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I’ve never heard of a book getting so much pre-publication press. The Bride sent us the NYTimes Book Review and pre-ordered it from her fabulous Nashville bookstore. Bob pre-ordered it on his Kindle. Then right after Parnassus uploaded Ann Patchett’s new year book recommendations on their blog, Musing, she sent out another special edition to sing the praises of a previously unknown author http://parnassusmusing.net

“When Breath Becomes Air” by Paul Kalanithi – Ann said

I’m making it my personal mission to urge everyone to buy it and read it, in part because the author isn’t around to do his own promotion, and in part because he’s left behind a wife and a young child who should get the royalties. I want everyone to read this book because it’s a brilliant piece of writing and a singular and profound piece of thinking, but it’s also more than that: When Breath Becomes Air makes us stop and think about how gorgeous life is, how heart-wrenching and brief and amazing. Paul Kalanithi’s life was short but utterly essential, as our lives are, in very different ways, short and essential.

From what I hear, every store in the country has sold out of this book!

Dr Kalanithi was a neurosurgical resident at Yale when he began to feel the symptoms of his disease. Metastatic cancer had flooded his body, his lungs were peppered with tumors. Time stood still. Should he and his wife have a baby? Would he ever be able to practice in a field he’d spent nearly half of his life studying and preparing for; could he learn how to die in such a short time. He had been a student for so long, obtaining two BAs and an MA in Literature at Stanford. Then still searching, he received another MA in Philosophy at Cambridge. Finally medical school, with a residency in Neurological Surgery, followed by a post-doc Fellowship in Neuroscience.

We know what this life is like, the Groom is in his last year of a Fellowship in Pulmonology and Critical Care Medicine. They have been waiting to buy a house, waiting for that academic posting, waiting.

Dr Kalanithi was almost finished with his training, when he would have to reverse course, and become the patient. But from everything I’ve read, his writing is sublime. He takes us on the adventure of his life, from being home-schooled in Arizona, to his first introduction to a cadaver in medical school. Witnessing both birth, and death in the same day. Not every doctor can craft a perfect expository essay, but it seems his steep background in literature uniquely prepared him to write his own biography. He started typing during chemo.

Knowing how this will end, normally I’d pass on this book. I’d say no to the pain of reading what happens around us every day. Aunt Sue died of lung cancer last year, Bob became a patient last Fall suffering complications from spine surgery. The Groom’s mentor at Vanderbilt succumbed to pancreatic cancer right before Christmas – a physician who was so loved at Vandy, his nurses stayed at his bedside round the clock for weeks before he died. My brother Mike and Brian. And then there is my own Father, dying at 47 from brain cancer, when I was seven months old.

But I’ll be next to pick up Bob’s Kindle. Maybe I’ll learn how to live each day as if it is my last. I’ve always wondered what that phrase would mean to me. Would I start trying to squeeze 20 or 30 more years into the time I had left, check off my bucket list, or would I relax and simply enjoy each moment? Accepting the fact that we will all die, and choosing to live life with grace in spite of that, is our highest calling.

I only have a picture of my Father on my desk, Dr Kalanithi’s daughter will have so much more.

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“What’s that term honey, the one you use when somebody tries to sue a doctor for no good reason and it gets thrown out of court?”

I was reading a local news article about a woman in the next county who was suing her ObGyn doctor for “coercing and threatening” her if she didn’t deliver her baby by Csection. The Mother had diabetes, and for one reason or another her doctor actually had her sign the consent form five years ago, and now she’s crying foul. Bad doctor, oh and BTW good baby and mommy were just fine after the surgery, so I wasn’t quite sure what this was all about, besides the 2 Million dollars.

“Frivolous, are you talking about a frivolous law suit?” Bob said. Indeed I was.

