Silver not Gold

Happy 25 year anniversary to me!

To celebrate my 25 years of service as a general pediatrician I share with you 25 of my thoughts in no particular order. These thoughts are mine and are not supported by my employer.

When I celebrated twenty years of working it was two months before my world fell apart. I am acknowledging my 25 but not celebrating it. These past five years feel like twenty and are not the best ones of my life.

I am sorry to say my profession is slowly eroding in respect. Pediatricians are at the bottom of the pay scale for physician salaries but we take care of the most important patient population. (I am biased I know) I have been called horrible names by angry parents, told I am stupid and selfish and that I work just for the money. (huh?)

God made puppies and babies cute because they poop and pee a lot and many times in places they are not supposed to.

Being a parent is the hardest job in the world. Sometimes you feel rewarded. Sometimes you get your heart broken.

I think I hold the record for the most newborn circumcisions performed in my hospital in a 24 hour period.

Don’t tell me you understand how it is to grieve the loss of a child. Until you bury your son due to suicide don’t tell me your perspective. I don’t tell people how to grieve. I listen. That is what I ask people to do.

Kingdom, Phylum, Class , Order, Family, Genus, Species. If you don’t get it you did not major in Biology.

Practicing medicine would be so much better if I didn’t have to spend hours at my computer charting and justifying medications, studies/labs and therapies to insurance companies.

When you make a mistake in medicine you can cause permanent damage, have a patient suffer or have a fatal outcome. I do not take my job lightly. I ask people to honor my 25 plus years experience when I recommend a treatment or give advice.

In my early twenties I used to attend Friday night lectures at Fermilab, a particle physics laboratory in Batavia, IL. Yes – I loved physics and I am a science geek.

Don’t expect another 25 years of work from me. How many I have left I don’t know. I DO know it is time to retire when nobody wants to see me or listen to my advice.

If I knew back in 1996 what life was going to be like in 2021….

I think all women have been sexually harassed at work sometime in their career. My most memorable event was in med school when I was invited to “help” a senior resident in his call room. Hell. No.

It is not an emergency at 2 am if your child has not pooped in a week and you feel now is the time to get advice.

Goldfish crackers are not a protein food.

The medical profession had been waiting for a pandemic to happen. It was never if – but when. I thought it would be a super strain of influenza. I never thought it would be so politized.

Our brain is the least understood organ of our body and obviously the most important.

I feel I will still need to defend vaccines and discuss how they do not cause autism until my last days of work and up to the end of my life.

The first child I ever saw die was carried into the emergency room crying and fully awake. 30 minutes later meningococcemia took his life. The worst sound is hearing a mother wail when she is told her child is dead.

You don’t need to tell me I am strong. I know I am. I also know people who are much stronger than me.

The parent who rubs you the wrong way, the one who makes you feel frustrated during your visit with their child, is the one who you need to listen to and spend more time with.

The worst recurring thought is when you remember your child is dead. Every morning you awaken and are reminded of this.

Pediatricians have the best patients and even on my saddest day I feel joy when I see them. Ok – maybe not 15 month olds – they hate being at our office no matter what and scream and cry the whole time.

It is my honor to be a doctor. I worked hard and thank God for my talent. I am grateful that I found my purpose.

Every day I wake up and pray my intentions: I pray for others and for our world, I pray to serve God thru my work, I pray to share and be present for those that are suffering like me, and I give thanks that I am one day closer to being Home.

I had no idea I could cry so many tears in 5 years.

I don’t know why we are here on this earth at this time 2000+ A.D. But I do know we all are really strong spirits living during this time on this blue ball in this big universe.

Thank you for allowing me to be your child’s doctor

(That was 26. You got a bonus one.)

Eyes without a face

Can you tell if I am happy? sad?
How about now?

Are you sure you guessed correctly?

My eyes

1980’s Lisa

They used to be young and vibrant. My husband Scott even wrote a poem about my blue eyes before we were engaged.

And now? Well – my eyes show my age and the work, trauma and grief I have endured.

My eyes can’t hide my truth.

