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)

Why I changed my mind about Colin Kaepernick, and you should, too.

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I, as an individual, am as pretty WASP-y as you can get. I am white, middle class, Protestant, grew up mostly in the South, and come from a military family – my grandfather was in the Army, my brother was in the Marines, and I have 3 uncles who served in the Navy.  So, when I first heard about and subsequently saw Colin Kaepernick’s response to the National Anthem, it stung. 

Okay, I’m hedging. It more than stung. I thought it was disrespectful and I flat out disagreed with it. 

Yeah, yeah, my family members served to preserve his right of free speech, I get it. Now, I am not in any way going to condone his other choices, but I am going to specifically address his choice to kneel during the National Anthem. I thought what he was doing was wrong.

I now realize I am the one that was wrong, and here is why.

I have written previously regarding my feelings about the current state of our country, working alongside members of law enforcement every day, being married to a black man, and being the mother of two biracial boys. The current level of violence in this country, American citizen on American citizen, is nauseating. And we are scared – black, white, police, non-police. 

WE ARE SCARED. 

For each other, our neighbors, our friends, our husbands, our wives, our sons, our daughters. And we are letting that FEAR WIN. I have realized… even in 2016, we are still very much of country of “us” vs “them”.

I have listened to so many people talk about how Colin Kaepernick is being disrespectful by kneeling. Military, non-military, men, women…. but all mostly white. 

And that got me thinking. I started thinking about race relations in this country, and I started thinking about my own family, and my fears for my children. If I had something to say, once my children started driving and I began to pray for them to come home safely every night… not just in fear of a car accident, but in fear of them getting shot… How could I draw attention to it? How could I get my voice heard? How could I start a national conversation to actually help the situation, and make some progress?

So I had to ask myself, how do “we” (White America) want “them” (Black America) to protest? To show their fear? To demonstrate their pain? 

We complained in the 1960s with sit-ins and boycotts (“they are interrupting businesses”), we judge harshly with riots (“they are being violent”), and the church prayer meetings largely get ignored. So how, in this day and age, are we going to allow a population of people in the United States, the “land of the free” be heard? How are “we” going to allow “them” to start a conversation with “us”?

My guess is, Colin Kaepernick is scared for this country. I know I am. 

As a trauma surgeon, I am the one behind the scenes, with my hands covered in the blood of the injured. Their blood not only stains my skin, it stains my soul

The patients I have lost live forever in my mind. Enough blood has already been spilled onto our streets. With all the violence that is happening, why can’t we prioritize our feelings and support a non-violent means of expression? He is nonviolently expressing his fear, his anger over what is happening by kneeling. He’s not turning his back. He’s not burning anything. He isn’t breaking into a building, or throwing rocks at police. He is kneeling, which is still a position of respect. A man kneels to ask a woman to become his wife. People kneel to pray. And he is bringing attention to an issue that should be in all of our minds and on all of our hearts.

As Americans, regardless of race, we should be encouraging non-violent means of communication, and kneeling during our National Anthem, is one of them. I’m not saying everyone should sign up for the Colin Kaepernick fan club, but what I am saying is that we should stop focusing on the how of the protest and start focusing on the why of the protest. The only way for there to not be an “us” and “them” is to allow each other to not only speak, but also to be heard.  

So, White America, I encourage all of us to put on the hearing aids, and start listening.

If only we treated our parents like our pets – Death, Dying, and Dignity in America

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otis

Otis was our first baby. He was covered in a caramel colored fur, weighed 150 pounds and was the best Bullmastiff dog anyone could ask for. He protected me from my husband’s incessant tickle attacks and thought that my lap was the best place for him to try and sit.

Two years ago, I was walking Otis and he suddenly collapsed. After an extensive workup including an EKG, blood work and an ultrasound of his heart by the doggie Cardiologist (yes, they do exist), we started him on a new regimen of medications for his heart failure. It cost $300 a month but was worth every penny – almost overnight he was a new dog, back to his usual daily routine and enjoying all the activities he loved most in the world.

About a year later though, he started declining again. His favorite spot to sleep was on the floor, right next to my side of the bed. But our bedroom was upstairs, and he just couldn’t make it anymore. He had to sleep by himself. He couldn’t go on walks. He slowly but surely began to get left out of family activities, and for a dog who was as much a part of our family as a pet could be, this was life-altering. He couldn’t participate in any activity which had previously given him joy. He was becoming more and more isolated, becoming physically separated from the people he loved most in the world.

That’s when I knew – it was time to say goodbye. It still hurts, but I know it was the most unselfish and loving thing I could do – focus on him, his wants and his needs, instead of me and my own.

As a trauma and critical care surgeon, all too often I see families struggle in the intensive care unit with loved ones who have devastating diagnoses and injuries.

