The woman had tried to flush her baby down the toilet in a motel. She deserved my ire.

I immediately dismissed her as less-than for not, at least, leaving the baby in a warm blanket. Why try to kill him– a near-term boy who probably cried as he hit the cold toilet water.  There was just no state of mind that would justify such a heinous act.

I didn’t want to see her, didn’t want to force myself to smile, and didn’t want to be empathic. That’s just not how I felt. And, I would have to walk past the police standing outside her door, which only added to my discomfort.

I sat at the computer in the middle of the nursing station and reviewed her labs and read the notes written on the previous shift. “She’s fine. She’s ready to go to jail now,” I scoffed.

“Please be kind. She has been through a lot.” Bridget’s hand reached toward me as she spoke. She had been a nurse at this hospital for 25 years. Bridget was a white nurse who carried a toughness that belied her small frame and olive complexion. The type of nurse that every doctor wants around in the midst of an emergency. She has a keen clinical eye and calmly executes her duties.

“Are you kidding me?” I thought without responding to Bridget’s plea. The hotel maid heard the baby crying when she came in the clean the room. Who would do such a thing?

As I walked down the hall, a swarm of emotions filled my head. I was embarrassed by the admonishment. It was my role to exhibit professionalism and forgiveness. Confusion and surprise also visited my mind. In 25 years I have never heard a labor and delivery nurse defend an abusive mother. Not once. I have worked in six different hospital systems in the Northeast. Yet, today I was alone in my wrath because my negative emotions were not aligned with that of the clinicians around me.

Walking towards the patient’s room, I tried to cool my disgust: maybe she was raped and felt nothing but hatred for the baby; maybe she was a prostitute and was under duress; maybe she was homeless; maybe mentally ill, etc.

I said good morning to the police officers as I entered the room.

At first I saw a pair of slender feet that managed to escape the cover of the blanket. The room was too warm.  I was thinking about the temperature when the room, slowly, came into focus. The shades were drawn. A glance down at my notepad gave me a few seconds to put on my “doctor face.” I took a deep breath and managed a closed-lipped smile. It took a few minutes more for the scene to register.

The patient was white. She was not a Black mother.

I had to consciously un-wrinkle my face as I took in the blue eyes and light brown hair sitting up in the bed. He faced displayed no emotion whatsoever.

Wow.

I, a black physician, had assumed that she, the patient I deemed horrible, was a black mother. The picture of the crack mom is so inked into my mind. It’s a story printed there by decades of imagery that consistently delivered negative images of black mothers. It never occurred to me that the baby who was found bloodied, screaming, cold, abandoned in the toilet of a hotel room, came from a white woman. And, of this I am almost certain, Bridget would have never had come to her aide had she been a black woman.

Unconscious bias is all around.

it’s like the gleeful swimmer who is unaware that a shark is close by, until the shark bites. Or, like the fisherman who merrily gets his fish having never appreciated the harm done to the beings in the ocean by tactics that are harmful. We’re both guilty—Bridget and I. But I thank her still, for holding up the mirror.

I’m a sorry, Black mother, for my participation in the processes that contribute to your deaths. Alia McCants died after giving birth to her twins: implicit bias was responsible for her death. We can train our doctors and clinicians to do better. 

I was kind to the patient when I spoke, as I recovered from my fugue. Every patient deserves professionalism and respect. Every person deserves a chance to explain, or at least to ask for forgiveness. This should be the expectation of every clinician, no matter his or her creed or color, sex, gender—whatever the type of PRIDE celebrated. Certainly, Covid had made getting care even more difficult for women in general. As we emerge from the pandemic, we need to keep our attention steadfast on the issue of racism in healthcare in America.

~Juliet_MD~

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Juliet_MD chats with psychiatrist and fitness guru, Dr. Ludmilar Mesidor, about how to survive pandemic related depression and isolation. We need to find a way to stay COVID free and stay sane while adhering to social distancing recommendations. See the conversation: BelowTheBellyButton with Juliet MD.

COVID 19 has dispaportionately affected black and brown communities. We are working harder to stay afloat. We are not sleeping. And we are suffering, in silence, from the significant impact of this pandemic on our emotional and physical states.

If you need help coping during this time, The Love Land Foundation provides a fund for therapy for communities of color.

There you have it. Spread the word.

