Healthy Stress- Busting

This was my first full week back at work after a glorious two- week vacation. It’s summer and the schedule’s been light, but there’s still lab results and paperwork to catch up with. And, we had the orientation for the first year medical  student interviewing and communications skills course I help teach. 

So when my Thursday home with the kids rolled around, I felt guilty. 

And, the news. Lord, the news. Horror after horror, heaps of hate and ignorance and violence, and I’m not only referring to the Republican National Convention. 

We protect our kids from the news nowadays. We also want to model for them how to manage stress and anxiety, how to clear the mind of noxious thoughts and negative emotions. They’re going to need those skills. 

And so we headed to a nearby bike trail for some scientifically sound, evidence- based, free and effective medical treatment. 

These kids blew me away. They are essentially novice bicyclists (these “real” bikes are brand- spanking new). It was 88 degrees and sunny, and they had never ridden bikes for more a few blocks. 

They biked a total of 4.5 miles! Midway, there’s a wonderful little watering hole, a fountain park for little ones to run through and cool off. They scooted joyfully in and out of water shoots laughing, so happy, rejuvenated. 

How I SO wanted to scoot through the shoots too (I ran alongside them as they rode). But just watching them,  I felt so much better, knowing we were doing the exactly right thing for a Thursday in July in the world today. 

Beach Inertia


It took a full week of vacation before I was really on vacation. C’mon, I’m not the only working zombie on the beach who just keeps chugging through emails, logging into the office, adding my two cents’ worth here and there, unable to just let it go, dammit…. Die, working zombie, die!

But seven days in, when my most complex patient was well tucked in to her new oncology bed (handed off to a solid team), and there were no more acute results or possible surprises (like, a few days in, whoops! positive urine culture!) and my opinion on anything just didn’t seem to matter so much, I actually started to relax.

Damn that news app on my iPhone, though. Horror after horror, another mass shooting, another terror attack, hatred and racism and extremism… It’s all very important and there is so much to SAY.

But even with days and days off, even with each news story creating emotion and opinion and ideas inside me, I could not write even one word about it.

Like that dream we all have when we’re running but our legs feel heavy and jellylike, and we can’t actually get anywhere, I just haven’t been able to write. I’m calling it beach inertia, a dreamlike state where one is aware of events, and knows logically what one must do, but any attempt to do so requires painful, massive effort yet yields no result, and so one reaches for that last chilled seltzer in the cooler bag instead.

Of course the days have been filled to the brim with the kids. Let’s face it, when you are one of two adults in charge of two young children, vacation is in quotation marks. But truly there was time, a lot of time where I could have cradled my laptop in the hammock or after dark, and I did not.

Back to work and the grind tomorrow, and I expect a relapse of the writing virus as well.



*This photo was taken at Skaket Beach, in Orleans, MA, at low tide.

Creature Beach


This past week has been chock full of Cape-Coddy type adventures, but the favorite so far is the salt marsh beach down the street. Just as Babyboy’s anticipatory book predicted, there are many creatures at this beach. Give each kid a net and they’re off for hours of creepy crawly wiggly squiggly fun, even in a light rain. The only doctor take I have on this is my anxiety secondary to the large sign posted at the march which states “No swimming zone: High bacteria count”. So, what does that mean? No face in the water? There are a hundred small children with nets and buckets roaming the march, families kayaking, babies splashing.

The kids are having such a blast, I shrug and make them use hand sanitizer prior to eating any snacks…

We’re Going To The Beach!

The kids love, love, love the beach. This weekend, we’re going to the beach, and they’re like little soda pop bottles of anticipation, fizzing over with joyful excitement…

Babyboy writes simple books when he wants to express things, and he disappeared this afternoon to create this little gem, which he proudly presented to us as his “plan” for the week:

“At the Beach, by Gio”

“Crabs are at the beach”

“Fish are at the beach”

“Dolphins are at the beach”

“Have fun at the beach”

“The End”

0.88 Miles

Friday morning, 6:20 a.m. I was standing on the train in my favorite spot, leaning against the back wall while holding my coffee mug and staring at my smartphone. At Park Street, one stop away from the hospital station, the train lurched and halted and the crackly voice over the loudspeaker announced,

“Due to a malfunctioning signal this train will not be proceeding. All passengers please disembark here. There will be shuttle buses lined up on the street continuing to Charles/ MGH and beyond. Please disembark as there is another full train directly behind us.”

