Writing for Wellness

Writing Prompt: Sparks

This week, I saw a plastic bowling set given to a child with cancer to use as a tool for occupational therapy. The way his face lit up as he prepared to show his family over FaceTime his unrivaled bowling ability was the spark of joy I needed to get me through my day. More importantly, I could see how excited it made his mother and his family as well.

On an oncology service, we encounter a lot of sadness day in and day out. We have kids with terminal diagnoses who are admitted for immediately dangerous conditions. Many of them are very sick. Most of my patients who have just received their diagnosis (especially the young ones) hate me. I am absolutely impressed with the ability of five-year-old children to give side eye and the silent treatment because that is typically what happens when I walk into a room. I’ve learned to move past it – after all, they have a terrible disease and we are the people who keep poking them and making their belly hurt and making them want to puke. I get it. But five is one of my favorite ages, and as a human being, it wears on me.

So we look for the sparks of joy in every day. They make it easier to do our job, a job I honestly would not give up for anything in the world. Here are some of the joyful moments I experienced at work this week:

Decrying the unfairness of the Rainbow Road level of MarioKart with my school-aged patient while scrolling through YouTube videos with him
Helping a patient who had previously not said three words to me build a Lego tyrannosaurus rex
Enjoying the lovely fresh cookies distributed to all the teams by one of the senior residents who is on vacation
The “lol!” messages I receive from my fellow
Meeting my patient’s favorite stuffed animals who are helping her through this difficult time

None of these moments are that exciting. But they’re enough. And it’s those little sparks that keep us going day in and day out.

The prompt for this week is this:

“Write about sparks.”

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

More unedited writing of mine. Seven minutes all about sparks.

Sparks of Joy

The dense fog settles
Once the truth is revealed.
Weighing down on their lives
Like a heavy blanket,
Obscuring all of the things
That made them
Them.

Every once in a while,
A memory from days past
Will peak through the surface:
An old toy,
A phone call from a dear friend.
A spark of joy,
Creating a beam of light
Streaming through the fog.

Some of the sparks come from above:
A new friend,
A new song,
A new toy to love.
The warmth clearing the fog,
So we can see the child below.

Writing Prompt: Heroes

I don’t feel like a hero. And I am probably not one. In this eerie time of lockdown during a pandemic, we describe healthcare workers on the frontlines as heroes. Many, as they should, extend this designation to other essential workers, such as farmworkers, employees at supermarkets, bus drivers, paramedics, meatpackers, custodians, warehouse clerks, and others. It takes all kinds of people doing their jobs day in and day out for society to function, and for the most part they go unacknowledged, especially during typical circumstances.

For those of us who are physicians, we read about the sacrifices being made by our colleagues in COVID-19 hotspots. Emergency room and ICU physicians, even residents, succumbing to a virus they have vowed to fight. Beloved nurses who cannot even have a proper burial due to fear of viral spread. As a pediatrician in central Ohio, most of my colleagues and I have been spared from the brunt of the gore. This is a relief to me and to my family.

But I cannot help but feel weighed down by guilt. Why is it them and not me? Why am I allowed to continue my pediatric training when other pediatricians are being called to care for sick adults, putting themselves at risk? Why have I not been given the opportunity to serve? Or have I been spared of the burden?

This is a topic that Dr. Lisa Rosenbaum discusses heartbreakingly and beautifully in her Perspective, “Once Upon a Time…the Hero Sheltered in Place,” in the New England Journal of Medicine¹. In it she makes the case that it is not only essential workers and physicians on the frontlines who are heroes, but all of us, doing our part, to take care of ourselves and others. I implore you to read her perspective and then consider your own.

The prompt for this week is this:

“Write about heroes.”

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

References:

Rosenbaum L. Once Upon a Time…the Hero Sheltered in Place. NEJM. 6 May 2020. DOI: 10.1056/NEJMp2015556.

More unedited writing of mine. All about heroes.

