New Year Baggage (Vol 1) 

Heading out for the Disney marathon trip today (more on that soon – if I survive!) and amidst my combination of fear and excitement is the joy of debuting two new travel bags. I travel a lot and have been wanting more reliable and still stylish options for both a medium hall trip (think 3-5 days of work clothes, workout gear, and evening casual or black tie options) and a long weekend getaway (inclusive of noodling around clothes, at least one running get up, and an out on the town outfit). I will confess the latter are for date weekends/race weekends which I don’t do enough of but hey…Anyway, the point is these bags are in general for separate purposes. 

This particular trip, however, combines a race weekend, a family Disney mini trip, and a 4 day conference with multiple evening outfit changes. So, my pre-race energy was amped by the joy of putting BOTH new bags to use. 

So here is my new 26 in Tumi Larkin (accompanied by the Lo & Sons OMG

Here are some views from the manufacturer. 


To be sure, it is a heavy suitcase compared to many others on the market of this size. Without my stuff it checks in at 17lbs. But the design is gorgeous and construction is durable. The interior is split into a suited side (I fit 3 work appropriate dresses, spanx, and 2 pairs of heels on that side) and a larger compartment with two side zip compartments and a 3 pouch (one basic, on velvet lines, and one waterproof) carrier with a hook that doubles as the compression strap. The wheels are really smooth and allow for unencumbered 4 way motion. It also expands via solid brackets in the middle of the bag so no tipping over when expanded (but there is no way I would be able to do that and stay under 50lbs). Of course, it’s all backed by Tumi’s warranty and much lauded customer service. 

This is an investment piece. I especially love the gold tone hardware that is stylish but not gaudy. I am looking  forward to many trips for years to come with this medium haul suitcase. 

[See Volume 2 for my weekender duffel.]

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To ring in the new year!

We decided to throw a last minute holiday event recently mostly owing to the fact that I had a blazer and shoes that NEEDED to be worn. This a a ball drop outfit to be sure, especially the heels. Happy New Year! 
Blazer: Rebecca Minkoff Silk with Sequined shawl collar (Nordstrom Rack)

Top: Pleione tuxedo ruffle sleeveless blouse (Nordstrom) 

Pants: St John Tuxedo pants Knit with leather (Nordstrom)

Shoes: Michael Kors Leather platform sandels with vero cuoio sole and bedazzled heels (Nordstrom Rack)

Trauma Surgeon’s Ballad by Lin Manuel Miranda

Like much of America, my family is currently obsessed with everything Hamilton on Broadway. We jammed to the sound track all summer. The season culminated with a late August trip to the show which I described on social media as the best day of my life. Seeing the show, the actors, the set, and choreography, come to life with lyrics we had all memorized was such an amazing experience.


I cried.

Part of that was pinching myself that it was actually happening (NB: Tickets now that the original cast is gone are not that hard to find on resale sites but still cost quite a bit above face value.) And the other parts were one particular segment that just cut into my soul when I saw the character of Aaron Burr singing it.

I sobbed.

Let me provide you context. Burr is an orphan who is in love with a married woman. He has decided that with everything he has gone through, all of the losses he has suffered, he is willing “to wait” for the woman he loves. As someone who was taught to hate Burr by her high school history teacher who was a Hamilton scholar, this humanization of Aaron Burr was a bit off-putting at first. But the reason I simply could not stop the tears while experiencing the song with all of my senses as the show was not about the forbidden love story behind it, rather is was the commentary on death.

“Death doesn’t discriminate

between the sinners

and the saints,

it takes and it takes and it takes

and we keep living anyway.

We rise and we fall

and we break

and we make our mistakes.”

These words resonate so strongly with my trauma surgeon’s soul. We provide care indiscriminately, irrespective of race, socio-economic status, mechanism of injury, insurance, etc. And we lose people. Sometimes they arrive lifeless; sometimes our efforts fail. When that happens we are broken. We wonder if we could have done anything differently; did we make a mistake? But we have to go on “living” because there are more patients waiting. Some of them are sinners while others are saints and it doesn’t matter we treat them all the same. Then we wait for the next patient to arrive.

The title of the song is Wait for It.

The Hamilton sound track is still more or less played in a continuous loop in my home, in our cars, on my runs. And every time I hear this song I cry. I can’t help it. It simultaneously breaks my heart for all my patients who have died and provides me reason to keep coming back to this very emotionally challenging and physically exhausting profession. I know it was not Lin Manuel Miranda intent to write this segment of music (the lyrics and the accompaniment which is haunting) for the trauma surgeon in me but that has been it’s effect and I am so grateful.

