Category: Musings

Memories (In a pile of old receipts)

Originally posted in heelskicksscalpel.com

In college, soon after I got my first bank account and a credit card with a $300 credit limit, I started keeping every receipt for every purchase I ever made. At the end of every calendar year, I would box up an annual pile of receipts. This continued until a few years ago when my husband decided he could no longer tolerate me forcing us as a family to save every receipt filed away into individual envelopes for necessities, frivolities, groceries, gifts, etc. He was right, outside of certain big ticket items and shoes from Nordstrom, there really was not any reason to “hoard” receipts (his words, not mine).

It’s been a tough habit to break. Now, when I empty out my wallet after a few days I scan the receipt for what I purchased and then cringe as a toss it. Every. Single. Time. Not sure if it’s just me still trying to break the habit or some weird paranoia that I will truly someday miss having proof of purchase for that t-shirt from target or that gallon of milk.

In any case, during some spring cleaning yesterday I came across all of my receipts from those college years. It was a fascinating lens into my past habits and routines. He’s what I remembered/learned about myself all these years later.

  1. I bought a lot of feminine hygiene products. A lot.
  2. I spent a lot of money on photocopies and laser printing.
  3. I ate out. Often. And, surprisingly I can remember who I ate with for each of those meals away from our usual two or three go-to restaurants. Making the effort to go somewhere more expensive or (gasp) leave the general vicinity of campus = a special occasion and I found myself imagining everyone who I thought was special to me all those years ago.
  4. I didn’t, however, indulge in snacks at convenience stores or similar. This is notable only because I am married to someone who definitely did.
  5. I always love to shop, it seems.
  6. I never paid more than $19.99 for any of my shoes or clothes back then. Typically, my stuff came in well under ten bucks.
  7. I owe a special thank you to the Wexner family of Columbus, OH. Were it not for their Limited/Express stores back in the day I might have had to go through college naked.
  8. I even once purchased something at an Abercrombie & Fitch store. This must have been before I developed migraines in response to strong perfumes or colognes. I won’t allow my daughter to shop there (at least when I am with her) because it’s some sort of moral stand I decided to take for reasons related to the forced inhalation of strong smells as I walk by their stores in the modern American mall.   I have always denied ever shopping there; evidently, I am a big liar.
  9. I never bought anything that would be considered athletic. Nope. Not a thing in which one could workout. This is regrettable, not only for the fact that it is evidence of my complete lack of physical self-care back then but also because it likely led to the backlash known as my current Athleta problem.
  10. I got just a bit nostalgic that Caldor, Lechmere, and Filene’s no longer exist.
  11. I evidently was also the kiss of death for any bank I decided to do my saving with. None of the three banks I used during those years exist today.
  12. I used to listen to a lot more music than I do now. Today I could stream constantly if I wanted to but honesty I don’t ever listen to music outside of my car or on workouts. Back then between mail order and the local Tower Records, I bought a lot of CDs.
  13. I enjoyed live music far more often than the concert every couple of years I enjoy today. But, there was no genre in particular that called my name as was evident from my ticket stubs for House of Pain, Duran Duran, James Taylor, and They Might Be Giants. And, as with those special dinners, I remember exactly who I saw each of those shows with.
  14. If there wasn’t live music to be enjoyed, I went to the movies. I saw some great films and some mediocre ones. I often sought out art house cinemas for limit release films. I didn’t just seek out the big screen for films whose effects would warrant the time, effort, and cost of going to the movies [read: the only movies I have seen in the theatre in the last 3 years are the 2 Star Wars movies.] I simply enjoyed going to the movies back then unfettered by the logistics of sitters and evening little league games or by the gravitational pull of my pajamas at 7:30pm.
  15. Occasionally, I went to a play but I was not so much a theater person. Rather I was an ardent supporter of my friends who ran the set, played in the pit, or were making their acting debut on their way to become ophthalmologists, lawyers, and Drosophila experts.
  16. I clearly went out a lot. But when I was in, I spent a lot of time on the phone at substantial cost. If I had invested the money I spent on hours of late night calls with my best friend from home, she and I would be enjoying some really tricked out girls’ weekends now. Calling friends came at a premium back then. Now, we have unlimited minutes to talk yet we rarely do; and, if we do it’s for minutes, not hours.
  17. I was proud of the fact that I worked to finance all of these “frivolities” that lightened my college years. I made $65/week at my work study and always deposited $40, spending about $25 on the typical weekend (Thursday night through Sunday brunch back in those days — never paying for a brunch until years later because, well, dining waffled were just that good) and putting away the rest for my phone bill and summer adventures.
  18. I didn’t really have any real adventures, though. I visited my sister and my best friend in New York a lot. I had a great trip to visit my roommate on the west coast our first summer after college. And, yes I saved every boarding pass and bus ticket. Greyhound and Peter Pan still exist but wow my TWA ticket for the *non-smoking* section was a real blast from the past. As was that boarding pass for my first every Southwest flight in 1993 — an experience that kept me from using this airline for the ensuing nearly a quarter of a century until driven by desperation about 2 years ago.
  19. I wonder what has happened to the carbon paper industry. I miss the satisfying mechanical sound of the credit card impression maker thingy. The screeching feedback that it’s time to remove my chip is not the same.
  20. I also miss my original signature with first, middle, and last name fully legible. receipts

