Monday, August 23, 2010


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!

Wednesday, August 11, 2010

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!

Tuesday, August 10, 2010

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.