Don't forget they are someone's baby

Living in DC and taking the metro regularly provides me with ample fodder for social analysis and ample opportunities to be upset and amazed by humanity. For example, I get upset when able-bodied people see disabled, elderly, or pregnant people standing and sit in their seats anyway. Especially while pregnant, I spoke up very loudly (ex. As able-bodied men crowded on an elevator as I waddled to catch the door for a man in a wheelchair. I stared everyone down and said someone needs to get off so he can get on; we were obliged begrudgingly.). I am amazed when folks step in and help someone in need during an emergency.

An issue of growing contention in my neck of the woods is middle and high school students getting onto crowded trains. They are loud and there is often cursing involved. However, I have noticed that most of the adults regard them in a very unfriendly way or simply ignore them. The local listservs I am a member of are far worse; the disdain for these children is palpable and I have had to step in several times when the racism and classism became unbearable as well-to-do grown folks called children thugs, crooks, and goons. It literally hurts my heart!

I personally make it a point to acknowledge these teenagers every chance I get with a smile or a hello; sometimes I’m ignored or begrudgingly acknowledged, but oftentimes you can tell these young people relish the positive attention and are surprised to have been seen. I remind myself regularly that they are someone’s baby no matter how “hard” they are appearing to be. No matter how many tattoos they may have on their young skin. No matter how many curse words they and their friends yell. And I try to remember that someday my little Zo will be one of these students taking the train and I hope that others will treat him well knowing that he too is someone’s baby. My husband and I are well-read in the studies that show that Black boys like my Zo are seen as being older than they are by the majority and less innocent than they are by police (see FURTHER READING below). We know the sickening statistics of disproportionate violence against boys that look like him. We pray that folks will remember these children are someone’s baby and that he is ours.

To bring it back home to the DC metro, the other day on the train a handsome young man with beautifully styled locs and sagging skinny-jeans and a uniform high school shirt  entered the train with a young woman I assume was his girlfriend. His new-aged rap music (the kind old hip-hop heads like me can’t understand and abhor due to the crazy amounts of auto-tune) was blasting. Adults bristled. Some sucked their teeth. He walked on the train and I smiled at him, he was visibly surprised, smiled back sweetly and sat directly behind me. Every other word of his song was f--- this and blast that. I turned and said as gently and respectfully as I could “Sweetheart, don’t you have headphones or something? My old ears just cannot take all of that cursing.” He said quickly “Ohhhhh my bad! My headphones broke and I don’t have another pair, My bad!!!” I pulled out a set of headphones from my bag and said “here, you can have these!” He smiled and said “For real?!? You serious?!? Thank you so much!” And just like that - connection. Respect. Compassion. His mama would be happy.

It could have ended differently. Someone else could have started cursing at him. He could have rebuffed my offer and cussed me out. But it ended wonderfully. And I modeled appropriate, compassionate behavior for children and adults alike.

I exited the train at my stop and wished him and his lady a good day and he did so too.

___________________

FURTHER READING:

http://www.npr.org/2014/03/19/291405871/consequences-when-african-american-boys-are-seen-as-older

http://www.apa.org/news/press/releases/2014/03/black-boys-older.aspx

http://www.theatlantic.com/national/archive/2014/03/cops-tend-to-see-black-kids-as-less-innocent-than-white-kids/383247/

Saying their names

I don’t have a television but your story flashes across my Facebook feed, my friends tell me about you, my husband the Anthropologist tells me about you, and I look you up online.

You were bullied for being a cheerleader and you took your life (Ronin Shimizu). You went out for a pack of Skittles, a stranger chased you, you were shot and killed (Trayvon Martin). You were selling cigarettes on the streets of New York and you were choked to death as you screamed “I can’t breathe” (Eric Garner). You were playing with your big brother and he accidentally shot and killed you with a gun you found (9 month old in Missouri whose name will not be released). You were born a girl but your birth body was that of a boy, you tried to be your true self but took your own life after not being accepted by your parents (Leelah Alcorn). You were misunderstood, you were playing with a toy gun in the park and you were killed (Tamir Rice). You were with your friends listening to music in your car at a convenience store when a stranger approached you and began arguing with you about your music, he shot you and you died and he went back to his hotel room, walked his dog, and had dinner and drinks (Jordan Davis).

