Tuesday, June 19, 2012

Happy birthday, Dad. Even if you probably won't read this.


On that hot July afternoon, I was fifteen years old and just beginning to sample the sweet taste of freedom that driving could provide.  I had a valid learner’s permit but limited driving experience, always in the company of a fully licensed parent.  I felt (too?) confident on the back country dirt roads in my neighborhood; I think my parents picked up on this and in their wisdom told me in no uncertain terms that I was never to drive any of the vehicles by myself, not even down the road to the neighborhood mailboxes. I listened – until my youthful hubris decided that it had had enough of silly rules.  After all, I was a good driver (!), so why were my parents stifling my youth?  One day, after a long internal debate about the best way to get to the mailboxes in the July heat, I grabbed the keys to our old, dented International, my father’s “camping” truck, and set out down the road.  My parents were both at work, and no adult accompanied me as I entered the truck. I turned the key in the ignition, rolled down the windows, and flew down that road watching as dry dirt swirled in my wake.  At fifteen, there is nothing more freeing than the wind through your hair as you drive by yourself.  And oh!  How sweet that freedom tasted!

When I finally made it to my destination, I pulled up alongside the old, rusted metal mailboxes and opened the door to our own box.  I grabbed the mail and stowed it on the seat next to me.  Looking cautiously in front of and behind me, I switched into “drive” and attempted to pull forward only to hear the ugliest sound in the world – that of metal creaking, grinding, and jerking against metal.  In my ignorance, I had pulled far too close to the mailboxes and had run the driver’s side of the vehicle into them.  I panicked and stepped on the gas harder and suddenly that same, once- sweet freedom became a dense mass in the pit of my stomach. 

When I finally disentangled the International from the row of metal mailboxes, I drove the half-mile back home as fast as the speed limit would allow, hyperventilating the entire way.  Once the vehicle was parked I hopped out of the car telling myself, “The International is a beast.  There’s probably nothing wrong.”  But, as it turned out, I was oh so wrong.  Jerking along the length of the driver’s side was a long, ugly scrape accompanied in some spots by unsightly dents.  I fought the mailboxes and the mailboxes had won.  Now I was really in a pickle.  Not only had I done something that I had been expressly forbidden to do but I had also damaged the vehicle in the process.  I was in full-on panic mode, fairly certain that my young life was about to end before it had really had much of a chance to start.

I turned to my go-to emergency contact, my best friend’s mother.  I dashed into the house and phoned Anne.  In a panicked voice, I asked if she had in her possession a blue Sharpie marker.  (Yes, that’s right…I was convinced that if I just colored in the scape with a blue Sharpie marker, my problem would disappear along with the scrape).  Using her own motherly intuition, Anne sensed that there was a deeper issue at work and she dutifully walked up the hill to my house with a Sharpie marker in tow.  Once she had arrived, the story spilled out and Anne walked around the side of the house with me to view the damage. 

I still remember Anne doing her very best not to laugh at the notion of a blue Sharpie fix as she looked at the International. Instead, she simply looked at me and said in her knowing way, “Chelsea, we can use this marker to color in the damage, but do you really think that the marker will fix this?”  I knew that Anne was right – no amount of blue Sharpie could fix the damage that my illegal jaunt had caused.  So I asked the only thing that came to my mind, “What should I do?”  She looked straight at me and said, “It will be better for you if your father hears it from you instead of finding out about this in a few days.  Trust me.”   And since even youth recognizes good advice when it is offered and with a heavy heart I spent the rest of the day stewing in my room, nervously pacing the floor and trying to calm the deepening hole that had invaded my stomach.  I practiced my carefully chosen words over and over again. Finally, when the sun had set and the house was quiet, I decided that the time was at hand.

Steeling myself for the yelling and dire punishment sure to follow, I trudged into my parents’ bedroom with my head hung low.  My father was already in bed reading a book.  He looked up as I came in, placed his finger between the pages to mark his place, and smiled at me.  He thought I had come in to give him his customary goodnight kiss and in that instant I felt so very terrible that the tears began to flow.  My father’s smile disappeared and worried creases formed in his forehead.  He patted the bed next to him and said, “Sweetie-pie, what’s wrong?”  I sat down next to him, he put his arm around me, and between wracking sobs the story took shape.

“Dad, I’m so sorry but I did a bad thing today.  I did a really, really bad thing.  I did something you told me I was never supposed to do.  I got bored and wanted to go to the mailbox but I didn’t want to walk because it was too hot and I’m a good driver.  So I drove the International to the mailbox to get the mail.  But then I ran the International into the mailboxes...and Dad…I am SOOOO sorry.”

