Writing for Wellness

Writing Prompt: Uncertainty

With many of my friends and myself matching for fellowship in the last few weeks, I’ve been overcome with emotions that I have had a difficult time processing. I even had a panic attack the night before Match Day when I realized that there was a possibility that I could not match into fellowship. I was able to calm myself down by reminding myself that even if I did not match into palliative care fellowship this year, barring unforeseen circumstances, I would still graduate residency as a pediatrician. I also had just received my copy of home body by Rupi Kaur in the mail, so I calmed myself down by immersing myself in her musings as she dealt with life, love, loss, and depression.

One of her poems really spoke to me. Actually, at the time, I felt targeted and upset, as it definitely hit a nerve, though over the next few weeks, I was able to appreciate the sentiment. The poem was on page 27 of home body, and is transcribed below:

“i am trusting the uncertainty
and believing i will
end up somewhere
right and good”¹

I definitely wanted to throw my book against the wall when I read it, but I later came to acknowledge how uncertainty contains its own brand of beauty. However, I also appreciate that I am privileged to be able to trust uncertainty and that being in an uncertain situation will often not cause me harm. We are living in a difficult time, not only with our careers in flux (for my colleagues particularly), but with mass death due to COVID-19 and its variants, destruction from climate crises, worsening child and adult mental health epidemics and poverty, an epidemic of systemic racism, and so much more. It brings up a lot of emotions, and as much as we do not have control of so many outcomes, it can be incredibly scary and almost impossible to believe that everything will be alright. And honestly, that is often justified.

The prompt for this week is this:

“Write about uncertainty.”

You have as much or as little time as you would like.

References:

Kaur, R. home body. Andrews McMeel Publishing; 2020, p. 27.

More unedited writing of mine. Way more than ten minutes about uncertainty:

Why do I fear the future? Is it uncertainty I feel? But doesn’t that come with so much potential? Why does it scare me so much? What am I worried about?

Uncertainty just means I don’t know what will happen. I might achieve all of my goals without any setbacks. I might lose everything I’ve worked towards personally, professionally, physically, emotionally. Somebody I love could die. It’s all happened before. But honestly, whatever happens will likely be somewhere in between. There will be joy, there will be suffering, there will be contentedness, there will be boredom.

In fact, my emotions right now are helping me predict some of the future (though we all know how wrong these projections can be).

I feel pride at how much my colleagues and I have learned and grown over the past 2 ½ years of residency.

I feel unprepared to be a fully-fledged pediatrician in six months, as there is still so much that I don’t know.

I feel excitement to start palliative care fellowship at a program where I will be exposed to the full breadth of medical humanities in addition to incredible career mentoring and just getting to work with lovely people.

I feel grief at another year living in a difference city than my husband while also moving away from the wonderful friends and family I have made in residency.

I feel anticipation at finally finishing pediatrics residency and moving on to the field I want to work with for the rest of my life.

I feel anxiety about preparing for my pediatric board exam a full year after I have stopped practicing general pediatrics.

I feel sadness about no longer taking care of all of my continuity patients that I have grown to love in clinic. I will miss them deeply.

I feel trepidation moving away from my current home in Columbus to my new home in Akron, but exhilaration to make new routines, find new coffee shops, walking routes, parks, and bookstores.

I feel apprehension that I am not going to be able to handle the difficulty of pediatric palliative care. That I feel too deeply and I will be overcome by emotion too frequently for a life working in this field to be sustainable.

But mostly I feel grateful. Grateful to have a job, to have friends who love me and will keep in touch (#BookClub4Ever #WineAndCheese4Ever #NimsAndBad4Ever), to have a supportive husband and family who push me to fulfill my dreams, and to have learned and grown so much in a wonderful training program. If this is what uncertainty is, I can face it with my head held high one day at a time.

Writing Prompt: Art

My lovely co-residents and I have been continuing our book club throughout the pandemic. In this period of such loneliness, it is a balm to be entrenched in a story and to form relationships with the characters; this is in addition to the monthly discussions and group texts. And bless my friends for regularly choosing works of fiction that I would have never read otherwise.