I honor your legacy with my tears. I think about your family. I snuggle my little one more tightly knowing this world is both a beautiful and dangerous place. I honor you with this post; I apologize it has taken me months to find the courage to say your name in this space. This space that is sacred to me but after my last post about Trayvon Martin received some insensitive comments I was hesitant to share some of my deeper feelings since I don’t see much social commentary here at MiM. Why is that? We are mothers and we are providers and don’t we see how unique our vantage point is? We can talk about the intersection of life and policy, public health and personal life from a place most others cannot. I struggle to find the time to read anything besides mindless fashion blogs when I’m not balancing my own needs with full-time medical practice, my husband’s needs and those of my four year old let alone to allow myself the freedom to reflect on society’s transgressions and tragedies.

I thought of you today while looking at my ever growing to do list. And because your life matters to me I put away other thoughts and wrote your name, I am saying your name.

#BlackLivesMatter #ProudLGBTQAlly #MothersInMedicine #2016LivingMyTruth

"You're full of it"

I have read countless articles about how medical trainees have been berated and belittled, yelled at or pushed. I have never in my years of training felt that way or been treated that way. Yes, I’ve been questioned strongly. Yes, with lines of questioning sometimes called “pimping.” I have felt like I needed to study for 40 more hours and have gone into the bathroom afterward to cry, but I’ve never been berated. I’ve never been pushed. I never even thought of what I would say or do in those situations. I have heard my share of racist and sexist remarks and have found ways of addressing it directly and highlighting to the team why it’s unacceptable. But what would I do if someone directly belittled or disrespected me? Would I cry? Would my knees buckle? Would I yell?

Well, that all ended when a Pediatric Surgery Attending told me, “You’re full of it” in front of my staff while I was working in the Pediatric Intensive Care Unit. This particular Surgeon has a history of yelling at Resident Physicians that I learned of after the incident. That night, I was caring for a postoperative patient who had just left the operating room. During interdisciplinary sign out I asked for clarification of a medication dose as I was preparing to enter routine orders such as for PCA-administered pain medicine. The Surgeon turned and said, “No, we will enter the orders” meaning the Surgery Residents. I told him that in my experience PICU Residents enter the orders and manage the PICU patients. He said, “No, who trained you, this is my patient?”  I looked around and of course, everyone was staring at their feet. I was in my second month of PICU service and had heard countless times how our unit was a “closed unit” and that we managed our own patients, but this gruff, aggressively self-confident, tall male Attending with salt and pepper hair and a fresh tan was staring me down. I said, “You will need to speak with my Attending because this is not what I have been trained to do.” He turned, stomped away, and snuck in a low, yet completely audible, “You’re full of it.”

I stopped in my tracks and said more audibly, “Excuse me, but you just said ‘You’re full of it.’”I paused, collected myself and continued: “I feel very uncomfortable, and that was disrespectful. It is not appropriate to speak to trainees that way. I only want to provide excellent patient care.” He froze. When he turned around he had a look of utter contempt and disbelief; it was like no one had ever told him he cannot speak to people that way. His eyebrows furrowed and he spit out, “Well, I’m sorry,” and turned around. At that moment, my Attending arrived and my Fellow said, “Well, I’m glad you said it because I was about to.” I quickly excused myself as my hands began to shake and the pounding in my ears began to dull everything else out. I exited the unit, and sank onto the bathroom floor and cried. Big crocodile tears as my grandmother would say. I was anxious and nervous, but I was damned proud of sticking up for myself.

My PICU Attending found me later and asked me what had happened. I explained the facts and he shrugged and said, “I’ve heard worse,” and told me something about how that Peds Surgeon had cursed at him during his Residency. I told him that I hadn’t heard worse and had never experienced that type of behavior but that I thought it was unacceptable to speak to any member of the team that way. He shrugged and said he would address it with the Surgeon later. As I entered the Unit, the Nurses individually applauded me for speaking up the way that I had. I asked a trusted Nurse mentor if she thought I handled it well and she said I nailed it, and my Fellow echoed the sentiment. I didn’t get emotional, I said what I needed to say, and kept it focused on the patient. One of the Peds Surgery Chiefs came up to me later and had heard about it and gave me a quiet nod of support. She agreed that Surgery Residents who did not spend the night in the hospital should be consulted but they shouldn’t be the ones putting in orders since the PICU Residents are the ones who stay in house overnight. It’s a patient safety issue.

Many thanks to a different fabulous PICU Attending who a week earlier coached us on working in uncomfortable situations. She told us to use words such as “uncomfortable” and “unsafe” and keep things focused on the patient. Without her words, I probably would have shut down, my knees buckled and I wouldn’t have been able to say things in a way that would have gotten any response from that Peds Surgery Attending. I still believe, “You’re full of it” has no place when we are caring for patients.

