Living Your Best Life

Life Lessons - Living Your Best Life

The Grounded Nomad

April 21, 2020 by 0 Comments

For most of the past few years, I haven’t stayed in the same city for more than 10 days at a time.  Even on my longer work assignments, I used my free weekends to explore nearby towns or states or countries.  Driving to Montreal from Maine is still one of my favorite trips.  On one such trip, the beautiful countryside provided a peaceful ride, I stumbled upon a street festival and downtown sidewalk sale, relaxed in a hotel downtown, and toured the historic Basilica all in the course of less than 2 days.      

All my travel, like most of the world, came to a screeching halt last month.  So where does a nomad shelter-in-place?  As you all know by this point, I love the freedom and flexibility of being a nomad.  But I respect the seriousness of COVID-19 and the importance of social distancing and limiting unnecessary exposure to others during a time of many unknowns.  I am humbled by those essential workers on the front-line, healthcare workers, custodial staff, truck drivers, grocery store employees and emergency responders to name a few.

Many nomads around the world have hunkered down wherever they happened to be at the time.   Others rushed home during the initial chaos and confusion around the closing of the US borders.  Many, like me, are in limbo until we can safely and comfortably travel again.  After I canceled trips to Kansas, California and Georgia, I decided to shelter-in-place in Maryland, the location of my last assignment.  I am grateful for friends who have taken me in over the last few weeks and the hotels who have remained operational to accommodate those of us without a permanent residence.

In this time, it is important to reflect on members of our society who always have housing instability.  Our homeless population continues to be at increased risk.  With shelters closed due to constraints of social distancing, more people are left without access to food, shelter and bathrooms.  This population already faces huge health concerns on a regular day and the CDC recommendations to keep us safe don’t apply to a group that can’t “just stay home” or “quarantine and chill.”

As the country plans to re-open to a new normal, many lessons can be learned.  As a nation, we have united and supported each other in extraordinary and compassionate ways.  My wish is that we continue to band together to protect our most vulnerable populations, to re-evaluate the definition of the essential worker and remember how we can be better together.

https://www.wired.com/story/coronavirus-covid-19-homeless/
https://www.cdc.gov/coronavirus/2019-ncov/community/homeless-shelters/index.html

***photos from Montreal, Canada 2018

Life Lessons - Living Your Best Life

The Nomad Christmas List

December 5, 2019 by 2 Comments

My mother asked me what I wanted for Christmas last year.  I replied, “nothing”.  Afterwards, I realized that may not have been the best response.  I wasn’t trying to be rude, but following the Christmas holidays, I was immediately traveling out of the country on vacation.  On my return, I headed off to two work assignments, in two different states.   While I love receiving gifts, it can sometimes be challenging to fit extra items in my suitcase.

So for those out there with nomadic loved ones, let me offer you some suggestions.  Though remember, for many of us, nothing is an acceptable answer, your love and support is gift enough.

  1. Give something experiential.  Tickets to a show, concert, movie or a gift card to white water raft, canoe or zipline.  Cover the costs of a language, art or cooking class.  Gift certificates to spa treatments, gym memberships or exercises classes that can be used in multiple locations.  These experiences are invaluable and are transferable in the mind or body. 
  2. Give something consumable.  Food and beverage always work!  Whether it’s a home cooked meal, Garrett’s popcorn, Grippos potato chips, Cane’s Lemonade or a well-aged Kentucky Bourbon (oh wait, that’s my list!)… But you get my point.  What does your nomad like that’s hard to find when traveling the country or the world? 
  3. Give something sentimental.  A small picture or memento that can be placed in a journal, a pin or pen that expresses hometown pride or a handwritten card that shares a little encouragement will go a long way.  It can get lonely on the road; these little things help tide us over.
  4. Give something travel related.  Your nomad may need an adapter for international travel, packing cubes, rechargeable batteries or a blanket.  A backpack, suitcase, sleep sack or sleeping bag may need to be replaced.  How can you make traveling more comfortable or efficient for your nomad?
  5. Give the gift of technology.  How does your nomad communicate or document her travels?  A new phone or camera may be helpful.  A smart watch could make communication and fitness more efficient. 
  6. Give something wearable but small.  Necklace? Friendship Bracelet? Earrings? Navel ring?  What can you give your nomad to wear that won’t take up much space or add much weight that will still remind him of you?
  7. Give the gift of travel.  How does your nomad make it from one destination to the next?  A gas card or airline, train or bus gift card may be helpful in traveling to their next stop.