My father didn’t say a word.  He bit his lip and thought for a moment before rising out of bed and putting on his clothes.  I followed dutifully behind him as he walked in silence to the International to survey the damage that my teenage foolishness had caused.  My father walked around the truck and paused near the driver’s side door, hands in his pockets, his face unreadable.  I was relatively sure that something very bad was going to happen to me and I waited for the yelling to start.  I was petrified.

But them something astonishing happened: my father simply turned to me, put his arm around my shoulders and said, “Well…it could be worse.  The International was never very pretty anyway.   The important thing, Chelsea, the most important thing of all, is that you were not hurt – and you didn’t hurt anyone else.  Accidents happen to everyone but the reason that you are not to drive without your mother or I present is because you are still learning how to drive safely so that you don’t hurt yourself or someone else.  It was only the mailboxes today, but it could have been a neighbor child that ran out into the street.  You could have taken a corner too fast and rolled the vehicle.  Cars are replaceable, kiddo, but people aren’t…YOU aren’t.  Understand?”

I understood perfectly.  And somehow, without yelling or screaming, without threats or grounding or loss of privileges, my father had gotten his point across to me with absolute clarity.  In that moment, I fully understood why my parents made certain rules…it had nothing to do with stifling my youth and everything to do with preserving that youth and ensuring that it would grow safely to adulthood.  My parents’ rules had everything to do with love.  I learned a lot of lessons that day, courtesy of my father.

So here’s to my Dad – the man who taught me that we are meant to learn from our mistakes so that we can do a better job the next time around, and the man who taught me that mercy and gentle words teach stronger lessons than angered denunciations.  But most importantly, here’s to the man who has always shown me, with every breath, just how much he loves me . . . and who has always treated me with care.

Happy Father’s Day (and birthday) to the best father a gal could ever hope to have.  I am so incredibly lucky.  I know you probably won’t ever see this, Dad…but I love you oh so very much and I hope that you always know that.

Saturday, June 9, 2012

To mom, on her birthday

This year, more than any other, I feel so very thankful to have my mother in my life.

When she was diagnosed with colon cancer last year, the bottom (temporarily) dropped out of my world.  After my father finished relaying the news to me over the phone, all I could do was sit on the couch and cry for the rest of the evening.  I've always been scared of losing my parents too soon (although, is there ever really a good time?), but in that moment, I was terrified because cancer is a serious thing.  People die.  My mother could die.  I know that I'm an adult and have lived on my own for awhile now...but I am still nowhere near ready to say goodbye to the amazing woman that is my mother.

I've always thought of my mother as this incredible, invincible woman.  Through the years, she was always my Super Woman, ready to come to my aid or defense at the drop of a hat.  She was the woman that worked tirelessly to provide for our family during the years when my father was in college and still managed to make it to all of my high school concerts and piano recitals.  She was the woman who drove me at breakneck speed in a winter storm for nearly 2.5 hours so that I could join my friends on the school bus (whose local departure I had missed) heading to the state Science Olympiad competition.  She is the one person who can always tell when something's wrong in my world, and when I lie and say that "everything's ok," she always calls me out on it.  She's the person who has been by my side at every major turn in my life - whether it was driving me to college, to medical school, or to residency, she's been always been there for every journey.  And though she probably doesn't know this - she's the part of moving that I love the most.  I don't enjoy the packing/unpacking, the sleeping in hotels, or eating crummy food...but I do enjoy traveling with my mother and I am always thankful that she gives up her time (when she might have better things to do) just to spend it with me.  She's the woman who has never let me settle for less than my best and the woman who has never given me less than her best.

I know she'd argue and say that she hasn't always been the best mother,  but trust me when I tell you that's a lie.  Because the best parent isn't someone who never messes up.  It's not the person who always puts a homemade meal on the table, or the one who never yells at you out of sheer frustration - the best kind of parent is the one who is there for you in all circumstances and who loves you in all circumstances, who strives to show you how important you are to them every single day.  And by those standards, I'm pretty sure that I have the best mother in the world.

So happy birthday to you, Mom.  Thanks for being a terrific parent and for always giving me better than I really deserve.  I love you.

