weekend, and I had to laugh at myself. I transitioned from complaining about the denial of the parents of one of my former patients to happily entering into my own state of denial.  Denial can be an important coping mechanism, but it can also be dangereous, so very very dangerous.

In the case of my patient, her parent's denial lead directly to harm being done to her.  Lead to them puposely not bringing her medical history when they brought her to a different ER hoping against all hope that they would be told something different.  That they could be told she was fine.

It makes me sad.  She is a beautiful little girl. Of course they want something different than to accept that her time is limited.  Because that is awful, unbelievably awful. Still the fact that painful, unnecessary things were done to her is also awful.

Yet still I laugh at myself because, not 12 hours after I tweeted about the strength of their denial and how sad it made me.  I sat in my doctor's office and heard that I might have a recurrence of my cancer.  I was numb, I couldn't think, I couldn't believe what I was hearing.  How can that be??  I'm the picture of health.

My own denial kept me from asking the questions I needed to ask.  My own denial kept me from demanding to find a way to get an answer.  My own denial was every bit as strong.  Every bit as potentially harmful to me, to my health.

Fortunately, within 24 hours, I was out of my state of denial and ready to deal in facts.  I talked to my doctor today.  I'm having more tests done.  We're working on a plan.  I'm out of denial but still oh so scared!

Swimming in the Ocean isn't Just a Walk in the Park!

I’ve been swimming since I was a small child.  I swam competively in high school.  I’ve swum more laps in various pools than I count.  Sighting along the black line at the bottom of the pool, flipping off the walls. I am comfortable in the water, I always have been.  It is rote muscle memory for me to swim a few thousand yards. I’ve written papers, blog posts, and even had arguments in my head while automatically gliding through the water.  However, these days, I typically just count the laps and relish in the fact that it is one of the few times in my overly connected life that I am completely unreachable.

Suffice it to say that when I decided to do my first tri last year, the 500 yd swim didn’t even give me pause.  I had no concern over that part of the race.  I hadn’t been on a bike in 10 years, and I hadn’t run over 2 miles in about 5.  So, I had other things to focus on. Sure I swam during my training, but it was the easy part.

Then along came race day….

The swim was horrible!  I was completely unprepared for open water swimming.  I had no idea how to sight in the open water.  People kicked me, clawed at me, and I couldn’t see my hands in the water.  Afterwards, I didn’t get back in the pool for 5 months.  I felt anxiety about swimming for the first time ever.

So, when I started training for my upcoming race, I had a mind block against the swim, but I knew I had to get in the ocean and prepare.  I’ve worked my way up to it by doing open water swims in LongBeach Bay and Lake Arrowhead, but that isn’t an ocean.

So, last Saturday, found me sitting on the sand at Zuma Beach in Malibu waiting for an ocean swim training class…

It was good, being with others who have similar issues.  We practiced entry and exit from the ocean.  We practiced swimming while sighting.  We swam only about 500 yards or so in total, but it was enough. 

Afterwards, I went for a 50 or so mile ride along PCH with some colleagues from work.  It was a beautiful day to ride PCH.

I’ll be back this Saturday, and am practicing the swimming with a head up stroke every 10 strokes in the pool.  I’m going to rock this thing!

I’m doing this to support Pediatric Cancer Research at my hospital.

If you want to support me, follow the link here!

Thanks, all!

Reality Check on Foreign Aid

I heard the news today of the medical aid workers who were killed in Afghanistan over the weekend and my heart fell.  As a physician who has spent a fair amount of time in devloping countries providing healthcare, I have always been aware of the inherent risk involved.

In one of my many trips to the Atlantic Coast of Nicaragua we were on the road between Bilwas Karma along the Rio Coco and Puerto Cabezas, which was our home base, when we were passing through a small town and were held at gun point until our Miskito translator could convince the drug runners to take money and let us go safely.  Looking back on that incident 10 years later, I am aware of how easily it could have gone the other way.  At the time, I trusted that they wouldn't really hurt us.  Naivete can be so dangerous.