What is a hero? In the current zeitgeist, the word brings to mind superheroes: Captain America (my personal favorite) sprinting across Germany and punching Nazis to bring down the Third Reich, Wonder Woman fighting the God of War to end World War I, Black Panther struggling to save his country from a military coup led by a warmonger. The Cambridge English Dictionary defines a hero as “a person who is admired for having done something very brave or having achieved something great.” This seems very innocuous as a definition and fits nicely into the narrative we have constructed about heroes in society.

The 7 pm applause, the social media celebrations of #NursesWeek, the infographics thanking essential workers all paint a picture celebrating heroes. But I find two things troubling about our treatment of our so-called heroes in this society.

The first problem is how we define “brave” and “great.” Definitely going to work every day with the risk of contracting a highly contagious virus is brave. But it is also brave to stay home and put your life on hold for the greater good. The worst part about our narrow definition of brave is that we then admonish those who, while they are doing their best, stop meeting our expectations. When a respiratory therapist silently continues treating patients despite unsafe working conditions, they are a hero. But when they want to protect themselves, complaining about the lack of protective equipment, the lack of sick leave, lack of child care, they no longer fit our narrow definition of heroism and face a fall from grace in the public eye. I would argue, though, that fighting the status quo for a better life for all of us is one of the bravest things that one can do.

The other concern, one that requires us to push changes in policy to remedy, is how we show our admiration. Social media announcements and free food delivered to frontline workers is appreciated (or so I have read). But hospitals, grocery store clerks, subway workers, all of whom are exposed to multiple people on a daily basis are in many cases not provided with the protective equipment they need. Nor do they receive fair compensation or adequate sick leave. It makes the rest of the admiration ring hollow and the use of the term “hero” misleading.

But it is easy to do this when we don’t think of ourselves as heroes. They are otherworldly, they are super, “I could never do that.” The problem with that thinking is that we don’t realize that they are human beings with needs. We also don’t empower ourselves to contribute the way that we can and we should. You don’t need to be unusually talented to make a difference. As Dr. Chuck Dietzen, a pediatric physical medicine and rehabilitation physician at Riley Hospital for Children and founder of Timmy Global Health, says, the goal for each of us should be to “be ordinary…but have an extraordinary mission.” We can all make the world a more extraordinary place.

Writing Prompt: Perspective

I love newborns. They are so perfect, as untouched as anyone can be by outside influences. They love unconditionally; all they need is milk, a clean diaper, attention, and snuggles, and they are happy to see you (metaphorically – they can of course see very little at this age). So working in the newborn nursery this month was an absolute delight. A new baby is nothing short of a miracle; I am reminded of this every day.

In addition to the fact that an infant has to figure out how to live outside the uterus (their oxygen and nutrients no longer come through their umbilical cord! What an adventure), new parents also need to learn basic skills to care for a newborn, things that are nonintuitive to those who have not done it before. We regularly assist first-time mothers with breastfeeding. The other day I taught one new father how to change his first diaper and another one how to swaddle his baby. Even bottle-feeding, burping, and holding a child are things we historically learned from the multi-generational support systems we resided with (ever-limited during the pandemic) as we welcomed our progeny.

It is incredibly gratifying to provide such basic, but life-changing education. It is also great to know that we are doing our best to give these newborns the best start. We follow their transition into the world and track their bodily functions, but also give them medications to prevent devastating diseases. The three most important treatments we give to infants are:

Topical erythromycin to prevent ophthalmia neonatorum (conjunctivitis that can lead to blindness)
Intramuscular vitamin K to prevent spontaneous bleeding due to vitamin K deficiency
An intramuscular hepatitis B vaccine to start them on an immunization schedule that will hopefully provide lifelong protection from a slew of infectious diseases to them and others via herd immunity

Most families accept all of our interventions without questioning them; they assume that as the pediatricians we have their baby’s best interests in mind and will do what is indicated based on the available data. Every once in a while, however, we encounter parents who refuse one or more of these medications. As a physician who wants to do what I think is best for the child, this can be frustrating for me, especially since my patient is not making the decision for themselves. But it is ultimately the parents’ choice.

