The Land of Denial

I don’t do sick well.  (Nice pun to start the entry, eh?)  To be ill is to be a burden.  I mean, really it is my job to work with sick people, not be a sick person.  I’m not one to get a cold or a simple virus, oh no, when I get sick I do it with gusto.

 

I’ve been known to catastrophize and then minimize my symptoms.  I’ve also been known to think that I have made up my symptoms.  I begin to think I’m a hypochondriac or worse, I begin to self-diagnose a la the DSM-IV.  Surely it’s better to have malingering disorder and be crazy than to actually need surgery, right?  Typically I go through the illness and then after wonder if I exaggerated symptoms. 

 

These are my typical thoughts:  Did I really need that knee surgery? (Even though I kept dislocating it every time I swam.)  Did I really have that much pain to be prescribed painkillers and go to the ER? (Even though I was sent for an appendectomy and kept inpatient for 5 days.)

 

My current, and yes, greatest is:  “Did I just imagine the blood in my urine?”  Surely I’m making this up right?  This all began last Friday night when I seriously stared into the toilet bowl for about 5 minutes wondering if I was supposed to be having accompanying pain.  I gave it another hour.  Nope, still blood.  Huh.  I began to self-assess.  (This is a dangerous proposition for someone who is used to medical trauma and knows that the nurses make fun of the stupid reasons people think they need the ER.)  Yup, I had an airway, circulation and I was breathing, ok so I must be fine! And then doubt set in.  I know!  I’ll call my doctor boyfriend (never mind that he lives 2000 miles away)!  He didn’t seem that concerned so I waited until morning when I asked my Mom.  She was extremely concerned.  Ok, so my ER viewpoint is a bit skewed, I’ll admit it. 

 

Long story short, I have been in and out of the doctors, on medication, finally felt the pain, given more pain meds, had blood work, CT’s, referrals to specialists, etc..  I’m really not supposed to be at work right now, but I keep thinking I’m not that sick.  They aren’t really certain what is wrong with me except that my tests are all abnormal.  (I keep thinking they will say, “We didn’t find anything,” but they don’t.)  Ok, so it’s a little scary because my Grandmother just died from bladder cancer and my boyfriend already saw his ex-girlfriend through a kidney transplant.  But really, I don’t feel that sick. 

 

What does really settle in is the emotional piece.  I think I’m different.  Other people get sick, I don’t.  I’m not certain how much to share with people.  Apparently I look sick (keep getting comments), but I can’t stand the pity.  I’ve seen chronic illness cause divorce, bankruptcy, grief, and dependence (whether on the medical system, loved ones, or medication).  I don’t want any of that…then again, who does?  (See, this is where the catastrophizing piece comes in.)

 

I tried staying home Monday.  I was tempted to go out and garden, so then I felt guilty that I stayed home.  I could hear my Mother’s voice, “If you’re sick enough to stay home, you are sick enough not to go play.”  However, when I spoke to my doctor she thought I should be home.  (Doing what?!?) 

 

I don’t have a solution…they haven’t come up with a medical test for that one yet.

The Power of Trees

Today we had an Arbor Day celebration here at work.  I have to admit, I never knew there were so many grown men so passionate about trees.  The State arborist actually wrote a poem for the kids and researched out what tree could be planted in all 5 states we cover as a hospital.  The kids were given a copy of the poem with some tree seeds on their lunch trays.  When I heard that these zealots were coming I couldn’t help but have a vision of some big burly forest ranger dude with graying hair in a ponytail and some teacup poodle dog named Muffin.  Why Muffin, you ask?  Well really what else are you going to call a small dog owned by a burly guy?  (And I just assumed a guy who wrote poetry was sensitive and wouldn’t have his masculinity called into question by owning small pets, wearing the color lavender, and proud that he could make a mean quiche.)