While in Haiti, our compound was under lockdown several nights due to civil unrest.  Several of the people there complained about that, but I figured they knew more than I did, and I was perfectly happy to be kept safe.  Plus, from the perspective of Project Medishare an entirely volunteer run organization that was requiring 150-200 volunteers a week to function.  Any perceived increased threat to the workers could cripple the organization, and, despite the difficulties, I believe that organization is doing good work.

The night before I arrived in Haiti, there was a bus accident involving a group of college relief workers.  Several of whom were critically injured.  They were all taken to the Project Medishare hospital because even though it was  "hospital" in tents on the airport, it is one of the best staffed trauma centers on the island.  Many of them had to medivacced to Miami after stabilization.  I shudder to think what might have happened to those teenagers without that group.

So, back to what happened in Afghanistan. Apparently it was a small group with a Christian affiliation that was conducting eye clinics in a small province and they were killed on a mountain pass near where this picture was taken.  The Taliban has claimed credit for the killings of the 8 medical aid workers and their Afghani translators for "trying to convert the Afghan people to Christianity."

It is horrible, my heart aches for their families and the loved ones left behind.  I miss my 20 something year old self who was certain that even with a gun pointed at me I'd be fine.  I pray for all relief workers, and especially for those who were involved in this tragedy.  May it not prevent others from being willing to give.


My dad made me write out a will and file durable power of attorney paperwork before I went to Mongolia.  Maybe he had a point even though I didn't want to think about it. Will this deter me from doing this kind of work in the future, probably not.  I don't want to think that my idealistic side is dead.

To Vaccinate or not to Vaccinate!!

I wrote this post last year.  I decided to repost today...

I read this article in the LA Times yesterday about vaccines and recent outbreaks of Measles in certain communities and it made me mad.  I well realize that parents on both sides of this argument feel very strongly.  So, this could get me in trouble, but I'm willing to take the risk.  The gist of the article is that in California there is a rising number of kindergartners who are getting vaccine exemptions  (essentially the parents saying we don't believe in vaccinating our kid).  They just have to sign a form and the kid can enter school unvaccinated.  This isn't such a problem if the majority of the other kids are vaccinated, but with as few as 5-10% unvaccinated kids you can get mini epidemics of diseases that are otherwise quite rare these days, ie measles, mumps, diptheria etc.  According to the LA times there have been several such measles outbreaks in the San Diego and the rate of unvaccinated kids is especially worrisome in several charter schools and non-catholic private schools.

OK, here is my take on this vaccine thing.  When I was a pediatric resident at the beginning of every year in clinic we reviewed the vaccine schedule, risks and benefits of all the vaccines and why we vaccinate against them.  As you can imagine, by the time we were third years my friend and I would joke that the reason to vaccinate against these diseases is because they can KILL.  Most of the diseases vaccinated against are things that kill people.  (OK recently we've added a few not so deadly disease to vaccinate against and I used to use this same argument to question if that was right).  But I digress the main issue at hand seems to largely be the Measles/Mumps/Rubella vaccine (MMR).  This one started to fall out of favor after an article linked it to autism.  The fallacy of that study is that autism typically becomes apparent around 15-18 months and almost every child gets the MMR at 12-15 months.  The two were temporally linked, nothing more.  The only study that really looked at vaccines and autism rates showed no difference.  So, my argument and what I used to advise people to do if they were really worried was just delay the shot until their child was already talking.  OK, so there is the mercury thing, but manufacturers have gotten into that and combined more shots and made more of the vaccines without the mercury contained preservative so that is pretty much a nonissue.  Of course, again, you can delay, space them out and make it even less of an issue if really worried.

So back to the diseases behind the vaccines, why care.  Let's start with measles since that was what the article was about.  Measles still exists in the US and is especially prevalent in certain European countries, not to mention less developed nations.  Measles isn't so bad for the average school age kid, but it is DEADLY for infants, and not good for the elderly or immunocompromised.  I took care of a 9 month old infant who had measles encephalitis as a resident.  The child spent two weeks essentially comatose.  She ultimately went home, but the long term effects are likely significant.  Hello this baby almost died, her parents were rightly infuriated and scared.