I spoke on a panel earlier this year sponsored by the Student National Medical Association. They asked a group of underrepresented minority Attendings and Residents to discuss discrimination in medicine. I shuddered as I listened to the horror stories the Black and Latino Attending Physicians recounted. I think I would have quit if I had to endure the downright hostile environments they practiced in in their early careers. I don’t discount the real experiences highlighted by other trainees around the country and applaud them for their candor in sharing. I hope that we all are continuing to work so that abuse and disrespect are not allowed, and when they do occur can be apologized for and learned from.

A Pause...

I have today (Friday) off from my clinic, in preparation of Babygirl's first birthday party tomorrow and Christmas in general, but I came to work anyways, to drop off Christmas presents for the nurses and office staff. I was feeling pretty good until the NPR commentator announced, "...let us now pause to take a moment of silence to pause in honor of those exactly one week ago. Remember that it was at this time of the morning last Friday December fourteenth that twenty elementary schoolchildren and six teachers were gunned down at a Connecticut elementary school...."

I cried last Friday when I first saw the headlines about this shooting, and I cried again as I was driving in. Every day, I think about those families, and wonder we can do for them.

I can't help but pause for a moment to think about them, and then to be thankful for my own little family, our two beautiful kids, our hectic workaday lives, every day full of small and large joys.

I want to help them. There are things that I can do as a human being, a parent, and a physician, to offer some help to those families... There are things we can all do.

Since last week, I have signed two petitions appealing to our politicians for stricter gun laws, including a ban on all military-style assault weapons. The most effective of these is on the We The People website, an open-access petition site: anyone can start a petition to the government, and any petition that gathers more than 25,000 signatures is guaranteed a response from the White House. In the hours after the Newtown shooting, user David G. started a petition asking for stricter gun control legislation; this gun control legislation petition has now gathered over 190,000 signtaures, in a week, and has received alot of attention as the most popular petition to ever appear on the We The People site.

Guns are a public health issue, and need legislation around them protecting citizens from risk of harm, similar to cars. Try replacing the saying "Guns don't kill people, people kill people" with "Cars don't kill people, people kill people". Hello? Not everyone can have a driver's license- they need to pass a test first. They need to be checked to make sure their previous license was not revoked. We have seat belt laws, we have drunk driving laws, we have speed limits, we have traffic laws, and our driving is regularly monitored by cops on the road.*

Why, for God's sake, do we not have even a fraction of the same legislation and monitoring of guns? We don't shrug and say, " Oh well, no need for laws around car safety, we just need to work on our substance abuse and mental health care system!"*

*I take this analogy - though it is a common one- from Nicholas Kristof's brilliant New York Times Op-Ed piece Do We Have The Courage To Stop This, published after the Newtown shooting, and I recommend it to everyone.

These are my personal thoughts and opinions, as a doctor and a mother... and a rational human being.

Vote for a future colleague! Vote for love!

Mothers in Medicine, our help is needed. Kirby is a MS3 who is a dedicated reader of this blog. She and her fiancee are finalists for a free wedding...but needs votes to win! You can read about their story and vote on the right sidebar for "Kirby and David" at the website. It takes only a minute to vote but could mean making the dreams come true for a future mother in medicine. Voting ends the morning of Sunday, April 5.

I just voted. It took me all of 0.2 seconds.

Good luck, Kirby and David! You'll have to promise to post pictures of the wedding here if you win.

The Mothers in Medicine Challenge: Giving back to public schools

Getting into medical school is competitive. We're hoping that competitive streak in you will help us in our goal to raise money for a great cause: our public schools. Many public schools, particularly those in poorer school districts, can't afford the materials they need.

Have you heard of DonorsChoose.org? It was started by a former teacher as an experiment and now is an alternative funding source for teachers nationwide. Teachers upload projects they want sponsored such as Biology Lab basic equipment for a Mississippi high school where students have never had an exposure to a real laboratory ($818). Donors can contribute as little as $5. DonorsChoose purchases the supplies and ships it to the classrooms, along with a disposible camera. Donors receive thank you notes from the children, as well as photos.

According to Fortune magazine, "Donorschoose.org has raised $24 million to get support to 1.4 million students in 50 states. Nearly 60,000 projects have been funded."

Now, to the competition.

Starting October 1st, bloggers around the country will be competing to see who can generate the most donations to DonorsChoose classroom projects. Last year, blog readers donated $420,000 toward books, art supplies, technology, and other resources, reaching 75,000 students in low-income communities.

Mothers in Medicine in joining in and we're hoping that we can show the internet who wears the pants. Please visit our giving page and see what projects we've selected to raise funds for. You can also get to our giving page via that nifty widget in our sidebar. After donating, you can leave a message for the students you are helping. Since the giving account is under Mothers in Medicine, leave your name, if you wish, in your message and where you are from.

Give if you can!