Sweet Princess Peach

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To my dearest princess peach, in honor of the day you turn four.

Four! Four years ago your daddy and I had our world turned upside down in the most wonderful way with the news of your birth. For some reason four seems so small, so young, almost insignificant. But to know you, to REALLY know you, is to know that none of those words are accurate descriptions of your personality.

The story of your birth is yours to tell, someday. In the meantime, I wish to share the following. I expected that I would love you. I was ready for it. I had prepared myself for it. Even when I emotionally prepared that I might someday lose you, I loved you still. The truth is, I could have never imagined how much love I would give and receive. I now consider that my first lesson in being a mama. The first of so many lessons.

You are your own person. You have paved your own path since the very moment you were mine, four short years ago. Short years, but long months and some even longer days. You have filled our days with learning, laughter, and unending love.

You have pushed every limit and have taught me to be more flexible. You have challenged every boundary and taught me to choose my battles and communicate differently. You have taught me to truly stop and see you, to look and to listen to what you’re unable to say.

You have broken apart every idea I had about what a mom should be. You taught me to just be me; to parent and to love and to guide with my truest self instead of with all these ideas of what others might expect.

The deep and strong current of stubbornness running through your very core has taught me to use new eyes, to think differently, and to lead with love and patience instead of anger. It has forced me to slow down and to stop and take a deep breath, and then another.

Your obvious unwillingness to bend and fold and fit yourself into my expectations of what I think you should be is incredibly refreshing, albeit frustrating at times. You remind me to be present, to be kind, to be stubborn in what I think is right, and most of all, to speak up for what I want and not back down just because someone told me I should. You remind me to expect more out of the people around me. To love hard and often and without abandon, but also to hold a strong line when it comes to my boundaries and what I need in the moment.

You are my wild child. My child who fears nothing. Who jumps from the top of playground equipment without a care in the world. My child who does and then thinks. My child who just needs to move and explore and be given the space to play in her own way, all day long.

My beautifully wild rose; my wish for your fourth year is for you continue to be your reckless, deeply loving, strong and stubborn, curious self. I hope that those things which make up the core of your sweet soul continue to be celebrated and appreciated and noticed. I hope you continue to demand from the world the same that you contribute. Most of all, I hope you know, without question, you are always and forever so very loved.

Love,

Mommy

Courage

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“Courage is not the towering oak that sees storms come and go; it is the fragile blossom that opens in the snow.” Alice Mackenzie Swaim

I have loved the above quote for as long as I can remember. In fact, if I recall correctly, I used this quote for my senior yearbook. I cannot find the yearbook to confirm. Therefore, you, reader, will need to take my word for it.

Despite the fact that this quote has always resonated with me, I once viewed courage differently. As a child, when I thought about courage, I would think of the typical “hero.” I am sure you know the one. The one up against impossible odds, who leans into whatever challenge they are faced with and comes out on top. The strong, brave ones and not the fragile underdog. Specifically, what I definitely did not think of in my younger years was foster care.

I previously mentioned I have been absent recently due to a multitude of life changes. Some of these changes have challenged me on the deepest level. Among the changes, was becoming a licensed foster care provider. The same day the license was official; our first foster placement was born and we got our first call. To say it took some courage to say “yes,” to that call is an understatement. After a frantic two days of nursery set up, I learned my first lesson as a parent in courage. This now permanent yes, is one of the best yes’ I have ever said.

There are a number of things I thought I might learn from being a parent. Courage was not one of them. However, there it was…a deeply buried, beautiful, flowering courage not previously identified, but nonetheless shining bright within my heart. Simultaneously, there was that same flowering courage existing so vibrantly in the children I love. My kids are the most courageous people I have ever met. That they can still experience joy after all the various traumas they have endured, is unbelievable. When you meet them, you might never know the abuse or neglect they have experienced….but we do. We know their joy is fragile; it does not take much to remind them. We are with them through the sleepless nights, the tears, the tantrums, the fears, and the anxiety. It is nauseating to listen to the the older children we have parented tell stories no elementary student should even know. Courage sometimes makes me want to throw up. Most often, it makes me want to cry. It regularly causes loss of sleep. Courage is ugly, messy and not at all heroic looking when it is actually happening. It is hard…so terribly hard.

My little superheroes are worth it. Their courage is a choice. So, too, is my choice to love them. Foster care teaches you very quickly that love is NOT just a feeling. Nobody lacking courage would choose to feel this way. Many people have told me they could never do what we do, and honestly, we cannot either by ourselves, but God is present. Therefore, we get on our knees and send a plea to the one who can do anything. Courage looks a lot different to me, now. Watching my little blossoms flourish is the honor of my lifetime.