I usually never jump into the fray of a public forum, since I neither have the time or the energy to fight with true believers. But I was home sick, teetering on the edge of adding a snarky comment to the long list of online comments either praising said doctor or lambasting our entire health system by internet thugs who use pseudonyms for names so they can’t be traced. The lurid underbelly of social media, trolls living under an online bridge of anonymity. I wrote, I deleted,, I worried. Finally, I said:

“We live in litigious times. Certainly we deliver more babies by Csection than any other country in the world, but at the end of the day I believe most docs are recommending what is best for their patient.”

I only hooked one smirky, smiley comment.

“So American women just generally need Csections more than the rest of the population?”

I smiled. Should I tell her about Brazil? But before I had time to pick up the bait, the news posted that the jury had decided in the doctors favor, Not Guilty, after 20 minutes of deliberation. My faith in our justice system was temporarily restored as I put fingers to keyboard:

No we need to train American Doctors differently, transfer well patients to nurse midwives, and institute a board of docs and citizens to review lawsuits and throw out frivolous ones like they do in MA

Ps, my daughter was breech and a section was MY decision – as much as I wanted a natural birth, I didn’t want to risk the health of my baby

This lawsuit disturbed me because it assumed the woman could be coerced, was not in her right mind because she was in labor or something and all of MY feminist peeps, the type of women who believe we have the right to make our our own decisions about our own bodies were lining up behind her defense. Like HE MADE HER DO IT…She was of sound mind and maybe her body was trying to expel an alien at the time, still she could have put on the brakes and said, “NO, WAIT, I want another opinion.”

Childbirth is messy, it is a risk/benefit analysis. Some women go through days of labor only to have an emergency section to save their child, or even their own life. This was the Bride’s biggest nightmare last year, she was determined to have her baby boy VBAC, and she knew everything that could go wrong. My husband has seen women come into his hospital’s ER with a dead baby from a homebirth with a midwife who didn’t transfer them fast enough.

When you hire a dola, a midwife, or a doctor to assist you in delivering your child, you are entering into a sacred trust. When we won the right to vote in the early 20th Century, when science gave us birth control in the later part of that century, we women willingly gave up our status as arm candy and fertility goddess. We got tired standing up there on that pedestal for so long, all those corsets binding us into place. And now we have a woman in a pantsuit running for President. We should never be willing to be coerced or threatened by a man, boyfriend, husband, doctor, or lawyer ever again.

And the mom/plaintiff reduced her amount from 2M to $200,000 yesterday afternoon before having her case dismissed. Ask me again why our health system is so crazy. http://www.nbc29.com/story/30455784/update-augusta-co-jury-rules-in-favor-of-doctor-in-c-section-case

Here is our friendly little ghost, delivered by section three years ago because she was breech, just like her Mama!

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Summer’s here and it’s time for singing in a horse barn! And dancing in the street too, but I just had to drop a quick note about the Groom. Some doctors play golf in their free time, some fly planes or collect trains. And then there is that rare one, that cerebral brainiac that can also play a guitar like nobody’s business, and write his own lyrics too, and sing…oh, and did I mention he can sing! It’s our Groom. J&M  0975

He’s been in a band since high school, and indeed created a band during his residency at Vanderbilt. With a few other talented, young doctors they were known as The Bourbon Family, and they played roots Americana music all over the state. They’ve played at weddings, bars, and private parties. They even produced a record! https://itunes.apple.com/us/artist/the-bourbon-family/id445461482 And more importantly, almost every night, he would play and sing to his new baby girl.

Then the doctor/musicians finished their residencies and went off to pursue fellowships all over the country. The band broke up and you might have thought the music died. Except the Groom didn’t move, he was still playing his guitar and singing to his family in the Music City where he continued to be a Chief Resident and continue his education in Public Health. Until one night at a Full Moon Pickin Party in Nashville, this happened – here is his Facebook post:

So, at last week’s Full Moon Picking Party, a bunch of recording engineers from Dark Horse Institute (of Faith Hill, Tim McGraw…Megadeath) set up a makeshift recording studio in one of the horse stalls. They grabbed people walking by and recorded videos of them playing. Whoever’s YouTube video gets the most ‘Likes’ wins $15,000 worth for free recording time at Dark Horse…which for me would mean an official reunion for The Bourbon Family.
I don’t think I have ever asked Facebook for anything before (partly because I lost my password for about a year and had to reset it for this post)…but this would be pretty cool. Please consider using the mouse on your personal computer to place a ‘Like’ on the YouTube video attached by hyperlink.