And as for the burnout that is particularly rampant in my specialty, despite the tears from this particular song, the overall experience of seeing the show on Broadway was truly one of the happiest days of my life – a perfect way to spend a weekend off and return to work refreshed and ready to wait for it

The Brand that Made Me Wear Flats to a Wedding

Ordinarily, I relish dressy occasions to ditch the scrubs and clogs in favor of a cute dress and a pair of my coveted heels. While I have a number of very comfortable heels, at the end of the day they are still heels forcing me to maintain a high half toe for a long time, often with my toes pushed together. So I have opted to spend the rest of the fall as much as possible in flats as a torture my toes regularly to train for a marathon (more on that someday if I survive!). 

I invested in a pair of black Tieks (size 7; they only offer half sizes and I am a consistent 71/2) last May and grew to love them as my back up flats when a long day on heels wore me down. But at the end of the day, if I wore those for too long my toes screamed bloody murder, just like after a very long run even in appropriately sized sneakers. So recently as I went head-on into my flats mission I got another pair of Tieks, this time in size 8. Fit like a glove crafted from a baby’s bottom the first time around and voila today I wore my new ruby red pair to a wedding feeling totally fashionable. Tieks for the win! 

Here are some overly lit pics on this very sunny, perfect day for a wedding, day. 

  
    
 

There is much internet lore from women obsessed with their Tieks and I confess I might be going over to the flats dark side here. These are the most comfortable shoes (at least for my feet when sized correctly). I simultaneously ordered taupe (pictured below) and wore them for 12 hour days four days straight and hit the stadium seats for the Adele concert with them. No aches. No pains. No blisters. No break in needed. My first pair of ruby red had distractingly different crinkle (for OCD me anyway) between the right and left shoes so I exchanged them. As long as not worn outdoors, Tieks has a great return or exchange policy and they will even send a second pair to compare without charging you. Shipping in both directions is free. The packaging is totally cute and always arrives with a hand written note (I am a sucker for good customer service!) along with a pouch to hold the flats in their very compact form and a bag for your heels should you choose to use your Tieks as a heel back up. As a fan of bright hues, I am obsessed with the plethora of colors the flats come in. But for now I have red, taupe, and just ordered black in size 8.

As always, while I would relish a new pair of heels or flats for free, unless clearly stated my reviews of my own purchases as in the case of all the Tieks cited in this post. Tieks can only be ordered online at tieks.com and sadly as far as I can tell they never go on sale. But I do believe they are well worth the investment. 

  

Hero

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Cross-posting from the heenastat blog.


 

A colleague of mine was recently questioning her capabilities having lost yet another patient who had arrived nearly lifeless after being shot.  She was despondent over the nation’s overall complacency about our gun violence epidemic giving her far too many opportunities to fail or succeed as a trauma surgeon. Truthfully, neither quick decisive action nor expert surgical skill was enough to repair that much damage. Not in the hands of any trauma surgeon.

As trauma surgeons we bring everything we have–every ounce of energy and drive, countless years of specialized training, and an ever expanding armamentarium of medical technology to fix broken bodies–to our work but sometimes we simply feel like failures, both unable to save our patients and unable to move the dial on policies that might ameliorate gun violence.

Here are the words of support that I offered to my friend: a compassionate, highly skilled trauma surgeon who without hesitation took a hemorrhaging gun shot wound victim to the OR to try to save his life:

“The grief is understandable. For your patients. For your community. For our society. You have a skill set that makes you brave enough to even try, my friend. As a trauma surgeon when you hear audible hemorrhage you run toward it, just like the police run into the gunfire or the firefighters run into the flames. Each and every patient is lucky to have you and your strength; their families will be grateful for your efforts and empathy no matter the outcome. Don’t be too hard on your self.”

Having been raised in a culture of morbidity & mortality conferences where we scrutinize every decision and every action preceding a death or complication, having a chosen specialty whose goal is to salvage badly damaged bodies, and living in a world where these patients keep appearing in our trauma bays even when we speak up about gun violence, this self-doubt is common among us.

But sometimes we just needed to be reminded we are heroes who have chosen to run toward the audible bleeding so we can get up and go back to work the next day.

The Dignity of Pants

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Cross-posting from the heenastat blog.


 

“Please don’t cut off my pants,” he pleaded. “I am homeless and they are my only pants. Please.”

