Two Things To Teach My Kids This Thanksgiving

I was chatting with a doctor-mom friend about our kids today. We’ve both recently managed illnesses and injuries, but in the end, everyone is alright, and we are thankful.

We discussed a case in our practice that touched us both: a woman who was babysitting a preschool-aged child had a medical emergency, and lost consciousness. The child was alone in the house with the unconscious woman for many hours. When the parents came home, they administered first aid and called the paramedics right away. Thank goodness the child was safe (he later said that he thought the babysitter had just been sleeping), but the ensuing panic and sirens and emergency personnel bustling around was quite traumatizing to him.*

My friend has not only taught her young kids how to dial 911 in case of an emergency, which I have not, but she also has taught them a very comforting thing.

Whenever they hear sirens, any sirens, they stop what they’re doing and say:

God bless the helpers and the people who need help. Amen.

It’s a simple little thing that acknowledges the fact that somewhere nearby, someone is in danger or hurt; but that also, someone who is dedicated to helping is on the way.

A couple of years ago, this same friend had to call 911 for her child, who was seriously injured and in great pain. While they were riding in the ambulance, with the sirens blaring, she told him:

“Remember, honey, all those times we’ve prayed for the helpers and those who need help? Right now there are people all over who can hear this siren, and they’re praying for us. They’re praying for us right now, hon. It’s going to be okay.”

She took as much comfort from this as he did.

I thought that this was such a beautiful story, and tonight, when I go home, I intend to do two things:

One, teach my kids this simple and lovely little prayer:

God bless the helpers and the people who need help. Amen.

and Two, teach them how to dial 911 in case of an emergency.


*Case details changed significantly to reflect only the key salient points

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My Poor Sick Pooky

Many doctor-moms tend to be laid-back about sickness and injuries.  If not laid-back, then at least, non-alarmist. After all, what is medical school and residency but learning to recognize sick vs not sick.

Sick is real, acute illness, and actually, isn’t that common. Not sick is most patients.  Not sick is the worried well, chronic slow-moving diseases, anything that time will heal, and most viruses.

Early in training, you don’t know what’s what, and so, everyone looks sick. There’s alot of panic.

As the years go on, you get a bit jaded. You’ve seen alot of really sick folks, and you don’t worry as much about the rest.

Of course, this lax attitude can lead to missed diagnoses. Hubby will never forget his 2007 sore throat:

“It’s a virus,” I kept telling him. “It’s going around. Gargle.”

Hubby is non-medical, and surprisingly stoic about his own suffering. For a guy.

I didn’t know him well enough at that point to know that if he said his throat really hurt, it must REALLY hurt.

A few days into that illness, he phoned me from the broadcast booth, where he was getting ready to call a minor league baseball game. I was driving home from work. The connection wasn’t great.

“My throat really hurts,” he said.

“Do you have some tea with lemon and honey there? That might help.”

“Well, I would, but I haven’t been able to swallow.”


“Yeah, I have to spit into a cup. Nothing will go down.”

“Excuse me?”

“I can’t swallow. Will this get better?”

I realized that his voice wasn’t weird and muffly because of the poor connection. It was Hot Potato voice. This is when swelling and inflammation and pain cause the voice to change.

Later on, a quick exam revealed a massively swollen and red left tonsil, pushing the uvula to the side.

Oh God, this might be a tonsillar abscess, I thought. I cringed: I’m such an asshole. My mind ran: How can we get a CT scan tonight? An ENT consult?

But Hubby would have none of that. He had to travel with the team. He hadn’t missed one game in twenty years of broadcasting, and he wasn’t about to start. We compromised: Augmentin, and massive amounts of NSAIDS. He got better, and I try to take him seriously when he says he’s got pain.

Regardless, it’s become a running joke that I tend to minimize my family’s illnesses. (Honestly, it IS usually is just a virus.)

So when Babygirl came down with fevers and vomiting last Friday, I didn’t stress. Babyboy had just had a cold and cough. This was probably her manifestation of the same thing. A virus.

“Oh, my poor pooky,” I comforted, and we let her do what Babyboy had done: watch endless Curious George.

But Friday, Saturday, then into Sunday morning, she had high fevers and vomiting. No stuffy nose, no cough, no diarrhea. She wasn’t eating at all, she was only drinking some cold juice here and there.