For those of you up for an adventure, meet us out on the road.  It’s always lovely to see a familiar face in an unexpected place!

Life Lessons - Living Your Best Life

What Being a Nomad Means to Me

October 21, 2019 by 0 Comments

I’ve been extra nomadic over the past few months.  Since I’ve started my journey, my normal has been to be in one city for 10-14 days, at least, before traveling again.  Lately I’ve been averaging maybe 4 days in city before moving on to the next.  It has been exhilarating and exhausting!  But at the end of the day, I love it.

What being a nomad means to me…

  • Sometimes forgetting what city I’m in… I’ve woke up on more than one occasion with a cautious survey of the room to remind myself whose house or hotel I was sleeping.  I’ve forgotten where I parked, and I’ve even gotten into the wrong car.
  • Being flexible.  With the frequent travel, plans change, work schedules evolve, and flights get canceled.   Being able to adjust on the fly and adapt is necessary.
  • Learning how to pack enough, but not too much.  I travel with the same items for 4 to 12 weeks depending on my schedule.  I have to prepared for not only seasonal changes but also clinical work, recreational activities, formal events, workouts and who knows when I’ll find my way to the beach or a pool.  In addition to clothes, I need my laptop, toiletries and hair essentials (that I may not be able to find in some of the towns I find myself).
  • Being content my own company.  Honestly, I probably hang out with my friends more than most.  I’ve seen 2 of my friends who live in separate states, at least 6 times over the past 6 months.  But there are weeks that I see no one.  I am comfortable taking myself out to dinner or happy hour or just on a walk.
  • Though I’m constantly traveling, I’m not constantly on vacation.  Being mindful of my spending, eating habits and physical activity is a must to be responsible and provide some level of consistency.

How long will I live this way?  Short answer, I don’t know… Being nomadic is definitely a personal journey and not for everyone.  I’ve met a several people over the last few years who have been location independent for various amounts of time in their lives.  Some planned to be nomadic for a finite number of months or years.  Others became fatigued with the travel, some stopped to start families or for a permanent job opportunity.  We’ll see what life brings my way.  For now, my journey continues.

Life Lessons

Avenues of Communication

September 1, 2019 by 0 Comments
London 2016

As I try to continue to hone my writing skills both medical and non-medical, I have sought out opportunities to grow said skills across multiple avenues.

As a freelance physician editor and medical reviewer, I have learned to review information and synthesize an opinion influenced by my medical training as an Ob/Gyn.  Blogging allows me to write in a more informal conversation manner. 

Recently, an online magazine presented me the chance to give medical commentary regarding a very common gynecological concern.  This project required I write in a different way:  answering questions concisely and in language a general audience would understand and appreciate.

These different avenues of communication allow me to reflect on the importance of how I communicate and how to communicate effectively in each platform.  As physicians, how we deliver information, is just as important as the words we use, to ensure our patients “hear” us.

I believe oscillating between these modalities has improved my use of language and facilitated better interactions across the board, between friends, co-workers and patients.

https://www.bustle.com/p/what-causes-painful-periods-7-signs-your-cramps-may-be-due-to-a-health-issue-18169357

Life Lessons

Friends in all the right places

August 18, 2019 by 4 Comments

While I keep my eyes open and my ears to the ground, for new opportunities, nothing else seems to quite fit.  Being a locums physician suits my lifestyle.  It allows me the freedom to practice clinical medicine on my terms, to travel, to write and to spend time with friends and family.  I’m sure I get asked at least once a week, “So, you like all that travel…?” or “When do you plan to settle down and get a real job?”  For now, I’m content.  Though, I’m making new friends, and creating new families, I still like to keep the old ones too. 

