SOAPBOX

President Obama’s budget as it stands will substantially slash pediatric graduate medical education (PEDIATRIC RESIDENCIES) and funding for all of our nation’s childrens hospitals on Sept 30. The current plan would force many smaller pediatric training programs particularly the primary care based programs to have to close their doors to new residents. Larger programs would have cut their numbers and cut out benefits and educational funding for research and care for the underserved. It also cuts crucial funding to all childrens hospitals many of whom (like mine) give care to children who otherwise would have limited access to care. Ironically we desperately need more pediatricians in the US, particularly primary care doctors yet this plan would make it nearly impossible for us to expand our numbers and would in fact CUT THE numbers of pediatricians that graduate every year!

My patients don’t have a buck and they don’t have a vote, they can’t buy their own health insurance/health savings account/or even barter a chicken in exchange for their care. So no matter your opinion or political affiliation, stand up for your children and grandchildren (Not to mention all my people who always get the shaft any way (all the gimptastic, disabled kids who need health care so they can grow up and become politically incorrect pediatricians if they want)).They are the future voters, physicians, teachers, politicians and citizens of this country. They are also the patients whom if we don’t provide care for now will be the future citizens on disability, medicaid and welfare.

Please help me support children! Please help me by clicking on the link through the National Association of Childrens Hospitals and sending a letter through their program to your representative. (it will link you to the right people in your area through the link and it took me exactly 125 seconds) (or if you have more free time than me and feel inclined write your own letter). Make sure to note your local Children’s Hospital or a Hospital that has made a difference in your life or the life of your child or grandchildren!!!!!!!

HELP KIDS!

Love,

Amy

(just another American voter who just works 90 hours a week to takes care of other people’s babies who apparently are just not that important)

Please don’t send me to suburbia I don’t have what it takes

We are sitting around the table. We are all the same age. Nearly all of us have doctorate degrees or something similar. We are talking about our goals for the 1-10  years.  Everyone is buying houses and working for top positions in their field. Some of the older ones are having babies.

Then the conversation turns to me.  So Amy?

WHAT I SHOULD SAY if I WAS BEING AN 100% honest: um.. in five  years…..I want to work and teach  in Africa.  I save money for plane tickets.  I  am not sure if I will ever own a home. I dream about having a clinic that has an x-ray machine and a wheelchair ramp.   Oh and I dream about having two shiny hips  so I can put my socks on in the AM without extreme pain.  My desires for the next 10 years:  I want to get married but even if I dont I want to adopt babies, currently I am praying about interracial adoption because African American babies particularly boys hardly ever get adopted. And I want to write books about disability and doctoring and Africa.

Response: Oh.   silence.

Right so Bob, where did you say you were looking to buy a house?

What I say instead: Oh you know get married, have some kids, get a academic pediatric position somewhere, write some books.

Response:  DO you want to buy a house?

silence.

Me: Um probably not.

Right, so Bob…?

Recently I have really been trying to make friends here outside of work. I love my work friends but it would be nice to have friends at church or elsewhere. Its been about like the above snipet every time.  Apparently my interests at 26 are supposed to be marriage, career, house and a retirement plan.   I may live in the city. I may go to a inner city church plant but I feel like I live in the suburbs. I am surrounded by people who in five years will live in the suburbs and have 2.5 kids, a SUV and picket fence.

How is it that I can make friends in  the slums of Romania or with beggars and homeless young mothers in Africa but I struggle to  make friends with my peers in the US OF A? How is it I have so little in common?

Someone’s Drug Baby, Unwed mother, HIV positive, Gimptastic, Homeless, Homosexual Leper

I find myself smiling knowingly. It’s not faith healing that our leader is preaching, its wholeness. Its realization that what we see as doctors, as humans is only a small part of what makes a person. The illnesses we seem so keen on fighting are a part of a larger whole. He is talking about how people are never bad outcomes. But as I look at my peers’ expression I shift uncomfortably. I realize that I am once again in the minority. I get this because this is fundametal to who I am, to how I see the world as a wounded healer. To my young, healthy, ambitious peers this is a very hard concept.

He goes further and begins to tip another sacred cow of medicine… He says a word that we say all the time in church but really has lost the luster it had centuries ago: L E P E R. He tells the story of St. Francis of Assisi walking down the road and hearing the clanging of a cow bell. He tried to get out of the way but found himself transfixed to the spot in the middle of the road as a leper with a warning bell around his neck approaches. He talks to the LEPER who is shocked that he is spoken to. As he turns to go, the LEPER turns into Jesus for a split second. St. Francis is brought to his knees.

I have never met a patient with leprosy. But I know about LEPERS.

These are all real stories of real people who I have met who all needed physical healing of some sort but what they really needed was understanding and compassion. Some of them had done things to themselves but most were a vicitim of how they were born, somone’s else choices or worst of all society’s warped conception of their lives.

I took a chance and tell perhaps the least offensive story for my audience (the one about the street child on the subway). At the end I briefly mention some of the other new forms of lepsory that exisit in our medical and wider culture.

It makes us all cringe a bit.

But I think that is the bibical meaning of the word Leper….it was not meant to be PC or assuage our sensitivites it was to call us to radical wholeness, compassion and sharing of brokeness with our fellow man.