Febrile Babygirl napping on the couch

Febrile Babygirl napping on the couch


Still, it didn’t dawn on me. Not until she looked up at me and said,

“Mommy, my throat hurts,” and she did that thing where she swallowed and grimaced. I realized that she’d probably been doing that for awhile.

Oh, no. I thought. I’m screwing up again…

I ran and got a flashlight. As I bent down really close, I got a whiff of her breath: that unmistakable bacteria stench.

And her throat, here it is:

There’s some exudate back there, didn’t show in the photo. Angry tonsils!


I texted the photo to my mother and Hubby, and after some conferencing, I decided to take her to the pediatrician.

Our kids have the BEST pediatrician. Their office has urgent hours on Saturdays AND Sundays. They put my clinic to shame. I called, and within a half an hour we were in the office.

The pedi took a swab. The rapid strep was positive.

“Strep can often present as fevers and vomiting in little kids,” she explained.

Oh, I felt bad.  We went straight home. I stroked Babygirl’s head, tried to tempt her with sugar water (she likes that). Hero Nana picked up the Amoxicillin. Our awesome neighbor brought over popsicles. It’s Wednesday and Babygirl is much better, but still has barely eaten any solids. She’s lost a bit of weight.

Didn’t I do a pediatrics residency? Um, yup. Many years ago. In my own defense, it was basically an inpatient residency. There was very little exposure to basic outpatient stuff. But still. It’s embarrassing.

My poor sick pooky.


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How To Think About The Unthinkable

Yesterday evening, I left work and hurried to the subway station. As my train rumbled close, I bolted up the stairs  in a frantic attempt to catch it. As per usual, I missed it by about thirty seconds.

But even as I stood shivering on the windy platform, I wasn’t sad. A few minutes standing idle waiting for the next train would be perfect for catching up on news, social media, and non-work email. I opened up my phone.

Right away, headlines about Paris. Terror attacks, unfolding live. Coordinated violence targeting venues crowded with civilians, in the heart of a major city. Exactly what has been feared and predicted. Exactly what we have wanted to prevent.

Though the details were sketchy, it was very clear that these were acts of terrorism: survivors recounted the perpetrators shouting religious slogans.

Whether the motivation is religious, political, or personal, violence must be condemned. These acts must be denounced, and protective measures undertaken.

But from there, what? We, humanity, seem to be stuck in an endless spiral of hate.

One of the best articles I’ve read on how to approach violence and terrorism outlines some basic diplomatic steps that make a lot of sense. John Morehead wrote this piece for Christianity Today after a different terror event in 2014, and yes, it is based on Christian values.

I always hesitate to mention religion for fear of losing some of my readers. Many are doctors or other healthcare providers: scientists of the human body. I know very well that many of these colleagues are, at best, casually engaged with faith, if not frankly agnostic. And those that do practice religion may very well not be Christian. Start throwing around phrases like “Christian values” in your blog, and – click!- there goes a chunk of your audience.

But what is religion other than a moral framework to guide our thoughts and actions? Without a moral framework, humans are not much better than animals. And we need a moral framework to make sense of the horrors of yesterday in Paris,  to be able to move forward.

Many say that religion itself is at the heart of the violence, but that is a superficial view. People rationalize horrible acts in many ways: war in the name of democracy, execution in the name of just punishment, violence in the name of God. Per Morehead:

“….we should pause for some difficult self-reflection. Is it possible that we…. have been too quick to sanction the sword, often in the name of promoting freedom and democracy?”

He offers three steps: Promote peace, learn about other faiths, and create interfaith relationships. These peaceful, diplomatic steps may, indeed, be more powerful than military retaliation.

Think about it.


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60 Minutes A Day!

Both of my kids have carefully curated candy caches. Halloween is a week past, but those piles of sugar and fat haven’t shrunk much. Babyboy is more interested in organizing and displaying his (he keeps building a “candy store” in the living room), and Babygirl tends to try one bite of anything and then reject it. Regardless, they are still eating about two pieces of candy a day.

I know we could take the candy away and manage it ourselves, or negotiate them out of it, but we like the idea of them learning to manage the sweets in a normal way. We want to model and to teach them: everything in moderation.

Hubby and I were both “husky” sized schoolkids. We were teased for being chubby, to the point of tears. For both of us, this has resulted in a lifelong focus on health and fitness.