The most difficult circumstance is when the parents refuse administration of intramuscular vitamin K. Because of the increased risk of vitamin K deficiency bleeding that is almost eliminated with its administration, parents need to sign a form indicating that they were educated on the intervention and made an informed choice to refuse it. I detail the risks, especially of spontaneous bleeding, and try to convince the parents to change their mind.

In my brief time as a pediatrician, my success rate is 0%.

It is exasperating. But I have to remember in these cases that the infant’s parents and I have the same goal: we want the baby to be as healthy as possible now and in the future. I know why I believe that they need the injection, and I have a hard time accepting why they believe it is unnecessary or possibly harmful. This frustration is normal. But even if my patient’s parents don’t make the same decisions as me, I need to understand where they are coming from. Only then will I be able to provide the best care possible for their child in every other aspect of their health.

This is why perspective is important. Understanding their story can help us to realize the basis for their decisions.

It is not only important in patient care, but in all of our interactions in the current climate during the pandemic. We all want to minimize death and suffering without completely decimating the economy. But we don’t know the best way to do that, and we all have different perspectives on it. It is something we need to be open to exploring.

The prompt for this week is this:

“Write about perspective.”

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

More unedited writing of mine. All about perspective.

Shaped by the Current

Oh to see through your lens,
That which you use to gaze at the world,
The glass shaped by the current
Of your life,
Like a stone smoothed by
Years in the river.

The canyon in which you reside
Blinds whole swaths of the sky.
Carved by that powerful stream,
Year after year
Slowly etching the same path
Into permanence.

If only I could climb
Out of my own immovable canyon
And into yours.
Would I see then
Through your lens?
Be privy to your view of the sky?

The beauty of the landscape
Lies in the variety.
The cracks in the rock,
The misshapen stones.

But for my piece of the sky
You cannot see.
And yours hidden from me.
Keeping us from empathy.

Writing Prompt: Possibilities

The only thing that is certain during this time that we are living in is that so much is uncertain. It can be difficult to plan for the future when we have no idea what the future will entail. There is a considerable amount of anxiety and associated paralysis that accompanies this ambiguity and it reminds me of the stories I have read of patients with chronic illnesses. It somehow seems that individual members of our population are getting sick, and at the same time, our whole society is under siege by a dangerous disease.

The poem, “After a Long Illness” by Judith Harris, PhD was published in the March 3, 2020 issue of JAMA¹. It resonated with me due to its imagery of a “fiery red cardinal” in the “colorless gray fog, when all struggles to survive,” what I saw as a metaphor for signs of life and vitality in a sea of death and sadness. But the cardinal is only there for an instant, as nothing is sure during this time. The way I see it, the fog is over all of us.

The prompt for this week is this:

“Write about possibilities.”

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

References:

Harris J. After a Long Illness. JAMA. 2020;323(9):897. doi:10.1001/jama.2019.21841

More unedited writing of mine. About all of the possibilities.

I see a lot of terrible things every day. Babies who are born with neonatal abstinence syndrome. Children who suffer from physical abuse at the hands of their caregivers. Life-threatening illnesses that take the lives of our youth much too soon. Refugees from war-torn countries whose families are thousands of miles away. Victims of our broken medical system who cannot afford basic healthcare.

And now, during this pandemic, it is all amplified. An invisible, life-threatening scourge circles the globe, wreaking havoc in its wake. Not only does it kill us, but it brings out all of our worst qualities – fear, intolerance, hatred, hubris. Nothing is certain in this time, especially not how we should proceed as humanity or how we will all decide to proceed.

I have been beaten down a lot this year. Not only in my personal and professional lives but when I see the decisions being made every day by our national leaders. I want to break down, to give up. To jettison my belief in the profound good that we can accomplish as human beings, as I see all of the terrible things that we do in the name of greed, power, and selfishness, but attribute to more noble causes. It might be easier to just give in, to believe that we are truly evil, use all of the available data to confirm my biases.

But the data does not point to wickedness. I see possibilities in the acts of kindness happening every day. Yes, many people have died. Many more are out of work with no safety net. Families are separated. Businesses are shuttering. Essential workers lack basic protective equipment. The cracks in fabric of our society have opened into chasms and swallowed us whole, along with our last shreds of sanity. And none of this should be minimized.