He could say these words as we were conducting our initial assessment in the trauma bay so at least he was hemodynamically stable with an intact airway at that moment in time. However, he had arrived seconds earlier with potentially life threatening injuries as a level 1 trauma activation. Based on the location of wounds that were visible on his torso this was a real possibility so we needed to quickly conduct our secondary assessment. That meant rapid exposure by taking the trauma shears, one on each pant leg from my assistants, as we examined him from head to toe, front to back, in every crevice or crease that might hide a wound.

I looked him straight in the eye and said “Don’t worry. We will get you a pair of pants but right now we have to take care of you.”

Straight in the eye.

He relented. How could he not? The pants were already cut off even as I made eye contact. The process takes just seconds in the hands of a coordinated trauma team.

He was a very polite young man. He didn’t yell or kick or scream. He followed all of our instructions. He quietly told us his health, social, and family history. He told us he was scared. His life story mirrored that of many of our trauma patients: food insecurity, lack of affordable housing, few resources for education and job training, addiction, interpersonal violence, an endless vicious cycle. He was caught in that cycle and it was obvious that he was heartbroken to be there. He wanted a better life and tonight in the trauma bay, without his pants, he had failed once again to break it.

I always say that I was attracted to a career in trauma surgery because I am part surgeon and part social worker. In reality neither I nor the social worker employed by my hospital to help patients in need of socioeconomic support have much to offer our patients with these very real struggles. The policy level changes and investments that would bring grocery options, better schools, safe and affordable housing to our most underserved areas are not in our control. Even for those patients who want to make a change there are too few addiction treatment beds and job training programs. While these issues are clearly predictors of health, they are managed partly (addiction services) or entirely (basically everything else) outside of the healthcare system.

Yet every day we see the ravaging effects of socioeconomic insecurity on our population’s safety and well-being when they become our patients. We open the trauma bay doors and provide the full armamentarium of modern medicine to save a life acutely while feeling powerless to save lives at the societal level*.

We finished examining and working up our patient. He was not going to die that night and could be discharged. Discharged where? It was 3 in the morning. The social worker could give him the address of a shelter in town. There might be a bunk free. She could refer him to addiction treatment. There might be an available bed. A local non-profit might intervene in the light of day if we could make the connection.  But we had no way to guarantee that this man, who was lucky to be alive, would not simply just slip back into his otherwise unlucky life after discharge.

Oh, and there weren’t even any pants to give him. The social worker’s closet of donation was empty of men’s pants it turns out**.

This was not something the trauma team to could bear. We might not be able to provide our patient with better groceries, housing, or addiction treatment to this man who in all of his words and actions as our trauma patient showed us a deep hope to be in a better place in life; but the least we could do is provide him the dignity of a pair of pants to head back into his unfair reality.

So we pooled our cash on hand, asked him what size he wore, and waited until the local Target and Kohl’s opened***. The next morning the light in his face and the sincere words of gratitude when he saw his new jeans and a back up pair of track pants and shorts felt like as much of an accomplishment as stabilizing the unstable patients who had entered the trauma bay earlier or the exploratory laparatomy we had done.

“Thank you. Thank you. Thank you,” he said. “I really need these. Thank you.”

He needs so much more. But this was the least we could do.


*NB: Most trauma centers do provide targeted injury prevention like helmet, seat belt, or firearms safety education through small investments or grant funding but these typically address to specific injury mechanisms rather than social policy.
**Men be like the ladies and cull your closets seasonally; donate to your local trauma center.
***If any Kohl’s or Target folks are reading this consider donating items or gift cards to your local trauma center.

Defining “Mommy Friendly”

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I had a familiar conversation the other day with yet another female medical student.

“I really loved surgery!” she said, “but I was concerned about the lifestyle so I decided on _______________.” 

Lifestyle, it turns out, almost always seems to be code for having a family (maybe it’s just the kind of students who are apt to seek me out as I have yet to encounter someone who is concerned that a surgical career will hamper their aspirations to compete in triathlons or become national fencing champions or write books for the general masses–I personally know surgeons who manage to work full time and do all of these).

The other day, I came across yet anther discussion board on what advice to give to women in search of “mommy friendly” medical specialties. There were lots and lots of suggestions, some were full time jobs with predictable hours and others were part-time jobs but not one of the suggestions was a surgical subspecialty. 

Not. A. Single. One.

Sigh. This makes me sad for my chosen specialty and for all the promising young women who will not go on to realize their potential as amazing surgeons.