Our car was packed with folks in scrubs or professional clothing, all, like  me, bound for the huge hospital complex where we worked. There were mumbles and groans, and then hundreds of us poured out of the train and onto the platform.

“Hi, Dr. Tello!” I heard, and turned around to see a colleague who was also making their way through the crowd. We joked for a minute and then, when there was a choice between the stairs and the escalator, I chose the former and they chose the latter. Very few people were trudging up the stairs with me, while a glob of humanity bottlenecked at the bottom of the escalator.

At the top, through the glass doors of the station, I could see thick lines of hundreds of commuters awaiting the shuttle buses. Apparently, ours had not been the first train halted at Park street.

It was clear that even after waiting for a spot on a bus, the ride would not be a quick one, as each bus would then have to wend its way through the early morning rush-hour-clogged crazy streets of Boston.

Meantime, it is less than a mile walk to the hospital from Park street, a beautiful walk through the Boston Common (well-tended city green) and then down the antique red-brick sidewalk of hoity-toity Charles street, past cafes and shops, many that are open for business at that hour, selling overpriced french pastries and such.

Here it is, June, and it was already a pleasant 70 degrees and sunny. Perfect walking weather.

I naturally assumed that a healthy handful of folks would choose to walk the relatively short and safe distance, rather than wait in exhaust-fume-contaminated lines with all the crowds, only to sit on a crowded bus for a frustratingly long ride.

But as I veered off through the Common, I looked around, and:

No one. Maybe one or two other walkers in the distance, hard to say if they had also been kicked off the trains.

Basically, I walked alone in complete peace, past the gorgeous brownstones and ivy gardens of Beacon Hill. There was more noise from the birds in the trees than from other people. On Charles street, the smell of roast coffee beans and baking breads (croissants maybe?) was both distracting and enjoyable. There were dog-walkers and joggers and shopkeepers sweeping their sidewalks. The entire distance measured 0.88 miles on my pedometer.

“Geez, I should do this every day!” I thought to myself.

Less than a mile. A short, pleasant, safe city walk. On a perfect early summer day. And hundreds of my fellow commuters chose the shuttle buses instead.

Of course, some folks can’t comfortably walk that far due to pregnancy or injuries or health issues. And, maybe many people didn’t realize how close we actually were, or didn’t know the route.

But seriously, there had to be others among the morning masses bound for the hospital who could have walked. So, why was I the only one walking?

For the same reason that there was a bottleneck at the station escalator, which was right next to the wide open stairs. And crowds awaiting the cramped elevators in my building, when the staircase is clearly marked and inviting, bright with sunlight from the floor-to-ceiling glass windows. And people at the grocery checkout with a handful of small items in a push-cart, when there are ample carry baskets available at the entry. And road rage to nab the closest parking space, when walking a little extra distance can burn a few extra calories.

These small, unhealthy choices are what put pounds on, weaken the core and sap our energy levels. Fitness is a choice, and all of these small, seemingly insignificant moments in our day add up over the course of our lives.

Choose fitness!


Doctor Parties*

And I’m not only talking about cocktail parties.

Recently, a small group of us primary care docs were talking politics. The Orlando shooting has our hackles up through the roof. It boggles our collective physician minds that such an obvious and proven public health hazard as semiautomatic weapons cannot be legislated by our paralyzed government; that the overwhelming evidence in support of gun control provided by the rest of the developed and civilized world is being overtly ignored; that the selfish views of a few are allowed to put the rest of us in danger…

As we lamented the ideological gridlock in our government, and even more so the bizarre, ridiculous, laughable Republican presidential candidate, we realized that someone in the back of the room had quietly gotten up and left.

“Oh,” one of us whispered. “I think she may be a Republican.”

“No!” we all gasped.

As it turns out, it was just a nasty rumor. But it got me thinking…

It is very difficult for me to imagine that anyone who has dedicated their lives to the healing of other human beings, who has achieved the highest levels of education and endured years of exhausting training, and who regularly interacts with the sick and suffering, could possibly agree with or support many of the views espoused by the right.