But I also see the good, those that are donating meals and protective equipment. All the innovation in education, in telemedicine, in vaccine development, in medical technology. The way that the medical community has come together to share information so rapidly when none exists through the more traditional channels. Even a change in our social interactions, as we let down the walls that have defined us so much in public. I can only hope that this innovation and desire for growth and improvement leads to positive changes in how we take care of our most vulnerable populations. I believe it is possible. It has to be.

Writing Prompt: The Voice

I have sat down to write a blog post multiple times in the past few months. But every time that I did, I felt paralyzed by the fact that I didn’t have anything important enough to say in this time of crisis. I felt that no one would want to listen to me or that my message would be insensitive or impertinent or just noise. But these are unprecedented times. Who is to say that one voice is more important than another, that one opinion matters more than the next.

We are constantly being barraged by information telling us what we need to do right now. Some of these guidelines should be followed for sure (wash your hands, stay at home if possible, stay six feet away from each other when possible, etc.), but who is to say that I should be using this time to do all of the things that I wouldn’t be able to do otherwise? Should I feel ashamed that my home isn’t spotless or can I just feel proud that I picked up some of the clutter? Should I be working to catch up on all of the medical journals that are lying on my coffee table or am I allowed to just read for fun? Should I feel frustrated that I have a hard time focusing on writing or can I forgive myself in this time of overwhelming stress? Am I a bad wife for staying at home away from my husband or am I being a good wife/physician/citizen no matter how hard it is? Why haven’t I made sourdough bread yet?

I am finding that what helps me the most is to allow myself to have a voice in determining what I need. Yes, there are external expectations that must be met (I do need to show up to the hospital on Monday morning and take care of newborns and all that that entails), but I can also look inside myself and process what my body and mind are telling me.

And what better way to process than to write? Not only can it help us cope with challenging situations, but we are living through a historic moment right now, and we have a chance to be a part of the writing of history. We all have a chance to make our voices heard, whether it is to ourselves, our loved ones, or to as big of an audience as we can find. And that in itself is powerful.

To that end, I would like us to read a poem by beloved children’s poet, Shel Silverstein¹:

The Voice
By Shel Silverstein

There is a voice inside of you
that whispers all day long,
“I feel that this is right for me,
I know that this is wrong.”
No teacher, preacher, parent, friend
or wise man can decide
what’s right for you – just listen to
the voice that speaks inside.

The prompt for this week is this:

“What is your voice telling you?”

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

Also, in the spirit of using your voice, if anyone would like to have me share their writing, I would be happy to do so next week. Just leave me a message in the comments.

References:

Silverstein S. Falling Up: poems and drawings. New York, NY: HarperCollins; 1996. 38.

More unedited writing of mine. What my voice is telling me.

My voice is telling me:

To fight the noise. To fight the years of seeking external validation and guilt for not making every second of my day productive. To forgive myself for not being able to focus on writing or reading or making elaborate meals when I am on vacation. That it is ok to not spend all of my time reading the news to understand intricate details about the sterilization process for N95 respirators. To allow myself to rest and heal.

That it is alright to be sad and to cry. This is a traumatic time. People are dying unnecessarily. And those with COVID-19 are dying alone. It is unfailingly awful. Refrigerated trucks are being used as morgues, and people are unable to see their family members. I have not seen my husband in two months and probably will not for several more weeks. I am worried about my family, about my patients, about those who cannot physically distance themselves. All of this worry and anxiety must manifest somehow.

I am not a bad physician, even though I worry I am not giving me patients the care they deserve. We limit entry into each room. We wear face masks and eye protection in all patient encounters. I try to touch as little furniture as possible. With all of this, when I am counseling new parents, I cannot sit down and be at eye level. While I am working on my Tyra Banks smize, my face is nowhere near as expressive and empathetic without using my mouth. There is a reason for all of it, I know; but it doesn’t make it any easier.