Now if only most of us treated our parents and loved ones as we do our pets – knowing and respecting their wishes, valuing the quality of their life over the quantity.

Granted, I never had to ask Otis what he enjoyed in life, what his priorities were or what kind of life he wanted to lead – it was pretty self-evident. Your loved ones are clearly more complicated than that, and that’s even more reason their wishes should be known. Do they want to be kept alive by machines with no hope of a recovery that would allow them to participate in their favorite activities? Or be able to participate in relationships with their family? Do they want you to try everything no matter what the outcome might be? If they cease to enjoy eating and can’t communicate anymore, do they want you to put a feeding tube in them? These are the types of questions and conversations that I implore you to ask and have with your family members – no matter their age, no matter how healthy they are at this very moment, because things can change for any of us… in an instant.

In situations like these, my role as the intensive care physician caring for your family member is to find out what HE or SHE would want if they could speak for him or herself, not what anyone else wants. But I’ll never know your loved one like you do. I don’t know what they value in life, what they hold most dear. That’s why I need YOU to help me help them live or even die in the manner they’d want. Because let me tell you, there are a lot of things I can “do”. But your job is to help me make sure I’m doing these things for your loved one, not to them. I’m not asking you to make a decision, I’m asking you to tell me more about them. You aren’t “turning off” any machines, you’re telling me what kind of life your loved one wants… or doesn’t want, and it’s my job to help make that happen to the best of my ability.

Many of you may already know the answers to these tough questions, but I know just as many of you may not. Nope, it’s not going to be a fun conversation. You’re not going to enjoy it. But don’t let your fear of the conversation prevent you from being able to speak for your loved one because they physically can’t. Don’t let your discomfort then put you in a situation whereby you’re not honoring your loved one’s wishes, simply because you don’t know how they’d want their life to end. The greatest sign of love is selflessness – be selfless enough to have the conversation. Be selfless enough to honor their wishes. And know, when the time comes, you’re showing your love in the most profound way possible.

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.

What makes you a #bettermother?

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Nope, not a better mother than your neighbor, than your friend, or than the president of your local PTA…but what makes you the best mother you can be?  Going even further than that… What makes you successful as a person?  As a human being?

 

John C. Maxwell defines “success” as:

“knowing your purpose in life,

growing to reach your maximum potential, and

sowing seeds that benefit others”.

 

Very recently I was approached by www.inspiringwomeninsurgery.com to provide some words of advice or encouragement, and while my 4 year old was brushing his teeth at night I thought about work/life “balance”, envisioned a set of scales, and came up with this.

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Why am I a #bettermother because I am a surgeon?  Because I know my purpose in life, I am growing and I am sowing seeds.  I know that this mother may be sad that I miss my son’s soccer practices, but I also know there are lots of other mothers out there that are glad I did… because I was able to help their children in their time of need.  And although my children may miss me at times, I know they also gain valuable lessons from my career – independence and selflessness chief among them.  My children always know that I love them, and they are important to me… whether I am sitting at their bedside, or at the bedside of one of my patients.

And no, you don’t have to be a trauma surgeon or work outside the home to be successful, or a #bettermother.  Again, look at the definition.  Nowhere in that definition does it mention spending every moment of every waking day with your child(ren).  It doesn’t mention making your child’s first birthday cake by hand, or becoming Vice President of a company.  Nor does it mention “leaning in” to the point that you are about to fall over.

YOU are at the center of your success, and you have to give back to yourself in order to be in a position to give to others – whether that is your spouse or your children or your community.

An example for you.  The wife of one of my partners volunteers with her daughters’ Girl Scout troop.  This makes her a #bettermother – not because she spends time in an activity that involves her own children, but because she gives of her time to an activity that gives many children joy when other mothers can’t.  Another friend is a #bettermother because she is a Crossfit addict… She is teaching her daughter that strong is beautiful, and physical health helps build emotional health.

Taking time in activities, away from your family, work related or not, that develop your sense of self, fulfill your purpose in life, and replenish your soul is not selfish.  In fact, it is essential to being a #bettermother and a successful human being.

So what makes you a #bettermother?  Is it the 30 minutes you spent exercising this morning?  Or is it the 2 hours over the weekend you took to train for a marathon?  Is it the overnight business trip in another city that allowed you to present a project that will better your company?  Is it the hours you spend volunteering at your child’s school because other mothers can’t?  Is it that extra time you took at the hospital treating a patient who needed you?  Is it the time you spend organizing a book club giving women the opportunity to fellowship with other women, building their support system?

Success doesn’t require a title, or a degree, or a paycheck.  It requires YOU being the best YOU possible.

So take that time to develop yourself, replenish yourself, fulfill your purpose.