Wednesday, May 30, 2012

A small request, friends

Quit posting anti-abortionist pictures of fragmented babies on Facebook. You have a moral objection to abortion and want to share it with the world. Good for you. But trust me when I tell you that I already know what dead and fragmented babies look like. I wish I could tell you that the sum total of this knowledge was gained solely by gazing upon your useless, graphic, and ultimately Photoshopped Internet images but then I’d be a liar. I know what these little souls look like, but do you? Do you really know? I know what they look like because they are often a part of my daily job. I have reached into more formalin buckets and pulled out more fragmented baby parts than I really care to think about. I have prosected 16-week-old fetuses and watched as their organs are turned into a glass slide. My heart breaks for these tiny beings each and every single time, but this is my job. My job is sometimes messy and nightmare inducing, but it is also very intimate. I am a doctor and these are my patients. I am the last hand that will hold them and the last eye that will see them and the last doctor who will mourn them. So quit your Internet crusades, please. I see these images at work and I see them at night when I sleep and I see them when I look in the mirror in the morning. I’d rather not see them in front of me when I log into Facebook. I take enough work home with me as it is. Let these patients rest. Please give them some respect. Quit using them to further your own agenda. And on a related note:
Quit trying to legislate a woman’s right to choose. I believe in the beauty and the mystery and the miracle and the gift that is life, but I also believe strongly in the right of a woman to choose what happens to her own body. I have seen the abortion procedure, I have met women who have chosen to walk that long road, I have held the consequences of the procedure in my gloved hands, I have shuddered in despair and sadness over these tiny beings – and despite all of the horrors of each of these things, I will ALWAYS believe in the right to choose. I will always believe that what a woman does or does not do with her body and those that may dwell in its depths is solely between the woman and her God. It’s not between a woman and her pastor, her friends, the news media, or her political representatives. And it’s definitely not between an unknown, pregnant female and YOU. Knock. It. Off.

Saturday, May 19, 2012

Beautiful days

It was an absolutely phenomenal Vermont spring day today. It was kind of day made for fishing or gardening or kayaking on the pond or hiking and birdwatching. But I did none of that, because today was also, unfortunately, the kind of day made for weekend call {insert a grumbly, frowny face here}. Reluctant to venture too far from home lest the black box of evil (also gloomily referred to as the call pager) begin to shriek, I pondered how to best enjoy the beautiful afternoon. In the end, I gathered up all of my sundry electronics and settled down into one of the wooden Adirondack chairs on the back deck. A perfect amount of gentle breeze was wafting around me – enough to cool down the 80 degree sunshine, but not enough to whip my hair into my face and annoy me. The leaves rustled, the scent of freshly mown grass filled the air, and the distant (and somewhat obnoxious) sounds of the neighborhood ice cream truck filled my world. It was a perfect moment in time. I looked up at the bright blue sky and for the first time in about three weeks, I felt completely relaxed. These quiet moments… the moments where my back doesn’t hurt from carrying around internal stresses, where my head doesn’t ache from all the noise that constantly envelops me, where the headache that lingers between my eyes dissipates…these moments don’t come nearly as often as I would like since I joined the world of medicine, so I’ve learned to seize them as they come and simply enjoy them. They are not
grand moments filled with adventure but for me, they are simply enough. I miss these beautiful moments desperately sometimes. But no matter how quiet and sweet a moment is, a pall always lingers because it is in these peaceful moments that I find I miss Chandler most of all. It is during these moments that my heart breaks over and over and over again. I miss my little brother still. I miss him so very much. It’s been ten months and my world still feels upside down and inside out. And after ten months, I am (still) not even remotely able to understand how Chandler could ever have given any moment of this world up. I can't even understand why that thought even crossed his mind...and I certainly can't understand how he decided that these small moments weren't worth his time, how they weren't enough for him. I am slowly learning to accept that I am not meant to understand these feelings, that none of us are, really, and for that I suppose I am grateful. At the very least this world and these moments are enough for me - so I will savor them enough for the both of us.

Saturday, April 14, 2012

Of mice and men. Or dogs. It's the same, really.

The pager’s shrill scream blasted into my stream of consciousness. I immediately put down what I was working on, glanced at the screen to see an unfamiliar name, and dialed the provided number.

The clinician on the other end of the line immediately began babbling in doctor speak: elderly gentleman, multiple bilateral pulmonary emboli, Warfarin, heparin, coagulopathies, ICU, transfer….

