Mama Doc Philosophies

All Articles in the Category ‘Mama Doc Philosophies’

Day In, Day Out

There happens to be whole, large parts of adult American life that no one talks about in commencement speeches.

It’s the season for commencement speeches. A season I love, I keep a post-it note on my own computer from Steve Jobs’ 2005 Stanford commencement address. The post-it note is faded and bent, worn and tired. But there’s rarely a day I don’t see it. I see it right now…

Advice at the moment of transitions in our lives is helpful, but rarely sinks past the skin at the moment we hear it. Sometimes it’s upon reflection and maturation that we look back and realize how much we value wisdom we’ve heard. It’s as if advice has to brew. It’s just this past year or so that I’ve really embodied the concept of “Be a willow, not an oak.” That was the message delivered at my older brother’s high school graduation. Clearly it struck me then, enough to remember it, but the advice only got heart-deep this past year, some 20+ years after I first heard it.

This 9-minute snippet from David Foster Wallace’s 2005 commencement address at Kenyon College (my beloved Alma Mater) is worth your time. I’ve listened to it three times in three days. I suggest this will change not only your day, but your year. This is the type of parenting advice I love most: it’s marketed as life advice, college-graduate advice, or advice for the young. Yet all the while it’s actually perfect for we frenzied, over-worked, tired, callous-handed parents. The monotony, the hard labor of caring for young children is rarely glamorized and never snags enough attention to make it worthy of a speech. I think David Foster Wallace’s wisdom is profound and on-point.

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Home Births: Polarizing Views

baby OLike so many controversial parenting topics, discussing home births brings out dynamic opinions. These controversial topics unfortunately often tear us apart from one another. This week, the American Academy of Pediatrics (AAP) issued a policy statement on home births that will hopefully help inform. In general, the policy statement identified data confirming it’s safer to have birth in a hospital, but outlined ways to decrease risks for moms and families, midwives, and doulas that want to partner with moms to have their babies at home, as safely as possible.

  • Home births only occur in about 1% of births here in the United States although interest in increasing. Distance from the hospital matters~ if it takes more than 20 minutes to get into a hospital from home, risk of complications including infant mortality are higher. Data shows that home births carry at 2-3 fold higher risk for infant death when compared to hospital births. 
  • The AAP states home births should only be considered if no maternal health problems, if it’s a term baby (after 37 weeks and before 41 weeks gestation), labor started at home spontaneously or as an outpatient, and it’s a single pregnancy that isn’t breech. Having had a previous C-section makes a home birth a no-no in their mind.
  • The AAP recommends having at least 2 people attending the birth with at least one person at the birth who’s sole job is to care for and tend to the baby after the birth. They outline that the baby’s caregiver needs to know how and why to resuscitate a newborn. The team caring for mom and baby need access to consultation with obstetricians and pediatricians and a well-planned way to access the hospital or medical team easily if needed.
  • The AAP says, “Every newborn infant deserves health care that adheres to the standards highlighted in this statement.” Care described includes warming the baby and initial transitions, glucose monitoring, infection monitoring, feeding assessment, jaundice checks, vitamin K shot, Hepatitis B shot, eye infection prevention, hearing screen, newborn blood screen, and follow-up care plans.

I believe we each have the right to make health care decisions that are best for our families. We also must have access to un-biased information on safety. Every single health decision we make is a process where we weigh risks against benefits. Home birth versus hospital birth is no exception.

My disclaimers: I had 2 hospital births which required all sorts of intervention and intensive care—2 C-sections, a bedside resuscitation for my newborn, and a short NICU stay for one of my sons. I would never have wanted to have a home birth after my training in pediatrics. That being said, there were aspects of the hospital care that really upset me. I didn’t have a birth plan, per se. I wanted this: a healthy baby and to survive the delivery without complication. I got both, thank goodness, but it wasn’t perfect. The beginning of motherhood was a challenge for me both times around and in part, I’ve always looked back feeling I should have been a stronger mom in the hospital… Read full post »

Work Trip Kiss

Screen Shot 2013-04-28 at 10.40.16 AM

Leaving our children for any reason makes our hearts hurt. Fortunately, the technology of our time provides incredible proximity. Tonight I got a kiss from my 4 year-old from 2000+ miles away while in a Google Hangout. Every parent has tricks that allows them to endure working trips or distance from their children created by time or space. FaceTime and Google Hangouts allow me to join books at bedtime and spontaneous conversations on the fly.  Ohhh, thank you 2013…

I Love Being A Working Mom

View from our seats at TEDx during the afternoon session

View from our seats at TEDx during the afternoon session

I love being a working mom. This is really the first time I’ve known it like I do today. I had one of the best days of my life two weeks ago, seriously ranking up there in the top 5 thus far. And unsurprisingly to me, it was a work day. However unlike ever before, for the very first time I brought my son with me.

