Dear Graduates - You Knew that Already

No surprise to you, all of your plans will not come to fruition.

It is graduation season so I've read a couple articles and speeches that were aimed at high school and college graduates.  One of the themes is, "Life doesn't turn out the way you dream and plan it will, so be prepared for failure and change."  Guess what - you already knew that.

Childhood is the time of biggest struggle for change.  Learning to walk takes a lot of effort and painful failed attempts.  As does learning to ride a bike.  As does learning to get along with other people.  And talk about failed dreams - you can't fly like superman, you won't make a ton of money with a lemonade stand, you can't collect the biggest ball of chewing gum because your mom said no way.  You struggle to balance  the profoundly differing stories about Santa that are told by your parents and by kids on the playground, or ponder the existential motives of a tooth fairy.

You struggle for separation from parents, yet desire their support and nurture.  You long to make an identity for yourself, and then long to re-invent it.

Here is my message to you - grown up life is not that hard compared to negotiating the minefield of childhood and adolescence.  The school room and play ground become the work place.  You turn from child to parent.  Your friends are ... maybe as immature as ever, maybe not.  You come to this place in your life having navigated a myriad of difficult mazes.

You already know that the only constant in life is change.  Keep on keepin' on.

ALB

What Not to Say

http://www.nytimes.com/2011/06/12/fashion/what-to-say-to-someone-whos-sick-this-life.html

This is a great article in the NYT about what not to say, and what to say, to someone who is seriously ill.  And, I would add, to their family members.  The author went through cancer treatment.  His suggestions are spot on.  All the things I want to say to people but feel too polite to say.

I recall a time when I was in the hospital quite ill and in a lot of pain.  Five days into the hospital stay a newly consulted specialist walked into the room and said, "You look miserable."  I wanted to cry and hug her.  That was what I really wanted to hear, an acknowledgement of how I felt.  If you had asked me how I felt I would have said, "I'm hanging in there."  Which I was.  But it was miserable.  I try to remember as a physician that if I can't do anything else, I can always acknowledge a patient's suffering.  "This is such a miserable experience, I am sorry you have to go through this."

Compassion is the best medicine.

Why Good Parents Make Their Children Cry

I heard screams coming from the shower.  When I went to investigate, there stood a child with a large amount of shampoo in her hair, crying that shampoo went in her eyes and now it burned.  I told her the best thing to do, which would make her feel better faster than anything else, is to put her head under the shower and let it rinse all of the shampoo off her head and out of her eyes.  She hates getting water on her face and refused.  I raised my voice - she refused and continued to cry.  I yelled - she refused and continued to cry.  So I took her screaming, wiggling body and shoved it under the running shower until all of the shampoo was out of her hair and off of her face.  As she stood wrapped in her towel after the experience she looked at me with scorn and said, "A good parent wouldn't make her child cry!"


Good parents do things all the time that make their kids cry.  Get them immunized.  Refuse to buy them toys they don't need or can't afford.  Reprimand them for bad choices in their behavior.  A parent's job is to see the big picture and do what is best for the child, even when it causes temporary pain and sorrow in the child.

Our Heavenly Father sees the big picture much better than we do.  I wonder how many times I have stood before him crying out for help and the answer I got was painful and made me cry.  How many times have I figuratively screamed in the shower and refused his gentle advice to put my head in the shower - only to have myself bodily pushed under the falling water.

At those times, when we are sputtering in the midst of hard times and sorrows, and we are tempted to yell at God, "A good parent wouldn't make his children cry!", we need to remember that he sees the big picture.  Bad things things happen because it gives us the chance to learn.  Whether we cry and become bitter, or consider the good that could come of each bad experience is up to us.

God lets bad things happen to us because he loves us.

ALB

My Beautiful State of Denial

Brian has a sore in his mouth.

For anyone else I would say, "Big deal, put some numbing medicine on it, it will go away."
Life after oral cancer, however, is a waiting game.  Will it come back?  If so, where?  Will we recognize it if it comes?  A simple mouth sore is a pit in my stomach.