I don’t get it.

So I researched it. Who among us physicians leans conservative?

This graph popped right up:

Political leanings of physicians, by medical specialty and income.

This data was compiled by Crowdpac (independent and non-partisan resource for American policy change) and originally published in a 2015 article by Greg Dworkin.

Look at the trend:

All specialties that make lots of money, i.e. mostly surgical subspecialties, lean politically right.

All specialties that make the least amount of money, i.e. mostly primary care and pediatric specialties, lean politically left. (**I am aware the “least amount of money” is a relative term. These incomes are substantially higher than what the majority of Americans are able to earn. I am thankful for what I have, and recognize that it is far more than most.)

This data is fascinating. What explains it?

Do conservative medical trainees veer towards the higher-paying careers, while bleeding-heart liberal ones choose with their… bleeding hearts?

I doubt any of us primary care docs say, “Hey, I never wanted to make a ton of money, so I’ll just choose from amongst the lowest-paying of all the different doctor things I can do.”

And I knew going into this what I was in for, as far as income. I was an honors medical student, and a few of my mentors openly grimaced or even warned me away from primary care, citing things like, “It’ll take you forever to pay off your loans!” or “Why would you choose that, when you could choose anything?”

At the time, it just felt like primary care was addressing the root cause of most medical problems, really getting to the nitty-gritty, and addressing the “whole person”, not just an organ or a body part. It made more sense to me. It still does. (And yes, it will take me forever to pay off my med school loans.)

But I would also hope that no one says, “I’m going for orthopedic surgery so I can make TONS of money.” I would rather believe that these folks have a real driving passion for surgery, and it’s just coincidental that they also enjoy the higher incomes.

But then, what explains the consistent conservative leaning of all of the higher-paying specialties?

I don’t have the answers here, but I find the whole thing very interesting, and I invite hypotheses/ commentary.


*I usually refrain from political rants. However, in light of recent events, I. Just. Can’t.

I Want My Kids To Be The Guys On The Bikes

I used to keep the car radio tuned to the local news station all the time. Then, the kids started hearing and understanding the inevitable grim reports about mass shootings and terror attacks etc. and they’d ask, “Mom, did the announcer just say that people were shot and died? Did people really die?”

Now, we listen to inane pop music. Worse, I’m starting to like it.

I would love to listen to the news and discuss these important world events with my kids. But the fact is, at four and six years old, they are not only too young to understand very much, but they are also vulnerable to be traumatized. Pediatricians advise parents to take great care when exposing children to words and images of violence.

Of course, bad things happen, and we can’t protect them from everything. In our family, the greatest loss they have experienced was the death of their beloved cat Raffy; Babyboy still cries about it. The American Academy of Pediatrics has a wonderful guide for how to help children cope with death and disaster , and for the little ones, they advocate sharing only what is necessary, and keeping it really simple.

But while I don’t plan on openly discussing mass shootings, hate crimes, domestic violence, rape, and terrorism with them anytime soon, I still want to address these issues. And we try, every day, by preparing them to face these challenges in the future.

Basically, we’re trying to raise these kids with the firm moral values, resilience, and character that they will need to survive, thrive, and lead in a world full of mass shootings, hate crimes, domestic violence, rape, and terrorism.

Yes, survive, thrive, and lead. Lead by example, and with conviction.

For example: the one overwhelming thought I had about the horrifying Stanford rape case was: God, of course I pray that my kids are never victims nor rapists; but I especially pray that they ARE the kids on the bicycles, who stop and do the right thing.  (It was two randomly passing guys on bikes who saw the rape in progress and intervened, even chasing down the perpetrator, tackling him, and holding him down until the police arrived. They are real heroes.)

And so we try to raise our kids to be adults who know right from wrong, and are not afraid to stand up for a cause, and for the truth. We try, every day, in a million small ways, and then we worry that it’s not enough or that we’re screwing it up.

It helps us to be better people, knowing that the most powerful childrearing thing we can do is model who we want our children to become. Do we slip up? Hell, yeah.

But we keep trying. Because the world needs more people like the guys on the bikes.