A few weeks ago, I stopped by my last place of permanent employment.  The visit brought back feelings of anxiety and excitement, just like a visit home.  Though I’ve been gone for almost four years, returning to the hospital always feels like going to visit family instead of past co-workers.  Initially, I was worried that things may have changed and I wouldn’t remember my way around or maybe no one would be working that day that I knew.  But I found my way around just fine.  I was greeted with surprised eyes, smiles and hugs.  And just like visiting relatives, my plan to stop by for a minute, turned into a two-hour visit.  Complete with the “since you’re here, go say hi to…” and “let me call Denise and let her know you’re here…”

There are those who have moved on like me and those who are moving on soon.  One day I will return and I may not know anyone or I may forget my way around.  But I am grateful that day has yet to come.  I’m not sure when I’ll make my next trip back to Norristown.  This trip was prompted to clean out my storage unit, the unit I opened the day before I moved out of my apartment almost four years ago, to start my locums journey.  At the time, I thought I’d give it a year or two to see how it goes…  Four years later, I’m happily nomadic, and it was time to officially cut the physical ties to my old home.

The End of an ERA!!!

Moving on can be bittersweet, but just like the places I lived before, Norristown will always have a special place in my heart along with all the wonderful people I met there. Though the physical ties have been cut, the friendships are forever.

Life Lessons - Locums Lessons

Why can’t you just follow directions?

August 4, 2019 by 0 Comments

As a frequent traveler, I know my way around many airports.  The process is ultimately the same, right? Check your bags, go through TSA, wait at your gate and board the plane.  Recently, I flew out of Atlanta.  The TSA pre-check line required you to collect a large bin from the bottom row of conveyor belts, put all your belongings in the bin and place it back on the top conveyor belt to be screened.  After passing through the metal detector, you collected your bags as usual.  Thankfully, this day I did not set off any alarms, and as I removed by backpack and shoulder bag from the tray, I noticed the woman in front of me was visibly upset.  “I don’t understand why people can’t just follow directions.  Why does it have to be so difficult?”  She gathered several empty trays, stacked them at the end of the line and walked off in a huff with her travel companion.

Being aware of more than one TSA system makes traveling less daunting.  In many TSA pre-check lines there are no bins.  All items, except wallets and keys, go directly on the belt.  In some small airports, there are no separate TSA pre-check lines.  Other than keeping your shoes on, there are no special perks for being pre-check.  In many airports, the TSA agents collect and return the empty containers. Your end goal is still the same, to get on a plane. 

  • Traveling from Nairobi, Kenya to Bujumbura, Burundi with Dr. Bella

Being aware of more than one system of medicine makes practicing less daunting.  As physicians our goal is to take optimal care of patients. The traditional system of medicine teaches us that we need to get the right (if not perfect) grades, a high MCAT score, pick the right medical school, a competitive residency and the ideal job that we can keep for 35+ years until we retire.  This system does not teach us that we can change our minds and not finish medical school, or transfer out of a residency program or work in more than one place by choice.  We are taught to work until we are exhausted and that’s just the way it is.  We are taught that locums is only for transitioning or for physicians who just can cut it.  We are taught that we should feel guilty if we consider non-clinical options.  This system is no longer working.  As we are beginning to see, there are multiple ways to practice medicine.  Even more, we have the ability to choose or influence the system in which work.  The end goal is still the same: to take optimal care of patients.

Rounding at Our Lady of Lourdes Hospital in Mutomo, Kitui County, Kenya

We have the power to choose how we practice, when we practice and for how long we practice.  I joined a community-based practice in a suburban town, which I loved.  I enjoyed the diversity of the patients, the collegiality of my co-workers and the pace of the clinical requirements.  Over the course of a few years, the practice grew and changed.  The dynamics of the practice no longer fit my needs.  I approached the leadership to discuss the changes, looking for a new normal for me.  Instead, I realized my purpose could no longer be met by the organization and chose to move on.  One of my goals as a locums physician is not only to practice on my own terms, but also better understand the various practice models across the country so that I can help and encourage other physicians to choose to live a well-balanced life.  I want to see us practice safely; care for our patients, and ourselves and to feel like there are options to combat physician burnout other than leaving clinical medicine.