 How did she get it?  Her older sibling's friend wasn't vaccinated.  She came home from vacation with measles and before she got sick played at the vaccinated friends house.  Thereby exposing the unprotected child.  The child who was too young to get vaccinated even though her parents would have.  You see there is the problem.  It isn't just one kid.  It effects the community.  The LA times article had several similar vignettes of infants under 1 year of age being exposed to measles by unvaccinated friends of their older siblings.  The year before the measles vaccine was released-  ~500 people died from the measles and ~4500 kids had measles encephalitis.  Do I really need to say more?

OK, so now mumps.  Mumps doesn't seem so bad, right?  It used to be the biggest cause of male infertility.  That's right mumps infections in prepubescent or adolescent boys can leave them infertile.  How about Polio?  Now eradicated from the Western Hemisphere, but its long term effects were devastating.

I could go on, but I think I have said enough.  I guess my bias is obvious.  Please people vaccinate your kids.  If you're really worried, it isn't terrible to slow down the vaccinations, but please.  These are bad diseases.

So, I have a stalker...

So, I have a stalker..
Or there is a very bad spy?
Or there's a time traveller in my neighborhood?
Or just a very creepy guy?

I run from my house around the Silver Lake Reservoir and back, a lovely almost 5 mile run with a nice amount of hills v. flat, few stop lights, on packed dirt.  I run the route 2-3 times per week most weeks. Sometimes in the morning, sometimes in the evening, whenever I have time.

Still some large percentage of the time, I see the same guy on the same corner in the same clothes. He's older, with a big pot belly and wispy grey hair that always looks the same.  Lately he even acknowledges me.  Who is he? Why is he always in the same spot?  I thought about this while i ran the other day.

Having read the Time Travellers Wife, I wondered if he is a stalker travelling throug time to alway sbe there when I run.  Maybe that explains why he always looks the same.

Maybe he is jsut a sad, lonely old man who stands on the corner all day, but nah that story is sad.  I prefer it to be something fantastical.

Mr. Stalker guy will I see you tomorrow?

Triathlon for a Cause

Last year I completed my first triathlon as a testament to my own health and recovery from cancer. In my mind it was the conclusion of my journey as a cancer patient. It was my way of stating that I had prioritized my own health and fitness.

Initially I never thought that I would do more than one triathlon, but as soon as it was done, I knew that I would do another.  However, I wanted to find a way to both pursue my personal athletic and fitness goals, while also benefiting this community of cancer patients of which I had unwillingly become a member.    The perfect solution is the CHLA/ Nautica Malibu Triathlon, which takes place on Sept 12.  In which I will do a 1/2 mile ocean swim, ride 18 miles, and run 4.

I am proud to work at Childrens Hospital Los Angeles (CHLA), and to be a member of their team for this event.  Even better, the official beneficiary of the nautical Malibu Triathlon is Pediatric Cancer Research at CHLA.

I remember all too well receiving my diagnosis, the first weeks of figuring out what to do, and that feeling of terror and confusion.  I was an adult, a physician no less; therefore,  I had loads of resources and support.  Further, my diagnosis wasn’t life threatening exactly, more threatening to my lifestyle.  I can’t imagine having to deal with that as a child, or worse as the parent of a child diagnosed with cancer.  The money raised by this event will help to give more of those children a chance to learn that through trials you can not only survive but achieve things you never thought possible.  I  hope that more children will be given that chance.

Thank you for your support of me while I train for my first International Distance Triathlon and thank you for your support of the outstanding research being done at Childrens Hospital Los Angeles to help pediatric cancer patients.

In order to donate please click on the link below or you can mail me a check (email me for the address and details.)

Again thank you!

To donate click here!!

Chanting in Haiti..