We don’t want our kids to become overweight, and we certainly don’t want them to get teased, but we also don’t want them to obsess over it. Living well should feel natural. So we haven’t been too pushy or preachy about eating healthy and exercising. Rather, it’s just the way it is.

We usually have plenty of produce and plant-based foods in the house, and not many processed foods (Halloween candy excepted…). We ourselves don’t frequent fast food joints, so they don’t, either. Yes, we do hot dogs and fries and pizza on weekends. Luckily, both our kids prefer fruit and yogurt over most other foods, and even seem to be self-regulating the candy intake, for the most part.

That leaves the physical activity part…

Many of the families around us have their kids involved in organized sports of some kind: soccer, karate, dance. To date, we’ve been too disorganized, and, dare I say it, too lazy to figure all of that out. Hubby and I both work, our schedules are pretty hectic, and so… we just haven’t gotten to it yet. He and I are fairly OCD about our own exercise. I can safely say that if we don’t get regular intense cardiovascular activity, we don’t feel normal.

But, neither of us has been able to commit the kids to any scheduled exercise activities.

Every respectable medical and public health organization in our country recommends sixty minutes or more of physical activity a day for kids. Per the Centers for Disease Control (and like, everyone else too):

“all children age 2 and older should participate in at least 60 minutes of enjoyable, moderate-intensity physical activities every day that are developmentally appropriate and varied”.

Hubby and I ran a charity 5 k yesterday, with the kids. But they sat in the double jog stroller. They got fresh air, yes, but they also ate plenty of the complimentary bananas and Munchkins. So when we got home, I got out the big and little rakes, a bunch of lawn and leaf bags, and we went to it.

It all counts, right?

Running around the backyard jumping in leaf piles; riding bikes, however slowly; hiking, or even strolling, through the woods; collecting shells on the beach; climbing the playground, or hay bales, or rocks… it’s all exercise, and it’s fun!

Someday soon, we’ll get our acts together, and we’ll let them try soccer/ karate/dance. For now, though, we do a little of everything, as long as it’s fun.



Jumping in leaves counts as exercise!



Learning to ride a bike counts too…


Hiking through the woods...

Hiking through the woods…


Collecting shells on the beach!

Collecting shells on the beach!


...and climbing on hay bales

…and climbing on hay bales


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There Are Scarier Things

It’s late into Halloween night, and since I woke up in a coughing fit, I haven’t been able to get back to sleep. There are some scary things on my mind. Not the ghosts from my previous post, nor modern-day vampires, serial killers and zombies on network TV (a frightening phenomenon, IMO). No, none of that.

See, I opened up our online newspaper, and one thing led to another… I’m now immersed in the Irish Famine.

I don’t remember learning much about the Irish Famine as a schoolchild. Seeing as we live in the metro area with the highest concentration of Irish outside of Ireland, this boggles my mind (1).

This is one of many chapters in history that gives me chills: the world did very little as over one million Irish, mostly poor rural families, died of starvation and the epidemic illness that flourish on malnutrition. The BBC has published a quality, easy-to-read summary of all aspects of the tragedy that played out from 1845 to 1852. The scientific side of me is fascinated by the origin of the crisis: a fungus, the cause of common potato blight. The crisis morphed into catastrophe… There are hundreds of historical etchings showing the desperate and dying; emaciated children clawing at the earth with their bare hands; hordes of hopeful waiting to board ships bound for better places.


Irish children dig for food with their bare hands


This is what really grabbed me: the ships, also known as “coffin ships”. These were British government- commissioned ships contracted to ferry the starving poor from Ireland, mainly to the U.S. and Canada. Unscrupulous captains and crew took on far too many passengers and spent very little on provisions, the result of which was an over 30% estimated en-route mortality rate among the already suffering. By many accounts, sharks trailed the vessels, anticipating the bodies that were tossed overboard.  A 2013 Washington Post article about human remains found washed up on a Canadian beach provides a well-illustrated history of these coffin ships.

In all of these links appear disturbing images: masses of desperate people waiting at the docks; terrified mothers cradling skeletal children; miserable humans crammed below decks. I can’t help but think: Where was the world when the Irish were literally dying of hunger?