It struck me that the lady in the TSA line was accustomed to a single system, a single way of doing things.  Instead of acknowledging that others could be accustomed to a different system and adapting, she allowed her frustration to manifest in a way that was only destructive to herself.  As physicians, we may be overwhelmed and overshadowed by expectations of our groups, hospitals or accountable care organizations.  Exhaustion and frustration can lead to burnout, bailout and self-destruction.  When we recognize that we are not prisoners to the current system, we can adapt, change it or move on.  We don’t have to follow directions. We have options and burnout does not have to be one of them.

Enjoying the view, Jaco, Costa Rica

Life Lessons

Physician Prioritize Thyself

July 21, 2019 by 0 Comments
Cape Town, South Africa 2016

When I mentor medical students and residents I always emphasize the importance of  considering their personal well-being when choosing a residency program or their first post training position.  I remind them to place as much importance on staying connected to family and friends as they do on studying. To balance off time with academic time.  We review their healthy coping strategies and ways to maintain them during the stressful and sometimes erratic periods during the year. I remind them to enjoy the journey.  I share with them that I had so much fun during both & I came out on the other side alive.

When I went to college, I had a standing Sunday night phone call with my mother.  It was part of my schedule and there were consequences to missing that phone call just as there would have been if I missed an assignment or a test.   I made use of my planner to organize my schoolwork and deadlines.  Each week, I made a to-do list. In medical school, during particularly rough weeks, my list may have been detailed to the hour. My well-being also required that I prioritize staying connected to my social network. I didn’t study on Friday nights. That was my night to chill on the couch with my roommate, catch up with friends or go out if there was something to do that was also financially friendly to my college budget.

  • Besties from college @ my residency graduation, Nashville, TN
  • Besties from residency celebrating in Negril, Jamaica

When I applied to medical schools, I chose schools that were within driving distance from my hometown.  When I applied to residencies I chose programs in cities where I had family or friends close by. I ended up matching to a program in the same city as my medical school, which worked perfectly for me.  I could still drive home and I already had a strong social support system, all while being able to have a new experience at a neighboring institution. Nearby support systems proved invaluable during my most stressful moments.

As physicians, most of us will continue to practice medicine the way we were taught by our attendings in residency.  The subtle art of medicine becomes important when we encounter a clinical or social situation you can’t look up in a book. In such situations, we draw on those pearls of wisdom passed on over surgery patient in the OR, over peanut butter & crackers in the doctor’s lounge or during those dreadful checkouts at 3 am; “Dr… I’m so sorry to wake you, can I run this patient past you?”  In the same vain, the self-care habits you establish during training will be just as important as the clinical aspects of your training.  Learning to prioritize yourself in your career, early on, will allow you to be a more healthy and well-rounded physician. Though not the only solution, hopefully it’s one way we can begin to decrease the burnout that is plaguing our profession.

Enjoy the view!!! Phuket, Thailand 2016

Life Lessons

Race Disparities and Medicine

March 7, 2019 by 0 Comments
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https://www.civilandhumanrights.org/

I’m grateful to re-share this article picked up by SheMD. As we continue to do the work to achieve health equity, we must also do the work to combat racism. One way to move toward that goal is to talk about it!

I share the picture above, captured during a recent visit to the National Museum for Civil and Human Rights, in Atlanta, GA. It reminded it me that it was not too long ago when 4 little black girls, were killed in a church, in a viscous attack motivated by hatred and race. It reminded me of our humanity. It reminded me that our journey is not complete. My hope is that I can contribute to the conversation to help Our Country grow and heal.