The week I was in Haiti, I was the pediatric and newborn intensivist. I ran the combined NICU and PICU servicing upwards of 20 patients, the first and only such unit in Haiti. I worked with an amazing team and had lots of help and support. Still it was hard. We had lots and lots of really, really sick infants and toddlers brought into us. Sadly, often near death from dehydration or infection.


The first few days it seemed like there was some direct line from what I was doing behind the curtain that divided the ICU from the peds ward that would let them know when I child was fighting for its life. Without fail they'd start into a religious chant. The entire peds ward would fill with the sounds of the chanting, while the parents, patients, and the workers would clap, dance, and sing. The sound was sometimes deafening but spine-tingling at the same time. Reminding me that I wasn't alone in what I was doing.


On and on the dancing and chanting would go. We would sometimes wish for silence so we could do our jobs, but never really. The experience was too amazing if not otherworldly surreal.

A video that includes the chanting...

Transition

I’ve wanted to write about Haiti, but right now I’m feeling the transition back to my real life… So, sorry that’s what’s on my mind…

While I was in Haiti, I constantly was forced to make decisions based on allocation of limited resources, decisions based on the needs of group, it is not something I am used to. Alas, it is a reality there, if you have two functioning ventilators and three babies who might benefit from being ventilated a choice must be made. Those aren’t easy choices, and they tug at my soul, but I don’t question any of the choices I made. I had to trust in myself, in my training, in my skills.

Yet here we don’t have to make those choices, at least not so acutely. The other night, I was at work and confronted by the futility of so many of our patients. The dichotomy of my limitations in Haiti where I know with a few more resources, I could have saved some of those kids v, the reality of US medicine where we often go beyond what is reasonable tore at my heart.

After the night was over, I sat outside, I ate my breakfast, and I thought. U2’s lyrics played through my head. “Its not where we live that should determine if we live or die.” The problem is, I was equally torn by the kids I couldn’t save in Haiti as those I can here but for whom there is no life, no real independent life. I cried for all of them. I never cry, but alas the emotions overtook me. So, I just sat there and I cried in my coffee. I let emotion have 10 minutes then I collected myself and I went back to work. I had no choice.

I know in time I’ll sort this out. But for now, I’m going to feel this and maybe it’ll help me be a better doctor or maybe just a better person

Tweets from Haiti

So, although I wasn't really able to blog from Haiti, I tweeted my way through my adventure. Here is a summary of my tweets from Haiti for waht they're worth. Real blogging to commence soon. So much to write about.



Interesting crowd heading to Haiti! The adventure is about to begin! #Haiti 



Sitting next to me on this airport is a native Haitian returning for the first time with a disaster relief group. Amazing! #Haiti




And so it begins..... #Haiti




My first glimpses of Haiti reveal a beautiful lush tropical island, but even at the airport the damage is visible. #Haiti

Day 1 of Haiti is winding down, I'm finding my groove, amazing people, united for a goal! #Haiti

Camp is under lockdown tonight, but it's great sitting around chatting with all the other great people here in #Haiti

Happy Haitian Flag Day!!!! (ie. Haitian independence day) #Haiti

My friends were worried I'd come home w a Haitian baby. Holding a beautiful abandonned baby, they had reason for concern. #Haiti

This compound looks like it was taken straight from a scene in Mash! #Haiti http://twitpic.com/1oz1al




I'm melting.........

Finally venturing into the streets. Piles of rubble still line the road, although rebuilding is obvious too! #Haiti

As I watched this mom walk away with her twins the look of fear in her eyes tore through my heart. Www.callmedrlisa.blogspot.com

I just resuscitated a 2 month old while all the Haitians moms in the Peds unit were chanting some prayer. Surreal!! #Haiti




I'm eating a backpackers meal, cause I need the protein. Just realized it has more salt than I eat in a day.