There was food aplenty, especially in sovereign England. The real reasons for the world turning their backs on these suffering were purely political and idealogical. The British press had long depicted the Irish as freeloaders. Intellectuals scoffed at their Catholic religion and their agrarian society: the Irish were considered primitive, less-than-human (the BBC article above outlines these facts, rather dryly and succinctly).

These prejudices were metastatic even to America. How many of us have seen the drawings and photos saying “Irish not welcome” and “Help wanted, Irish need not apply”? Still, this was better than life at home, and so, over two million Irish attempted emigration, refugees from Europe.



An Irish Coffin Ship arrives in New York City

I’m drawn to story of the Irish Famine on this supposedly evil evening, not by random coincidence, but because the etchings and the history are strangely familiar.

As a doctor and a mother, I’ve found myself closely following the world’s current refugee crisis. Similarities abound: Desperately suffering and starving masses flee an untenable situation in their home countries. They clamor to board ships, choosing a perilous, possibly fatal journey over a sure death at home. They are preyed upon by smugglers, then met with apathy, and even cruelty, by the wealthy countries around them.

Wait. Am I talking about now? Or it this the Irish famine thing again?

No, this is now. These have been the headlines for weeks, and yesterday, it was worse: more crisis, more drownings, more misery. I’ve been wondering why the world is doing nothing, and often, I am shocked at the negative commentary on these articles, referring to refugees as “invaders” and “freeloaders”, portaying them as “actors and liars”, exhorting them to “go back to your own country”. Back in 1845, this cold-heartedness  was referred to “Famine Fatigue”. Now, it’s “Refugee Fatigue”.  Same thing.

Again, the world holds enough food, shelter, and wealth for all. The reasons for us turning their backs on these suffering are purely political and idealogical. Most of the refugees are of a different religion, and their society is viewed as less-than by the rest of the world. Many of us who live comfortable lives do not want to share, especially with those we see as so “other”.

It all sounds so familiar, doesn’t it?

Deep into the Halloween night, almost dawn, now really, this is what I find the most frightening:

We haven’t learned from history. As intelligent as human beings are, we are just not getting it.

And that is really, really scary.


  1. Over 35% of the population of Boston, as a metro area, claim Irish ancestry. While Breezy Point section of Queens, New York claims an even higher concentration at over 50%, it’s not a metro area.


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The Haunted Hospital: Tales From Residency

“Sometimes, late at night, you can still hear the screams of the poor souls who died a torturous death in the old ICU…”

During our four years of Med/Peds training, we rotated on the medicine floors at a small religious hospital. One of our most well-liked residency teaching attendings thoroughly enjoyed telling ghost stories. It wasn’t difficult to come up with a tale or two about a place that had been dubbed “The Haunted Hospital” by the residents ahead of us. Almost everyone who worked there had had some odd experience, and stories abound. There was more than one longtime employee who would not venture onto a certain floor of the century-old original building after dark, for exactly the reason that our attending was describing.

Vintage Postcard St Mary's Hospital

This is a vintage postcard of the original hospital, which was built in the early 1900’s.

It’s the main job of a brand-new intern to act tough, so we all laughed off the tales and warnings. But as residency wore on, more of us had unexplained, or even frightening experiences while on call.

The resident’s overnight call room was located in an older building where was no overnight patient care, and so after business hours, it was dead quiet. Religious paintings and icons were scattered throughout the entire hospital, a reminder that for many years, there was an attached convent, and the nuns provided the care. There was a life-sized wooden statue of Jesus set in the perpetually dim hallway near the call room. The Christian artwork was no doubt intended to reassure the sick and suffering, but I cannot tell you how many times I literally sprinted past that Jesus statue, eyes averted, praying: That thing better not move.

Our chief resident, who was by all accounts a jocular, confident guy, described that one night, he had tried to catch a few hours’ sleep in the call room. He closed the door, and collapsed on the bed. He was just drifting off when he heard a light knocking at the door. Knowing that sometimes other residents need beds, he got up and opened the door. No one was there. He shrugged it off, and lay down. Again the light knocking, and again he got up. No one was there. He decided it must just be the pipes, and, determined to ignore it, lay down.

The knocking persisted. It got louder, and louder. He turned away and covered his ears.

Suddenly, the door burst open.

No one was there.

He grabbed his pager and shoes and ran all the way down to the emergency room, which was always well-lit and busy. He never tried to sleep in the hospital again; instead, he would plant himself where there were people, and do work, all night.