Today is “Bring Your Kid To Work Day” but really any day we do it counts. Pick an ideal time and involve your child. My contention is that you’ll rapidly recognize the incredible fortune it is to live this lunatic life that requires navigating the dreaded work-life-balance ordeal.

When my 6 year-old joined me on a work trip earlier this month it was as if at once two huge ships met at sea. All the sudden my little boy was welcomed into the world of making change. I felt unlike ever before I represented more of my whole self while at work. And let me tell you, his eyes were wide open. All day.

One of the post-it notes on my computer at home says, “Design a beautiful day.” The quote stems from Dr Marty Seligman who’s known to have founded the field of positive psychology. He devised the concept of the beautiful day activity (seriously encourage you to click on that link).

Thing is, every time I’ve talked about designing a beautiful or meaningful day, work is a part of it. If I only had one more day to live, I’d work for a few hours in the morning. No question about it. I really do love working as a doctor. Of course, I really do love being a mom. Valuing both of these roles takes skill and I’m don’t always have it…

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Chopsticks

Chopsticks

You don’t need much to play a duet if you know a piano player.

Although my boys don’t play piano, I was reminded this weekend how children really sponge-up opportunity. They’ll try most anything and catch on faster than we do. After we finished a delivery to my mom, our 6 year-old sat down at her piano. A few minutes later he was playing a Chopsticks duet, my mom providing the accompaniment.

Count to 6 and have 2 fingers– it’s possible. Perhaps he is a piano player, perhaps it’s time for lessons.

This was just another reminder that we often don’t plan the most precious moments of our day.

Free the child’s potential, and you will transform him into the world.
– Maria Montessori

Listening To The Periphery

hallway baconWe learn so much from our children. How to slow down, how to speed up, how not to behave. How to be present, mindful, and attentive to immediate needs. I’m not always entirely mindful and I certainly find myself easily distracted–it’s not just the phone I need to put down. Yet one low moment of distraction came to light late last summer when my 4 year-old literally put his body between my phone and my face to get my attention.

But ever since August I’ve felt more aware of the moments that pile on and feel more able to witness those I am lucky enough to work with and those with whom I am lucky enough to spend time. I enjoy clinical medicine more since I felt a more intimate proximity to my own mortality. I enjoy my children more and my time alone more, too.

It’s often those much younger and those much older and more experienced that clarify issues and help us focus the lens. It seems to me the simplicity of knowing what to do and what matters most stems up from those at the periphery. I’m not saying those of us stuck in the middle of this generational sandwich don’t have insight, I just think we draw heavily from those for whom we are indebted for their pace, their age, and their innocence.

I learn so much from children every day. In clinic today my stomach dropped at one point simply because of the story shared by a 6 year-old. The day had been laid out differently because at our morning huddle in clinic we review comments that come in. A patient had detailed in a comment card that he/she felt the nurse and medical assistant had spent more time listening to them than the doctor had. Sometimes we can do such a bad job showing those for whom we care we’re listening. It’s pretty obvious that as we work hard to witness our lives we often get more quiet. I feel so much more porous to the lessons in this wicked-packed-full-generational sandwich. Which reminded me of this: Read full post »

Soccer Mom

Soccer net

I had an unusually good time watching my boys play soccer this past weekend. It’s not always been easy to get our youngest on the field and I’m not the mom who’s really loved being there. There’s been years of standing on the cold sideline where I didn’t think the boys were getting much out of it. And there have been countless minutes on that sideline where I’ve been consumed, weighing the costs and benefits of the soccer class, while my coffee went cold. Fortunately, something has changed recently. I’m certain it’s not only me who’s noticed–the boys seem differently positioned as well. Although I look in from the net and see something that seems entirely clear (a soccer field, a group of children–excited and eager [or exhausted and angry], and a coach) these little boys have reminded me yet again of the diversity of vantage points we share. They really do see those green fields as a part of their future. A great coach can really make our children immensely proud and excited to be alive.

Wonder is priceless and the pristine innocence harbored within our children often delivers moments unique to childhood. Children often hold the gift of believing that anything is possible. So often when they share this perspective we get to see a glimpse of unconfined opportunity. We’re reminded of our own potential, too.

Two things recently passed through my ears I have to share. They’ve enhanced my soccer mom experience immensely. Read full post »

Let Us Break The Silence on Stillbirth

This is really beautiful. There’s little to say other than we can do a better job supporting parents in their loss and in the celebration of their children’s life and legacy.

Watch this and enjoy the amazing amount of love you will feel…

“I want the baby I didn’t have.”  “I feel like a bad luck charm around other moms.”

“I couldn’t understand why that happened to me…”

“His life was a good thing.”   “People say really sad, crazy things.”

“We said don’t come and they came….that was what we needed.”

“I love to tell people about my son…I don’t get enough chances to talk about him.”