I recently had the opportunity to speak to a group of undergraduate students at Ohio State about narrative medicine. One of the questions they asked me was how, in this tumultuous time of a global pandemic, climate change, racial reckoning, the threatening of the rights of trans individuals, etc., I use narrative medicine as a physician to advocate for my patients and otherwise. First of all, what an excellent question. Secondly, I realized in that moment that reading literature not only helps me build my overall empathy (see previous discussion of the data on this), but that these books expose me to the experiences of human beings I may never interact with otherwise.

We read Transcendent Kingdom by Yaa Gyasi, a novel about a family of Ghanaian immigrants in Alabama ravaged by depression and addiction and grief. We read The Vanishing Half by Brit Bennett, a portrait of twin girls who are Black, but pass as White, growing up in the American South and the disparate trajectories of their lives as shaped by individual decisions. The last book we read was The Last Story of Mina Lee by Nancy Jooyoun Kim, the story of a single Korean immigrant mother and a Korean-American daughter who spent their lives struggling to understand one other.

All of these stories and the characters therein are completely fictional, but I feel like I know them. They are fully formed humans to me, which speaks to the effectiveness of the writing, absolutely, but also to the power of storytelling in general. In fact, as a doctor, I have met some of these characters in real life. Reading fiction provides me with a lens through which I can see my patients in more than 15-minute segments. The fear that one lives with being undocumented. The constant stress of living with a child or sibling with addiction. The pervasive generational trauma of poverty.

And writing does the same thing. When we consume or create any type of art, we become more connected to one another as human beings. We add beauty and joy to our lives. And we find a way to release emotions we never knew were there.

I was reminded of this while reading The Last Story of Mina Lee. Margot, the titular character’s daughter, picks up her old notebook and pencil from her childhood desk and begins to draw for the first time in years. She is struck by the fact that she has always loved art, to create, and to tell a story with her work. But the concept of creating art just for art’s sake seemed so foolish and impractical given her upbringing in a world where her neighbors were struggling to survive. But she reconciles these two things.

“Yet, everyone needed art. Why else did her mother assign so much care into the fruit that she sliced, that long peel of skin, a ribbon that revealed the tenderness of the flesh inside? Or the tiny flick of her eyeliner that she angled perfectly in the mirror, the arrangement of the outfits that she hung on the walls of her store.”¹

We all need art and beauty, and we find ways to incorporate it into our lives even if we don’t realize it. How we do this can help us learn about ourselves, just like Margot was able to better understand her mother.

The prompt for this week is this:

“Write about the little pieces of art you create every day.”

You have as much or as little time as you would like.

References:

Jooyoun Kim, N. The Last Story of Mina Lee. Park Row Books; 2020, p. 257.

More unedited writing of mine. Ten minutes about the pieces of art I create every day.

Nephrons

But why is my child swollen?
How do the kidneys work?
Why is his urine frothy?
Why did this happen?

How do I explain
In 10 minutes
What took me years to understand?

Well, he’s losing protein from his kidneys,
Yes they do look like beans.
No, they do so much more.
There is something called a basement membrane
In the glomerulus
And it filters blood
And the size of the pores
Well not just the size…

The words are
Jumbles of letters with no meaning.
But I mean to say so much.
So I draw.

The nephron is a marvel of nature.
So I sketch it as such,
Basking in its beauty,
It’s utility.
Art for education,
But also to remind myself
How lucky we are to exist.

Every stroke of the pen,
No matter how practical,
Allows me to share this beauty
With someone else.

What a miracle.

Writing Prompt: Gray Areas

I haven’t had the bandwidth to blog or even write for myself in a long time, between my clinical responsibilities and time focused on my research and other projects. But inspiration comes sometimes, so I finally put pen to paper (fingers to keyboard?) a few weeks ago and drafted an essay. Ultimately, I decided to be brave and share my own writing (full drafted and edited, as opposed to just impromptu) on this medium for the first time. I hope it inspires you to write down your own thoughts as well.

Black, White, and Gray

It seems like every pediatrician has one: a story about co-sleeping that ends in a dead infant. Usually, they present the same way. The parents put them down for a nap and curled up beside them. When they woke up, the baby wasn’t breathing and had no heartbeat. They were rushed to the emergency department and could not be saved.

