When it's time to get unstuck

Have you been feeling stuck? What are you going to do to get unstuck? Maybe start with your sock drawer? Or start with a vision board for your practice? Or start with a date night with your partner or a girls' night out with your friends. Or start with a breath. Whatever you do, just start!

For the last few years since finishing residency, I have been grappling with many things. After my disappointing first job as an academic pediatrician (my "dream job" I thought), and my foray into private practice I realized that the system of medicine many of us practice in, corporate medicine with the primary goal of seeing enough patients in the day, simply didn't fit with the what fuels my heart.

I spent two years during my American Academy of Pediatrics Leadership Innovation Fostering Education Fellowship researching physician wellness and in particular how systems and practices must incorporate wellness and burn out prevention at all levels. It is not enough to tell physicians to meditate if they are being "strongly encouraged" to see more and more patients, have burgeoning administrative tasks (click this meaningful use button), have mountains of debt, or are in jobs that they hate because of loan forgiveness, have less and less control over their schedules, and less time to make meaningful relationships with their patients. A mindfulness seminar won't cut it. Physicians everywhere are saying enough! It's to much! Record numbers of our colleagues are walking away from medicine or are joining the ranks of the hospitalists and specialists. What happens to our system when there are more hospitals, urgent cares, and intensive care units than quality, sustainable primary care practices? What will continue to happen when emergency rooms and surgical suites continue to be more lucrative than wellness centers and small, high quality private practices? Does it mean people will be allowed to get sicker and sicker? Does it mean that large hospital systems will continue to invest less into primary care and more into expanding their Emergency Rooms? Money talks, right?

This year I will be undertaking some exciting new endeavors. To try to get back to what inspired the premedical student who had all of the time in the world to sit with my patients, to commune with them, to build with them. We see it all around us. Patients who can afford it are flocking to naturopaths and integrative medicine doctors. The overwhelming response is that those providers listen. They have the time. So I have to make the time.

I have been hustling and working, but I still felt stuck. Stuck in fear. Stuck in a laundry list of things to do. Stuck in the what ifs. Stuck. So again, I use the tools that I have and start to research solutions. I have been listening to a lot of podcasts about following your dreams and reading books about decluttering and re-envisioning your life (see the list below). I even watched Marie Kondo's Tidying on Netflix. I saw the piles of clothes folks had and thought "yuck! How could things get so bad?" And then I did this while my boys are away:

(clothes stored in my closet, attic, and drawers - don't judge me until you try it! Very eye-opening!)

It's no wonder I feel stuck. I have been holding on to so much. I still have clothes from my first attending job and from my corporate job that I know I will never wear again. Letting go of them causes so many mixed emotions. Failure. Courage. Pride. Anxiety. Commitment.

It's time to get unstuck. The piles and piles of donations, maternity clothes to pass down, and work clothes to pass on won't unseat themselves. No one is coming to save me. I am saving myself. Starting right here. In this moment, again. And I will do it again and again PRN (as needed for those who don't abbreviate on their prescriptions). One day at a time.


Above references mentioned:

Podcasts:

• Dreams in Drive
• Side Hustle Pro
• Therapy for Black Girls

Books:

• Marie Kondo's "The Life Changing Magic of Tidying Up"
• Dr. Dike Drummond's "Stop Physician Burnout: what to do when working harder isn't working?"

Blogs:

• mnmlist.com
• theafrominimalist.com
• zenhabits.com

Netflix shows:

• Tidying Up with Marie Kondo 

Keep your mama friendships guilt free

I have been so blessed to have several amazing groups of girlfriends, most of whom are mamas. I have a handful of dear friends from high school, sorority line and big sisters who have become like family, my college international housemates, my college friends whose spouses have become my husband's friends, beloved friends from our time in family housing at UNC, my Code Brown Crew from UNC Pediatric Residency, the mamas from the parenting group my husband and I started 3 years ago, and my family - I count my mother, mother-in-law, and great aunt as three of my best friends - these women fill my life with advice and love and accept my text messages and incoming calls day or night. I love, love, love them!

I truly believe that it takes a village to raise a family and it takes a tribe of girlfriends to keep a mama sane and thriving. Over time I have come to realize that it is impossible to be everything to someone and as such I have been able to find over time that all of the different qualities my girlfriends have make for some diverse, sound, and priceless advice. I have never been a one-best-friend type of girl even though I wanted to be and instead do much better with a cadre of lady friends. 

As our lives have ebbed and flowed, sometimes the calls are more frequent, sometimes months or even  years go by without communication. But the love is always there. After months of not speaking I have done consults on sick kiddos, talked to family members who had medical questions, done an emergency contraception consult for an adolescent volunteer visiting the United Arab Emirates (it is dangerous in many countries to have unmarried sex). I have walked with friends through infertility, infant loss, miscarriages, marriage challenges, spousal communication issues, school issues, health issues, you name it. 