The Long Pause…as I like to call it

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I guess I am back. This profound silence in writing manifested itself in numerous ways. When I stopped writing, it was the beginning of the pandemic. Now, so much has changed.

My life is vastly different and I almost do not know where to begin. I have been putting it off so long it almost seems silly to start over. However, in my lack of writing, I lost my therapeutic outlet and my unorthodox “unicorn space.”

Optimistically, I guess this should give me an abundance of topics with different perspectives.  I will probably throw in some foster care stories and parenting snafus along the way.   

One of the things I have learned throughout my time observing the practice of medicine is the therapeutic value of silence. The long pause. Sometimes this allows the freedom for stories to reveal themselves.  Sometimes there is simply nothing to be said. 

The pandemic was one of those times where I could just not identify the right words.  Reflecting on the situations I encountered made me overcome with sadness.  So, there was also value (for me) in my silence.  Lots of learning, lots of introspection, lots of re-prioritizing and identifying what I hoped to accomplish in this life.  

For better or worse I’m back into it. Feel free to read my ramblings, or not, it won’t hurt my feelings. If you do read them, I hope you learn something about yourself you previously did not consider or maybe it will give you something to ponder.

Still a pharmacist, still uniquely inspired. Talk to you soon.

The Most Troublesome Interview Question

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“Don’t live the same year 75 times and call it a life.” – Robin Sharma

Residency interviews are upon us. It is a somewhat hectic time of year which requires everyone in the department to take on extra duties in order to support those who will be interviewing the candidates. I am grateful to work within a program that values training and preparing the future generation of pharmacists. I always look forward to the excitement surrounding this time of year! I guess you could join others and call me a nerd. As I sat down to compile the list of questions that will be asked of candidates this year, I recalled my least favorite one. It goes something like this… “Where do you see yourself in ten years?”

Each time I was asked the question in my own interviews, I desperately wanted to say “Oh, I don’t know, let me get out my crystal ball for a consult.” Instead, I answered for my audience. It was a well-rehearsed speech about my career goals. I answered the question in the way I wanted to be perceived, i.e., career oriented, little focus on social life, non-time-consuming hobbies, work experience with X organization, blah, blah, blah. At the time, I gave very little thought to what a balanced life would mean.  This question did not tell the interviewer anything about me, anyway. After I answered, the interviewer was no closer to making a decision regarding my qualifications than before the question was asked.

Watching the unknown unfold, creating new short-term goals, and maintaining some measure of focus on the things that mattered most, was the best part of my college and residency tenure. The things I love most about my life now were definitely NOT in my ten-year plan. And so, nearly ten years from when I first answered the question that I still loathe, I am someone far different than who I thought I would be. Today, I hold a position within the profession of pharmacy I never imagined or knew was a possibility. When asked the question, I did not say anything about how much knowledge that I hoped to gain in my field, which seems odd to me now.

Thinking everything is figured out is a mistake. That sort of mindset will almost certainly haunt the “know it all” as the world crumples around them. The preferred question to ask is lengthy and probably too personal in an interview situation. “Where do you see yourself in 50 years?” In order to answer that question, one must likely ask themselves this follow-up question. “In 50 years, what will I wish I had done with my life?”

If one lives and dies by their ten-year plan, it might mean missing out on the fifty-year goals. When looked at over many years, exceeding in well thought-out ten-year goals sometimes means sacrificing the long-term goals. In other words, we need to look at the bigger picture. Ten-year goals are self-centered. Fifty-year goals, then, are the ones that may take a lifetime to build, the opportunities that may take years of courage to complete, and the things people often regret not doing. They also include how you affected those you come in contact with. I will be honest…it is so difficult to live in a manner that focuses on the fifty-year plan. Believe me, mine is a work in progress.

The fifty-year plan requires vulnerability in order to create a legacy. So, go ahead and ask me “where do you want to be in 50 years?” I can already tell you! In my big picture, I am old and telling stories of the places I have traveled, the risks I have taken that paid off, and those that did not. I am confident I will be imparting life lessons learned through experience and will have created a legacy that remains on the Earth long after I depart from it. I hope those around me will remember how much I loved them, and how I choose meaningful relationships instead of a rote ten-year plan.

In short, I will not be asking the question “where do you see yourself in ten years” this interview season. Moreover, this week I encourage you to come up with a plan for those missing 40 years. I will be sure to let you know how my fifty-year plan turns out…. if blogging is even a thing in 2070!