“His life was a good thing.”

“I’m not afraid to mention him.”  “Why don’t they tell you about it?”

“You second guess everything you did, everything you didn’t do.”

“I don’t want another baby. I want the baby that I didn’t have.”

“I love to tell people about my son… I just don’t get enough chances to talk about him.”

Can Soda Companies Help Fight Obesity?

Screen Shot 2013-01-28 at 10.38.06 AMI’m curious what you think. Do you think companies that make, sell, and market soda can improve the challenges we face with obesity? I’m asking sincerely. I was struck by the Coca-Cola ad (below) recently released. I’m a pediatrician and I’ve never worked for a beverage company or any company that sells products to children. I don’t like that these companies market salty, fatty, sugary products to children. As a pediatrician, I would suggest I’m very biased. The food industry spends $15 BILLION marketing and advertising to children every year. Food advertising, directly to children, is known to increase rates of obesity. Even familiarity with fast-food ads has been found to be problematic. As parents, this isn’t hard to believe; I’ve seen my boys introduced to a product on TV and then ask for it at the grocery store. Because of my bias, I’m asking you—do you think companies like Coca-Cola and Pepsi can help?

As the obesity problem persists, strategies have turned to protocols and regulation. Today, the American Academy of Pediatrics (AAP) released it’s first policy on managing weight-related diabetes. And in the past few years, the American Heart Association released a statement asking for increased regulation on advertising high-calorie, low nutrient-dense (“junk”) foods to children. In 2006, The Institutes of Medicine (IOM) said, “Food marketing intentionally targets children who are too young to distinguish advertising from truth and induces them to eat high-calorie, low-nutrient (but highly profitable) “junk” foods; companies succeed so well in this effort that business-as-usual cannot be allowed to continue.”  Similar sentiments are shared by the American Psychological Association, the Center for Science in the Public Interest (CSPI), Children Now, the American Medical Association, and the American Academy of Pediatrics. The public, too. Last fall, the majority (67%) of international readers polled in The New England Journal of Medicine believed we should regulate sugary-beverage consumption. This on the heels of New York’s regulation banning sale of large sugary drinks. This isn’t just about a tax. Can these companies help? Read full post »

Mindful Parenting

mindful and the skyThere was a moment, just after President Obama was sworn into the office earlier this week, that I’ve been returning to in my thoughts relentlessly. He turned amidst the regal archway of The Capital and stopped. His accompanying family and tribe of lawmakers waited. He said something like, “I want to take a look one more time.” And then he looked back upon The Mall and seemed to take it all in. A few seconds, maybe 1/2 a minute or so. Not long, no, but the moment seemed to take up enormous space. Quietly, eyes wide open, he looked out to the millions that had come to celebrate and bear witness to his honor and his responsibility. Instead of looking at him, my eyes migrated to his daughter, Malia. I saw her watching.

It may have been mindfulness.

It’s of course never clear to an outsider who is mindful or not. Thinking and spending energy to be more present is a passtime that I was introduced to as a medical student because of the work of Dr Jon Kabat-Zinn. I use lessons from his work in my personal and professional life on a daily basis. Therefore, it was a sincere joy last night to sit amidst 1000 other parents and hear Jon Kabat-Zinn and his wife Myla talk about, “Mindful Parenting.” I was surrounded by my husband and friends, many colleagues and pediatricians, and I was lucky enough to sit near parents of my patients. It was community. To me it felt like a needed touchstone and a hearty reminder of how nicely being mindful fits into a busy, reflective, hectic, and imperfect life.

5 Lessons From Kabat-Zinns On Mindful Parenting:

  • Mindfulness is not the antithesis of anything. There is no single ill or evil that impedes it. In fact, the last question on the night from the audience begged The Kabat-Zinns to detail the biggest obstacle to mindfulness. They couldn’t answer it really. All this, precisely because mindfulness in its simplicity is openness, compassion, and love. At the opening of the talk, Jon helped us recognize the work that it took to bring us there, amidst the heavy Thursday raindrops, rush hour traffic, busy workweeks, needy toddlers or teens at home, and the truth that there was potentially something else we really should be doing. He reminded us all that is was LOVE that had brought us together to listen to ideas about mindful parenting. This we all share. This is why mindfulness is possible for everyone at every time in their life. Each new moment is evolving into something entirely new.
  • At one point, Dr Kabat-Zinn looked down at his watch. At first glance it appeared he was tracking the timing of his talk and then he burst out, “If you check your watch, it’s now again.”  A hilarious reminder that each and every moment that unfolds is always now. We have a chance to bear witness to time indefinitely. We are offered up the opportunity to be mindful, open, and present with an infinite number of “do-overs.” Oh, wow–it’s now again. Myla furthered this saying, “Every moment is the possibility of a new beginning.” Every single moment is a new chance to be aware. Read full post »