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My Grandfather Was An Immigrant–Embracing Diversity

“The bosom of America is open to receive not only the Opulent and respected Stranger, but the oppressed and persecuted of all Nations and Religions; whom we shall welcome to a participation of all our rights and privileges…”
–George Washington

 

My grandfather moved to the United States when he was 15. He was seeking a better life, and when he got here, lied about his age to enter the army. Eventually, he met my grandmother and they settled down in a small town in central Washington. One of his most proud accomplishments was sending all of his six children to college.

In my own personal experience, my family moved to the island of Oahu in the state of Hawaii when I was 8. We moved from a small town in Idaho when my father, a Presbyterian minister, got a job at a church in Honolulu.

You would think that the cultural change was massive. It was, for my parents, but for my 8-year old self, I remember landing at the airport and being met by people who put more leis on our family than our shoulders could accommodate. I remember staying in a hotel, I remember that our first rental house had a stream running through it with a bridge over, and I remember that the kids at school didn’t wear shoes. I didn’t want to wear shoes either. The warm weather was a nice change, and I loved wearing shorts during the holidays. By the time my birthday arrived, I had made enough friends for a small party. I recall my parents commenting that there were no Caucasian (haole) girls at my party. I dismissed the comment, there was only one other haole girl in my class, and I didn’t really like her.

Growing up in this uncommon mixture of cultures and being forced to do so at the age I was has forever changed how I think about diversity. How I perceive our differences, and how important it is to have the child-like innocence of being oblivious to the differences of culture and skin. I tried seaweed for the first tine not long after we moved there. I thought it was gross. But when all of my friends were eating seaweed and rice together in musubi—I learned quickly to like it. I even began taking my shoes off when I got to school.

Life changed when middle school started, and we and my classmates graduated to a much larger school. I was twelve. All of a sudden, things were different. My best friend from elementary school stopped talking to me. We were in different classes, but her skin color was darker, and she was also born on the island. She was way more interesting and cool than I would ever be. Suddenly I wasn’t worth her time. My skin color became a liability. At the time I would have done anything to not be white, which also equated to boring.

We moved back to the mainland right before I started my freshman year of high school to St. Louis, Missouri. This time, I did experience culture shock. We entered a largely white town, whose high school had inner city African American students bussed in, still apart of the desegregation efforts implemented in 1954. I struggled to understand the divide, why when you went into the lunch room it looked as though someone had drawn an invisible line, keeping the kids who grew up in different parts of town, and had different skin colors, separate.

I now live in Seattle, which is more culturally diverse than St. Louis, less than Hawaii. I believe it was my formative years in the islands that shaped me. I feel fortunate that although I know I still have my own implicit biases, I am as not susceptible to the fear many have developed around immigrants. I think diversity is vital to our society, it helps us to be kinder and more compassionate. It helps us to be forced to put ourselves in someone else’s shoes, to try to see the world from their perspective.

In thinking about diversity and immigration and where I live, I realized that I rely on a lot of immigrant women to help make my life better. I need them, and it would be so tragic if they were not in my life.

I have Isabel, my Chinese masseuse who helped me when I was trying to get pregnant to ease my mind, but also relieve my stress. I have Nancy, my Vietnamese nail manicurist who invariably always asks me how my mother is doing, even though the last time she came in with me was over a year ago. Raj, an immigrant from India who owns the wax salon I go to, always shows me pictures of her daughter, who has about 10 times as much hair as my son!! Then there is my tailor, who is an immigrant from the Philippines, who I hadn’t seen in a few years, but when I brought her my latest request, she insisted I bring my son when I came to pick the item up because she really wanted to meet him. I think I probably unconsciously chose these women to be in my life, possibly because of our differences or maybe they just felt trustworthy.

They are all excellent at the jobs they do, and I know my life would be less rich without them.