I need to not take touch for granted. Though we work long hours, my anxiety level decreases significantly when I am in the hospital. Human contact is healing. Even though the only people I touch are newborns, the release of oxytocin is real and provides me with so much joy. Even witnessing the touch of an infant with their parent is gratifying; it is a powerful thing.

It is alright to be frustrated by the response of our leaders. On some levels it has been grossly ineffective, while others are making up for it. I am very proud to be living in Ohio where our state government is trying to use science to guide its decision-making. It’s not perfect, but it’s coordinated and compassionate and transparent.

Hope can be good. Even if you are disappointed, it’s ok to be hopeful. That this pandemic will be a stimulus for change, that we will see that we need to protect our citizens who work hard and are the backbone of our economy, but who are terribly undercompensated. Without hope, nothing good ever happens. Even though it’s painful, hope helps us change the world for the better.

I need to do more than to hope. I need to keep going to work and taking care of patients like I always do. I need to use my privilege to do something positive, like donate money to a food bank. I need to use my platform (no matter how small it is) to create an outlet for others to find a distraction, to read, to write, to find some sort of connection with someone else. I need to use my loneliness as an impetus to reach out to others, not only for myself, but for the general good of the community.

I need to write. Even if the writing is terrible, my voice is important. It tells my story. It helps me to heal myself. And it hopefully encourages others to do the same.

Writing Prompt: Listening

It’s primary season! While the season itself has at once nothing and everything to do with medicine (Medicare for All or updating the Affordable Care Act?), what is most interesting to me is how it demonstrates how we practice democracy in this country. It seems that it has changed over my lifetime, especially my adult life. Though, it is possible that only my perception is changing.

Astra Taylor, a documentary filmmaker, examined the importance of listening to the functioning of democracy in her essay in The New Yorker, “The Right to Listen.” In this essay, she discusses how as a country, we have shifted away from listening to each other, and rather just wait for our turn to speak, only caring about our own views. This is the same whether you are on the left or right, old or young, an average citizen voter or in a position of power, though it is amplified for those with influence. How much do we expect the CEO of a corporation or our senator in Washington, DC to listen to what we have to say?

This power differential when it comes to listening reminds me of the physician-patient relationship. Our jobs as physicians is to treat our patients, to heal them as the individuals they are. In order to do that, we need to listen to them, not just regurgitate facts based on the disease state they present with. Regardless, I sometimes find myself in the trap of preaching to my patients without truly paying attention to what they need. I need to do better.

The prompt for this week is this:

“Write about listening.”

You have seven minutes. See you next week.

References:

Taylor, A. (2020). The Right to Listen. [online] The New Yorker. Available at: https://www.newyorker.com/news/the-future-of-democracy/the-right-to-listen [Accessed 7 Feb. 2020].

More unedited writing of mine. Seven minutes on grief.

The word, “grief,” itself brings me back to some difficult times in my life. I remember all of the funerals I’ve been to. I remember the day we found out my PhD advisor had died (and it is actively making me cry as I write this). I remember the phone call I got in the hallway and bursting into tears, as well as the agony I saw on everyone’s faces as my colleagues all came to know of her passing. Sitting by myself in our empty building after her memorial because I couldn’t bring myself to move and drive home. The mornings when it was too difficult to get out of bed, not just after her death, but when her life was no longer hers, but controlled by the cancer. The chasm in my life left by the loss of my mentor, one as important to me as I have ever had.

The beautiful thing, though, is that connected to all of these moments of melancholy, are expressions of love. My labmates and I partaking in lab traditions (burritos and My Fair Lady) on the day of her death, celebrating the wonderful culture she had created. The beautiful memorial celebrating her life, the support of all of our colleagues as I broke down into tears several times during my eulogy. Those same friends treating me at my favorite ice cream shop that same day. The jade plant that still sits on my coffee table, a present from our department staff, new life in the face of death. And all of the support from near and far to help us cope.

I realize I am very blessed to experience grief this way, to express it, to own it, to feel it wholeheartedly. It is what I have needed to continue on.

Writing Prompt: Grief

Death is a terrible thing. Yes, it eventually comes for us all, but even when expected, it is still hits us like a freight train careening off the tracks. And when the Reaper finally arrives and carries one of our brethren off into the sunset, no matter what else we feel, we are also overcome with grief. A profound sense of loss.