 

Trauma Surgeon’s Ballad by Lin Manuel Miranda

Originally posted on heelskicksscalpel.com

Like much of America, my family is currently obsessed with everything Hamilton on Broadway. We jammed to the sound track all summer. The season culminated with a late August trip to the show which I described on social media as the best day of my life. Seeing the show, the actors, the set, and choreography, come to life with lyrics we had all memorized was such an amazing experience.


I cried.

Part of that was pinching myself that it was actually happening (NB: Tickets now that the original cast is gone are not that hard to find on resale sites but still cost quite a bit above face value.) And the other parts were one particular segment that just cut into my soul when I saw the character of Aaron Burr singing it.

I sobbed.

Let me provide you context. Burr is an orphan who is in love with a married woman. He has decided that with everything he has gone through, all of the losses he has suffered, he is willing “to wait” for the woman he loves. As someone who was taught to hate Burr by her high school history teacher who was a Hamilton scholar, this humanization of Aaron Burr was a bit off-putting at first. But the reason I simply could not stop the tears while experiencing the song with all of my senses as the show was not about the forbidden love story behind it, rather is was the commentary on death.

“Death doesn’t discriminate

between the sinners

and the saints,

it takes and it takes and it takes

and we keep living anyway.

We rise and we fall

and we break

and we make our mistakes.”

These words resonate so strongly with my trauma surgeon’s soul. We provide care indiscriminately, irrespective of race, socio-economic status, mechanism of injury, insurance, etc. And we lose people. Sometimes they arrive lifeless; sometimes our efforts fail. When that happens we are broken. We wonder if we could have done anything differently; did we make a mistake? But we have to go on “living” because there are more patients waiting. Some of them are sinners while others are saints and it doesn’t matter we treat them all the same. Then we wait for the next patient to arrive.

The title of the song is Wait for It.

The Hamilton sound track is still more or less played in a continuous loop in my home, in our cars, on my runs. And every time I hear this song I cry. I can’t help it. It simultaneously breaks my heart for all my patients who have died and provides me reason to keep coming back to this very emotionally challenging and physically exhausting profession. I know it was not Lin Manuel Miranda intent to write this segment of music (the lyrics and the accompaniment which is haunting) for the trauma surgeon in me but that has been it’s effect and I am so grateful.

And as for the burnout that is particularly rampant in my specialty, despite the tears from this particular song, the overall experience of seeing the show on Broadway was truly one of the happiest days of my life – a perfect way to spend a weekend off and return to work refreshed and ready to wait for it. 

What Brock Turner, his a$$ho#e dad, and a biased judge make me want to scream at my daughter (and my son)!