We need as a society to reject this narrative of ‘otherness,’ that because someone was born in a different country, or may have a different color of skin or religion, they are dangerous or ‘less than,’ or not deserving. We should instead be embracing the mindset of our forefathers, that America was made for you, and for me, that it is a place where those seeking asylum can rest.

We are fortunate to live in a country where we are free. I am enjoying my freedoms, but I know I didn’t do anything special to deserve them. I am fortunate that my grandfather made a choice to leave his country and settle here. It was luck that he came and was able to make a life. We have to embrace our inner empathy. We are all just people, after all, trying to keep ourselves and our children safe, and that when we show each other love and compassion, we all benefit.

What I am truly afraid of is the hate that we are sowing. I am afraid of unrestricted gun access that could hurt me in my place of employment or my children when they are old enough to go to school. I’m afraid of the rhetoric that has consumed our society declaring people seeking refuge as ‘dangerous’ and family separations as acceptable. I am scared that one day my cute, silly, fun-loving son will treat another person with hatred due to the color of their skin. Those are the things we all should be very afraid of.

After all, most of our ancestors were immigrants at one time.

Please vote. And if you can, try to imagine what it must be like to travel far and long in order to try and make a life in another country, because the one you were born into is too dangerous. Try to find compassion for those who are different than you.

Saying Goodbye To Camp

“I’ve heard it said that you can leave camp, but camp never really leaves you.”
–Paul Newman

Camp Korey’s summer season ended just last week. With it also ended my tenure leading their medical program. It has been a truly bittersweet ending, as I will miss the long hard days of making kids laugh into the evening, while also ensuring they receive the safe medical care they need. But having small children and running a time and emotionally-intensive summer medical program is untenable for me at this moment in my life.

My time at camp will forever have a very special place in my heart, as will all of the friends I have made along the way. I am a better doctor and a more compassionate human being for spending my summers there. I also learned a few things that I will never forget.

1. Put away your ‘cool’ card
You know, that thing in your back pocket that tells you not to be silly? I know, we all want to ‘not look stupid,’ and make sure that we are ‘mature’ with our doctor title, but camp is the place to let it go. To not worry what other people think. There is too much judgement in society.

The kids at camp are suffocating from judgment, they are the kids who are different, and all they want is to be themselves and be accepted. It is not surprising that children model how adults behave. So at camp, it is vitally important for us to wear funny hats, cheer as loud as we can, and dance as if no one is watching. At camp, no one cares whether you can dance… what matters is that you are dancing, having fun, singing and throwing spaghetti during Silly-O (a massive food fight).

2. Everyone needs a place that feels like home
Remember the theme song to Cheers, “You wanna be where everybody knows your name…?”
Most of the kids that come to camp don’t have places that feel safe to them. As I mentioned earlier, there is a lot of judgement in the world. If you are a child that looks different, needs frequent medications, or spends a lot of time in the hospital, life can be extremely challenging.

For these kids, it is very hard to have friends, to have “play dates,’ to go to birthday parties or sleep-overs. At camp, the medical team makes sure ALL the camper’s medical needs are taken care of, and taken care of in the background. So there is no anxiety about ‘how will I get my medicine?’ Or, ‘what if someone sees my scar?’ Every child at camp has something that brought them to camp, so it becomes this harmonious place where children feel accepted in a way they haven’t outside of their home. It is often life changing for them.

3. People desire to be in community with one another
The word community can mean different things for different people, but I feel as though it is being a member of a group that really appreciates my presence, and one that I choose to go back to. It is a group of people who I care deeply about, that cares about me as well.

Every camp season required the recruitment of 50-80 volunteer nurses and 15-20 volunteer physicians. Our volunteers came from all different aspects of medicine, I had NICU nurses and adult critical care nurses, I had orthopedic surgeons and dermatologists.

Once at camp, our identities and our white coats or our scrub tops get stripped away and replaced with camp T-shirts and funny hats. It felt almost like college, where we lived together, worked, and shared all of our meals together. In this environment, we developed relationships that were impossible within the confines of the hospital walls.