As my life has become busier I have been doing more lately to immediately send a text when one of them crosses my mind. Just a quick "you ran across my mind, it's been so long, sending you a big ole hug. How are you and the family?!?". Which leads to a flurry of updates before we have to run. And if I really feel compelled and have some alone time in the car, I pick up the phone and call. Some of those impromptu catch up calls have been life changing for me and for the other ladies. 

I have incorporated a saying recently when the inevitable "I am so sorry it's been so long" is uttered. I quickly say something like "Girl!!! Our lives are so busy ain't nobody got time for mama guilt! Call or text me when I run across your mind and I'll do the same for you!" and then we laugh and continue to catch up in the few minutes we have.

So to all of the mamas out there. Call or text your friends when they run across your mind. When you talk, carry on where you need to. If you feel the need to apologize for it being so long, be gentle and forgiving with yourself and stop yourself! Let's minimize the guilt we have in our lives and do what we can when we can unapologetically. If your friend apologizes, tell her you refuse to have any guilt in your relationship when life is already so complicated and you promise to do what you can when you can to stay in touch. Here's to keeping your mama friendships guilt free and full of love! 

How do you keep in touch with your friends? How do you minimize guilt in your relationships? Please comment below!

5 months in - just breathe, just love!

5 months into being the mother of 2 little boys and I barely have time to breathe sometimes. I work as a Pediatrician but I had completely forgotten how very very very very very very (can I just type the word “very” for the rest of the post?!?) hard mothering a newborn is. Add to that some complications, a rambunctious, highly intelligent 6 ¾ year old, a husband 2 years into his tenure-track and 35-year-old bones and you have a recipe for fatigue that rivals the best of them.

5 months of cuddles. Of tears. Of such profound joy that it takes my breath away. For example, I remember the first time Zo told us how very much he loves his “baby bro” and how he’s his “best buddy”. Mothering for the second time has also been very humbling. When we found out that our little one was losing too much weight and could not exclusively breastfeed I felt like an utter failure. I KNOW how to breastfeed a baby after successfully doing it with our first and I thought if I powered through, me and Mau would get-it-done! But I had to come to terms with the fact that sometimes a mama’s body and a baby’s body just can’t power through, you just can’t will enough strength in his little low-birth-weight jaws to muster up enough energy to be a good breastfeeder. It took lots of letting go, lots of submitting to our reality. And y’all know I cry, a whole lot, so this made me weep and gnash my teeth like nothing else! But as I snuggle his now chubby little thighs, I remember the donor breast milk, the formula, the supplemental nursing system, the bottles, the reflux and I can smile. And it’s all okay even if it’s not what I envisioned.

So 5 months in, I know why my patients miss follow up appointments. Even with my father here with us almost full time I am inundated with Early Intervention, Cardiology, Ophthalmology, and other appointments. He’s perfectly and wonderfully made (took a while for me to be able to say this) but his little life requires a team for him to thrive. And thrive he is! We have all overcome so much and we have so much more to go. To all of the mamas out there in MiM land - wishing you and your babies so much love, health, and happiness. Even when mothering isn’t what you envisioned just remember that you and your baby were meant for each other. Learn all you can. Teach all you can. Be gentle with yourself and your baby.

5 months in. Inhale. Exhale. Smile. Inhale. Exhale. Smile. “The greatest thing you’ll ever learn is just to love and be loved in return” (Nat King Cole).

Forty years and counting......

Random ponderings on turning forty........