These last weeks I can’t hide the sadness in my eyes. Crying make my eyelids so puffy. The mask hides my bags partially but you don’t have to be close up to me to see how bad I look. It is convenient to not have to wear makeup with a mask covering up most of your face. Why bother putting eyeliner on- it can’t fix these fifty something year old eyes.

I wish my patients could see my full face. See my smile. I would be happier if the smile that I DO get when I see my patients was apparent to them and their parents. I now have to rely on my voice to be the way to share my emotion.

I know it will be a long time before I can be at work without a mask. How long? Who knows.

My mask won’t show if I am smiling or frowning. But my eyes….

I found my special purpose

(I love this movie- ok – he had a different special purpose- but this saying makes me laugh)

I wrote this blog entry in honor of National Doctors’ day, today, March 30.

“I always knew I was going to be a doctor”

Some people can say this – but not me.

I didn’t always know what I wanted to do. In fact, in high school I liked photography, flower arranging and since I really loved staying at hotels as a kid, I thought being a hotel manager would be fun. Yes – the girl voted “most intelligent” in school had great aspirations didn’t she? I excelled in the sciences and math was easy (but I didn’t like calculus – still don’t} and my GPA and ACT scores were stellar.

So off to Loyola I went and with my parents and teachers suggesting the medical field I thought a biology major would be good. My freshman year I volunteered at a small Chicago hospital spending time in the ER and I liked it. Chemistry, Biology, Physics, Philosophy, Logic, Religious studies – I was educated in the Jesuit tradition. My love of science, of the complexity and care of the human body and mind were fueled and shaped.

Yes – I want to be a physician. I will do this.

When you commit to becoming a physician you know you are giving up some things. You have very delayed gratification. You see the completion of your goal is many years away. When I used to talk to junior high students interested in medicine the two questions I was asked consistently were #1- how much does a doctor make? and #2 how many years does it take to become a doctor? When I told them it was 11 years minimum to become a practicing primary care physician and as many as 15 years to become a neurosurgeon, many of the students dwelled on that timeline.

If you went straight through from high school to medical school and completing your residency with no break, you started your practice – really your career – at age 29 or 30. You spent your 20’s studying and learning. Yes – many physicians in training get married and start their families during these years, but the truth is the study of medicine is really first and most important. Your profession is your life.

Can I say I am thankful I know my life’s purpose? God gave me these gifts of knowledge, of love of medicine, the drive, devotion and stamina to succeed and continue to practice caring for the most important population I believe I am honored to serve – our children.

Yes – Yes I am so very thankful. Grateful. I state my gratitude in my morning prayer and intentions.

I know many people go through their life feeling they have not found their purpose. We have this pressure put upon us by our society and our educational system. Starting around age 14 our kids are asked “what do you want to be?” They are asked to pick a career- no commitment- but still the pressure. They are put on career paths and told college is the goal. Both of my sons took career aptitude tests during high school yet after given their result it still was not clear to them what they wanted to study or pursue as a career.

I pray our children feel they can do whatever they desire. I pray that they continue to dream. I hope they also understand they might wait half or most of their lifetime to understand why they are here. Dreams can be big or be small but they are of equal importance.

You may not know your purpose in life until you spend most of your life searching, only to discover the search is the purpose – and that is ok.

The sun is coming up. I need to stop writing and go to work. I have patients to see.

Emotional soup

The Class of 2020. Well they sure will have a lot to tell their kids when they are older. We can think of many ways to describe the year 2020. For me, it was the year of anticipation with Sam graduating and going off to college. But the pandemic changed everyones plans and I remember it felt like we were (and still are) working on a two week timeline. Lockdown in March and time passed by in two week increments. When will school open? Update in two weeks. You are in quarantine? Two weeks.

Yet it still was a shock last August when two weeks and two days before Sam was to leave for Chicago the school announced the dorms would not be open. He understood but the disappointment was so difficult for him and for us. Friends left for college. He stayed. Time marched in weeks and months.

And here we are- today he leaves.

Sam wanted zuppa toscana last night.