It’s horrible for the family, and there is no doubt that their loss is the most profound.

But it is also a story that we, as the pediatricians, never forget.

I am trained as a physician scientist. During my PhD training, I learned how to critically interpret data, evaluate study design, and understand the nuance that accompanies the results of every experiment. And I empowered myself and others to conduct experiments on our own, armed with the knowledge that the truth and best practices were always changing and that the world was full of gray areas.

Much of that subtlety was thrown out of the window as I entered my clinical training. Yes, medicine is based in clinical research that is conducted in that same way. But medical school teaches you to memorize tidy little snippets for tests and choose the best multiple-choice response to a clinical vignette. We are trained in pattern recognition, standards of care, and practice guidelines. We have to apply these rules during 10-minute visits where there is no opportunity for critical reflection for the parent, the child, or the practitioner. There is some room for creativity (“the art of medicine”), such as when existing clinical evidence is not clear cut, as is often the case in pediatrics. However, there are many situations that we treat as completely black and white.

Safe sleep. Vaccines. Vitamin K at birth.

And to a lesser extent: Breastfeeding. Screen time. Healthy diet and exercise.

Halfway through my residency training, I have softened on a few of these positions. Due to the COVID-19 pandemic, I have learned to embrace my patients’ and their parents’ humanity when it comes to screen time and healthy eating. If there are days (weeks?) when I have a donut and a cup of tea for breakfast, who am I to judge them for their choices? I can educate them and offer them the medical recommendations, while still acknowledging their reality of working a full-time job and simultaneously educating and caring for their children with little control over their daily habits. My job is to share my expertise and use it to help them meet their goals as a family.

I have even become more flexible with vaccines and postnatal vitamin K. I am sure this would be different if I had seen an unvaccinated child present with preventable life-threatening epiglottitis or meningitis or a severe intracranial bleed. However, thanks to wide-reaching immunization campaigns, in my young career so far (we will see if this changes), those scenarios have been relegated to board question stems and the writings of William Carlos Williams. I am also more aware of many of the reasons for hesitancy surrounding vaccines and medications for infants among various populations. So I provide my parents with my recommendations and literature to support my claims, and I let them make their own informed decision, making sure they are well aware of the risks. Ultimately, even if they do not choose to vaccinate, they still trust me and count on me when they have other questions and concerns about their child’s health. I would rather them not vaccinate and continue to bring their child to see me than to lose contact with them entirely.

But co-sleeping? This situation evokes a visceral response. My first thought is always, “Do you want to suffocate your baby? Do you know how many babies have come in dead from co-sleeping?” Admittedly, this is not the most helpful approach, so the thought resonates inside my mind until I gather my composure enough to have a conversation with the parent about risk-mitigation.

Since the Back to Sleep campaign started in the early 1990s, sleep-related deaths (including those from suffocation and unknown causes) have stabilized at between 80-100 per 100,000 live births. That’s 0.1% of otherwise (as far as we know) healthy children, or about 3500 deaths per year¹. As a pediatrician and a human being, that seems like a lot of babies to lose. But that data doesn’t tell the whole story. Not all of those deaths would be preventable if the baby were alone, on their back, in a crib. More granular data indicates that about 24% of those deaths are due to suffocation or about 800 deaths per year².

When you have witnessed a family experience that loss, it is hard not to fight tooth and nail to prevent as many of those deaths as possible. But I am not a parent. I am not up every two hours breastfeeding. I have counseled patients on strategies to console a child with colic, but I have never been the one to drive an infant around the block for hours until they have cried themselves to sleep. And as much as I say that I will stay strong when I make my future child “cry it out,” I am not 100% sure that that is actually true.

And so I gather my data. I pull my empathy out from behind the trauma-induced wall of fear I have constructed, and I talk to the parents about mitigating risk. If they insist on co-sleeping, I have to give them my medical recommendations, make sure they are informed, and do my best to help them create a safer sleep environment in their bed for their child. That is all I can do.

And if that baby is the next one that comes in in cardiopulmonary arrest? I don’t know if I could handle that. But I guess I’ll have to.