Enjoy it.  Own it.  And snap a photo of yourself doing it.  To keep as a reminder – when you are coming home late, or have 18 loads of laundry piled up, or serve Cheerios for dinner for the umpteenth time that week, or in any way feeling like you are “failing”…that you are, indeed, not.

I am a #bettermother, and so are you.

 

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.

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The police lights flashed, and the 2012 Yukon Denali immediately pulled over.

The police officer got out, and began to walk to the vehicle.  As he approached the driver’s side of the vehicle, he saw the large black man behind the steering wheel and moved to put his hand on the butt of his gun.  The driver, sensing the change in dynamic, immediately shoved both hands out through the open window and called out it was okay for the officer to approach the car.

That “large black man” is my husband.

I was just featured in an article in Forbes, and I was chiding Americans for not discussing end of life topics with their loved ones just because it is uncomfortable.  However, I am ashamed to admit that I have fallen victim to this myself.  Dr. Brian Williams, a friend and colleague of mine, recently had an interview on CNN that reminded me of my own failure, because I have not addressed this aspect of my life before now.  And this was consciously done because I found it to be uncomfortable… But no more.

The situation occurring in America now can not tolerate any more non-discussion because the topic is “uncomfortable”… So here we go.

As a trauma surgeon, I have a wonderful and unique relationship with law enforcement. We work side by side, and a day never goes by without some interaction between myself and an officer or detective. We testify at trials and all too often we take care of them when they are injured. I treasure this relationship with the people who keep us safe. It is important to me, and one that I enjoy immensely. However, I know that I live in conflict.

I am married to an amazing man who has been my best friend for the past 16 years.  He happens to be black, and I happen to be white.  Although I know him to be the wonderful husband and father that he is, that he has so many accomplishments both from the football field and now in law school, I also know he is “just” a black man to the police.

I fear for him.  

Right after the shootings occurred in Dallas, I called him with tears in my eyes, and reminded him to be careful.  To make sure his tail lights always work.  To not go a single mile per hour over the speed limit.  To do everything in his power to prevent any encounter with law enforcement…  Because I know that his 6’6″ 300 pound frame makes people, and especially the police, nervous.

When we were in college together, I got sick with a terrible stomach flu, and he took me to the emergency department.  It was 3:00 in the morning because he was in 2 a days for football and we needed to get home before his early morning run.  Shortly after we arrived, another black man, approximately 5’10” and 160 pounds, entered the emergency department with blood on his face and shirt.  Two police officers entered the emergency department about 15 minutes later… One white, and one black.  The white officer beelined to my then boyfriend, now husband and began to question him, while the black officer watched.

Which leads me to my point… How can we make this better?  How can we prevent more innocent lives from being lost-  regardless of gender, race, or occupation? Because yes, All Lives Matter.

It has been a campaign in inner city communities “If you see something, say something”.  This is an effort to encourage community members to tell the police if they see illegal activity, to make their community better.

Well, quite frankly this movement needs to move across not only racial lines, but the Blue Line.  Police shootings should be investigated by an agency other than their own.  When a police officer sees another officer acting in an inappropriate way, or begin to question clearly the wrong black man, they need to be able to say something- to that officer, to their superior, whomever.

Far too many young black men fit an unfortunate stereotype.  We need to educate, provide opportunities and invest in their future so this stereotype no longer exists.

We need to engage each other… Black, white, law enforcement officer and civilian.  We need to have these difficult and uncomfortable conversations, and even more importantly as Dr. Williams so eloquently stated, we need to start Listening to each other, really listening.

I not only see, hear, and understand both sides of the coin, I live them.  I am in pain over the losses that our law enforcement agencies have suffered, as I view them all as friends and colleagues.  I relive in my mind my own patients that I could not save-law enforcement and civilian alike.

And I also fear for my husband.  I fear that one day he will get pulled over, and won’t come home to me.  We have got to start listening to one another, trying to view this situation from a perspective other than our own, and most of all…

The Shooting Has to Stop.

I am the proud mother of 2 boys, who are biracial.  My 4 year old looooves police cars.  Recently we were in Chicago, and these amazing CPD officers (thank you!) happily engaged my child who was so excited to see their vehicle.  They invited him to not only sit in the car, but to turn on the lights.  My son still, over a month later, talks about this day.

It breaks my heart that if things don’t change dramatically in our country, that I will one day have to tell him some things that will change his love for those flashing lights.

Although I have never posted any personal pictures on this page before, and certainly not of my children, I am going to change that today, for a reason.  I want to leave all of us with some hope, an image of innocence…

The image of a little boy in love with a police car.

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To my friends and colleagues in Dallas, to the victims and their families- my thoughts and prayers are with you.

Now, let’s all get uncomfortable, and change the conversation.