I love this soup too – lots of bacon and a rich cream base. As I am prepping the ingredients I have my thoughts wander…

Finally he gets to experience college, although rather modified. All but one class online. He has to screen twice a week for COVID. Mandatory two week quarantine for all students living on campus. No roommate. Social distance, masks and all organizations meet virtually.

Mixing in the chicken stock I feel a chaos of emotions. I am happy, scared, anxious. I am sad. Nolan should be here enjoying this soup with us, having our family dinner.

I know he is ready. Am I? Am I going to be able to have him gone and not worry about him all the time? I am fine with an empty nest. He will be back.

Nolan left for Valparaiso University and he never finished the semester. One month later he was gone.

He never came back.

I try to not have my mind go there but I can’t help it.

It is in a mother’s nature to worry. College should be a time of independence. Meeting new people. Exploring the campus and for Sam, the city. The will be so different for him.

But then again – he never experienced what college should be like.

Nolan should be here but he is not.

In my heart I know he will be with Sam, a big brother watching over his little brother.

Will I still worry? Hell yes. But work keeps me occupied. I have my patients to care for and worry about. I guess that is what makes me a good doctor.

Christmas in Heaven

So what is it like to celebrate Christmas in heaven?

I imagine all my loved ones feeling eternal joy and love. The amount being unimaginable for us here on earth to really understand. And everyday is Christmas for them.

I have two more people I love very much join the celebration in heaven this year, 2020—

Until I come Home …. I will miss them all so much.

May we all try and feel the spirit of Christmas every day.

The present – no, not a gift

Today is my birthday.

Remember when you were a kid and your birthday was THE best day of the year? Right next to Christmas?

I am not feeling that way today. And the prior days were not great either.

Yes – the present really sucks!!!!

I’m not upset that I am a year older. It doesn’t suck at all. It means I am getting a year closer to joining Nolan.

Five years ago the night of my birthday was when Nolan attempted suicide when he was at Purdue. Thankfully he did not succeed. Two days later he texted me what he had done, asking for help. That was how he told us he was depressed.

Prior to today I have been thinking a lot about what I assume we all have –

When are we going to get back to “normal”? When will we be done with physical distancing, where we can travel and see people without worrying about getting the virus? When will kids be able to attend school? Concerts and plays and movie theaters open?

When can Sam experience college the traditional way? – not only by his computer alone at home.

When you live everyday thinking about the future, a day with a big questionmark as to when “normal” will return, it is exhauting. When will we wake up and not have coronavirus and the pandemic be the headline day after day? What new record are we going to break today?

Living a life waiting for the future makes you anxious. And I have been having anxiety lately. Anxiety is not contagious but we sure live in a world where more people are experiencing it. My little patients and my big ones. Parents too. I can help as best as I can. But I can’t change how bad things are.

When a normal life in the future is too many months away and the present is not a great time, you think about the past. I try and think mainly about the good memories. But my mind is not kind and I think about the hard times with Nolan. I start to blame myself. Again.

Sorry this post is not giving you great words of encouragement.

I am like everyone else – somedays I have a heck of a time keeping my spirits up. I am not asking you to feel sorry or bad for me.

I wanted to put out there that sometimes birthdays are hard. And for some people Christmas time is hard too.

Oh – and one more thing…. please wear a mask.

It is going to get better, isn’t it?

This cartoon is me.

Is it you too? Probably.

With election day this week, cases of corona virus surging, work pressures, financial strain and the holidays just weeks away you can’t tell me you aren’t feeling some amount of stress.

It reminds me of how I felt when Nolan left for school a second time, when he appeared to be at his best and chose to attend and live at Valpo University.

I was overwhemed with anxiety.

Initially I couldn’t sleep. I texted him daily. How are you? Did you go to class? Did you take your medication?

I had done all I could before he left for school. I had my responsibilities as his parent and I did the best I could. I had to trust him.

I had to let go.

I called and told him I could not keep checking on him daily . I trusted that he would call me if he needed something. He told me thank you. He understood and I know he was relieved I wasn’t stressing about him.

One month later he was gone.