The dedication and compassion of the volunteers here amazes me! #Haiti http://twitpic.com/1pes6m





Last night was a lesson in practicing medicine with limited resources. We do the best that we can. #Haiti

OMG! My ankles are so swollen from being on my feet for almost 33 hours straight. #Haiti



Liquid malaria prophylaxis once again! I deserve it after the last two days! #Haiti




Tonight's malaria prophylaxis was brought to you by these people. http://twitpic.com/1pk3gs




Leaving the Medishare compound today to run a clinic in Port au Prince! #Haiti


The view from the top of the police station in Port au Prince 4 months post earthquake! #Haiti http://twitpic.com/1ps96p


Driving through downtown PaP, there are tents everywhere, sometimes completing filling small streets. #Haiti




The countdown to flush toilets and handwashing has begun... #Haiti

Oh, and a LONG shower!!!!


I just consumed what is hopefully my last backpacker meal for awhile! #Haiti





As my time in Haiti nears it's end, I am finally beginning to process some of the amazing things that have happened this week.




I just took a cold shower outside in the rain, and it was AWESOME!!! #Haiti 4:43 PM May 21st via Twitter for iPhone

Student’s Ear Reattached by Miami Docs in Haiti – NBC Miami http://bit.ly/dduK8q #haiti (via @Haitifeed) So, I was a part of this....

Project medishare had 160 volunteers (doctors, nurses, SW, support) this week. Amazing the capacity of people to give! #Haiti

I've itched ever since clinic yesterday. Scabies is rampant in the tent cities! Gonna bath in permethrin ASAP. #Haiti

As much as I want a shower, debating if I'm really ready to go home! #Haiti

Post #Haiti the throngs of people in the Miami airport are overwhelming to me.

You know you've been somewhere crazy when the restroom on the airplane feels like luxury!! #Haiti

First Haiti Thoughts

Landing in Port Au Prince, my first glimpses of Haiti revealed a lush Carribean island like so many others. The large central mountains, relics of the islands volcanic origin, the rocky coastline, the lush vegetation, then we landed and we were shuttled to the boarding terminal. Damage from the earthquake was still visible in the buildings at the airport. Then we left the airport grounds, and on our short drive, the disarray of the city was obvious. Although despite the extant destruction there were many signs of regrowth.

The hospital at Project medishare is actually on the airport grounds and is one of the larger functioning hospitals in Port Au Prince even though it is basically a Mash unit. I have been amazed at the dedication of the staff, and at what we both can and can’t do. I have primarily stayed in the combined pediatric/ neonatal ICU area, but even there some of these stories are so tragic. For example, tomorrow we will discharge a set of twins, the children were born 3 months early just weeks after the earthquake that claimed their father’s life like so many other Haitians. They have suffered no major complications of their prematurity, but what is the world they are being sent into. Their mom has a spot at a UNICEF tent for Mothers and Babies.

So many more stories, so little time. Each one has its own portion that tugs at your heart.

This experience is incredible and reminds me of the good that still exists in humanity, and the challenges as well.

More yet to come.

T minus 2 days to Haiti

I leave for Haiti in 2 days. I planned on writing all about the build up to this trip, but I seem to have spent my time working instead, sorry.

I am going to Haiti to provide medical relief with a program coordinated out of the University of Miami (blasphemy to us Domers, but still..) called Project Medishare. They are running a Mash style hospital that is on the airport grounds. We will all be staying in a large tent in the compound. We will work at least 12 hour shifts caring for whoever is comes. I’ll be functioning as a neonatal/ pediatric intensivist. I’m a little afraid of the pediatric part, since I haven’t done that in awhile, but it will be fine and there are some resources.

I’m so proud of the number of people from my hospital who are working with this endeavor. The team from my hospital includes a pediatric surgeon, anesthesiologist, peds resident, several nurses and myself. We will be joined by groups from other hospitals. I have no good idea of what I’m getting myself into, but I’ll do my best. That is all I can do.

Mother's Day in the NICU

Working in a Neonatal intensive care unit on Mother’s Day, I watch the mom’s of my patients coming in to spend time with their precious babies who can’t be home with them yet. It is poignant and heartbreaking. One woman, said to me the other day that she just wants to feel like her baby’s mom, and to take care of her. She acts as her mom in everything she does even if it wasn't what she imagined.