Many of the stories described how a room would suddenly become freezing cold, without anyone touching the thermostat. Or the elevator would suddenly stop, and the lights would flicker. Or call bells would ring, from empty rooms. All of these could easily be explained by the antique infrastructure of the place. Old vents, faulty electrical wiring, that sort of thing.

But sometimes these coincidences made you think. I took care of one patient, a troubled young man, hooked on heroin. He had died in the night, complications of his addiction. He had died alone, no family by his side.*

I pronounced him dead, and as I sat at the nurses’ station writing the death certificate, the call bell rang.

“That’s odd, ” said the clerk. “It’s from thirty-two. Isn’t that the room where the guy died?”

There was some joking around: “Ooooh, he’s calling to complain about the care!”

“They want their pillows fluffed, even in death!”


A nurse went down to the room and fussed with the call bell. I remember that it was a male nurse, Mark, the one who was often assigned to physically challenging or even dangerous patients.** Not much flustered him.

“I think it was just tangled up a bit. It shouldn’t ring again.”

A few minutes later, it rang.

One older (or I should say, more experienced) nurse commented matter-of-factly, barely looking up from her charting:

“You need to open the window.”

There was another round of joking: “Right, to let the soul out!”

“He’ll never leave until you open the window, Mark, get to it!”

But Mark was not really amused, and ignored this. “It’s just a stuck call bell. Some wiring thing. Ignore it.”

But the bell kept ringing. A few of us wandered down the hall to check out the situation. The deceased patient lay still under his white sheet, awaiting the orderly who would take him down to the morgue. We checked the call bell, which was  just that analog TV remote thing with a button on it to press for the nurse. It looked fine.

Still, it rang.

Everyone kind of looked at each other and shrugged. “Might as well open the window,” someone suggested. There were some anxious giggles, but no one opposed the motion.

The window didn’t open very easily. Finally, between a stepladder and few staff, we got the window open from the top.

The bell stopped ringing.

But the most frightening experience I had could really have been just a wiring thing. I’ll never know.

I was on call, of course. It was late in residency, and most of the Haunted Hospital stories had gotten kind of old. Honestly, as scaredy-cat as I am, I was so exhausted most nights that I could have slept in a graveyard.

If you know me, you know that I avoid elevators, and I especially avoided the elevators at that hospital. They were old, and quite frankly, probably dangerous; not because of ghosts, but because they were so antiquated.

So I was in the stairwell, trudging from an admission in the emergency room to the call room. I was reviewing the case in my head, making mental notes of things that needed to be done.

I thought I heard a footfall behind me, like, a shuffling. It was probably three in the morning, and I was so fried, I was probably delusional. I glanced back, and there was nothing, of course. I started to run up the stairs, regardless.

And then the lights went out.

This was a completely closed stairwell with fire doors. There was not one light, not an emergency exit sign or a window to allow street light or anything. I could not see my hand in front of my face. And I was running, so when it went black, I tripped and fell. This did not stop me. I bear-crawled up that last flight and felt my way along the wall to a door and pulled it open and stumbled out into the hallway…

The lights were not out anywhere else. The nurses’ station was humming quietly, people charting, computers clicking. Meantime, I was in a bona-fide panic.

I don’t think I ever tried to sleep another night in that hospital; I would plant myself in a well-lit place where there were people, and do work…



These stories are all real. I was inspired to write about these old experiences after reading Victo Dolores’ piece titled Lucille on their blog Behind The White Coat Beats A Human Heart. Check it out!



*This is not the patient’s real medical history. Close, but not quite.

**It was a male nurse, but this was not his real name.


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Everything Happens For A Reason

Yesterday, Wednesday, was supposed to be a short, easy workday, just a morning teaching session at the medical school, observing students role-playing taking a sexual history. No finding inpatients to interview, no running around the hospital, no taking notes for meaningful feedback, and no checking in at the office. Heck, I could even wear JEANS.

I had a plan: I would go straight home afterwards, log into work for a bit, do some housework, and then take an hour or two of PERSONAL TIME before picking the kids up early from Nana’s.