The prompt for this week is this:

“Write about gray areas.”

You have as much or as little time as you would like. See you next week.

References:

Mathews TJ, MacDorman MF, Thorna ME. Infant Mortality Statistics From the 2013 Period Linked Birth/Infant Death Data Set. Natl Vital Stat Rep. 2015;64(9):1-30.
Sudden Unexpected Infant Death and Sudden Infant Death Syndrome. Centers for Disease Control and Prevention website. Updated 20 November 2020. Accessed 18 Febuary 2021. https://www.cdc.gov/sids/data.htm

Writing Prompt: Pleasure

Guys, who needs a pick-me-up? I felt low for the week after I came back from vacation, so I have been taking advantage of the beautiful weather here in central Ohio, as well as my more flexible work hours before I go back to inpatient medicine tomorrow morning, and taking regular walks through my neighborhood. Every time that I do, especially if I go through the park, I have been taking better note of the beauty around me. I don’t know if it’s because I started rationing my news consumption (highly recommend this, by the way), the crisp fall weather is lifting my spirits, or I am simply taking advantage of the time I have while I still can. But my mood has significantly improved.

Yesterday, on my walk, I noted that the ducks that are usually in the pond in Schiller Park were all napping in the grass (I suppose I perceived them to be napping; I am not actually certain how ducks repose). For some reason, the concept of a communal duck nap filled me with unending joy, only to be complemented by the human parents snuggling with their babies on the park benches I meandered past. It reminded me that sometimes (most of the time), our real purpose in life is to feel the pleasure of connecting with our loved ones. There is beauty in experiencing something so fundamental to our humanity instead of letting it be drowned out by noise.

Letting myself experience joy in this way reminded me of the writing of Mary Oliver, who was known for embracing nature in her poetry and deriving an incredible amount of meaning from what she noticed around her. In “The Storm,” she describes the simple pleasures of a fresh snowfall blanketing her world.

The Storm
By Mary Oliver

“Now through the white orchard my little dog
romps, breaking the new snow
with wild feet.
Running here running there, excited,
hardly able to stop, he leaps, he spins
until the white snow is written upon
in large, exuberant letters,
a long sentence, expressing
the pleasures of the body in this world.

Oh, I could not have said it better
myself.”

The prompt for this week is this:

“Write about the last time you felt a simple human pleasure.”

You have as much or as little time as you would like. See you next week.

References:

Oliver M. (2020). The Storm. [online] Poetry Foundation. Available at: https://www.poetryfoundation.org/poetrymagazine/browse?contentId=40069. Accessed 22 Sep. 2020.

More unedited writing of mine. Ten minutes about the last time I felt a simple human pleasure.

Ice Cream Sundae

Creamy and cold,
The sweet, frozen orb
Is surrounded by a
Warm, bittersweet waterfall
That creates rivulets,
Saccharine vanilla rivers
Wherever its fudgy path flows.

Hot!  Cold!
Sweet!  Bitter!  Salty!
Chewy!  Creamy!  Crunchy!
The inside of my mouth,
My tongue, my cheeks
Experience an explosion
Of flavors, textures,
And contradictions.

With each spoonful,
A new surprise,
A new pleasure.

I am awash with joy.

Writing Prompt: Caged Bird

Last week was a hard one for me. I did not have any sort of personal tragedies or difficulties; rather, I ached with my fellow citizens as we all do when faced with collective grief. Forest fires. Possible fire tornadoes. Hurricanes. A continuing pandemic with no end in sight, with over 58 million people having filed jobless claims since it began. Another Black man murdered by a police officer and the ensuing response. The death of Chadwick Boseman. And throughout all of it, the speakers at the Republican National Convention, many of whom are our current lawmakers, painting a picture of peace, health, and prosperity for all.

I feel like I’m crazy. Looking at my old posts, it’s almost quaint that my biggest worry in January was the weather and waiting for daffodils. Now, I worry that we have descended into a dystopian landscape, imagined by Ray Bradbury, George Orwell, and Margaret Atwood. In my heart, I am sure that authoritarian rule is just around the corner, unless we do something to stop it. I am convinced of it because of the dissonance between what I see and hear and what I am told by my leaders.