Originally posted at heelskicksscalpel.com

Warning: Expletives to follow

The internet has been consumed this week with outrage regarding the trial of Brock Turner a varsity swimmer at Stanford University who was convicted of 3 counts felony sexual assault and only sentenced to 6 months in the county jail for a crime punishable by upwards of a decade in the state penitentiary.

Evidently the trial was a classic blame the victim set up by the well compensated attorney hired by Turner’s family who was painted to be an all-American good guy. The jury didn’t fall for it and he was convicted. The judge, however, himself a former Stanford varsity athlete with seemingly similar racial and socioeconomic background, worried about the impact of a longer sentence on the convicted rapist. And so, the extraordinarily light sentence followed was in sharp contrast to what a young man of a different racial and socioeconomic background might expect from our judicial system.

Now twice victimized, first when she was raped and second when her behavior on the night she was raped and her character were drawn into question in a court, the young woman who was assaulted by Turner wrote a powerful letter that galvanized social media followers who were soon calling for the judge’s recall. The convicted rapist’s father countered the letter noting how just ‘20 minutes‘ of his son’s life had resulted in such a detriment to his well-being. He went on to suggest that his upstanding progeny take up motivational speaking on the the topic of alcohol and promiscuity on college campuses rather than taking up space in a jail cell. Not surprisingly, this sent the twitterati into an uproar.

‘Rape Culture’ and ‘White Privilege’ have been hashtagged repeatedly these last few days and I too am enraged. But, I am not here to talk to you about my rage. There are plenty of others who have expressed my thoughts on this brave victim, the entitled brat who victimized her, his piece of shit father, and a judge (no matter how neutral his prior rulings might be) who clearly was woefully imperceptive of his own unconscious bias in favor of affluent white males in rendering a sentence in this case.

I am here to express my grave concern about what to say to my children in response to this.

I don’t want my daughter to have to go through what this young woman went through. I don’t ever want to see her spirit wiped away by the most gruesome of personal violations and to have her reputation destroyed in the process of seeking justice. I want to provide her with wise counsel to protect herself from ever being raped. And by this I don’t mean the scary bogeyman rapist who lurks in the bushes preying on unknown victims; for that she will have a black belt in Krav Maga.  Since the vast majority of rapes are perpetrated by known assailants upon known victims, be they long-term intimate partners or recent encounters on a dance floor, my daughter needs solid advice on how to avoid the Brock Turner types now and in the future.

Wharton Professor and author Adam Grant’s post on Facebook (pictured below) sums up the causes of rape exceptionally well.

 And if these are it, then what can I say to my daughter to not play into the blame the victim stance that is so common in our society? I want to scream at her:

“Don’t ever, not ever, drink a single drop of alcohol, ever no matter what! I don’t care how safe the social scene appears to you. I don’t care how solid a crew your girlfriends promise to be. I don’t care if you are the legal age. You have no idea if and when you judgment will be compromised; and, since the Brock Turners of this world can’t be relied upon to exercise any judgment even when you are sloppy drunk to the point of unconsciousness just don’t let yourself to be vulnerable to the likes of him due to intoxication so JUST. DON’T. DRINK!”

“Ditto for drugs. Don’t expect anyone around you to exercise good judgment on your behalf. They won’t, especially if they are Brock Turner. Got it? NO DRUGS!”

“Don’t dress provocatively. No cleavage. No short skirts. Nothing that accentuates your femininity, NOT EVER! You can read about how rape is about violence, aggression and power rather than about sexual arousal, pleasure, and sex in the text books but in real life I beg you not to do anything that could possibly make you more attractive to the Brock Turners of this world. They are incapable of exercising control over their sexual urges and they will lash out violently and aggressively to satisfy these urges with bodies that are simply more powerful than yours so NOTHING SEXY on that body!”

“Ditto for flirty behavior. I wish a coy remark here or a sideways glance there could be just a fun, arm’s length interaction but to someone like Brock Turner it is like an invitation for sex even if it takes violent aggression to get it. So please DO NOT ACT LIKE YOU ARE ASKING FOR IT!”