 

My director was ecstatic about the new plans of this celebration.  Someone from the Mayor’s office, the governors wife, city and state arborist and some wanna be Josh Grobin guy showed up with the media.  We shuffled kiddos into the playroom and they messed around with glitter as official proclamations were read. Made me wonder, these guys do know it’s a children’s hospital, right?  Proclamations mean nothing when you are 6 years old.  I began to snicker to myself in the back of the room at this point in time while I wondered which ranger would be bursting into song with the set up cheesy synthesizer by the podium.  The gov’s wife looked a bit plastic as she took the stage.  Mary-Kay (perfect name) showed up in her pink suit with her pink matching pumps and pink lip-gloss.  She read her note cards with the official seal on them and wouldn’t you know the kids kept playing with the glitter.  There was one girl who was wheeled into the playroom by her mom.  She couldn’t have been more than 11 and she was a double amputee with both legs gone.  She sat through the readings looking small in her wheelchair and gown.  She never looked up, that is, until the Josh look-a-like began to sing.  She first began to look at him in awe (I have to admit, his voice was amazing) and then she began to cry silent tears. 

 

The whole ceremony culminated with a gazing ball being placed on top of a tree in our courtyard.  The pine has bright colored ribbons with laminated cards tied to various branches.  Each card has a child’s handwritten wish upon it.  Things like:  “I wish my headaches would stop.”  “I wish my Mom could have a happy marriage.”  “I wish I had a house with a back yard.”  But the most common one on there is, “I wish I could get cured and go home.” 

 

In high school I had a friend who hated signing yearbooks, but would do so in a very passive aggressive manner by wishing you well on obscure holidays.  My Sophomore yearbook I was wished a happy Arbor Day (today) and my Junior year I was wisheda happy Flag Day.  Incidentally I will always remember it is June 14th.  I used to think these various holidays were pointless, strange days established by the government for some odd reason.  Arbor Day never really meant anything to me.  Today it took a different meaning when I watched the pomp and circumstance actually reach the heart of a child.

Professional Parties

It’s amazing to me how people always identify themselves as human doers vs. human beings. Take for example last Friday night. I flew out to visit my boyfriend and on the agenda was a party with the group of residents in his profession. One would think there are other things to talk about than work, but I kid you not, those conversations never happened. I was actually quite nervous about meeting his colleagues and attendings, for some unknown reason.

 

The first thing that struck me is that people were happy to see I really existed.  Nothing like a long distance relationship to really get people guessing if someone actually has a girlfriend or is just super creative with photo shop for those pictures on the mantle.

People usually begin conversations with the typical: so-what-do-you-do question.  However, how do you interject yourself into a conversation when everyone does the same thing (with the exception of you)?

 

"So how is it that I didn't even get asked what was wrong with my own patient when they were coding last night?" One intern mused to her colleague. "I mean, I KNOW that this patient has congenital cardiac blah blah blah and yet, they insist on seeing the chart.  I ended up just sitting behind the oxygen tank not even feeling a pulse when the whole thing was happening.  Its like I got pushed out of the way." (Me thinking, gee, assertive skills is obviously not her strong suit, but not about to tell her that.)

 

"Oh I know what you mean, I actually was running a code on a patient when some stupid nurse decided to try barking orders.  I actually had to identify myself as someone who knew more than she did." (Me thinking, gee, you should have chosen surgery as a specialty...)

 

Most of the individuals would begin talking to my boyfriend and then eventually asked how long I was going to be in town. It shocked me that they were surprised when I said, 48 hours.  Hello? They all know how long a "golden weekend" is. Only once during the whole evening did one person ask what I did. When I began to tell him my title he actually dazed off in the middle of it and mumbled something about finding chips before he wandered off.  I'm not kidding here. Yup, doctors and their social skills at their finest.

 

I really tried to seek out the spouses and significant others of the doctors hoping to find some common ground. However that ended up being more of a daytime TV interview session.

 

Me: "So are you from here?"

Spouse: "Yup." or "No I was in forestry in California but I couldn't stand being away from so-and-so.  I left home and moved across the country and have been in retail ever since."

Me: "How did you guys meet?"