~Juliet_MD~

The post How to Survive Pandemic Related Depression and Isolation appeared first on Below The Belly Button.

Every time there is a shift in our culture, it usually means that women have to manage more tasks to keep the household running. And so it follows, women are working harder during this pandemic.

“More Work For Mother: The Ironies of Household Technology From The Open Hearth To The Microwave,” by Ruth Schwartz Cowan is one of those iconic writings that remains relevant, even in the midst of a pandemic. Women, even those who have partners, but especially those who are heads of households have been left strung out by the dizzying amount of house work that they alone must do.

Food preparation—breakfast, snack, lunch, snack, dinner, snack, and finally dishes—swallows swaths of time. Remote learning means that paid work or needed rest is often interrupted. And let’s not forget about the damn laundry! Social isolation means that caretakers or help from family is not available. And, even when a partner is available, the “homemaker” is still targeted for these additional chores.

A recent New York Times article described the results of a survey about housework and outlined what we already knew—-men believe that they contribute more that they actually do!

Before this is further cemented as the norm, delegate specific tasks to everybody in the house.

To start, never confuse self-care with selfishness. Second, delegating effectively means giving up on the notion of perfection.

Children, six and above, can expertly navigate the Ipad, Nintendo switch, and Zoom. Also, they can’t wait to get back to soccer practice and swim meets. Which means they can run down the stairs to put clothes in the washer and press a few buttons. There are lots of tools on how to assign chores to children, including verywellfamily.com and parents.com, for example. Make a chart, assign age appropriate tasks, and dedicate a period of time to do the chores together before cutting the umbilical cord.

The same thing follows with the dishes, someone else can load and press buttons, it doesn’t always have to be you. But don’t sit, pout and stew in resentment. Ask for what you need and be specific, “I need you to load the dishwasher, turn on the machine, wipe down the counter, and sweep the floors.”

For this to work, let go of the Superwoman Syndrome. Resolve to let go of bad stress. Send the teenager or partner to the grocery store with a list, and don’t freak out if they buy the wrong brand. It really does not make a difference if they buy Prego instead of Ragu.

In the long run, everybody will appreciate what it takes to keep a house running. They will wonder how you have managed to do it all by yourself. More importantly, you will have acted to preserve your health and peace of mind.

There you have it. Spread the word.

~Juliet_MD~

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We will not weather the pandemic, or this period of social unrest, unless we sleep. Without sleep, we will eat more unhealthy foods, drink too much alcohol, and will be persistently irritable and angry.

1 of 3 Americans do not get enough sleep.

The average person needs 7 hours of sleep. There are many ill effects of not getting enough rest. Without enough rest, heart disease, diabetes, and stroke will lurk in your future. Also, depression and psychosis are two other illnesses that are caused by sleep debt. And if you’re not worried about going crazy, you should worry about gaining weight. We eat more when we are tired. The hunger hormone, ghrelin, is released when we don’t sleep, leading to overeating. That craving for ice-cream may just be a call to get some rest! And, let’s not forget that tired people do not have good sex.

Take action. Take sleep seriously. 

“Sleep is about the preservation of life itself.”

Start with these tips:

Avoid alcohol. Besides the dehydration that is shaken into any good cocktail, alcohol interferes with the ability to sleep deeply.

Turn off the lights. Our culture of always being “on” is a major disruptor of our circadian rhythm, our natural sleep cycle. Our bodies should ideally rest and wake in tandem with sunrise and sunset. When its dark, Melatonin, the “hormone of darkness,” is released. This biochemical signals the body to relax. The bright lights, the television, the computer, and the phones, all interfere with how the body naturally prepares for sleep.

Exercise. Exercise is one of the best ways to release stress from the body, and movement also releases endorphins, “feel good” hormones that will help you to relax.

Why We SLEEP

Practice good sleep hygiene. Go to bed! You’re are better able to problem-solve and concentrate if you have had a good nights’ sleep. If you are totally exhausted, it’s better to get up early to finish that project, than to stay up late in an attempt to force your brain to work.

The American Academy of Sleep Medicine sponsors a great website: Sleep Education. This is a great resource to learn about specific sleep issues like shift work, sleep apnea, snoring, jet lag, etc.

We are living in what is, for many of us, the most tumultuous period of our lives. Sleep right, eat right, and exercise. We will get through this, in one piece, if you take care of yourself.