I would be lying if I said that surgery is lifestyle friendly. In fact, anyone who has followed this blog for more than a millisecond knows that many of our daily woes outside of work arise from the demanding hours and high stress of our career choice. But the question is: What does mommy friendly even mean? This is not the same as the “mother’s hours” often noted as selling points in help wanted ads. There may be ways to go really part-time or certain very specific specialties that enable a woman to only have to be at work when her kids are at school I suppose. But I have to believe that mommy friendly is about more than just the hours.

I know, I know. You are just waiting for me to launch into the cliche of it’s quality, not quantity. But I won’t. 

Because the truth is I wrote all the words above nearly 500 days ago. It turns out I never finished because I don’t know what mommy friendly means when it’s used as an adjective for a career. 

Since I first wrote the beginning of this blog post, I have spent well over a year of my life as a surgeon and a mother. I even wrote an open letter to young women with the same opening line evidently having forgotten about this draft. That letter, now read more than 15 thousand times, doesn’t define mommy friendly either.  

Paid maternity leave. Private pumping rooms. Childcare. A promotion clock that doesn’t penalize for maternity leaves. 

To be sure any work place can provide these but do the amenities in and of themselves mean the associated profession is mommy friendly? Not if the backhanded comments or outright displays of resent persist. Often, the culture of the profession is at odds with these progressive work place policies. And these replies on what medical career to choose clearly indicate that the culture of medicine has not caught up to modern times. 

Luckily, however, not every one is reading the same message board. And so this week across the country a whole new crop of women begin training as surgeons. They are less a minority and more just reflective of the demographic of modern surgery. Hopefully, they will all become surgeons (there is still some attrition in our programs nationally) and some will become mothers. And my hope is that, together with the men they are training with, they will foster a culture in which is it no longer necessary to ask if surgery is a mommy friendly. 

Liza & Stu: A fit & flare romance 

This past week was filled with glorious days and fun events. To celebrate I paired a series of Eliza J dresses with Stuart Wietzman shoes. The social media fanfare was so robust that I carried it forward into the work week. These were the results.  And also dresses with pockets are absolutely sublime. 

  

 

  

 
And for a few close ups of the shoes:

   
    
 

Here’s to all the Lead Parents, the co-Parents, and the Village it takes to Raise a Child.

I get the working mom dilemma. I am a mother and I work the hourly equivalent of 3 full time jobs. I get it. It’s hard to do it all. And sometimes the tasks involved in either or both are just not that much fun. Though I have never been a stay at home mom I suppose this is why many call this the hardest “job” of them all.  It’s not all coos and snuggles. Parenting can be onerous.

But every time I hear a working mom athem or a stay-at-home mom  anthem I feel sad for everyone who is left out, or worse, by implication, accused of not being able to or interested in parenting. As far as I can tell, other than gestating and breastfeeding, men can do every bit of parenting – the good and the bad, the fun and the tasking, the easy and the hard – that women can. And, just ask any adoptive mom or mom through surrogacy or step-mom and she’ll  probably tell you that those to bio/physiological processes aren’t requisite either. 

To be sure,  I too am guilty of getting caught up in the mob mentality of the “moms have the hardest job in world” even though my husband does the vast majority of parenting in our household.

But, it’s 2016.

We do nothing but reinforce old stereotypes about gender roles with tales of the plights of moms. These are plights shared by all parents. Single parents. Gay parents. Heterosexual parents. Widowed parents. Each person’s role in the day to day tasks of parenting will vary. Sure there are deadbeat dads (and moms!) out there and, without congratulating them on their parenting failures, let’s just agree that the definition of an involved parent will vary based on a number of complex, overlapping factors ranging from natural affinity for children to income potential.

I understand that statistically the bulk of childrearing in our society is provided by women. Social norms, cultural discourse, and possibly some biology are at play in determining this statistic. But, as a woman whose children have been well-reared by a devoted lead parent (who happens to be my male heterosexual partner), four healthy-able bodied grandparents, and a neighborhood of friends who I trust to nurture and admonish my children, it just makes me cringe when a mixed audience of dedicated parents is subjected to a “The Hardest Job is Being a Mom” mantra.

Parenting is hard no matter who does the parenting. It’s also filled with incomparable joys. So hats of to to all the lead parents, to the co-parents, to the moms and the dads, and to the various villages who are doing their best amidst the ups and downs to raise a child in our modern world.

Here is my village.