I have been living in a beautiful world of denial since Brian ended radiation treatments.  The hard part is over, the long road of recovery ahead.  Long, slow, but upward ... positive in direction.  My brain wouldn't even let me consider the possibility of relapse.  It is a peaceful place, this world of denial.  Not easy and not joyful, yet not filled with anxiety.
All it takes to crack the walls of my peaceful world is a little mouth sore.  At his surgical margin.

He already has an appointment scheduled with the surgeon for a follow-up appointment in 4 days.  Will I be able to see in the surgeon's face how worried he is?  Will he try to reassure us, yet walk out of the room with a pit in his stomach and feeling that this will not end well?  Will he take one look and say, "That is completely normal for this stage of healing"?  Whatever his response, he will be blunt.  And my world of denial will have to create new boundaries.

ALB
-----------------------
5/31/11 Update - saw the surgeon today.  He was cautious about the lesion.  Come back in 2 weeks, if it isn't gone by then he will biopsy it.  Seems fair enough.  Back to blissful denial.

6/14/11  Update - saw the surgeon again.  The spot looks better.  No biopsy, follow-up with the other surgeon at our regularly scheduled appointment in 4 weeks.  Back to blissful denial.

I Am a Child of God

Watch the whole thing, don't get overwhelmed if the beginning seems too sweet.  It gets even cuter when the big children appear!

And so are YOU!

ALB

Cooks Anonymous

Hi, my name is Angela and I just figured out how to cook rice at age 40.


Yes, the simple "one cup rice, two cups water, simmer covered for 20 minutes, voila perfectly fluffy rice."  I just gained confidence in doing this.  I have no idea why I have feared cooking rice so long.  Fear of burning or crunchiness maybe.
I could never remember the ratios (I realize how stupid that sounds).  It's like I had rice dyslexia.  I own a rice cooker, but that always produces an overcooked layer on the bottom.  Deliciously crunchy but not what I want on a regular basis.
This is a dumb post ... but I am proud of the fact that I managed to cook a perfect pot of rice without looking up instructions.  I will now slink off in embarrassment.

ALB

Why I Will Not Phone in Antibiotics

Dear Parent on the other end of the phone,


I am so sorry that your child is not feeling well and you are leaving on vacation tomorrow/out of town/can't afford another copayment/sick of coming in to the office.  I realize that having a miserable/feverish child makes your life hard and makes you feel stressed.  I know that you are sure the ear pain/sore throat/pain with peeing must be an ear infection/case of strep/urinary tract infection.  And I know you are very unhappy that I will not phone in a prescription for antibiotics for you.

Unfortunately not ever fever and ear pain is an ear infection - many of these kids have normal looking and functioning ear drums when I examine them in the office.  Most of the sore throats we see do not test positive for strep.  Most of the pain with peeing in young children is not a urinary tract infection.

I will not prescribe an antibiotic "just in case".  This makes your child more likely to have bacteria that are resistant to the antibiotics that we commonly use to treat infections.  And what if your child has a reaction to the medication?  Aside from a bad allergy, getting diarrhea or a yeast infection or a rash is still not a pleasant thing from a medication your child didn't need in the first place.

There is also the possibility that your child really has a bacterial infection and needs an antibiotic - it just isn't the infection you think.  What if that ear pain is a swimmers ear rather than a middle ear infection?  What if the ear pain is caused by a strep throat infection?  What if that pain with urination in your teen is a sexually transmitted infection, not a urinary tract infection?  I can only tell by talking to and examining the child.

I am sorry that your employer has contracted for a high co-payment insurance plan, or your insurance company doesn't cover out-of-area care.  I am happy to speak to you and problem solve, to suggest over the counter medications and other ways to make your child feel better.  I will even advocate for you with your insurance company the best I can.  But I will not phone in antibiotics.

I am used to the anger, the pleading, the threats to file a complaint.  I will try hard to be patient when I talk to you on the phone.  But I will not compromise my standards of giving your child the highest quality medical care I can provide.   If that means I need to examine your child to determine the best course of treatment then I will let you know that.  And I won't back down.

Sincerely,
Dr. Beeler


ALB