A Poet Reborn

Sometime in seventh grade (~2003/2004), I remember writing somewhere around 40 poems in 2 weeks for 2 english/reading/literature classes. From English sonnets, to free verse, haiku's, it was simply too much for a middle school mind to handle. Fast forward over 10 years and it seems the seeds of the poet planted by my amazing grandfather have finally be watered and are starting to grow. There has been nothing better than writing a thoughtful poem after a long day at the hospital, or better yet, on the walk into work in the crisp summer morning. I have provided a few of my more mindfully oriented pieces below and will continue to add at least one poem each week. Maybe a weekly Saturday poem is just the thing to share with the welcoming world.

Photograph

 6-3-2015

What is a photograph but a poem without words

Cursed without a voice, but blessed by the majesty of sight

The colors dancing upon my eyes, speaking a different language

Shadows, contours, reflections whisper in my ears

It takes more than silence to keep a picture from speaking

 a thousand words

Compassion

6-25-2015

Gratitude

We share our thanks

Positivity

We share our optimism

Caring

We share our thoughtfulness

Truth

We share our honesty

Acceptance

We share our understanding

The recipe for compassion is rather simple

All it takes is a little belief

Into how beautiful

The human connection

Can truly be

The Flame

7-16-2015

We all carry a single torch

At the center of our being

It is our eternal flame

Forever burning

Even after our physical form

Has passed

Nurture your fire with friendship

Let the light show you

What it truly means

To be nourished

Give from your source

And receive the gifts from all those

Willing to connect

Eternal being is not the same as

Always giving

Or

Perpetually receiving

We must seek to be

The wick when another is burning out

The light when a torch goes dim

The strength when only smoke remains

Blessed we are

To have courage

To let our fires burn

Under the care of another

Let vulnerability and compassion

Be the sustenance

To your flame

And you will never be worried again

By the question

Of when your embers

Will finally go out

Pediatric Medicine for Adults?

         Having recently completed a 6 week rotation for Pediatrics, in which I saw numerous children from the 2-hour newborn to the 18 year-old needing a sports physical, I was quite impressed with the depth of knowledge required to be a pediatrician. I often joke with my brother's girlfriend, who is a veterinary technical assistant, that being a doctor should be simple, you are just responsible for one species. When it comes to taking care of kids, however, the idea that they are all Homo sapiens somehow is just too hard to believe. Developmentally complex, children can be categorized by certain physical and cognitive milestones, but in reality, this is just a snap shot reflection of the person they currently are, and may have no bearing on the adult they will become. Nurturing and caring for our youth is something near and dear to my heart. Having grown up with all younger cousins, I literally saw the growth of my relatives from diapers, to tricycles and rec soccer, to finally graduating high school and moving on to college. If I were to tell you that the most important part of their physical maturation was constant oversight from a pediatrician via well child checks, sports physicals, the occasional visit during a tough cold, or getting comfort for some bumps and bruises and that really weird rash, you might think this to be a grand overstatement. But take a closer look and what you might find instead is a relationship of trust whereby the pediatrician or family physician nurtured the growth of a child by being a positive presence, someone who cared.

         After observing several visits with UVa general pediatricians, it became very obvious that the majority of our discussions revolved not around an illness or presenting complaint (even if there was an acute problem), but on how a kid was doing in life. What sports did they play, were they involved in dance or art, how much were they sleeping, did they have any problems with their diet- too much candy, food intolerances, not eating enough vegetables, binging on ice cream and Chinese food, how was life at school, did they have close friends, if they had siblings what was their relationship like, did they get to travel to another state or country, what did they want to do when they grew up, what was the coolest thing they had done in the past week? Taking a history was so far removed from asking about quality, duration and onset of pain, or reciting a laundry list of questions for a complete review of systems. Even when these components where required as part of our visit, it was accompanied by discussions about total well being: social, spiritual, physical, and emotional.

         As vulnerable as I have become during my years of medical school, I often tell people that I see a psychologist every 2-4 weeks for an hour at a time to simply talk about my life, review my well-being and make sense of any thoughts or doubts that are going through my head. While this relationship works for me, what I encourage of everyone is to find that person in your life with whom these types of discussions can occur, completely safe, secure and free of judgment. It certainly does not have to be with a trained psychologist or even a family member or friend, the arrangement and sense of true acceptance are all that matters. In thinking about the pediatric visits, it became clear to me that maybe this dynamic was being shaped without even the child, family or doctor being aware of the development. Through thoughtful and meaningful interaction over a period of time, the pediatrician could become a trusted presence in a child’s life such that the cultivation of positive well-being and the adoption of self care practices could actually develop. We all want to be happy, healthy and at peace with our true nature. Sometime illness, negative thoughts, and unexpected life events can cause upheaval in this balance. While I always want to know that I have people in my life that I can turn to when times are difficult, I ultimately want to know that I have the tools and personal resiliency to face any challenges, all the while with my support team waiting in the wings to catch me should I stumble.

         Being a pediatrician can be so much more than simply being the kid doctor. As physicians of adult patients, it can be rather difficult to see where we fit into the patient’s idea of wellness and day to day self-care practice. Often we get derailed by discontinuity or lack of communication/connection with our older patients, yet this is not an excuse. A recent Ideas and Opinions piece from the May 19^th, 2015 issue of Annals of Internal Medicine entitled “Balloon Animals, Guitars, and Fewer Blood Draws: Applying Strategies From Pediatrics to the Treatment of Hospitalized Adults” sought to showcase how we can improve care in the hospital for adult patients by utilizing a pediatric approach. While the article was creatively original as well as practically relevant to our current health care system, it got me to thinking: “What if we combined the pediatric approach with the holistic model of personal well-being and applied this in the outpatient, functional environment, away from the hospital? As I have said many times before, the hospital is all too often the home of sick care while true preventative holistic medicine conducted at the home is healthcare, so why not spend more energy changing the way we care for adult patients outside the home, than continuing to reform and revamp an institution that routinely fails to provide health and vitality to the majority of people seeking aid. I am never one to discredit the value of hospitals, and certainly do not want to come across as someone who views the thoughtful Annals article as misguided, I merely want to suggest an alternative use of our time, energy and resources. Sure, my kind of hospital would look a lot like the one described by Michael R. O'Brien, MD; Marjorie S. Rosenthal, MD, MPH; Kumar Dharmarajan, MD, MBA; and Harlan M. Krumholz, MD, SM, but I also see something more, a new frontier for medicine, a replacement for the hospital when one needs just a little more care than what is realistically achievable while living strictly at home. Just maybe, with the help of a few friends and many years of hard work, we might just see the creation of a new healing institution that truly embodies what it means to provide Healthcare.