We were a family, pouring hundreds of medications each Monday, working late into the evening each day and becoming friends. These awesome professionals donated their time and usually would take vacation to come to camp. Every single year. These people chose this community, and they also choose to return. I know these individuals better than I know my colleagues, because you learn a lot about someone when you spend a week with them. I consider these friends to be life-long because we shared such wonderful, challenging and inspiring times, and I also believe they are the gems of the medical profession. I adore each and every one of these people.

There was always so much hard work and integrity demonstrated by the medical teams. I knew that I could promise families we would take the best care of their children during each session because I always had fantastic volunteers who were the ultimate compassionate professionals. With silly hats.

4. The counselors that spend their summer creating camp experiences for ill children are the best people
This is the genuine truth. At Camp Korey, there are actually college students that do this and they get paid very little doing so. Our counselors would work about 80 hrs/week, only getting Saturdays off, for 8 weeks.

Their jobs not only involve being big siblings to our campers, but making sure everyone is having fun and no one is being bullied. They are responsible for ensuring our campers get showers and have assistance toileting (if they need help) and have sunscreen applied EVERY DAY.

They learn about all of the medical conditions prior to each session, so they understand what to expect. We have campers with massive food allergies, and our counselors were responsible for ensuring all of the kids with special diets only got “their” food. Which is really hard when everyone else eats ‘family style!’ They carry epi pens and inhalers in their backpacks for the kids that might need it during the daily activities. They plan “sneak-outs’ for the older campers, so they get to experience a little bit of delinquency.

Every night, they have “cabin chat” to talk to their campers, process the days’ events and teach the campers about lifting one another up and giving each-other warm fuzzies. I don’t think I could have been a counselor when I was their age. But, I feel lucky to have been able to witness such unadulterated compassion by such young souls. Watching the counselors be such admirable human beings makes one have faith in society.

They are heroes, and some of the nicest people you have ever met

5. We all do better when mealtimes take priority
I lived forever in the field of medicine, where you are lucky if you eat. I currently work in an emergency department, where I am still lucky if I get a moment to shove something into my face. At camp—everything stops for mealtimes, three times a day! Our entire schedule is based around our meals. Even if there is a sick camper, someone on the medical team brings food to the medical center to ensure those on duty get fed.

We all need to eat, and we especially need to prioritize eating during an active summer camp with kids who are medically fragile. I learned that I need to eat, too. I learned that my ability to take care of others is way better when I am taking care of myself first. I also learned that it helps to have a bunch of your friends standing by, caring about you and making sure you get fed.

6. If you spend your time giving away warm fuzzies, you will feel the warmest in return
A big part of camp is giving away warm fuzzies to our friends at camp. Each camper, volunteer, and staff member has a paper bag with their name on it. Throughout the week, we write little notes to each other, congratulating a camper for being brave by climbing the rock wall or thanking a volunteer for calling a parent or trouble-shooting a g-tube.

This translates to living in a space of gratitude and the act of constantly trying to find something to thank someone for. It is a very rich way to live. I found that my perspective changed, and instead of being concerned about what was not going well for me, I was constantly celebrating our wins as a team. We should all be giving each other warm fuzzies on the daily.

7. Taking care of a bunch of children doing things they never have done before is incredibly inspiring
I loved seeing these super courageous children take risks. Just attending camp is scary. Then these kids get here and make friends and climb really tall walls and dance and eat strange food. It must be terrifying for them. At the end of the week they would then get on a stage and show off their talents. It was always beautiful and always inspiring. I learned a lot about courage watching campers overcome their fears.

I was lucky to spend 6 summers at camp. Some of those were as a volunteer, most were as the Medical Director.

I am so sad to be stepping away, but I know that camp will always be in the background, as will the memory of my time there. I will always believe in the mission and I will always support the cause. I hope that if you are interested, you would get involved as well.
Thank you SO much to all of my camp buddies. You are the best, and I will always cherish our time together.