I’ve been thinking about grief a lot since Kobe Bryant’s death on Sunday. My relationship with Bryant is honestly not even that of a fan; I am just a casual observer who by virtue of living in the United States and paying attention to sports culture is aware of his impact. I know he was one of the greats. I know he had many amazing qualities. I know he made mistakes. And yet, even with this very intellectual and detached view of this man, I personally felt a sense of loss at the deaths of the people in that helicopter.

Why is that? Why do we feel that aching emptiness when someone passes to the next world? I don’t know. I am no expert on grief, though in my brief time on Earth, I have experienced quite a bit of loss. I think for some of us, it reminds us of our own mortality and of that of our loved ones. We are reminded of other people who have already left us. We mourn the loss of a future, of our expectations, of someone to inspire us. We are saddened not necessarily by missing out on things that we need or previously had, but by lost possibilities.

I lost my grandmother last year. She had been ill and bedridden with dementia for several years. She was living with my aunt and uncle in India in a small flat in New Delhi and her constant care requirements and deterioration in her health were hard on our whole family. When she died, it was as if God had freed her from a prison on Earth, from her endless suffering. Intellectually, it was a good thing. It had been difficult to have a meaningful relationship with her for a long time, and by the time of her death, she was experiencing significant pain and debility. And yet, her death was also immensely sad.

I sound like a crazy person writing that because it seems obvious. But I think more than missing my grandmother as she was in her 80’s, her death signaled to me that my parents were getting older and that soon my relationship with them could be in jeopardy. With her gone, I also had one less connection to the country, not of my birth, but of my heritage. My dreams of my husband and future children getting to experience what I loved about spending time with my family in India were slowly being crushed, as my older family members slowly died. And less selfishly, I watched my father through this whole process, helpless as his mother deteriorated, until he was able to ceremonially honor the woman who raised him by cremating her and scattering her ashes in the holy river. We grieve our loss of control.

And we can feel loss even if no one has died. In our family, we started grieving the woman my grandmother was long before she took her last breath. And it is not only in response to illness or death. We can grieve the end of a relationship or a friendship. The loss of a job. These past few weeks, I have had the privilege and honor to visit with homeless youth and those struggling with drug addiction and poverty in Columbus. As a pediatrician, but more importantly, as a human being, I grieve the loss of their childhoods. Of their dignity. Or their sense of hope. I will work as hard as I can to have any sort of impact on their circumstances, and I hope and I pray that they are able to achieve their goals. But I still feel that ache in my heart.

The prompt for this week is this:

“Write about grief.”

You have seven minutes. See you next week.

More unedited writing of mine. Seven minutes on daffodils.

When I suggested a prompt on daffodils, I was in a much better headspace than I am in now. Honestly, writing about them almost makes me angry. In the context of Wordsworth, daffodils seem like a diversion, a beautiful distraction from his pensive moods. I’ve also been feeling very pensive lately, about injustice, about homelessness, about our poor service as a country to those most in need. It is to the point where I feel that I don’t deserve diversions. I am planning a one-day ski trip with my husband and it occurred to me how expensive of an endeavor it is to hurtle down a snow-covered mountain for even a few hours. I feel guilty spending so much money. Why do I deserve to have this experience and someone else doesn’t even have a safe place to stay or enough food to eat?

On the other hand, daffodils are a spring flower, one that blooms from the frozen (or recently thawed) earth. They, with their best friends, the tulips, are one of the first signs that life is returning. It is a sign of hope. And it is impossible to do anything good without hope, hope that it is even possible for things to get better. Maybe all of the strife and injustice in the world is the winter, freezing the world over and causing moral injury to healthcare workers, social workers, case managers, volunteers, and anyone who tries to make things better. The daffodils that we dream about, they remind us of a Promise Land and help us to get there one day.