• There is genuine sadness and mourning when a favorite piece of makeup is discontinued.......it has taken me years to perfect the “easy, 5-minute, naked-face” look. Now I have to start that one piece over again and it genuinely hurts me..... 
• Alternatives to having a kid: 1) purchase $12,500 worth of organic produce and just pile it up in your living room. Leave to rot. Periodically stomp through it wearing Peppa Pig rain boots and a set of PJ Masks jams. Sometimes pretend to clean it up with a set of tiny wooden cleaning tools. When it starts to smell, scream at your spouse that it is his or her fault that the mess is there. Then toss in an emphatic “you hurt me, you’re not my best friend anymore!!” when he/she denies it. 2) drive to a bank on a tiny pink tricycle with streamers, rob it using only the threat of violence with your ridiculously fast-growing finger- and toenails, then take the pile of cash you claw away from the teller and just light it on fire in the middle of your living room. Repeat monthly. At least 10,000 USD should equivocate the experience of parenting. 3) buy some clothes that you really love, but get them two sizes smaller than your fit. Then look at them hanging in your closet every day while you pull on big shapeless scrubs, or Lycra yoga pants stained with unknown substances and with a forgotten mermaid sticker on the bum. Tell yourself that someday you will wear those again, but know that you won’t. In fact, you never did. Also, download an audio file of Honey Boo Boo complaining about a lack of syrup on her hot dogs and play that on an endless loop in the background. You know, just to sharpen your mind. 
• There are many trade-offs for waiting until later in life and marriage to have a kid. For example, with the presumed extra patience afforded by years of taking so much crap from the external world comes creaky, swollen and painful joints, stretching to their limits with every game of “pretend to be a floor worm with me!” or kneeling on the bathroom floor next to the bathtub, eating invisible cake slices out of bathtub toys with all of her rubber duck friends. But, when your kid makes you some fake strawberry shortcake out of a washcloth and some Paw Patrol purple body wash and hands it to you in a plastic cup with a star-shaped hole in the bottom, you eat that shit. Heck, I’m just happy to be invited to the party. 
• Alone time is the greatest gift the universe has to bestow upon me. There is never enough of it, and it nourishes my soul for when it gets people-y out there. The kid gets the majority of my energy, followed by job and hubs, mostly in equal proportions. Regeneration time is critical, and I’m learning to not feel guilty about it. 
• The more that I age, the more that I learn to stand up for myself and what I believe in a more fierce and unapologetic way. Being told how to use my voice by any number of different people with different agendas and issues is becoming harder to stomach. I genuinely appreciate differing opinions and polite discourse (the more animated, the better!), but when people try to strong-arm their issues and life views on me with tone-policing and gaslighting, well, Iam done sitting back and taking it, especially in my own personal space. I’m too old for that noise.
• Work-life balance is impossible (at least for me). It’s never balanced. One thing is always outweighing something else. It’s more about trying to keep my head above water, occasionally being really good at one thing or another, oftentimes just getting by, and hopefully not letting anybody die on my watch. There is also reminding myself that most of the time, the job I’m doing is good enough, and I’m learning to be okay with that. Being a doctor isn’t for the weak of heart. And being a mom isn’t for the weak of head. Sometimes my heart prevails in medicine and I cry. Sometimes my head prevails in parenting and I cry. It’s all so, so hard. But also pretty badass and (mostly) rewarding. And being a wife is a delicate and ever-moving target of balancing head and heart. Sometimes this is the hardest job, loving the one you’re with and nurturing that commitment. 
•  My husband and I have had an awful lot of loss in recent years, to include both of my parents, and his mother. Raising our daughter without these loved ancestors has brought on a lot of pain in such unexpected moments. She never got to meet them, and yet we see each of them in her nearly every day. Nature is a remarkable thing, perpetuating itself in this way. I wasn’t sure that I wanted to do this whole parenting thing for a myriad of reasons, but catching glimpses of my mom and dad again every now and again in my daughter’s face or voice is about as spiritual as it gets for me. I embrace this fully. 
• I’m truly happy to see forty, and I hope to have sixty more. I do love this life, including the joy, the pain, the humor, the tears, the angst, the stress, the happiness, the closeness and the love. Each new day is not guaranteed. The first forty (wow!) have been pretty damn good. Looking forward to what comes next.......

I Get To...

I had just survived one of those hyper-scheduled "days off." Early morning short work assignment at the fertility clinic, my daughter’s first gymnastics class, squeeze in a quick workout for me (as long as she agrees to stay in the gym daycare), back home for a fast lunch, then out for a mid-afternoon doctor’s appointment with babe in tow because I couldn't work out childcare. It was the kind of day that used to get me very frazzled, but I’ve been working on my organizational techniques lately, which has really been helping. I won’t lie, though, it’s hectic making that many logistical moves in a day with a two-year-old. It can be as busy or busier than a day in the OR! As the sun was going down, I pulled out my journal to reflect on all the day's events. Instead of the typical narrative you often hear from moms like us, “It was so busy today, I had to… (insert long list here)”, I decided to turn it around. I wrote at the top of the page, “I get to…”

I Get To:

• Wake up at 5 AM to provide anesthesia for two women at the same fertility clinic where I was a patient, giving them hope and reassurance that they too will someday be an IVF success story

• Take my daughter to a Mommy & Me gymnastics class on a weekday when I don't have to be in the OR

Warming up in Wednesday gym class

• Do a workout for myself, since after suffering for months with both a back and a shoulder injury, things are slowly resolving and I'm able to perform some of my favorite exercises such as the overhead press and barbell deadlift again

• Spend more time with my lovely daughter by bringing her to my doctor's appointment (she surprisingly behaved perfectly)

• Argue with my husband about what wording to use in a text to a landscaper, who we are fortunate enough to afford to pay for landscaping services, as opposed to arguing with my husband about something less frivolous (such as where our next meal will come from or how we're going to pay bills, etc.)

• Clean up potty training messes x 3 ("Oops, mama! There be poo poo on the seat/floor/etc."), including a wipe down of the whole bathroom each time, and then bathe my beautiful baby by candlelight before laying her down in her bed, where we read books and sing songs and have a cuddle-fest

• Have a few minutes of silence to myself after everyone in the house is asleep, where I prepare healthy foods for lunches the next day, and then reflect like this on my "crazy" day

What did you "get to" do today?