We deserve better. Every single one of us deserves better. And we cannot make this country better unless we have something to aim for. I was inspired this week by one of the greats, Maya Angelou, in one of her classic poems, “Caged Bird.” An excerpt:

“But a bird that stalks
down his narrow cage
can seldom see through
his bars of rage
his wings are clipped and
his feet are tied
so he opens his throat to sing.

The caged bird sings
with a fearful trill
of things unknown
but longed for still
and his tune is heard
on the distant hill
for the caged bird
sings of freedom.”

I hope you use your voice to sing past your “bars of rage,” as I will try to do as well. The prompt for this week is this:

“Write about your song as a caged bird. What do you dream of, what do you sing of? What are your goals for our country?”

You have as much or as little time as you would like. See you next week.

References:

Angelou M. (2020). Caged Bird. [online] Poetry Foundation. Available at: https://www.poetryfoundation.org/poems/48989/caged-bird. Accessed 31 Aug. 2020.

More unedited writing of mine. Ten minutes (let’s be serious, more like thirty minutes) about my dreams and my song.

I spent much of this week crying. Thursday morning. Saturday morning. Good, visceral, ugly cries with a scrunched up face and mucus running down my nose, going through tissues like I did when I read The Fault in Our Stars (my copy of the book literally has drops of tears and snot on it…you might not want to borrow it from me). I have no personal reason to cry. I have a good job. I have a beautiful marriage and good friends and a healthy family. Sure, we have had some personal tragedies, but not for a long time.

So I thought about what triggered my tears. Was it sadness? Rage? When did I cry the most? The first time was in watching the Republic National Convention. I had just finished reading The New Jim Crow, the sharp details of systemic racism and mass incarceration fresh in my mind. I had just watched videos of the teenage vigilante walk right past police officers minutes after he had murdered two protesters in Kenosha, WI. He deserves due process per the law, as did Jacob Blake. And then I watched the fear-mongering. The incendiary language. The hate.

And I was angry. But mostly I felt disappointed. And misled. My whole life I had read about other countries and their rulers who were dictators. The corruption. The bribery that it takes to get anything done if it has to do with the government. There are multiple Bollywood movies that detail this very thing, and some of my family in India lives it daily. But I never thought it could happen in the United States. This level of blatant dishonesty. Yes, it was naïve. But generally (and I say this as a very privileged non-Black person), I felt that my government cared about me. That maybe people disagreed on how best to create policy (economics is complicated! As is science! And healthcare! And diplomacy for goodness’ sake!), but they had the best interests of all of us at heart. At the RNC, that plainly wasn’t true.

And then on Saturday I woke up to news that a beloved actor had died. And my tears and my grief weren’t about Chadwick Boseman himself, though he seemed like a lovely, generous, and kind-hearted person. They were about what he represented, what his characters represented. I am, admittedly, the most familiar with Black Panther. But man, what an aspirational place we found in Wakanda. Weapons technology used to maintain peace, not start unnecessary wars. An advanced African civilization untainted by colonialism and racism. And all of that strength and pride in community, in the culture, in doing what is right, even in taking care of their most vulnerable. No, especially in taking care of their most vulnerable.

Now, I may be projecting onto Wakanda my dreams for the United States. I am for sure doing this. But what wonderful dreams. I want us to become the country that my parents dreamt about when they moved here 40 years ago. Even the one that my friends dreamt about when they immigrated within the last decade. One in which we realize and embrace that we have enough for all of us, we just need to learn to share a little better. That we are not constantly striving for greatness, but for goodness. That we don’t judge each other based on our skin color, age, size, sex, sexual orientation, occupation, neighborhood, hair type, tax bracket. But that we appreciate and love and learn from these differences. That we learn to say “I’m sorry” and encourage lively discourse. So we can learn from our mistakes. And constantly work to be better. As individuals, as communities, as states, and as one nation.

And just because we have not done this before in our centuries as a country, does not mean it cannot be done. In using our rage to sing of things unknown, we can make them happen. This is my dream.