Spouse: Various stories of college, quick marriages/house buying/relocation before residency.

 

There was a trend here:  no one really asked me questions and typically every spouse gave up something HUGE to be with their doctor significant other. Meanwhile, back at the ranch, the war stories of who stayed up the longest on call, how many codes, how many admits continued with the residents oblivious to outside interests we call "life." No one remarked on hobbies, activities, interests, etc.. (Although we did have a couple of exciting moments when the host played the accordion while the attending accompanied him on the piano.) One would say the conversation was due to the one-dimensional aspect of being a medical resident, but even the spouses couldn't elaborate

 

It was like two separate parties going on.  The doctors were describing how hard it is being a resident and the spouses were talking about their version of the journey in supporting a doctor. I truly was the only one in the room with a professional career without being a doctor.

 

How do we define ourselves and why is it mostly centered around our profession?  We certainly must have learned this somewhere along the way.  Somewhere between grade school and adulthood, we stopped talking about what really interests us and began to talk about the other stuff that fills up our lives. I think its because its emotionally safe to give ourselves labels like "accountant," "teacher," "lawyer," and "doctor" vs. "skier," "poet," "musician." Somehow those latter things just don't hold the weight of being productive.  We measure ourselves by what we do; what we accomplish; And I have to admit that even I passed judgment on those who identified their focus as the person they loved, especially when perhaps I assumed, it wasn't themselves.

Travel Bug

I do not have good luck when it comes to traveling and boyfriends.  Sure, it seems like a good idea to plan a romantic get-a-way, but when it comes down to it I panic.  The only reason why I bring this up is because I just bought over a thousand dollars worth of plane tickets to go to Honolulu in June with my boyfriend.

The bad traveling vibe began when I was 18 and dating a guy from Arizona.  We went to Disneyland with a group of fraternity people.  The crux was meeting his mother and sisters who were competing in a cheerleading contest.  I would say the highlight of the trip was watching my friend trip out on acid to the sidewalk by Space Mountain.  The worst part was having his mother not like me and then having to spend an additional three days with her in Phoenix. 

I abstained from traveling with lovers until I went to Tulane with another guy when I was 21.  Tulane was his dream school.  I got in + he didn't = we broke up.  Ok, moving on.

I did travel quite a bit when I was dating guys from back east, although usually those trips involved meeting parents and it wasn't a joint venture so it doesn't count.  This entry is to solely focus in on traveling WITH the person not going to see him.

Ok, well there was this one time when I was dating interracially and it was my turn to join his family for Thanksgiving.  He had just gone through surgery so LorTab was his best friend.  We drove to his grandparents in North Carolina and it was a cultural exchange to say the least.  We were in very small quarters, I was definitely the only Caucasian around, and they were equally fascinated with my hair dryer as I was with the fact that they shot Sammy the Squirrel, stewed him up, and served him for breakfast.  We broke up that following January.

In 2003 my current boyfriend asked me to join him for a wedding out in Pennsylvania.  It was an old friend from high school marrying a girl with my same name.  I apparently went to school with the guy, but I didn't recognize him at all.  Here is where the trouble began.  What he neglected to tell me was that his ex-girl friend was going to be there as well.  I don't know if he just thought the ostrich maneuver (stick your head in the sand) was a good one or what.  We had the most outrageous fight complete with the ex wishing me "good luck" (they had dated for 8 years), me smashing a scotch glass, and both of us standing out in the rain reconciling. 

We decided to try traveling again!  Another wedding!  Chicago that August for a medical school friend.  What he again neglected to tell me was that it was an interracial marriage.  Ok, so that pushed some buttons for me.  Her Irish family was not so accepting of the gospel singing way-to-do of the wedding, but as I hear it, they are still quite happy. 

Sure, third time is the charm... In January 2004, we again decided to go to Tulane for an interview for his residency. (Its like deja-vu all over again.)  An awful fight precluded me getting on the plane (although I can't for the life of me remember what I was upset about now).  Neither of us went.