And here is the YouTube link! Please consider “Liking” this post on your computer, the link won’t work on your cell phone

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jack-russell
Well we didn’t have a three dog night. In fact, NY and NJ are feeling somewhat slighted by the blizzard, while the Blue Ridge simply got a dusting. Ms Bean was snuggled tight in her little cave; her bed is under a credenza next to my side of the bed. Her snoring is my night music. I’m still waiting to rescue a Corgi so we can be a two dog family once again. But before I tell you about my matchmaking skills with a male Jack Russell dog named Mona, let’s go over why owning and loving a dog is good for our health.

The American Heart Association actually issued a statement saying that pet ownership, particularly dogs, is associated with a lowered risk of cardiovascular disease, and it can also increase your chance for survival after having a heart attack! http://www.heart.org/HEARTORG/GettingHealthy/Owning-a-Pet-May-Protect-You-from-Heart-Disease_UCM_453586_Article.jsp

…there are a variety of reasons that may be at work that influence this relationship. It may be that healthier people are more likely to be pet owners or that people with dogs tend to exercise more. Pets also play a role in providing social support to their owners, which is an important factor in helping you stick with a new habit or adopting a new healthy behavior.

I used to walk my first Corgi Tootsie Roll two miles every day, until one day we were approaching Rumson Road and she wanted to turn around. Every day she was cutting our walk in half! I told the vet she must be getting Alzheimer’s, but he said she was smart. She was getting older and I would have to accommodate. So I just walked the same mile twice; once with Toots and her son Blaze, and twice with Blaze. I called this my “meditative walk,” and it helped me think and prepare my mind for writing.

Little did I know it was also helping my heart. But who would have thought that rescuing a dog could open your heart to love? And I don’t just mean the furry kind.

While our family was vacationing in FL last week we got together with Meredith, an old Med School friend of the Bride and Groom. It just so happens she is a practicing Ob-Gyn in Tampa. The Love Bug played with her sweet son in the pool for hours, while Meredith did her best to sell the doctor couple on the pleasures of practicing medicine in the Sunshine State. And then I just had to ask, “How’s Mona?”

You see I feel personally responsible for Meredith’s marriage! One day long ago BC (before children) in med school, Meredith told me she wanted a dog. I accompanied her to the Charlottesville Albemarle SPCA and we found a little male Jack Russell, who was full of energy and a kissing machine. It was love at first lick! I would grand dog sit him when she had to do an away rotation and he got on splendidly with my crew. Little did I know that within a few months Meredith met her future husband at a dog park with his Jack Russell, and the rest is herstory!

Dogs are not only good for your heart, they are great for your love life! And Mona is still alive and kicking.

the Maid of Honor, the Bride, the MOB, and Merdith

the Maid of Honor, the Bride, the MOB, and Merdith

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After our sudden trip North to Sue’s funeral, followed by our planned trip North for Ada’s birthday party, followed by a week of the Bride and Bug visiting, Bob and I were supposed to have a few days mid-summer to ourselves. He might get to mow the lawn, I might actually get to finish doing laundry. Maybe we’d go out to dinner? But no, the Joints have arrived!

The Joint Commission http://www.jointcommission.org/accreditation/hospitals.aspx is the national agency that wanders into your hospital without warning for a few days of fun and relaxing oversight. I remember when I was teaching and was told the Principal would have to evaluate my performance, but I’d get a few days notice and would I mind sending him my plans for the week? Brand new to the profession, I thought well that’s kinda like cheating. If someone really wants to evaluate you, why not just walk in one day? Well, the teacher’s union would have none of that.

And a few years ago, the Joints felt the same way – unannounced visits are now de rigeur.

