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Easter exercises

My parents are strong believers in the idea of purposeful exercise. They couldn’t imagine working out in a gym, laboring on a treadmill with nothing accomplished at the end beyond sweating. No, for them, activity is critical – but it has to result in a tangible, quantifiable product.

And so it may come as no surprise that they left Manhattan in the early 70’s to raise their kids on a farm in Canada, where we were kept very busy herding cows, lifting milk crates, feeding pigs, fishing on the nearby ocean, and weeding our very large organic garden.

But as Manhattanites, my parents made sure that I read the New Yorker (we grew up with Calvin Trillin’s children), attended summer school in Paris and ski camp in Switzerland. We took a family vacation each winter to some tropical island, where I played with vacationing city kids.

But this strange combination of “country mouse, town mouse” occasionally produced some rather bizarre traditions – my favorite of which is the annual, December “Easter egg hunt.”

My parents would take us to a rather exclusive golf course on one of our vacation islands, sign up for a round in the late afternoon when most golfers were finishing up, then find us an empty bucket for golf balls. Then we’d walk off in the direction of the 9th hole, and my mom would tell us that there were golf ball “Easter eggs” hidden in the rough patches around the golf course, and that it was our job to fill up the bucket with as many balls as we could find. For young kids, I can tell you, such a challenging and large Easter egg hunt was really exciting.

So I searched fairly systematically through all the patches of rough, proudly announcing each new egg that I had uncovered: “Mom, I found one!” I’d beam, “and this one is bright orange!”

My younger sister wasn’t as successful at locating golf ball eggs. She tended to try to pick them off the fairway, where they were sitting targets. Of course my parents would have to reel her back in, explaining that the Easter eggs were only hidden in the deeper grass.

And we would spend hours and hours on our Easter egg hunts, until the sun set and the crickets drowned out the sound of the ocean waves. We often found an annoyed golf course crew waiting for us to return so they could close their pro-shop. My sister would hand them a bucket brimming with golf balls, saying “we found all these Easter eggs!” And the cuteness of her innocent glee would melt their annoyance as they put the bucket behind the counter, eyeing my parents suspiciously.

But those were good times – where exercise was effortless and fun. Where a common goal drove an entire family to activity, and kids maintained interest in something beyond the TV set.

Now as the real Easter approaches, I imagine what it would be like to return to my childhood activities at a local golf course. I suspect that my physician colleagues would frown upon me collecting stray golf balls at their respective courses. But to tell you the truth, I think that would be more fun than actually playing a round, don’t you?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Hope for accident prone kids

My mother had a good deal of trouble with me, but I think she enjoyed it.

–Mark Twain

Parenting is a difficult job – and one that few would sign up for given full advanced disclosure. I suppose my parents had their share of woes – my near-death experience as an infant, my being mauled by a vicious dog as a toddler, my getting lost in the woods (collecting poisonous toad stools) at age 4, my facial surgery after a bicycle accident, my head injury from a fall out of the tree house, my toboggan versus barbed wire fence encounter, my front teeth versus metal bar incident, my rib fractures and nearly ruptured spleen from another fall from a bunk bed, and my ski accident requiring knee reconstruction surgery… I guess you could call me accident prone.

Looking back it makes sense why my parents encouraged me not to play contact sports, but pursue academics. I took to jogging and tennis instead (yes, I managed to sprain my ankle and catch a racket to the eye nonetheless), and physical training in the gym. But my redirection towards reading and homework was probably a good thing – as it helped me to develop intellectual discipline, and at the very least kept me out of the ER.

So what is the moral of this story? I guess if you have a kid who’s physically challenged – or at least seems to be a magnet for high velocity metal objects, do not lose heart. With a little direction, he or she can grow up to become a doctor who helps other kids who injure themselves repeatedly in creative and unexpected ways.

Were you an accident prone kid, or do you have an accident prone kid? I’d like to hear some of your war stories!

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Your mom will always be your mom, part 1

Alright, I confess – my mother is probably the number one fan of this blog. Ever since I told her I’d be writing one, she has been reading it faithfully. I asked her not to post comments (only because it’s a tad embarrassing to have your parents interacting with you in front of an audience, and frankly, I haven’t noticed a single other blogger doing this!) but alas, she couldn’t resist on that last one. And that’s ok, because I know you readers don’t mind.

My mom does have rare occasions of impulse control failure. One of the more memorable ones was during “Parents Day” at my medical school. The Alumni Association had planned a reception for the parents of the incoming class of 2000 at Columbia U. College of Physicians & Surgeons. There was a full agenda, and my mom quickly noticed that the surgeon who’d saved my life was slotted to speak. The auditorium was full of hundreds of proud parents and their kids, all excited about embarking on a noble career in medicine.

Well, just as my former surgeon was introduced and was walking to the podium my mother jumped up and ran in front of him and asked if she could please have the mike. The MC was visibly nervous (not as much as I was), but after quickly sizing my mom up, she decided that it would be ok to let her have the podium briefly.

In one of the most moving speeches in recent memory, my mother proceeded to explain the story of how Dr. Schullinger had promised not to give up on me (a baby with little chance of survival) and how he had kept his promise to this day. She described the miraculous abdominal surgery (where he had to remove most of my colon), and how he had faithfully responded to every Christmas card she sent him, reporting on my progress for 26 consecutive years. She thanked him for what he did, and pledged that her daughter would devote her life to “doing likewise.”