I have bad luck with New Orleans and men.  Even my girlfriends from there tell me to quit creating awful memories with such a great city. 

Then there was a time when I almost went to Jamaica with an ex.  It was canceled because I was back together with my current boyfriend.

And then we went to one last wedding last August.  It was in Minneapolis and we went all out.  Great food, incredible hotel, and a very unique union of sorts.  Another interracial, intercultural, etc, extravaganza.  Imagine a born-again Ethiopian marrying a Russian Orthodox.  As I hear it, they too are very happy.  Come to think of it, the only hard part of that whole trip was I wasn't feeling very well and he was exhausted from being post-call.

 So, this brings me to now.  In June he has 2 weeks off.  My aunt has offered us a place to stay in Honolulu near Diamond Head.  Hello?  We would be crazy not to take it.  The search was on for airfare and today I found it.  I paged him and we talked for a brief moment before I hit "confirm." 

At this point in time all I can do is hope for the best, save for spending money, get going on my work-outs, and hope that good intentions produce incredible results.

Weed and Feed: The Saga of a New Gardener

Yesterday I spent most of the day running errands with my Mom.  We did the typical things like go to lunch, the bank, the grocery, and shop around.  It was a pretty typical Saturday.  The one thing that differed was we also went to our local plant and garden shops.  Ever since I bought this house I've been pretty focused on my yard and garden.  In the middle of January I couldn't wait to buy hanging baskets in anticipation for May.  However, life is not all a bunch of roses especially if you have weeds.

I have spent countless hours feeling pretty stupid searching internet sites trying to identify my own species o' weeds (prolific little suckers).  I finally broke down and pulled one of the thousands out of my flower beds and took it to the "Master Gardener" yesterday.  There were about 4 other women with samples of grass, roots, bulbs, and weeds in various ziploc containers waiting to see Dave as well.  He is in his 60's and clearly Gregor Mendel is one of his heros.  He put my flowering weed under the magnifying lamp and began to consult his countless books. 

"It has purple blossoms."  I said trying to be helpful.

Dave looked up at me and peered through his bifocals, "I know that."

Ooh kay.  Sooorrry!

I began to think of other weeds I've battled last summer, "I also have something that looks like a lily pad."

"Yes, you don't want that either."

No kidding.

He went through the genus and species of each picture until he triumpantly opened the book and said, "Meet the weed."  There it was.  It looked harmless in the book, but he hadn't seen my yard.  Poor daffodils were competing for the sun with this weed. 

He then began to ask me how close the weeds were to my precious spring bulbs.  I didn't know.  I just explained that the weed was everywhere.  He then used my Mom as a prop.

"You Mother is the bulb.  Where is the weed in relation to your Mother?"  He began to move the now flacid weed in various proximities to my 5' Portugese decent maternal figure.

"Uh, its just everywhere."

Dave sighed and then began to tell me what I need to do.  "Go get a 20 oz coke bottle.  Enjoy." He paused for the dramatic effect. "Then cut the bottom of it off, put the bottle over the weed and use this."  He pulled some random poison off the shelf.  "However,you will not be able to do this today.  You need 5 days of sun to do this.  We are expecting precipitation tonight." 

In Utah in March that could mean anything from rain to inches of snow.

He then told me I needed to get a marker and put skull and crossbones on the bottle.  No kidding. 

Mom and I left feeling quite patronized.  We did go to another local favorite garden shop to replace a plant she recently killed by accident.  The poor thing was just hanging out of the garbage can when I got to her house that morning.  It was not a very dignified death.  Part of me wanted to go rescue it and nurse it back to health.  It was at that realization that I knew my maternal instinct was in overdrive.

Mom could kill things, I can't keep their growth under control.  Ah, the irony.

We wandered around the plants until we were overcome with a sweet fragrance.  It stopped us dead in our tracks.  A lemon tree.  It was a good height, it smelled good, it was unlike anything we've had before, and it didn't need cross-pollenization.  How cool would it be to be making chicken piccata and say, "Gee, I need a lemon.  I'll just go to the entry hall." 