“Don’t walk alone. You never know when a stranger is going to assault you. Wait you have Krav Maga for that. What I really mean to scream is DON’T GO ANYWHERE ALONE WITH SOMEONE LIKE BROCK TURNER! Especially if you have not obeyed my prior four rants about drinking, drugs, dressing, and flirting. If you do, you better hope that the non-Brock Turners are randomly riding by on their bikes or their skate boards to save you.”

And here I am seriously teetering on the edge of an unprovoked screaming fit at my daughter because my first reaction is not to scream at my son:

“DON’T BE LIKE FUCKING BROCK TURNER!!!!!!!!!!!”

“Nope. Not ever. I don’t care how she dressed or behaved, or how compromised her judgment may have been for whatever reason, or whatever fantasies have been imprinted in your brain from the media, or how our society tends to treat men and women differently when it comes to matters of power and sex and everything in between. You are better than that. You treat women-all humans for that matter-with respect. You protect those who might be vulnerable, be they male or female, young or old, drunk or sober, black or white, whatever their potential vulnerability may be. You stand up for what’s right and you squash all that is morally reprehensible. You be the guys on the bikes or the boards. You help. And unlike Brock Turner, his asshole dad, and this biased Judge you be the one who sets a good example for all the little boys that follow.”

The Office Cleanse

Originally posted in heelskicksscalpel.com

I wrote a post this past weekend on doing nothing.

I think it was a successful strategy, albeit unintentional. I arrived fresh on Monday morning intent upon a full detox of my current state of academic and clinical affairs.

It was to start with the inbox. Somehow (well, I know how–too much spam targeting my clinical work, too much spam targeting my research, too many mass emails from my medical center, too many mass emails from my medical school, too many predatory journals,  too many published before print journal alerts, and well too many bogus unsubscribe links in the past), it has burgeoned to >3500 emails. Most were read but just had not be disposed of or allocated. In the ensuing 4 days I meticulously cut through these emails. I made choices not to be tied to past opportunities for knowledge or connection and got down to <10 rather efficiently.

In between I had several important meetings which were a good break from the task of purging all of these electronic communications. I also found a few almost missed opportunities and was able to take a break from the inbox to write a grant application due Friday and an abstract due Friday. I finally got around to editing a manuscript sent to me a few weeks ago. I updated my CV as with events/accomplishments I was triggered to remember by some of these emails.

Yah me!

When the inbox was a tamed beast it was time to shed more excess weight from my work life.

Though not really behind, I did not look for an excuse to wait another day to get my billing and coding done (yes, I was trained and educated to be a surgeon and a researcher. no, I did not go to school to become a medical coder. yes, I code and generate a bill for my own notes only to then have a trained coder submit them without ever having to code them for a portion of the fee). The electronic record came after that. Every time a resident gives an order over the telephone it has to be signed later. If it does not get signed, when the chart gets sent to medical records it becomes my job to sign the order. So on top of the discharge summaries, operative notes, etc. that I got of my front burner (yes, undropped bills and unsigned charts don’t really care what else must be done and there’s a stiff penalty looming so yes never on the back burner like say 3500 emails or a manuscript without a hard real deadline) I signed several dozen orders for the likes of “may go to x-ray off telemetry” and “okay to resume diet.”

And finally, even though I decided a few months ago to forego paper subscriptions to journals in so far as possible (mostly for the environmental impact but also to remove the possibility of visual clutter in my office; sadly, with this came a burgeoning of full journal contents in my inbox!) I had a pile about 5 inches high that I tackled. I read a few articles and scanned a few more after looking at each TOC and determining which were worth my time. I then filed some for my endnote library to keep for my future perusal. I have this thing about losing knowledge even if it was not mine in the first place (I think I got it from my immigrant parents). So if it shows up in my mailbox, it will get read lest I miss a chance to learn something I didn’t even know I wanted to learn.

And now, a mere four days after I walked into morbidly obese office situation, I feel cleansed and ready to tackle my real jobs.