Still, I did get to discharge two babies today. Two mom’s got to take their children home for the first time weeks or months after their babies were born. One of these babies is extra special to me, cause I know the family in my real life. She looked at me and said, "I finally feel like I'm his mom." "Oh no," I replied, "you've been his mom and advocated for the best for him all along, but now its time for him to go home." I wish them all the best!


I wish a Happy Mother’s Day to all of you mom’s out there. And a special Mother's Day wish to mom's of sick babies, you often amaze me with your kindness and your patience!

Tri again, this time for a cause!

Last year I did the Hansen Dam triathlon as a testament to myself and my own recovery.  This September, I'm going to do the Malibu tri with the team from CHLA and this time it is all about raising money for Childrens Hospital Los Angeles.

Here is a brief video about the race.

Leap of Faith

Standing on the edge of the Cornice at Mammoth, I look at the precipice of the run I’m about to undertake. I watch skier after skier complete their first turn off of the edge and disappear below.  The sun beats down on me. It is a perfect day for skiing.  For the first time in recorded memory the wind is not howling on this ridge so I can take a few moments to look around, to appreciate the beauty of where I am.

Then I turn my mind back to the run in front of me.  A big group has just gone. It is my turn.  I feel my heart beat faster, those few familiar moments of fear as I prepare to drop into the bowl I can’t see.  I trust in my skill on skis, my experience, my strength.  Yet still there is something awesome about having to take this kind of a leap of faith into that which you cannot see.

I take a deep breath, and I drop from the cornice.  The first few turns are so steep, but the snow is perfect.  I gather speed. I can only hear the sound of my skis speeding over the snow as faster and faster I carve my turns.  My legs, my body respond on muscle memory alone.  I am 100% in the moment, nothing else on the mind.  Just this.  At the bottom, I feel the exhiliration the rush of doing something that seems a little crazy.  There is no lift line.  I go again and again, different runs off the top, the same moment of fear, the same exhilaration at the bottom, until my legs scream that they can take no more.

There are days I walk into situations at work that seem so terrible, terrible beyond anything most can imagine.  I feel a similar moment of questioning, of anxiety.  Am I equal to the task placed on me?  I allow myself to question it, but only for a moment that is all that fear gets.  Then I’m calm and collected as I direct the team.  I trust in my training, my skill, my knowledge, my colleagues.  In those moments, my focus is similar, I am 100% in that moment, yet the two experiences couldn't be more different.  It is a leap of faith of a different kind.

Objectivity

I am a neonatologist, most of you know this. My specialty isn't all about happy endings and everything coming up roses. We deal with critically ill babies, babies so sick or with such rare diseases that they are transferred to us when they cannot be cared for in the community anymore. We have many wonderful success stories. I celebrate those because they keep me going through rough days. However, we also have many sad, sad stories and unfortunately some of the babies who come to us cannot be saved.

In my professional life, I am equally dedicated to saving the babies in my care who have a chance at survival and doing so with the highest level of skill and integrity that I can, as I am dedicated to not inflicting unnecessary suffering when it is clear that there is no possibility of survival. These dual goals of mine are not at all at odds with each other, but they do require extreme clarity and certainty of your knowledge. You must have the facts and when they are unclear fight for life. When the information is there you must be able to tell the family so they can understand and work towards acceptance. If you are not objective, this is not possible. This is why as physicians we do not care for family members, or those who are like family. Because try as you might, you cannot be objective. I have on more than one occassion wound up having to care for the children of people that I know in real life whether close friends or acquaintences. We have had family members of our staff in the unit etc. and try as you might that objectivity is affected. Which doesn't always translate to better care for the patient which is after all the whole point.  

However, this is not in anyway to say that you should be withdrawn. As a neonatal intensivist, my humanity, my care, my concern is my center, my driving force. I must care, so that I can do my job to the best of my ability. As I have said the day that I do not shed a tear when a baby dies will be the day I quit.  No questions asked, no second thoughts.