We carefully loaded it into the Jetta and drove it home with the promise that if it looks like it isn't doing so well, Mom will find a new home with someone who can't kill it.  AKA me. 

Pineapples

I've been on family overdose.  Not my family.  My boyfriend's. 

I'm happy to say that he is in town for a rare week break.  It goes without saying that when he comes home, he attempts to maximize time spent with everyone.  As a result, a setting for dinner is just automatically assumed for me every night.  I love these individuals.  They are stellar people.  I'm just needing a breather.

There are subtle signs that I'm needing a break.  I begin to develop a taste for chard as opposed to pinot noir.  I've begun to pick up mannerisms of the matriarch and sayings of the patriarch.  I know the organization of the kitchen so when it is my turn to cook I don't struggle wondering where the collander is.  These are all tell tale signs that I need to retreat.

In the days of plantations in the South a sign of hospitality was the pineapple.  I'm not certain why I know this or how in the hell it still sticks in my head, but it does.  When guests would arrive, a pineapple would be placed on the table or their bed.  However, when a guest had out-worn their welcome, another pineapple would silently appear back on the bed.  Perhaps this is why you see pineapples carved into bedposts now at Ethan Allen and pineapple motifs on kitchen towels.  The only reason why I mention this is because the family has a planter in the shape of a pineapple on their front porch (now with blue pansies in it).  I doubt they really know the symbolism, but it made me giggle when I passed it.

Last year I was snowed in at their house for literally 10 days.  I will not spend the night again.  That was a time of desperation and unbelievable hospitality.  However, although it met my boyfriend's needs of having everyone in the same place at the same time, it will never happen again.  He just doesn't get it (he attempts to coax me every night into staying.)  I am almost 30 with my own home.  Why he doesn't spend more nights with me when he's in town is beyond me...especially on the weekends. 

Its not like we have some strange moral code.  Hell, where do you think I sleep when I'm visiting him?  There is no denial going on here. 

I can go on and on about what psychologcial analysis I have about this, but I'm certain it goes without saying.

At any rate, I have about oh, 72 hours (but who's counting) o'family time left.  When he leaves, I'll be depressed...as I sit alone in my own home on my own couch with my feet up on my own table...well, you get the picture.

Morphing into Management

These days I spend most of my time prepping for "difficult conversations."  I actually rehearse, write down bullet points, and try to anticipate the worst.  My life was not filled with such measures before I hit management. 

I could breeze through telling parents their child died and some difficult decsions were needing to be made.  I could reality test families of what their grasp was of a new terrible diagnosis.  For some reason, these conversations were almost second nature. 

Now I deal with conversations surrounding accountability, realtiy testing their perceptions, and ultimately attempting to inspire people to do their best.  These were topics I did not learn in graduate school.  In fact, there really isn't any sort of formal training on these issues.  I have spoken with those who have their MBA's and even they struggle.

My boyfriend and I discussed our daily agendas last night.  He commented that all I do is have "difficult conversations."  True.  Its funny that I never used to call them "difficult" until I started picking up the jargon from my boss/mentors in leadership.  I think one of my biggest road blocks is that I have way too much empathy.  Not only can I walk in that person's shoes, I can tell you the make, size, and style of the footwear.  Yes sir, I really put my heart into it.  By doing this, I tend to soften the message and impact.  This just ultimately gives me cause to beat myself up after for not being as firm as I needed to be. 

I've learned in my tenure that leadership is not defined by people liking you.  Its about influence.  And with influence there comes trust and respect.  I find its a lot easier to foster people liking you more than the two concepts of trust and respect.  Think about it, have you ever seen a grade-school age kiddo trying to use "trust" and "respect" on the playground?  Hell, no.  We are taught how to make friends, aka getting people to like you. 

These can be foreign concepts to install in people.  However, it is my duty as a leader, to figure it out and unfortunately have a lot of difficult conversations.