I hadn’t planned on hitting the week this way. I did shift around my to do list a bit. I can’t help but wonder if it was the awesomeness of just doing nothing that gave me the pep to get through some of the most onerous stuff I have to do for my work.

Allowing myself to just be deserves accolades, not guilt

Originally posted at heelskicksscalpel.com

I am always telling myself to not be one of those bloggers who gives a play by play of his or her day. I prefer to blog about fun things or things from which I derive meaning and I hardly think that anyone gives a rat’s ass about what I did and when so fair warning:

THIS IS A POST ABOUT WHAT I DID YESTERDAY.

I woke up even earlier that I do when I feigning to be morning exercise person to get my daughter to a 6:30am arrival for a field hockey tournament 70 miles away. 4am is brutal for mom, for the tween player who now routinely sleeps until 10 or 11am on weekends, and for the sad sap of an 8 year old brother who needs to tag along since dad is away on a much needed and well deserved guys’ weekend. Of course I am chronically fatigued and it’s nice now that the kids are older that I can use the weekends to catch up on sleep. So to have this privilege stolen from me for a sporting event deeply hurt me but parenting wins so there I was driving 1 hour and 20 minutes each way. The kids both slept in the car both ways. I jacked myself up with caffeine hoping not to become a statistic we trauma surgeons like to study on driving and fatigue.

When we got finally got home at midday I was exhausted. Despite the caffeine coursing through my veins I could not keep my eyes open so I stumbled into a sleep on our ever so cozy sectional. But it was a broken sleep. I refused to simply go up to the bedroom and just give in completely to the tiredness. Nope, I kept hoping that I would soon rise and have a productive day. You see, after several years of working on work-life integration, I am still having a hard time with simply relaxing. I am so trained to think of it as lazy and unproductive that when I do nothing in particular (or choose to sleep rather than doing) I feel an enormous sense of guilt and failure.

In between my fits and spurts of sleep I was thinking:

The house is a mess. (I should be tidying up!)

There are multiple loads of laundry to be done. (I should be washing and folding!)

The kids are somewhere in this house fighting boredom. (I should be playing with them!)

The work to-do list is out of control. (I should be tackling whatever I can remotely!)

There are thank you cards to write. (I should be putting pen to Crane’s paper!)

The Kindle is filled with newly downloaded e-books. (I should be reading!)

My ass is getting fatter as I lay here and the sun is shining. (I should go out for a run!)

I woke up at dusk. I felt like kicking myself for these myriad failed opportunities to get stuff done, to be a better wife (who helps around the house every so often), to be a more engaged mother, to utilize any one of the 7 habits of highly effective people, to take care of myself.

Argh! The self-loathing was quick and sharp.

Later on, once the kids had made sure I ate and stayed hydrated (their dad has trained them well) and had headed to bed (after showering and reading to themselves)* I took the dog for a nice long walk feeling the need to pad the mere 1k steps I had accumulated up to that point since my daily target is 10k. It was a serene and beautiful night. There were no cars zipping by. No sound of Lifeflight that is frequently overhead. No other dog walkers even. Most lights in the neighborhood were off on the eve of returning to school after winter break.

As I was retelling myself all the failures of my day and tryinng to forgive myself, the peace and calm of the night got to me. It occurred to me that I surely deserved some peace and calm with all that I do day in and day out, at home and at work (okay, fine mostly at work!). It turns out that a perfectly calm and peaceful night was a fitting ending to a day of rest that I unintentionally engineered for myself despite all of my intentions (including with this blog) to take better care of myself. I deserved accolades and not self-flagellation. And so I tacked on 4k steps dropping a little more guilt with each stride, congratulating myself on a job well done, not for being lazy but for successfully allowing myself to just be. 

Today, I can see that it helped recharge me for the household chores, unending work obligations, needy family, and self-care that are still there today waiting for type A, get-the-job-done, me.

[*NB: It gets better as they age, I promise. I miss the cooing and burps and smiles of my babies but I sure do appreciate their self-sufficiency on these lazy, ummmmm restful, days.]