Writing Prompt: Daffodils

During these dreary winter months, I find that my motivation falters a bit. The awful weather (freezing rain in Columbus as I write this) and the short days, with no celebrations to look forward to, significantly deplete all of my energy. In the land of pediatrics, winter is also the busiest season in the hospital, as little ones fall prey to respiratory viruses and our floors fill with children debilitated by RSV and influenza. Inevitably, we do too good of a job teaching our progeny to share, as those infections go home with us as well.

When everything seems dead outside, I find that it’s nice to look towards the spring. Not that living in the present isn’t important (I am definitely present with this hot chai I am currently sipping on), but it can be helpful for my mood to remember that flowers will emerge again from the frosted earth in just a few months. Just like how in any difficult times in our lives, it is helpful to find something to look forward to.

To that end, today’s writing prompt is based on a well-known poem by William Wordsworth, “I Wandered Lonely as a Cloud.” I hope that as you read it, you are reminded of what fills your heart with pleasure.

I Wandered Lonely as a Cloud

By William Wordsworth

I wandered lonely as a cloud
That floats on high o’er vales and hills,
When all at once I saw a crowd,
A host, of golden daffodils;
Beside the lake, beneath the trees,
Fluttering and dancing in the breeze.

Continuous as the stars that shine
And twinkle on the milky way,
They stretched in never-ending line
Along the margin of a bay:
Ten thousand saw I at a glance,
Tossing their heads in sprightly dance.

The waves beside them danced; but they
Out-did the sparkling waves in glee:
A poet could not but be gay,
In such a jocund company:
I gazed—and gazed—but little thought
What wealth the show to me had brought:

For oft, when on my couch I lie
In vacant or in pensive mood,
They flash upon that inward eye
Which is the bliss of solitude;
And then my heart with pleasure fills,
And dances with the daffodils.

The prompt for this week is this:

“Write about daffodils.”

You have seven minutes. See you next week.

References:

Wordsworth W. (2020). I Wandered Lonely as a Cloud. [online] Poetry Foundation. Available at: https://www.poetryfoundation.org/poems/45521/i-wandered-lonely-as-a-cloud Accessed 18 Jan. 2020.

More unedited writing of mine. Seven minutes on the silent prayers I feel for my patients.

Silent Prayers

What do I pray for you,
Dear little one?

I pray you have a warm bed to sleep in,
With a fuzzy blanket
And a fuzzy friend to cuddle,
Keeping you company
And comforting you
And reminding you that
Not all that makes a sound at night,
Whether under the bed
Or outside the window,
Is a monster.

I pray that your parents have time
And presence
And love
To share with you,
That they are not drawn and quartered
By their own personal tragedies,
Fighting to stay alive.

I pray that you see pain
And tragedy of your own,
And see the strength that you have,
The fire inside
To move past it,
No matter what that means to you.

I pray that you see your light,
The flame inside,
Burning not just with strength,
Defiance,
Sheer will,
But also with love and curiosity,
Confidence,
Kindness.

For all children are good
Until we teach them not to be.

Writing Prompt: Silent Prayers

I have had a rough week. Coming back from vacation is always hard, and as I did, I wished my husband goodbye for a six-week stretch. And don’t we all do this thing over the holiday season? We either work too much over our time off, or if we do truly rest, we come back overwhelmed with all that we have left to do. I did the latter. Why did I spend time with my family instead of studying for my boards, which are next week? Or reading my book club book? Or catching up on journal articles? Why did I waste my free time?

Intellectually I know I made the right decision for myself to be present with my loved ones and rest, but it’s always hard to overcome the anxiety that accompanies that feeling of overwhelm. It’s the feeling that keeps me in bed well past my morning alarm and keeps the dirty dishes in my sink much longer than they should be there. And the more disheveled my apartment remains, the more I unravel into a never-ending spiral of despair.

But! There are a few things that help me get back to normal:

Lovely friends (and a husband) who just listen and make me feel less alone (the writing prompt for last week was surprisingly apropos)
Prioritizing my to-do list, which is why for the next few weeks, I will only be blogging writing prompts at the end of the week and taking a break with the literature
Making restful time for myself while I am awake, whether I am reading for fun, cooking, writing, rediscovering yoga, or watching mindless television
Paying attention to and finding role models to look up to, who have done the things I aspire to do even when it seems impossible. Twitter has surprisingly helped me do that, as I had had no idea how many amazing physicians were out there writing poetry and prose and getting it published (as described below).
Most importantly, one of the best ways for me to lift myself up is to lift up my peers, colleagues, and role models.