Writing Prompt: Masks

At the start of this pandemic, with the stay-at-home orders, I had a week of vacation that I needed to use. I was supposed to be traveling with my husband to my ancestral homes in India (and to be eating all of the street food my stomach could handle), but I was forced to spend the time in solitude in central Ohio.

Thankfully, one of my co-interns also had that week off. So we spent the week simultaneously watching movies and messaging each other all of our thoughts and feelings and realizations.

One of these movies was Crip Camp, a documentary about a summer camp for disabled teenagers (style guide for referring to disabled individuals/individuals with disabilities), many of whom then went on to become major players in the Disability Rights movement in the 1970’s.

Now, my friend and I are both pediatricians in an extremely large and busy children’s hospital, so we frequently care for children and teenagers with disabilities. And I, for one, hope that I do enough to create a safe space for them to be themselves. However, there were so many assumptions that I realized I had been making when watching this documentary, how much my personal perceptions of the individuals in this population had in my view limited their personal lives, their experiences, their humanity.

I was reminded of this when I read a beautiful narrative in the New York Times about a woman, Helen Hoang, a romance novelist, who “comes out” with autism to her family (you should definitely also read the other two essays in the series). In her essay, “Coming Out with Autism,” she heartbreakingly describes the way her family accepted her diagnosis at face-value, but didn’t truly allow her to be herself. Thus, she continued to wear the mask to hide her autism every day and has experienced a state called “autistic burnout.”

It made me wonder, how much of a toll do we exact on others by not letting them be themselves?

The prompt for this week is this:

“Write about masks.”

You have as much or as little time as you would like to take. See you next week.

References:

Hoang H. (2020). Coming Out with Autism. [online] The New York Times. Available at: https://www.nytimes.com/2020/07/13/us/disability-reveal.html [Accessed 15 July 2020].

More unedited writing of mine. Ten minutes all about masks.

Masks obscure the truth. Sometimes it can be nice to hide behind one, honestly, because showing and sharing all of the ugliness would be too much to bear. Not only for my colleagues or my patients or my family – sometimes I put on a mask to hide from myself.

But when is it ok to remove it? To be free from judgement? We preach a lot that you should be free to be yourself and that if those around you don’t like it, that is their problem to deal with, not yours.

But it becomes your problem. Negative comments, feelings, energy – it isn’t benign, and it wears on you day in and day out. Judgment from being yourself vs. a mask to hide yourself, both are exhausting. So what do you do if there’s nowhere else to go? Anyone who says to live for yourself doesn’t live in a society or with a partner or friends or colleagues or anything.

Sometimes that vacuum does sound nice, though. Can I join you in your hermit lifestyle?

Out in space, where I don’t have to choose – what does my public persona look like today? Why can’t it just be what I feel like, warts and all. Warts, insecurities, impairments, strengths, weaknesses, and all?

Space sounds great. Astronaut ice cream and no masks allowed (except to prevent the spread of COVID-19).

Writing Prompt: Revolution

The Fourth of July was different this year. Not only were large celebrations cancelled due to COVID-19, but with much of the United States finally coming to terms with and acknowledging our racist history in the context of our national holidays, many of the festivities required reframing. When we stop isolating racism as an academic concept that existed in our past and begin to see it in our day-to-day activities, how do we celebrate a holiday that glorifies its protagonists’ fight for freedom when they were actively denying it to their brethren?

My husband and I decided to create a new tradition and watched the newly released live recording of Hamilton. I love this musical. The score got me through the last several months of graduate school, and the story of the American Revolution, of the scrappy underdogs fighting and winning against the oppressive British Monarchy, is enough to inspire anyone with the Founding Fathers’ American ideals. There are many legitimate criticisms of the musical, including the way it glosses over numerous negative characteristics of its main characters, a group of white, landowning, slave-owning males. However, there are various thought-provoking themes and lyrics that can help us think about the future of our country 244 years later.

In “My Shot,” Alexander sings the following words as they prepare to fight the British in the Revolutionary War:

“And? If we win our independence?
Is that a guarantee of freedom for our descendants?
Or will the blood we shed begin an endless
Cycle of vengeance and death with no defendants?”