Homesickness

When i was a kid, my family was ridiculous…ok come to think of it we still are.  Moving was a lifestyle.  It sort of defined us.  We didn’t buy certain things because we wouldn’t be able to move them.   Or we would take great comfort that we would find that missing shirt or the remote when we moved.  When it came time to move.  It was like a well oiled machine.  First we house hunted, my parents knew all the tricks, knew how to find the right school district, church, grocery store, park all the while being frugal to a fault. Mom would have a party for each us to say goodbye to our friends, we made t-shirts with hand prints and quilts  and friendship bracelets.  Then we taped, we packaged, we boxed, we carted and we got it done in record breaking times. Then we got in the car and would drive 12-15 hours with three kids, a dog, a cat and various rodents that my sister Victoria had that never seem to quite last long enough for us to remember their names.  Then we started anew, we unpacked, Mom would take us to our new school and we would meet our teachers.  We would go to all the play groups and play grounds and meet new friends and then we would have parties to get to know them.  Basically my family made moving 10 times before the age of 18 a great adventure rather than a series of childhood traumas.

I am still that navybrat inside. I am still a homeless  nomad always in search of my next adventure. Or so I thought till I moved to the Midwest.  Yes my house was unpacked within 48 hours of hitting Ohio soil.  Yes by the time orientation started I had all my paperwork in to the state of ohio,  been to the grocery store and had house plants. I transplant well.  My family is still  like a moving machine.

But the difference is I am homesick. For first time in my 25 years of moving. I am truly homesick. Its not my parents, its not my school, its not even my friends that I miss. Its the sameness.  Its the culture. Its the manners: the thank you m’am, No Sir, hold the door open for a lady or a baby stroller every day occurrences that I have taken for granted.  Its the sunset over the mts in the summer all lavender and deep blue blending together. And its also the ability to get in my car and be at the ocean in 4 hours or with my grandparents in 4.5 or nearly all my best friends from college/high school and my family within 2-3.  Its the anticipation of basketball season even as early as July.  Its the accent, deep, slow and quick to laugh like a summer afternoon.  Its the people walking their dogs and waving at you while you water your plants. Its the neighbors who don’t need a reason to walk on over and shoot the breeze with when you get your mail. Its the check out lady at the grocery store who tells you about her dreams of becoming a famous artist while she rings up your ground turkey and bananas.

These things leave a hole deep down.  A hole that cannot be filled by amazing ice cream or my awesome, new friends who are just as nerdy and in love with pediatrics, global health and board games as I am or the best farmer’s market I have ever been too or a faith based pediatrics clinic that I get to be a real pediatrician one half day week for the next three years or my cute little emerging church…..

And I realize that I am no longer a nomad.  I have a home.   And its sort of rocks my world.  Because being a nomad is who I have been for 25 years.   I realize that for the better or for worse some time between 10th grade moving to Roanoke and May 17, 2010 graduating from Medical school.  Western NC/VA (very similar although unique in their own rights) became home.  Somehow the southern drawl, the BBQ, the outdoorsy, laid back, sweet tea, banjo music and James Taylor with a touch of class up Roanoke way has taken root and its not going to be able to weeded out by Ohio or probably anywhere else in the future.

It doesn’t mean that I am not glad to be here. That I don’t wake up and pinch myself that I get to learn pediatrics at one of the best (if not the best) children’s hospitals in the world.  Because I am still doing that.

It just means that when people ask me where I am from, for the first time in 25 years…I have an answer.   And it an answer that fills my heart with longing but also a sense of belonging, of being from…

And I think that doesn’t mean I won’t thrive anywhere, that I won’t thrive here, it just means I have a home.

and I didn’t know I needed one.  But I think perhaps I am a bit more whole now that I have one.

Tribal Educaiton

Tonight I had one of the most moving and profound experiences of medical school. I have befriended and mentored a peer with spinal bifda who is still living in her parents basement although is at long last making real progress torward finishing school, getting a job and learning to drive.

We had dinner and on our way home she mentioned a friend of hers, who also has SB was in the hospital and it was her birthday.  It was 8PM, only hour left of visiting hours but who cares. I have of course for 14 more days a pass that can get us in anyway.  We drove down to the hospital, parked in employee parking. I put her in the wheelchair (she walks short distances with a crutch so we had left her chair at home)  and we walked up to Brenner’s. (not to mention that up until about 8 weeks ago walking all the way to there seemed to be forever but with the new shiny hip its no sweat!).

There we were two gimps in the hospital late at night wandering the halls.  We found her friend’s room. I found myself after introductions falling back into the shadows of the darkened room perched up on the counter.  I watched as my young friend spoke words of wisdom and comfort to her friend in the bed. But then the most astonishing thing happened. She began to inquire about her symptoms, her hospital course. She listened in that way they try to teach but really is an art that one is born with. I stayed frozen in the moment both saddened and joyous by the potential in my friend.

Before we left she made sure her friend had her call button, a drink and offered her entertainment. As we walked back to the car I thought about what it means to be graduating from medical school. I know things now. But what I realize perhaps is that the things I know that are the most important I didn’t learn in medical school.   I learned them from my Kniest Dyspalsia in long sleepless nights at AI Dupont just as my friend did here at Brenner’s with her Spinal Bifida.   I told my friend I was impressed with her history and empathy skills. She shrugs it off  as just speaking from experience.

I smile I know that excuse. I use it often.

As I come to the end of my formal medical education I realize that it is not so much the leaving as it is the coming back to my first educators….my tribe…