I struggle with these issues when life forces me to cross those lines and the black and white that I can normally see all becomes shades of grey.  I try to avoid it, but sometimes I can't.  I just try to do the best that I can and admit my weaknesses.  Wish me luck.

What does it mean if you die in your dream?

I occassionally remember my dreams, most of the time I do not.  In the last few months, I've had several particularly vivid dreams.  Some a little disturbing on different levels.  I tend to dream more vividly at work, probably because I don't sleep deeply.

However, last night after spending a lovely relaxing evening at home.  An evening that included a great run, yummy dinner, long bath, productivity, watching of the olympics etc. I settled down for a good nights sleep after a busy wedding weekend.  I promptly entered dream land....

In my dream, I was a passenger in a car (not mine) driving down the Rim of the World highway.  We were singing off key to the music, laughing.  Not sure who I was with though.  When all of  a sudden we hit a patch of ice.  The car spun out of control, I screamed.  We hit the guard rail, tumbled over and then hit a tree on my side of the car.  All went dark, and I woke up a hair bit mad at my subconscious for doing such a thing to me.

So, if this means something bad is about to happen, its been awesome knowing you all.  I'm still going skiing on Monday, though.  I can't put too much stock in this dream stuff.

Conversations with my 13 year old self

Last October I found myself at my 20 yr high school reunion.  An event I almost didn’t attend because I wasn’t sure if I wanted to go back there.  Surprisingly, I had a really nice time, and I have reconnected with some old friends, and for that alone it is well worth it.  However, it was also fun to see how people have changed, grown, matured.  At the reunion itself many of the old cliques were still present, but mostly everyone was friendly.

So, a few weeks ago when I got an invitation for a girls reunion with some of my old classmates, I decided to give it a try.  So, there gathered at a bar/ restaurant in Pasadena was a group of 8 women.   Several of whom I had known since age 5 when we started San Marino schools, most I’d known since Jr High.  Some I was friends with, some not so much.  It was a gathering of people that would never of happened in high school, that much I am sure of, but it was fun.

As I sat around the table and listened to everyone talk about the reunion, their lives and some of our experiences.  Over half of those gathered had reasons why they had almost not gone to the reunion, or gone out that night. Yet there we all were laughing together.   I thought of Pink’s song, "Conversations with my 13 year old self.” I questioned, what I would tell my 13 year old self, if I could go back in time.  Pink says “You’re laughing, but you’re hiding. I know the trick too well…Don’t worry, everything will work out fine.”  That’s a nice message, but I’m sure that 13 year old me would have said “yeah, yeah what do you know.” Adolescents always think they know everything. Still it is true, we do all grow up.

So, I am grateful that I have reconnected with some of the people I grew up with. I hope that we stay reconnected and can call each other friends.

Why I'm proud of my hospital

When leaving work on Friday, I ran into our chief of surgery. He and I have a jovial relationship, but he was somber.  He is Haitian.  I asked if he’d heard from his family.  He said he’d had contact with half of them, and was leaving for Haiti the next day to do what he could to help and hopefully hear about the rest of his loved ones.

Here is a man at a zenith in his career who came from humble beginnings.  He has never forgotten this, I have always respected that about him.  However, to see a man of his power so scared was humbling,  because in this kind of situation it does not matter.  Money isn’t going to get you anything in Haiti if there is no water, when there are no roads, when the situation is that bad.  Yet, we hope. He is traveling to Haiti with a medical team. They will treat whoever is brought to them. He hopes to find his family.

My heart bled talking to him. I told him I couldn’t go this weekend, but if there would be future trips, I’d go.  He said he’d be returning in a few weeks.  I’ll try to go, if they need me, and my boss will let me. When I entered the medical field, I always believed that I’d spend a fair portion of my time working in developing nations, but I chose a technology dependent specialty and travel is limited.  However, if my skills could help in Haiti, I’d go in an instant.  Because it is the right thing to do.

I’m proud that our head of surgery understands this and supports it with his own time and skill.