There you have it. Now spread the word.

~Juliet_MD~

1.“The Science of Sleep”, National Geographic, August 2018

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The key to a successful year is to stop making New Year resolutions. Yes. Counterintuitive. But making, and breaking, New Year Resolutions is so…Bridget Jones. It’s just old. Bring in the new. Start with self-acceptance. When I watched Lizzo in her red Santa suite wagging her butt and doing her hair toss at the end of her Madison Square Garden performance, I thought, ummm, she’s at risk for heart disease and diabetes. (I can’t help it; I’m a doctor.) But, damn if I didn’t wish that I had a smidge of her love-me-don’t-judge-me bravado, and take-me-as-I-am-world confidence. I want some of that!! 

Second, add a little self-actualization. Who are you? When you take away the kids, the job, the partner, the friends…who are you? Take thirty days, more if you have to, just to figure that out. Once you are able to clearly define yourself, commit to doing ONE THING, everyday, that aligns with your true self. When all of those “one things” add up, you will find your joy, and quench that unyielding yearning for something “more to life than this”. Today, not New Year’s Day, today is the first day of the rest of your life.

There you have it; spread the word.

~JulietMD~

BelowtheBellyButton.com

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I’ve grown tired of the frenzied monotony of the holiday season. Crowds. Calories. Shopping carts fill with items you don’t need. Churches filled with people who you’ll never see again—until next year.   

Do less. 

Don’t indulge in wanton consumerism. Don’t buy anything that you wouldn’t by in March, unless the item has been on your planned shopping list—since March. If your beloved Fit bit has a cracked screen, waiting for a good deal is, indeed, a great idea. 

Don’t wrap yourself in the pumped-up, fleeting, joviality of company parties and after work meetups. Do surround yourself with the warm, cadenced company of the people who are there for you—everyday.

Don’t feel pressured to have a new man/woman/person in your bed. Do use you PTO to spend some time alone. It’s the best time of year to spend time reflecting, and being introspective. 

Do make the holidays yours. A time to ground yourself, and stay grounded. The time to start anew is today, not on January first when you’re ten pounds heavier and your disposable income has dwindled down to the bare essentials. 

It can be the best time of the year, if you do it right. 

Merry Christmas Everybody!

There you have it; now spread the word. 

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I bristle whenever I hear talk of suicide. I can’t imagine not wanting to be alive. This is not because I’ve never been distraught. I know despair; he has dipped in and out of my life at some of the most inconvenient times. I have the emotional and physical wounds to prove it.

September is Suicide Awareness Month. So, let consider the following:

We live in our bodies; the flesh allows us to interact with the world. But what if this exchange is colored by constant turmoil, and pain. Is it easier to just…leave? Forty seven thousand people killed themselves in 2017. Suicide is the second leading cause of death among people between the ages of 10 and 34.

Suicide is hard to think about.

Consider, the dead cyber-bullied thirteen year-old whose body slid off the stretcher, in the elevator, as she was being transported to the morgue. They forgot to use the strap, and her tiny little thirteen year-old “remains” sloshed around inside the too-big black body bag. I watched the transport team struggle to get the body back unto the stretcher. I didn’t help; it was bad enough that I had to ride the elevator with a self-inflicted act so poisonous it might as well have been the plague. I wasn’t going to touch it. The notion of suicide is emotionally uncomfortable.

When my beloved friend, a recovering addict, said to me, “I know how it feels to not want to be here anymore” I was silent. What do you say to someone who admits to a most morbid desire, and who embraces death so readily? How do you comfort such a person? Suicide is discombobulating.

Eight months ago, my sister-friend called to tell me she was called to a funeral. An eighteen year-old super-star scientist rigged equipment in his dorm room that poisoned him while he slept. He was his mother’s pride and joy. “I’m so sorry to hear that” was all I could mutter.” Suicide kills.

The American Association for Suicide Prevention has a great website with videos, classes, and others tools that teach you about the mental health states that lead to suicide; prepare you to talk about suicide; and, educate you about the grief process.

You can be the voice that changes a student’s perspective; that modulates a loved-one’s expectations; or that helps someone comply with prescribed medication.

A thought of suicide is the beginning; it doesn’t have to be the end.

~JulietMD~

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