Why is the capacity vital?

The blank space on the screen just invited me to come play. I just signed up for an online writing class -6 weeks, 6 essays, taught by Jennifer Mattson (www.jennifermatson.com).  The instructor asked us for twitter/facebook handles and website/blog information. It took me a second to realize I had a blog.  I revisited "The Vital Capacity" after many years.  It was like seeing an old friend, my former self.  My self who had bursts of creativity, saw irony and parallels in unusual sights and shared them with the nebulous "reader."  I read things I wrote that made me smile, like my last blog post.  Then my eyes gazed on the title, The Vital Capacity.

The vital capacity, in my profession, quite simply put, is the maximum amount of air that you can breathe in and out at any given time.  It the measurement of air, in liters.  I see patients who have trouble breathing the vital capacity out, and I see patients who have a limited amount of vital capacity due to perhaps muscle weakness or chest deformities.  It's what defines my livelihood, and in one sense, motivates me to come to work every day.  It's also what creates guilt - I'm a full time working mother.  As I walk the halls of my clinic and the hospital, I picture my lips touching my toddler's son soft bulging cheeks, and I picture myself digging my nose into his pudgy belly, hearing his soft, giggle.  These daily reminders and meditations of my son are vital to my day, and keep me breathing a bit more easily.  And I also dream of what my life could be - a perfect balance of keeping my patients healthy, teaching new things to my son, and... writing!

You can't be a practicing physician without seeing patients.  You can't be a mother without a child (whether he or she is yours or not, I should add!).  And you can't be a writer without writing.  I'm working on all three.

Unwinding, unsettling

The server pours me hot tea, and as she walks away, I notice that some water from the teapot in her hand drips downwards.  The water is hot, and out of concern I say, "Oh be careful!"

"Tt's just water from the teapot that i was pouring," she replies, and I realize that she did not pick up on my concern, but instead was responding in a way so as to defend herself from a chastising comment.  I felt sad, embarrassed and ashamed to be lumped into a group of demanding visiting guests always expecting perfect and perhaps inhuman customer service.

My husband and I are staying in a resort for a few days in Florida for some relaxation, and it certainly is working.  My iphone died several days ago and I don't really care to fix it - that would lead to a temptation to constantly check respond to work emails  (I have internet access on the beach, which enables me to blog, but I have not checked my email yet!).  I feel little anxiety, little tension in my shoulders, and as I write this, I'm sitting on a beach chair listening to the lapping waves as my my husband uses a paddleboard on the ocean in front of me.  I look up and see a pair of dolphins bobbing up and down, unusually close to the shoreline.  I recall the local travel station on TV, on which a woman repeatedly refers to South Florida as "paradise."

Even with the level of relaxation I'm experiencing, there is something about resort life that bothers me.  I'm being "served" by people who are less fortunate that I - some are college students who have a summer job (our initial bell hop plays football in college), but some are older individuals who are trying to make a living.  They constantly greet me with a smile and a "how are you ma'am", but I just wonder if they are even slightly are resentful of guests like me.  No doubt they are trained to be as happy as possible, to provide excellent customer service, hoping for that generous tip.

I do feel that I deserve a nice vacation, especially given how hard I work - all the weekends and calls I take have been very draining.  But resort life feels a bit unsettling.  It's gratuitous, consuming, and can be very wasteful.  I see other guests on the resort who are rude and demanding to those who are trained to have plastic smiles plastered on their faces at all times.  I think of my parents who came to this country with nothing and could never afford to take me brother and I on a vacation like this.  Maybe they would feel that I am spoiled.

A few months ago, some girlfriends and I shared a room at a bed and breakfast in Brenham, TX, hoping to enjoy the Texas wildflowers (shout out to The Brenham House http://www.thebrenhamhouse.com/).  The service was excellent, the owners were hospitable and willingly catered to my lacto-vegetarian diet).  There was nothing unsettling about the quaint and cozy weekend I spent here with my girlfriends.  Perhaps B&Bs can provide the personable touch to a vacation along with the relaxation in a way that resorts cannot.

An eye for a lavender sky (on vacation)

There may have been sunsets before that paint the sky with a small strip of lavender, just above the tip of the clouds so that you need to look up just a little bit more than you normally would when admiring a  sunset.  But I had never noticed this lavender until today.  It was subtle, almost mismatched against the blaring, loud oranges and reds, but present nonetheless.

Every mind needs creative distance from the daily stresses of life, and I think when  you have that distance, you see new colors, and it makes you smile.