XO,

Annie

An Open Letter to My Consultant in the ER

“If you want others to be happy, practice compassion. If you want to be happy, practice compassion.” —Dalai Lama

 

The emergency department is quite possibly the most exciting place in the hospital, but it can also be the most challenging and chaotic. Patients arrive at all hours of the day, families are scared and frustrated to be there and sometimes we can’t work fast enough to take care of everyone in a timely manner. We are also constantly taking phone calls from other institutions to help decide whether a patient from another hospital needs to come to us, and how (helicopter, fixed wing, or ambulance).

Needless to say, it is a stressful environment. Sometimes stress can make us (any one of us, from a resident, nurse, attending) anxious. Sometimes this anxiety manifests by treating members of our team poorly. When I discussed our shame culture, I talked about this a bit.

I used to get really anxious when the ED got busy, especially if I was fielding lots of phone calls, and felt as though I was being spread too thin.

There is nothing scarier than to think I might miss a diagnosis or not see a physical exam finding because I am too busy. I used to translate that anxiety into barking orders and being impatient with my team, which unfortunately, only increased anxiety!

I have since learned how to improve my interactions and communications with my patients and colleagues. But I know all too well how easy it is to project these feelings onto others, and sometimes it is also hard to recognize we are doing it.

Recently I had a patient that was sent to us for subspecialty care. My senior resident tried to discuss the patient with the consulting physician. Unfortunately, this particular consultant treated the resident with irritation and general nastiness, asking some slightly irrelevant questions she didn’t know the answers to, then shaming her for her lack of knowledge.

He also told her it was ‘inappropriate’ to call him when she was ‘unprepared.’  This kind of interaction (consultants being exasperated with patient consults) is quite common in our field and brings me back to my shame post (which describes in better detail how this manifests). I don’t always have the opportunity to give feedback to the perpetrators of this behavior, partly because I am not always aware it happens, or I get busy with my day, and it gets forgotten.

 

This blog post is for my angry consultant.

I see you.

For what it’s worth, please know that I recognize we both have really hard jobs.

I know that deep down, under the years of clinical practice, you and I really are the same person, bright-eyed and big hearted, who entered into this magnificent career of medicine with a desire to help others and possibly change the world.

Our jobs turned out to be a lot harder than we pictured they would be in those days. We sacrificed time and relationships, and life moved quicker than we anticipated. The cost to continue in this career has interest, and the rate routinely increases, with no one asking if we have the ability or stamina to pay.

I see you. We are the same.

But for some reason, you have found joy in making others around you squirm. Your ego feeds off of the power this gives you, and it makes you feel entitled to treat others as ‘less than.’ You get frustrated that no one understands the pressure, that every minute of your day is spoken for, and you act on that frustration by being mean.

I promise when you enter my world, there is no judgment. I know you are doing the best you can, and behind the delayed response to your page is a list of patients, a scared parent, and your own family at home. Everyone is asking for a piece of you, but no one is really appreciating the place you are in, the struggles you have.

I promise to see you with the same compassion I see my patients. I promise to thank you for coming by, that I truly appreciate your expertise. I hope that maybe someday you can see me, too. Know that like you, I really try to do the best for my patients every day. I try to only call you when I am worried about a patient, or concerned about the family’s ability to get answers and navigate our difficult health care system.

I see you. I care about you too. Maybe next time you can show me a picture of your dog, or your vacation, or your children, and we can talk about how hard it is to be a doctor, a parent, a friend and how it never feels like enough. How sometimes we give our best self to our job, and how it always feels like someone is getting short-changed.

We can’t forget those people we once were, the bright-eyed ones, that jumped into this crazy field. We are all in this water together, sometimes it actually feels good to help one another swim.

I see you.

 

XO,

Annie

Your Friendly ER Doctor