A Doctor’s Heart

photo (1)In just a few days I’ll be leaving the clinic where I’ve practiced pediatrics for the past six years. The last months have been a flurry of last visits with families, paperwork, and tying up loose ends. There have been many, many goodbyes. I’ve been deeply moved by the expressions of gratitude and affection that many families have shared with me. It seems it is always in these times of change and endings that we are most open with each other.

And so, as families share their gratitude with me, I share mine with them. I wonder if patients and families know how deeply they impact their physicians? I wonder if they know how much they’ve taught me? That I, too, remember our shared experiences. The joy of a new birth, the pain of an injury, the horror of abuse, the grief of death. That I’ve carefully guarded the most intimate of life’s details that they’ve shared with me. That these experiences have moved me as a fellow human and shaped me as a pediatrician. I wonder if they know that every kind note and drawing is saved and treasured. Brought out and savored during the hard days to get me through. I wonder if they know that, even on the toughest days, as they’ve waited too long to see me, or when I seem rushed, I still cherish my time with them inside the exam room.

The end of this particular phase of my career, taking my leave of a community of patients and families that I care deeply about, has left me with a feeling akin to grief. But, it has also given me the luxury of time to reflect. After years of training and now a number of years of busy practice, there are occasional flickers of fatigue (mostly related to the constant deluge of administrative tasks). But, my heart is still fully present here in medicine. What a gift it is to spend my days caring for children- partnering with their families to give them the best start in life. Helping them stay healthy and working to heal them when they are sick.

I remain profoundly honored to be doing this work and deeply grateful to the families who have entrusted me to do it.

And so, thanks to my patients and their families, I move on to this new chapter of life with a renewed spirit, deeper knowledge, and a full and thankful heart.

Book Review: Mama Doc Medicine

mama doc medicineFirst a disclosure- I am an unabashed fan of Dr. Wendy Sue Swanson, aka Seattle Mama Doc. I have long followed her blog and twitter feed and so appreciate her work. A pediatrician and mom, she writes clear, evidence-based blog posts in an open and transparent manner. She has an unmatched ability to break down emerging science around child health into relatable, practical tips. I’m excited to report that her book, Mama Doc Medicine, combines many of her best blog posts with new information creating a fantastic new resource for parents and all who care for kids.

Mama Doc Medicine is divided into four sections (Prevention, Social-Emotional Support, Immunizations, and Work-Life Balance/Mothering) and each of these includes short, pithy chapters well suited to the stolen moments of time we tend to have as parents. It was a great read cover to cover, but it certainly wouldn’t have to be read this way. This is a book one could easily pick up and read for 5-10 minutes on a topic that you are worried about, finding answers to those late night questions quickly and easily. It is obviously a book written for the digital age parent (by a very digitally savvy pediatrician) with helpful infographics and links to websites with further information.

My favorite section from a pediatrician perspective is that on immunizations. Dr. Swanson has long been an important public voice and advocate around childhood immunization. Here she succinctly overviews the strong evidence for childhood immunizations, while at the same time discussing how past experience and emotion play a part in each family’s experience of vaccinating their child. She then provides more in depth information for many of the essential child immunizations. Dr. Swanson manages to do all of this with a clear, kind voice that is often lacking in the public discourse around vaccines. This section in particular is a must read for all parents and pediatricians.

But perhaps my favorite section as a mom is the last- the section on work-life balance/mothering. This may (definitely!) say something about where I am in life right now. It may also be that I so relate to Dr. Swanson’s perspective because we are both pediatrician-moms working full-time while raising little boys. Whatever the reasons, I find her thoughts on work-life balance to be so refreshingly honest and full of common sense.

Dr. Swanson’s subtitle is “Finding Calm and Confidence in Parenting, Child Health, and Work-Life Balance” and remarkably (unlike many other parenting books) I did feel more calm for having read this book. I came away with renewed belief that, with a few important exceptions, our child’s health and well being is most impacted by us loving them the best way we know how. We all likely know this instinctively. But having it reinforced in such a lovely way is perhaps the best reason to read Mama Doc Medicine.

Copy and Paste Medicine

I’ve been working with the latest electronic medical record (EMR) for almost a year now. You know the one. There are many positive changes, to be sure. It has helped me more than a few times with calculating doses for kids’ medications. I can now easily check in on my patients’ progress when they are admitted to the hospital. And, of course, the notes are far more legible.

But what do the notes actually tell me? Sadly, sometimes, not much. Continue reading

The Perils of Distracted Driving

distracteddrivingI gotta say, the daily commute has been feeling a bit hairy lately. Seems like I’m passing accidents more frequently. Watching a bit more weaving. I can’t be sure that it’s all related to distracted driving, but sure seems like a lot of it is. Every day I witness drivers looking down at phones at stoplights, missing the change to green. I even saw a smartphone mounted to one car’s driver side dash and the driver scrolling through websites during rush hour traffic on the freeway. Scary stuff. Continue reading

3 Words for 2014. Focus. Accept. Sleep.

IMG_1401Over the past few years, in leiu of goal-oriented New Year’s resolutions, I’ve chosen words to serve as a guide for my year. Inspired by a few writers I admire, I’ve found this practice to be very meaningful for me. And setting it in writing here on the blog last year was quite powerful. I found that the words Decide, Attend, and Play stayed in the fore throughout the year. I went back to the post a number of times to gauge how I was doing. And, although I can’t say I always succeeded in meeting my own expectations, I do think that setting these intentions did affect the flow of my year. So, here are my words for 2014. Continue reading

Book Review: Quiet, and Its Implications for Parenting

IMG_1446“Why shouldn’t quiet be strong? 
And what else can quiet do that we don’t give it credit for?”  -Susan Cain

*A while back in clinic a nine-year-old’s mom came in concerned about her son. Turns out that at the parent-teacher conference, her son’s teacher had said, “Your son is very quiet in school.” Even though her child was excelling academically, had great behavior, and truly enjoyed going to school, this statement stayed with his mom. She worried about it. Because in American society, being quiet, or “shy”, is not often seen as a positive quality. I hope that will change. Continue reading

Medicines for Fever: When and How to Use Them

This is the second post in a two-part series on fever in children. Last week Dr. Cara Barone provided excellent information regarding why children get fevers, how to measure your child’s temperature, and whether to worry or discuss with your physician. This week I’m back to review when and how to treat fever in kids. Continue reading

My Child Has A Fever. Should I Worry?

I’m delighted to welcome guest Cara Barone, MD, FAAP to My Two Hats this week. Dr. Barone is a pediatrician and mother of two. She did her pediatric residency in the Boston Combined Pediatric Program and a fellowship in Pediatric Emergency Medicine at Children’s Hospital Boston. She happily practices general pediatrics at the Palo Alto Medical Foundation in the Palo Alto, CA division. Dr. Barone has written a great post about fever. Please read on to learn more from her about this very common child health concern.

Thermometer_REvery day in clinic I talk about fevers, fever-reducing medicines, and taking temperatures. This parental concern has been an absolute mainstay throughout my pediatric career and transcends all age groups in pediatric medicine. Continue reading