But, woman makes plans, and God laughs…

Now, Hubby was away for the past two weekends, and I had the kids last Thursday, my day off, so it has been two weeks since I had even five minutes of personal time. That is, time where I was not held responsible for the well-being of others, be it at work or at home. Let’s face it, even if the kids are asleep, and I am awake, it’s not really personal time, because I’m still in charge. And, that rarely happens anyway, because they go to bed too late and I’m up really early, so I often fall asleep with them. I don’t count commuting time either, even though I’m usually checking social media on the train; It’s still part of my workday.

So I was dreaming of having a few hours in my house, by myself. I hear it from many other parents, too, how rare an occurrence that is, and how heavenly it is to be alone in the house. This is not because we’re going to strip naked and go dancing around, but because we can sit and turn the television to ANYTHING. Me, I was secretly planning to get a really good workout on the spinning bike with America’s Test Kitchen on the TV. Give me a good sweat and a practical cooking show, and I’m happy.

Of course, I felt guilty about this plan. I have alot of work to catch up on (the medical administrative crap is sort of endless), work that is much more effectively completed from my desk in our office. Plus, I have a complicated patient admitted right now, whose condition was in flux at that point. I normally would visit them, and on a Wednesday I might bring my students, too. But if I wasn’t at the hospital, I wouldn’t see her until Friday afternoon. I fretted about this.

Not enough to change my plan, though- The medical school is across town from my hospital and office, and there is no easy way to get to and from. So, I ditched any thought of visiting my sick patient.

So. After a highly entertaining medical interviewing class, I exited the school from a side door. I got a little disoriented, and walked in the opposite direction from the train station. I hadn’t been looking forward to the train ride, which by necessity requires me to take my least favorite line, and go out of my way to connect with the line that can take me home. So, finding myself that much farther away from getting home, I gave up and summoned an Uber.

I’ve only recently started using apps like Uber. Alright, I won’t lie, it’s the only one I’ve used, and like, twice. It still amazes me. I clicked and almost instantly, my phone rang. Pietro (not a real name) was parked half a block away. (There are a gazillion hospitals in the area, and hence, there are oodles of cabbies and Ubers.) I hopped in, and off we went.

I buried my face in my phone, checking emails, answering some, reading someone’s blog post, et cetera. I admittedly was not paying attention to where we were. At some point, I looked up, and we were downtown, literally a couple of blocks from my hospital.

Now, this was clearly way, way out of the way and in the wrong direction from my home. The guy had driven due North, into the city, when I live South, out of the city. I was totally perplexed, and kind of worried. I mean, you hear stories about rogue Uber drivers with bad intentions.

Um, where are we going? I asked, trying not to sound panicky. This is kind of out of the way…

Pietro seemed genuinely surprised; I think he’d been as spaced out as I was. He was using an app called Waze, that’s kind of like GPS, but with traffic and construction taken into account. It’s supposed to find the fastest way around to anywhere. He double checked that he had the correct destination, and then, kind of embarrassed, he admitted that it was weird to be up where we were. Neither of us could figure out how on earth this would work, as we would have to get on the expressway, which certainly is anything but express at midday. We would have to go through the tunnel, a long, exhaust-fume-filled dark stretch that usually gives me migraines.

I could see my hospital up ahead. The thought of sitting in an Uber on the expressway (and paying for it) made me queasy. So I asked Pietro to let me off. He did, very apologetic: So sorry, so sorry.

And me, I walked to my office. I donned my long white coat over my jeans, and went and saw my sick patient in the ICU. I’m glad that I did, as she had some questions. So much of the primary care’s job is just translation and communication… She was appreciative of my explanations, and very grateful for the visit.  Since then, only 24 hours, alot has happened to her, and I’m thankful that we spoke beforehand.

When I got back to my desk, there was an urgent message from a complex patient. I called them back; it was a long phone conversation. I felt much better about calling them from my desk phone, for many reasons. If I had been at home, I would have delegated the call to my nurse, or postponed until Friday… As it turns out, that may not have gone over very well. I’m lucky that I took the call myself yesterday.

I also spent a couple of hours doing work, and I know that I got alot more done there than I would have at home. But really, the reason it was key for me to be there, in the office and in the hospital yesterday, was for those two patient interactions. That’s just the way it needed to be.

I ended up taking my usual train line home, and picking up the kids from Nana’s at the usual evening hour. I did not have even five minutes of personal time.

But it’s okay, because, everything happens for a reason…

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