Looking back on it now, it seems like we have hit on that cycle of vengeance and death, at least for some of us, as there are many groups in the United States who are far from free. From Black Americans dying from police brutality to immigrant children who are still held captive away from their families to residents of Flint, MI who still lack clean water to Native people on reservations who are constantly being threatened by corporate greed, there continue to be citizens fighting for their independence. And until they find it, the cycle will never end.

The prompt for this week is this:

“Write about a revolution.”

You have as much or as little time as you would like to take. See you next week.

More unedited writing of mine. Ten minutes all about a revolution.

Cycles of Power

One by one,
The replacements rise.
Each installed by a violent –
Or peaceful, as it were –
Revolution.

But why don’t they learn?
If they detested
Oppression, the taxation
Of their tea,
Why impose it on their fellow man?

Instead of tea and taxes,
It’s complete subjugation
Their bodies not their own,
The linear hypopigmentation of their skin,
Scars from the lashes,
Progeny they had no choice
But to birth,
Nowhere to go
But back to the chains.

Do we naturally separate
Into rungs on a ladder
Of society
Stratified by the quantity
Of melanin in our skin?

But why don’t we
Use that power to
End the separation,
With no more levels
There would be no more
Reason to rise up
And start the cycle again.

Writing Prompt: Creating Space

I have been taking a break from online media (blogging, Twitter, Facebook, etc.) for the past few weeks in order to determine how I can be a better ally for black Americans and use my, however meager, influence to amplify their voices. One of the ways I identified was to share their writing as examples of narrative works worthy of consideration and reflection (see also this writing prompt based on a beautiful poem by Dr. Alexandra Sims).

This week, that work is a piece by Dr. Kimberly Manning, who is a med-peds trained assistant professor in the Department of Medicine at Emory University School of Medicine who is also a prolific writer who has been extensively published and who regularly blogs at www.gradydoctor.com. Dr. Manning’s writing is thought-provoking and reflective, and she is an incredible storyteller. In her essay in JAMA, entitled “The Nod,” she tells the story of how an observant medical student noticed a subtle greeting and how the simple act of being curious helped create space for teaching cultural competency across the medical team.

Now, the issue of systemic racism in the United States will not be solved by conversation alone, but rather by action and the dismantling and restructuring of institutions that exist solely to subjugate black Americans and people of color. However, we can start changing ourselves, start recognizing our own biases, and start using our privilege for good when we make space for our fellow citizens and their stories.

The prompt for this week is this:

“Write about how you will create space.”

You have as much or as little time as you would like to take. See you next week.

References:

Manning KD. The Nod. JAMA. 2020;323(17):1684-1685. doi:10.1001/jama.2020.2868.

More unedited writing of mine to remind you that just as writing doesn’t have to be perfect, neither does allyship. You just have to start and be open to improvement. Ten minutes all about how I will create space:

I will notice. I will ask questions. I will not immediately judge and jump to conclusions. And if I do (which I absolutely will because I am human), I will learn that it is ok to admit fault and to learn and change. Making space for feedback and correction is huge and integral to being an ally.

So is making space for truth-telling, for someone’s actual lived experience to take the place of your perception of their experience. For their actions to take the place of your assumptions of their intention. When I see the black man sitting on the ledge outside of CVS as I walk home in my scrubs and stethoscope and my first thought is to tense up, I need to make space for a lot of things. For my impression to change when he thanks me for my service instead of doing goodness knows what I assumed he would be doing. For my overall impression of black men sitting on the ledge outside of CVS to change from the one I have been trained to have by society to one that is more honest to their experiences.

I need to listen. And observe. And create space for black voices in other areas by not burdening them with the job of educating me about their struggles. And that discomfort and guilt and shame I feel…to make space for that too. To learn from it and grow from it to make a better world for all of us.

Writing Prompt: Race

Race. It is a simple, but loaded word that many of us hate to think about. But it is important to do so. The United States has a long and storied history with race. From the moment the first colonists set foot on North American soil (and probably before), there has been racial bias, stereotyping, and discrimination.