But you know what? I am still here. Four years later I am still breathing, living, working, loving and smiling.

How did I deal with my worry about Nolan? How do I handle my anxiety now?

Take 4 minutes and listen…

So when you wake up at 3am and your brain starts thinking about all the bad things in the world, all the what ifs, the future we all want to know but cannot predict, and the things you can’t control – try and repeat the phrase.

It might work. It does for me.

Four years

Four years. It is how long we take to get through high school. Through college (that is the plan for most parents!)

Medical school is four years.

I should know how four years should feel. I have done four year tasks many times.

These four years have been painful and slow with my grieving.

The first year is all fresh with firsts – first Christmas, first Thanksgiving, first birthday. The Angelversary. You struggle to focus, you are exhausted.

The second year is horrible. It stings and all the milestone days come again and you are reminded he is not coming home. You are still exhausted. Wake, rinse, repeat.

For me the third year was the year of figuring out balance. How to still function as a full time pediatrician, mom and wife yet still honor my need to grieve.

Fourth year? My grief is still here but the need to stay current with the daily changes in a pandemic world keep me more as a doctor and less as a grieving mom. This world is getting harder for those struggling with loss, addiction, depression and anxiety. I have seen so much anxiety in my pediatric population.

I honor Nolan today, his fourth Angelversary.

I really don’t want to cry all day. I don’t have time for that. Life goes on. This day will come again and again. How many more I will have to live through I do not know. I would rather put my energy and grief today into my purpose – why I am supposed to be here.

100% preventable?

You have seen this saying before.

I agree- suicide does not need to happen.

But when a person loses a loved one to suicide this saying can sting. It can be read as “You could have prevented him/her from suicide. You missed the signs. You failed.”

The act of taking your life to end your pain, to be under the trance that suicide is the answer to your problems- that is what COULD be prevented. But not all suicides can be prevented.

The first year of life without Nolan I had no interest in advocating for suicide awareness and prevention.

How could I say it is preventable if I didn’t stop Nolan from ending his life? I FAILED. He was taking his medication and seeing his therapist. We supported his decision to go back to college. He appeared the healthiest he had been the months before.

The good Dr. Gold, a pediatrician with years of experience, she must of known Nolan was that bad, that low.

HOW DID SHE NOT SEE THE SIGNS??

The months after Nolan died I was a busy detective. What did I miss?

He was doing so much better. He had goals and he had plans. I went through his phone and read his texts. College was going well (at least that is what his professors told me) but he was seeking a relationship. With someone. With anyone. It appears he would have great anxiety (depression and anxiety love to hang together) in social situations. So when rejection happened he wasn’t able to bounce back. It pushed him farther to feeling like he didn’t fit in. Was this the final straw? Was it school and it’s stress? Was it because he couldn’t lose weight? Was his medication dose increase the push to give plan to taking his life?

I still do not know where Nolan was the night before his suicide, nor where he went for most of the day. I imagine he went to the dunes and hung out at the beach. All alone. It was a beautiful September day. What was he thinking? Was he at peace with his decision and enjoying his last day on earth? I understand from my research that people do usual everyday things up to the minutes before they take their life.

I will never know.

The detective mom did see what Nolan did the minutes before he got out of his car with a shotgun, walked a dozen yards to a large rock mound in a construction site in view of his home and ended his life.

He watched a mundane YouTube video on his phone of his favorite gamers. No goodbyes to anyone. No note. No hidden meaning in any texts to anyone. He just ended his pain.

Tell me where the signs are with that?

It will be four years since Nolan died by suicide. The guilt can still try and take over my thoughts.

When the guilt pushes me to think I failed, I remember the following:

  • You cannot control another human being
  • You can make home safe and give tools to find help but you can’t make a person heal
  • Suicide is not the survivor’s fault
  • The act of suicide is not to hurt others, it is to end pain

I see the phrase suicide: 100% preventable in a different light. It reminds me of my role in helping others and bringing awareness to pain that leads to suicide. I cannot prevent every loss from suicide. I can be the person who listens and offers the tools to help and redirect to a path of recovery.