Well, that brought down the house. Everyone cheered for Dr. Schullinger, who turned beet red (he’s a very shy and humble person) and stumbled through the beginning of his speech. It was a great moment in medicine.

Of course, I was teased mercilessly for the rest of the year – my classmates called me Valerie “semi-colon” Jones, and they would ask if my mother was going to help me with my homework… But kids will be kids.

What I learned from my mom that day is that this old Hebrew proverb is important to follow:

“Never withhold good from those to whom it is due, when it is in the power of thy hand to do it.”

So if someone has done something good for you, or you notice an act of kindness – why not shout it from the hill tops? May goodness rise above the low level grumbling that we live in day to day.

Let’s revel in the sunny parts of life.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Patient advocacy: a baby’s life is saved

Ok, so now that I’ve given you a really good example of the dangers of VIPs bullying doctors, I will present the flip side of the coin: a good kind of patient aggressiveness.

A 10 month old baby was vomiting and febrile, and her new mom brought her in to the hospital for an evaluation. She was told that it was gastroenteritis (my favorite diagnosis of late) and that the baby would get over it soon enough. The young mother insisted that she knew her baby, and that the infant had never been this fussy and that there really did seem to be something more serious at play. Again, she received eye rolls from everyone from technicians to nursing staff to physicians. “New mothers are so histrionic,” everyone thought.

But as the evening wore on, the baby became fussier and fussier, and began scratching herself all over. The nurses came in and tied her chubby arms and legs down so that she wouldn’t tear her skin. The mom wrung her hands all night. The doctor went home, yawning and sure that the baby would be fine in the morning.

Several episodes of violent, projectile vomiting ensued, and the mother pleaded for someone to take another look. No one would listen, as the doctor had written in the chart that the baby had gastroenteritis, so that was what it was.

In the middle of the night, after the physician had gone home, the mom insisted that the nurses page him to come back to the hospital. The nurses initially refused, but the mother told them that she would personally make their night miserable if they didn’t comply. The annoyed physician came back to the hospital against his better judgment, and found the mother and baby looking far worse than when he’d left. In fact, the baby’s vitals were becoming unstable and her abdomen was quite distended.

The physician ordered an abdominal x-ray series. It showed an advanced intussusception and the belly was distended with gangrene. He knew that she was likely to die. He asked the mother if she wanted him to call the general surgeon (who had no experience with operating on babies) or if she’d like to take a chance and get the infant to an academic center in New York City that had a team of pediatric surgeons on call. Time was of the essence, but surgical expertise varied greatly between the two options. The mom could tell that the physician was terrified, and her instincts told her that she should get the most experienced doctor to operate on her baby.

A few hours later, the baby was rushed into the O.R. at Columbia Presbyterian Hospital. The pediatric surgeon on the case told the mother that it was unlikely that the child would live, but that he promised not to give up on the baby. At that point, the baby was septic and seizing.

In a truly miraculous turn of events, the surgeon was able to resect the dead bowel and save the baby’s life. If the baby had arrived even a few minutes later, she probably wouldn’t have made it.

So in this case, I applaud the mother for being persistent and forcing the medical staff to take a closer look at this “gastroenteritis.” In our imperfect medical system, patients and families must sometimes advocate for themselves in order to get the attention they require. This story, in particular, means a lot to me, because I still bear the abdominal scar from the surgery.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Medicine’s real language barrier

A Turkish friend of mine told me that he had saved for several years to bring his grandmother to America for a visit. His pre-teen son had met her only twice in his life (via trips to Istanbul) but they corresponded frequently and had a very close bond. My friend said he wanted to surprise his son by having his grandma at home when he came back from school on his 14th birthday. The only hesitation, my friend said, was that his mom didn’t speak any English and he was worried that she might get lost during an airplane transfer or in the airport. He worried that she would be afraid and alone.

Being in a foreign country where you don’t speak the language can be a frightening experience. When I was a teenager, I flew to Zaragoza, Spain to visit a friend of my mother’s. I felt excited at take off from the US, but as the plane approached the unfamiliar red soil of our destination, a sense of uneasiness settled in. The flight attendants started messaging in Spanish, and as we touched down I knew that I wasn’t home anymore. All I knew how to say was “hola.”

As I made my way through the airport, all the signs were in Spanish, I knew I needed to get a cab, but I wasn’t sure where to wait – and the Spaniards didn’t seem to respect queues. Once I fought my way to the front of a gaggle of natives, I realized that the cab driver needed to ask me clarifying questions about my friend’s address. I responded in English, to which he repeated his question with increased volume. I felt really stupid and quite helpless.

My experience was kind of similar to the feeling that patients have when they are thrust into a medical situation with a sudden, life threatening illness. Healthcare professionals can forget how foreign everything is to the patient, and go about their activities without explanation, or with jargon-rich “medicalese” that is virtually inscrutable to the person with the illness. When questioned, they repeat the jargon, raising their voice for emphasis and “clarity.”

Hospitals spend lots of money on translator services for foreign languages, but many healthcare professionals forget that medicine itself is a kind of unique language that requires translation. As the consumer driven healthcare movement takes wing, it will be more and more important to provide a kind of translator service for those who need to make educated decisions about their medical options. The accuracy of the translation can be a matter of life or death, and so healthcare consumers need to be very selective in where they get their information. Considering the source of your information has never been more important. Don’t let your health be lost in translation.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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