Please follow the link below.

https://www.shemd.org/blog/race-disparities-medicine


Life Lessons - Living Your Best Life

A Proud Product of the Pipeline

December 24, 2018 by 0 Comments
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One of my earliest memories is going to the Presbyterian church a few blocks from my grandmother’s house.  Each summer they hosted a summer enrichment program for elementary age students in the neighborhood. Their goal was to bridge the gap for inner city kids that may have been deficient in reading or math during the year.  As the child of a then librarian and a grandmother who found a teachable moment in almost anything, I was already an avid reader. I greatly enjoyed the access to new books. More so, it set the stage for me to spend the rest of my summers looking for ways to learn as much as possible as I prepared for the upcoming school year.  Some summers, I even participated in three programs. I wanted to be a doctor… I was down for whatever it took. Some programs even bled over into the school year, with weekend meetings or weekday check-ins. Freshmen year, I started my favorite program of all time, hands-down, no contest. Healthwise. Part of a statewide initiative to expose students from vulnerable populations to careers in the health fields, the program targeted students from underserved and rural communities.

Healthwise consisted of two parts: 1) didactic classes in science and math, and 2) direct exposure to health careers via speakers, field trips and hands-on experiences.  The bulk of our time was spent at Central High School in downtown Louisville for 4 weeks over the summer. A historically black high school since the era of segregation that produced  great alumni like Muhammad Ali, Lyman T Johnson, Darryl Owens and Maurice Rabb conveyed an atmosphere of confidence and success. At the time, those traits were not often mirrored other places in the community, in popular media, or in the news.

Ms. DeBerry, the director of the program, who just recently retired, is a strong student advocate always encouraging each of us to be our personal best.  My goal of taking Calculus and Anatomy and Physiology as senior in high school was met with a little bit of a side eye by some of my peers. Healthwise prepared us for the standard curriculum.  However, Ms. DeBerry found someone to tutor me individually. She never told me no, she never told me I was striving for too much.

This summer, I returned to Healthwise as a speaker.  I was just as excited to go as I was in high school. I was also nervous.  I hoped that the students would be interested in what I had to say. I hoped that they found Healthwise as wonderful of an experience as I did.  Ms. DeBerry greeted me with a hug and I couldn’t believe 20 years had passed. Though the program is now housed at the University of Louisville, the energy in the room was what I remembered.  Young people eager to do great things. I hope that these students too will be proud, vocal and enthusiastic supporters of the pipeline.

http://northwestkyahec.blogspot.com/p/health-career.html
Life in Kenya - Living Your Best Life

You are exactly where you are supposed to be

December 8, 2018 by 0 Comments
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This time last year, I was two months into a six month volunteer assignment in Mutomo, Kenya.  Since I have been back people usually ask me one of two questions, “What was most different?” or “Would you go back?”  I use these opportunities to reflect on my experience and continue to contemplate what the experience meant to me then and what it will mean to my life going forward.

One of the most striking differences  I noticed immediately was the pace of the day.  Not surprisingly, everyone worked hard. The clinical staff was patient centered and each person worked diligently to make the most of the resources available. However, no one rushed around.  No one walked with coffee cups in hand or ate on the go.  Breaks were taken as needed and chai (or tea) was had sitting in the canteen or possibly at home on the back porch when time permitted.   This shift reinforced, while practicing medicine is always stressful, the environment you practice in doesn’t have to be.

Yes, I would definitely go back and yes, I would definitely recommend the experience to others. While I was blessed to be able to take respite in Nairobi from time, in Mutomo, it was not uncommon to be without running water or electricity for days at a time. While I adjusted, I will admit that I never got used to it completely.  The experience reminded me to focus on the present and not where I was going. It reminded me that I was exactly where I was supposed be. And though I hope sometime soon the community will have access to continuous clean water and reliable electricity, one of my favorite memories is playing cards by candlelight with my co-workers and friends.

I learned so much from the other clinicians, the patients, the community and from my new friends I would happily do it all again.  Recently, one of my patients in Maine mentioned that she found the CMMB video online when googling me. She shared with me that she felt encouraged to pursue her own dream to work abroad! Going forward, as I incorporate international medicine into my career,  hopefully I can continue to inspire others to do the same.