Ok, have to go and make sure the drapes are closed.  We were told to do so to keep light from attracting the newly hatched sea turtles.  It's sea turtle hatching season!  Who would have known?

Identifying with patients: a physician perspective

Recently, I was confronted by a mother of an extremely sick, extremely precious child with a question: “Do you have kids?” 

I think at the heart of this question, which I have often faced, is the concept that pediatricians with children are more empathetic and are maybe even better doctors than pediatricians without kids.  Perhaps the advantage of having kids as a pediatrician translates to an increased desire to help the patient, knowing that the physician would not want his or her own child to suffer.

But is this really a necessary part of practicing medicine, for a pediatrician to be able identify with a patient’s suffering more easily solely on the basis of having a child?  And, no matter what type of physician you are, there will be characteristics of the patient, of the family, that you will not be able to identify with.  Perhaps the family is of a different ethnicity and can’t speak English, or is of a different socioeconomic status, or the patient has a disability that is unimaginable to the physician.  There are an unlimited amount of patient attributes that a treating physician may lack.

As a pediatrician without children, I’d like to think it’s not necessary to have a child to be able to be a good pediatrician.  Maybe, my perspective will change once I have kids, but in thinking about this issue, I am reminded of the rigors of training and post-training that I have endured to be able to have the privilege to be a part of patients’ lives.  I get to help children breathe better.  I get to wake up each morning, go to work, and hear all the imaginable and unimaginable stories that are awaiting me behind the door of each exam room.  I get to wipe away the tears of mothers who are so afraid of their child’s severe asthma, that they worry their children will die in the dead of night - these mothers trust me with their emotions and fears.  I get to reassure parents to discard their fears about their precious babies with noisy breathing - the problem is nothing more than a soft upper airway, and that the problem will go away.  I have had the heartache of attending the funerals of patients with cystic fibrosis, and hugging the parents, who are grateful for what I have done, and I feel thankful that at least I have been able to impact a family’s broken heart at least in some small, minute way. 

Would these feelings be multiplied if I were to have a child?  I would like to think not, but it's possible. Is the male ob-gyn a less qualified physician?  What about the cardiovascular surgeon who has never undergone bypass surgery, or the infectious disease specialist who does not have HIV?

In answering the mother’s question, I would have liked to respond with, “No, I don’t have kids, but I don’t think that takes away from the fact that I want your child to be safe, healthy and happy.”  This should be the common goal shared by all good pediatricians, those with and without children.

Tofu salad not for bunnies

When I was in high school in college, I would become very defensive of my vegetarian diet.  "I don't eat salad all day, I eat real food," I'd say when people asked me what I ate, annoyed at people's poor perception.  I figured that most omnivores thought I probably ate like a rabbit.

My attitude towards salad has definitely changed since then.  Now, I'm proud of making a juicy, colorful, nutrient and protein-rich salad, and the tofu salad we had for dinner epitomizes how I feel.  I don't measure when I cook, but I can tell you that this salad contains field greens, cucumbers, shredded carrot, pan-fried tofu spiced with cumin powder, coriander powder, turmeric and sambar power, walnuts, some shredded cheese (optional), avocado, steamed corn, and the secret ingredient in my opinion, pomegranate seeds.  The pomegranate adds just the right amount of sweetness that gives this salad a nice juicy kick.

My husband used Whole Foods brand peanut sauce as dressing, but I thought that this salad tasted great  without any dressing.

Mmmm.... a salad a bunny would die for...

A Writer's Marathon

Is this the 3rd time I've tried to revive my blog?  I think so.  But this time, the revival has been inspired by the DFW writers conference.  I had signed up for it several months ago, in an attempt to connect with the writing world here in Dallas.  I found myself on Friday night, sitting on the couch, dreading having to get up early on a weekend where I was lucky to not be rounding in the hospital. Boy, was I in for a pleasant surprise.

Saturday morning began with an informal session on improving your "pitch," where writers try to convince literary agents to consider their manuscripts.  I discovered quickly that was surrounded by writers who... well, write!  Many had completed manuscripts that they were ready to pitch to agents who were attending the conference as well.  Many had set aside time in their busy lives to write and to produce and to persevere in perfecting their craft.  Not a single utterance of medicine the entire weekend... it was refreshing.  I felt like I was masquerading.  No one needed to know I was a physician, and it felt sneaky good.

Pediatrician by day, writer by night.  It has a nice aura to it!

But I digress...