You never know when they might arrive to evaluate your system. If standards are not met, a hospital might lose its accreditation, ie funding, ie money. A residency may have to shut down, which happened recently at Berkshire Medical Center, where I delivered my children. Surgical residents in the Berkshires are now scrambling for another hospital to accept them. So as you can see, it’s a very BIG deal when they show up, and poor Bob is one of three hospital board members not on vacation.

People have always assumed that because we have so many doctors in our family, that I would know about such things. In fact, I don’t. I cannot tell if a baby is dehydrated, or if a cut needs sutures.  I can’t tell heartburn from a heart attack. And I certainly can’t distinguish between a bug bite and shingles…or psoriasis. I knew very little about the Joints until Bob told me about them this week.

But if you live in VA and want to know what it feels like to go to medical school, you can sign up for UVA’s Mini-Med School in the Fall! http://www.medicine.virginia.edu/community-service/more/minimed/about-mini-med.html

During the 7 week program enthusiastic UVa faculty members, with assistance from current medical students, will lead the group in exploration of a wide range of topics in medical education. Participants will experience such integral parts of medical school as match day, research labs, patient interviews, and more. Mini-Med will provide a behind the scenes look at the training of those we entrust with our health, a greater sense of health literacy, and forge new connections between the health system and our community. Mini-Med will also feature entertainment provided by our talented medical students. There is no cost to participate and while participants will not leave Mini-Med School with a medical degree they will leave with knowledge, resources, and a certificate of attendance.”

For me, well I think I’ll pass. Unless they have a really good jazz singer this year. I’m happy giving kisses to the Love Bug when she gets an “ouchy,” and for now, that and some well placed Disney band-aids always do the trick!

PopBob entertaining the troops in Dover

PopBob entertaining the troops in Dover

 

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Here we go. A flip was switched somewhere and summer has arrived – triple H weather, hazy, hot and humid. Today and tomorrow are supposed to be scorchers, 90+ with crazy late afternoon thunderstorms. But July first also means the new interns and residents start at the hospital, and that means moving vans and cleaning crews.

When we moved South, we bought a hundred year old house in town. It was supposed to be our little nest egg, a small investment property, something to rent out to medical students, our own personal social experiment. But we bought at the height of the market, and the more we stripped away the years and “captured” space underground to make the basement rental beautiful, the more we realized this would be a non-profit adventure.

Our renovation to this grand little brick foursquare, three bedroom house proceeded with the vague thought that we may sometime in the future, when we can no longer drive, like to live in town and be able to walk everywhere. Presuming we could still walk!

My guilty TV pleasure is watching HGTV. I love International House Hunters, the Property Brothers, and Flea Market Flip.  But flipping tenants every three to four years is taking its toll. Most of the time I’ve lucked out, because word of mouth has meant that the house stayed in the general med school family. These students are rarely home, and when they are, they sleep. For a new landlord, this was a win win.

But as of today, the tenants are not med students, although one is a PhD student. They like to garden and take good care of the house. I feel bad for the new guy moving in today, on presumably one of the hottest days of the summer. And it was bittersweet saying goodbye to the emergency resident who packed up a van and left for Sloan Kettering. He got off a plane from Germany with two suitcases three years ago and is off to a fellowship in the Big Apple. That’s the best part of this whole thing, meeting new people.

We’ve even had two weddings that were linked to that brick house!

So maybe I could pitch a new show to HGTV called  “Investment in Medicine?”  About buying an investment property to rent to med students who only call you when they think the smoke alarm won’t go off and it turns out to be an abandoned beeper in the back of a closet. A Grey’s Anatomy meets House Hunters. I’ve got more stories, but I think I’ll keep them close to the hip.

I’ve turned over the key, and left a bottle of wine in the fridge. Here’s to you historic old house, we’ve had a good run. I hope your newest tenant loves you as much as I do. and I hope the AC holds out.

Bride and Groom near the brick house

Bride and Groom near the brick house

 

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