This week’s writing prompt is based on a recently published poem entitled “Keep That Same Energy” by Dr. Alexandra Sims, a pediatrician at Children’s National Health Center, and the co-director of the Minority Senior Scholarship Program. In the poem, she describes a patient encounter that (in my interpretation) fills her with hope, fear, and heartbreak all at once. I urge you to read it and think about what it means to you.

The prompt for this week is this:

“Write about the silent prayers you feel for your patients.”

You have seven minutes. See you next week.

References:

Sims AM. Keep That Same Energy. JAMA. 2020;323(1):95. doi:10.1001/jama.2019.19207.

More unedited writing of mine. Seven minutes on loneliness.

The Bottomless Pit

It seems that every connection I try to make, all of that love and goodwill, does nothing to fill the emptiness. Does anyone truly see us if they don’t see our demons? If they don’t see the insecurities, the shame, the feelings of inadequacy? As physicians we are trained to hide it, to be perfect. As medical students, every minute action was judged and had a place in determining our future. As physicians, we are told that we are not supposed to make mistakes. Patients expect us to have all the answers. And as an intern, I have been able to overcome much of that stigma. I know my job is to learn. Evaluations no longer make or break my ability to match into residency. I know I will make mistakes and need to own up to them and fix them in order to grow.

But I know where my insecurities are. Inefficiency. Overcommitment. The two dirty words that have followed me wherever I go. “She is great with families, but just needs to be more efficient.” “Why aren’t your notes done?” No but seriously, why are my notes never done? “You overcommitted yourself again; that’s why you didn’t meet this deadline.” I fill with shame, that knot in my chest whenever that feedback comes up. I know it’s to help me improve, but man. Why don’t I ever learn?

And when it comes up, when I do it to myself, when I have too many things to do, I go to the dark place, the bottomless pit where I feel that I deserve to be hidden due to my worthlessness. Unless someone comes and shines a flashlight into my pit, they won’t see me. They usually just walk right past, seeing my projection, my hologram at ground level. But that flashlight, when I feel seen? That feeble beam is a glimmer of hope that eventually forms a ladder for me to climb out.

Wouldn’t it be great if I could bring my own flashlight?

Writing Prompt: Loneliness

I know I wrote about fiction this week, so the natural focus of a writing prompt would be literary fiction. However, I wanted to share this powerful essay I was introduced to on Twitter this past week, written by Shannon E. Scott-Vernaglia, MD, the director of the pediatrics residency program at MassGeneral Hospital for Children. In it she shares her struggles with depression and the positive feedback loop between depression and the isolation it breeds. She makes a call to all of us to share our stories, for only by knowing we are not alone do we realize that it is okay not to be okay. It is truly moving, so I hope you take the time to read it.

The prompt for this week is this:

“Write about loneliness.”

You have seven minutes. See you next week.

References:

Scott-Vernaglia SE. One of the Many. J Grad Med Educ. 2019;11(3):353-354. doi: 10.4300/JGME-D-19-00007.1.

More unedited writing of mine. Seven minutes on how I feel on a snowy evening.

Snow Falling

The slow icy crystals fall,
Enveloping the ground in a blanket
Of sparkly white
Adorned by the scattered
Lights of the season,
The occasional reindeer.

From under my own blankets,
Though mine made of wool,
I feel the calm,
Like nature slowly adding a weight
To the world outside,
Begging it to slow down,
Take rest,
And breathe.

My tea next to me,
That healing elixir,
A candle lit,
My miniature fireplace,
And a book in my arms,
Transporting me to imaginary lands,
I breathe.

Tomorrow I ignore nature’s behest,
Cross the snow,
My footprints a mark on her beauty,
As there is always more to do.
But today,
We inhale and exhale
Slowly together.