At the conference, I met Sean, who had several published sci-fi short stories, and was waiting to pitch his novel because he wanted to instead focus on raising his teenage daughter.  I met Katie, a mother who works part-time from home, but wants to complete a manuscript based on her experiences with African refugees learning English as a second language.  I met Piper Bayard a "recovering lawyer" turned published author.  I met Kristen Lamb, a best-selling author and social media expert.  All these individuals inspired me to get serious and produce.

If Kayla, a mother of two, can write 3000 words per week and take care of her 20 month old, why can't I?

In one session, a published young-adult author provided us with this reality check: "5% of people want to write.  Of these, 5% actually write.  Of these, 5% get to chapter 3.  Of these, 5% get beyond chapter 3.  Of these, 5% finish the manuscript.  Of these, 5% revise their work.  Of these, 5% will query an agent." And so on.

Bottom line?

If you want to be a doctor, you have to study, and study hard.  If you want to be a writer, you have to write.  I've accomplished the first (and still working on it).  And now thanks to the DFW writers conference as inspiration, I'm going get working on the second.

Stephen King says in his book On Writing, that writing the first million words is practice, and I think Kristen Lamb and Piper Bayard reiterated this concept very well in their respective seminars, stressing that regular writing initially is an appreticeship.  They both stressed that blog writing is good practice, akin to marathon training before running a marathon.  Hearing that advice was the single best thing I could have done in my ambition to become a writer.

They also said never blog about writing.

Oops.  But I need to start somewhere!

So here I go....

The last letter

When I was a young child, I used to write to my relatives in India often. These letters often began very similarly: “My Dear ___, How are you? Everyone is fine here. I hope that everyone is fine there. I hope to come visit you soon.” And so on. My mother would often prod me to write these letters, and without her nudge, I probably would have never written them.

The last letter I wrote to my grandmother never reached her, which is something I will probably regret for the rest of my life. I was a fourth year medical student, and learned from my mother than my Ajee had fallen ill and was in the hospital. Her condition was critical, and my mother would be leaving in a few days to fly to India and see her. I knew the situation was grave and that she was probably dying. My mother made it to India in time to say goodbye, but because of the critical care unit’s policies on restricting family visits, she didn’t get to spend much time with my grandmother. The sorrow transmitted through the phone by my mother after my grandmother died made my heart ache, but it wasn’t till that my mother told me that she was unable to deliver the letter did I truly for the first time in my life, experience the empty emotion of regret.

My grandmother was constantly encouraging me to write. She often told me in between her asthmatic breaths, “Every day when you wake up, you must write down your dreams from the night.” She never really told me why. Perhaps she felt your dreams reveal your real dreams and hopes. Perhaps writing about your dreams is like writing fiction, and it provides you some respite from reality; after all, as an adolescent girl during World War II, she fled the Japanese invading her home country of Burma and walked through the jungles by foot to India, losing both of her parents along the way.

I can’t imagine what my grandmother would have thought of the electronic age of writing: blogging, emails, tweeting, and texting. After all, what can be beautifully expressed in cursive writing using a pen and paper becomes harsh, blunt, brief and impersonal on email. Electronic mail makes communication easy and global, but it also removes the excitement and thrill of opening a letter from your grandmother across the globe.

The art of letter writing, or any kind of writing with a pen/pencil and paper, I feel, is practically extinct. In fact, I just received an email, in which I assumed that the sender was harshly accusing me of not completing a patient task that I had completed weeks ago. This email incited anger within me. However, I responded to the email to understand the sender’s motivation: Was he accusing me of not completing my work, or was this simply a brief and impersonal email with no underlying negative connotation? It turned out that the latter was true. Today, he wrote back, “no offense meant. i know my writing style is very straightforward and brief. dont read any emotions into it.” But how, as a human being, can we separate a piece of writing from an underlying tone or emotion? Isn’t that what writing is meant to be: a composition of words and phrases that convey meaning and communicate feelings and emotions? Or must we always assume, in this age of electronic mail and Twitter status updates, that a message from someone is only meant for scheduling meetings, forwarding news articles or fulfilling a work-related task?

I’m very grateful to my mother that she made me write all those letters when I was young. Even though she had to expend a great deal of energy encouraging me to write, I will never forget the sense of satisfaction I had in completing a letter, mailing it to India, and receiving a response. Perhaps we may never be able to bring back the art of letter writing to this modern electronic age, but at least we could not only incorporate some of the etiquette of letter writing, but also the acceptance that within the seemingly innocent letters of the alphabet lies emotion that came from a human being. Perhaps my grandmother encouraged me to write down my dreams because writing is so much more than a grammatically incorrect and trite phrase on an email. It’s actually a meditation on processing and accepting yourself and your thoughts.