My brain immediately skipped over all of the information until it heard the words “pulmonary emboli,” “thrombolytics,” and “coagulopathy.” Inwardly I groaned at the thought of dealing with a coagulation question. Coagulation questions aren’t all that frequent during call, but they tend to be difficult and confusing (for me, at least) and I rarely have a good, immediate answer. It usually takes a fairly detailed search before I find an answer I am completely happy reporting to the cinician. I don’t mind the search if I’m in a coagulation kind of mood, but at that moment coagulation was something I was loathe to consider. So was I looking forward to whatever this particular physician was requesting? Not in the slightest.

The physician kept rambling for another minute, spewing laboratory values in a voluminous verbal emesis with words dripping from her vocal cords faster than I could possibly write. I cleared my throat, about to interrupt her with the age-old, "Can you please repeat that?" and “aside from spitting numbers at me, what are you really wanting from me?” spiel, when the provider abruptly stopped and then said…

“And then, we were going to transfer him to YOU for his coagulation needs, but well…he died and the family wants an autopsy and I’m not sure how to do this particular transfer but we need to transfer him to your morgue.”

Then something terrible happened. I smiled broadly, cheered silently, and fist-pumped the air. No coagulation questions for me after all! Hot dog! Just a morgue question and a call issue that I could punt to the junior-level resident covering the weekend autopsy issues. It took me a full minute to realize that my brain was cheering for something terrible, something sad, and something for which a mental cheer was wholly inappropriate.

It is at times like these where I realize that somewhere along the medical journey, I have lost some perspective. I (still) absolutely believe that I help to make the world better but some days my passion is slightly lacking. There are moments wherein I am so jaded, bitter, overwhelmed, overworked, exhausted, and numb – all things I swore to myself that I would not become. Sometimes I wonder who this cynical skeptic is that stares intently at me from the confines of my bathroom mirror. I wonder how to get rid of her. So I vow to be less cynical, less irritated, less grumbly, more accommodating and a little more passionate. I promise myself that I will remember that wide-eyed college student out to save the world - and that I will find her and bring her back.

Then I remember that sometimes my skepticism and irritation are perfectly allowable.

Like the time that I was called in to the hospital for a STAT CBC with differential for a "sick patient." Try as I might, I could not find them in the computer system and the tech didn't know much about them. So I got into the car, drove for 40 minutes, and discovered upon arrival in the lab that the "sick patient" in question was a dog by the name of Fly.

And on those days where my passion, enthusiasm, and naiveté have been chewed on like a dirty, used tennis ball in the mouth of Fly, I feel somewhat justified in my cynicism. I guess it all balances out in the end.

Thursday, March 1, 2012

The great fellowship search of 2012 has ended. Huzzah!

I think most people I chat with regularly are already aware but in case the news has missed anyone in my small world... My fellowship search is over! (Or Ov-ah, if I want to be all Vermont-y about it). Ok, it technically finished in February when I accepted the position...but still...
I am super stoked to announce that I am going to be the 2013 Blood Banking & Transfusion Medicine fellow at the University of Michigan in Ann Arbor. And no, dad...I'm reasonably sure that it doesn't entitle you to any free tickets to the football games. But come and visit me anyway.

Wednesday, February 22, 2012

It's like a caramel...

I do a fairly good job of blocking the tragedy of you from my immediate thoughts. This is good, because otherwise I’d never manage to do anything but sit in a dark room and trudge through painful memories. But every once in awhile, something jogs my memory. Sometimes a person walks past me and the scent of the cologne you used to wear lingers in the air. Once in awhile, I’ll catch a glimpse of a bright yellow car zooming past in my peripheral vision. Rarely, the song playing on the radio when I screamed out my grief as Mom called me to tell me that CPR was stopped plays once again in the car. I’ll see a face in an advertisement or brush past a blond stranger in a black leather jacket and then it all comes flooding back. My stomach sinks like a stone, a cold iron band compresses my chest, and all the anger and the grief and the fear and the loss and the senselessness rage through my head. All I can do is stop, close my eyes, force air into my lungs, and remember. And when I remember all I wonder is how in the world I ever managed to put you out of my head for even a second. I often meander through my day doing whatever it is that needs to be done.  I have good days and I have bad days but even in my best moments there is something missing. It is like the difference between a dark chocolate caramel topped with sea salt and a regular old dark chocolate caramel. The caramel is good by itself but that little pinch of salt elevates it, adds to it, and makes the moment more singularly sweet. In these moments of grief I figure out exactly what is wrong. You are the salt in my life. Without you, even the best of experiences are only “good enough.”

I guess this is what it means to lose someone.  I guess this is what it means to lose you.


missing someone pics on Sodahead