I am no expert on this, and I have no narrative piece to share this week because we all already have our own lived experiences. Whether it is perpetrating or experiencing racial injustice. Whether it is intentional or accidental. Whether it is being called out for a mistake you made or being brave enough to speak up yourself. There are a lot of strong emotions associated with our differences in skin tone, and those of us who are privileged enough to do so often hide from those feelings.

But it’s important that we face them head on. Because that is the only way that we can look inside ourselves to create change on the outside.

The prompt for this week is this:

“Write about race.”

You have as much or as little time as you would like to take. See you next week.

This week, I will keep my writing private and use it to change my actions. Feel free to share yours wherever you feel safe – with a loved one, with your community, or only with yourself.

Writing Prompt: Touch

I touched a patient’s mom the other day. I gave her an affectionate pat on the shoulder because we had given her even more bad news about her son. It is something I have done hundreds of times to hundreds of patients and their parents. It lets them know that I am here, I am thinking about them, and I am willing to sit with them through their trauma and sadness and fear.

Just a simple touch can signify so many things. But this touch was laden with something else as well: guilt. In the age of COVID-19, personal contact can be deadly. We wear masks and goggles in every patient room and limit contact to only that which is necessary. We test all of the patients who are admitted in my hospital, but we have no idea if their parents or even our colleagues or ourselves have been exposed. So we do our best to keep our distance to keep everyone safe.

But I worry what will happen as we come out of this. The only human contact I had had in two months (until yesterday when I saw my husband for the first time in 12 weeks) was with my patients. The first hug I received was from my husband yesterday. It was such a great feeling to melt into his arms. But it is also hard to reconcile that impulse to touch with our need to slow the spread of disease.

Kristen Radtke illustrates this concept beautifully in a graphic essay from March in the New York Times entitled “What Do We Lose When We Stop Touching Each Other?” In it, she describes the fundamentally human desire, nay the need, to touch one another, the health benefits it brings, and how that might be altered after this pandemic. I hope it gives you something to think about.

The prompt for this week is this:

“Write about touch.”

You have as much or as little time as you would like to take. See you next week.

References:

Radtke K. (2020). Op-Art: What Do We Lose When We Stop Touching Each Other?. [online] The New York Times. Available at: https://www.nytimes.com/2020/03/19/opinion/coronavirus-touching.html [Accessed 23 May 2020].

More unedited writing of mine to remind you that writing doesn’t have to be perfect, it just helps you express what you feel. Ten minutes all about touch.

When I leave the house, I noticed everything that comes into contact with my bare skin and the sequence in which it happens. I close my door with my clean hands, now dirty because they have touched the doorknob on the outside of my apartment. I put the dirty keys back into the pocket of my bag, where they hopefully stay isolated in their compartment. My hands stay in my pockets as I push the door of my apartment building open with my hips. The walk button to cross the street to the hospital, I press with my elbow to minimize skin to metal contact. I am realizing that I should probably wash my hospital-issued fleece more than once every four days with my scrubs, but it is also showing signs of wear from all of the cleaning cycles it has already been through. As I approach the hospital, I reach into a brown paper bag that I keep in my tote for my hospital-issued surgical mask that I brought home yesterday. I hope that any viral particulates that had been left on it from the day before have since died, but who really knows? I put it on my face to enter the building, thanking the heavens for automatic doors.

Once inside, I grab a fresh mask from the staff working at the entrance and hold it in my now dirty hands. Why didn’t I remember to sanitize before accepting it? Then, holding my tote, my lunch box, and my new mask, I use my ID to tap the badge reader and push open the door, again with my elbow. I have yet to master the art of pressing the elevator buttons with my elbow, so I hope the first elevator that arrives is going up. More automatic doors, then more badge readers. I dangle my new mask off of my fifth finger, so I can sanitize my hands again before touching the door handle to our work room.

As I walk in the room, I turn on the lights, quickly dirtying my sanitized hands again. The bags go on an empty chair and with no one else in the room, I switch out my old mask for my new one. Now grabbing gloves and a bleach wipe, I sanitize down my workstation, trying not to gag at the smell of the cleaning solution. As I wait for it to dry, I print out patient lists for my team, set up my materials for the day and get to work. I don’t know how much I prevented the spread of disease (I am glad the mask does something), but I am ready to start another day.