©2020 Inspired Pharmacist

Deliberate Deliberately

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Our intention creates our reality. – Wayne Dyer

There is something so very exciting about January.  A blank slate, a fresh year full of promise, and a chance to let go of what no longer works in our lives and embark on whatever it is that helps us to have a banner year.  Typically, I use this time of year to set resolutions for myself.  Resolutions I sometimes fail at by mid-February.  I realized only recently, when I was texting my cousin about a resolution I had made, that the meaning of the word does not put me in the correct frame of mind to accomplish anything…resolution smesolution! When I looked back at my text to her, I thought, “Why did I put the word resolution in quotations?” I put quotation marks around it like it was a made up word without meaning.

Last week, you may have noticed, there was no post from me.  Part of the benefit of working at a not-for-profit organization is the chance to give back to the community in many different ways. The slight downside is it often means completing work for the organization in personal time. Last week, I was busy finalizing a letter to accompany a grant written in an attempt to secure additional funding for my organization.  The whole process was very detailed.  There were many items required, forms to be signed, explanations to be detailed and painstakingly placed in the grant document.  It was a tedious process! As I crossed my fingers and sent the grant on its way to the reviewers, I suddenly realized what my problem was with New Year’s resolutions.

My problem is with the word itself!  Resolutions, while made with wonderful intentions, leave me feeling frustrated when I do not achieve what I set out to do 100% of the time.  Instead of lifting me up and improving my situation, the failure drags me down.  The reason it seemed to hit me so abruptly this year, was because I realized I would have no time to write this blog…one of my resolutions for this year.  There it was early in January, and my resolution was already botched. I felt guilty, but why?  I was excited about the grant.  I WANTED to write it.  I enjoyed the challenge. And, I desperately hoped my organization would receive the funding to support something I am passionate about.  Admittedly, the guilt bothered me.  It forced me, however, to explore alternatives to resolutions…and I found one!

Here is my plan! It involves erasing all of my resolutions and instead approaching this time of year with a different mindset.  This does not mean I do not have goals, rather, it just means I will go about reaching them in a different manner. Instead, this year, I have set an intention to do two things. To be deliberate (adj.) and to deliberate (verb.). My plan then, is to be conscious, mindful and intentional with decisions.  I hope to concentrate on those things which are most essential.   Mainly, to deliberate my options and then make a decision.  My mantra this year is: TO DELIBERATELY DELIBERATE.

In my family, this looks like making the decision to be present and not distracted.  It means taking time to plan activities that are meaningful and not feeling obligated to attend every event for which an invitation is received.  In my work, it means digging in and reminding myself why I enjoy my work while making it relevant and memorable.  In my personal life, it means carving out time to escape a little and write.  In action, it means questioning why I do just about everything.  Should I feel guilty about this?  Can I fit (x) in if I cut (y) out?  Why do I do it this way and not that way?  In essence, figuring out what is essential.  With deliberate as my intention for 2020, I hope that I can get rid of all the things that do not matter and replace them with the people and things that matter the most.  In 2020 I will deliberate on doing less, and deliberately do better! I hope you do, too. Have a wonderful 2020!

©2020 Inspired Pharmacist

Birth, Death and In-between

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“When your eulogy is being read,
with you life’s actions to rehash,
would you be proud of the things they say
about how you lived your dash?” -The Dash by Linda Ellis

One day as I was making my way to lunch, a visitor approached me asking for directions to a patient’s room.  Despite the fact that I have worked at the hospital for three years, I still get lost and tend to roam about trying to find my way to areas outside my comfort zone.  We have a “rule” at the hospital that essentially requires visitors, or really anyone asking directions, be accompanied to their destination.  On this particular day, honestly, I really did not want to walk beside anyone anywhere.  It had been a somewhat stressful day and I would be required to make small talk with this stranger, which is not my strong suite! My directional challenges would probably be obvious and present themselves and my conversation would be prolonged as we wandered the halls.  Nonetheless, he looked lost, weary, sleep deprived, and like he could use a listening ear…so I asked him where he was headed.  

In the course of our conversation, he relayed that he lived a few hours away.  I asked if he had ever visited our hospital before.  He said, “Last time I was here, was for the birth of my son.  A lot has changed since then, that was a couple of years ago. It was such a different feeling walking into the hospital today.  I cannot believe I am here because my grandpa is dying.”  After we walked in silence a few steps, and as I was about to say how sorry I was, he said, “I think I’ll just try to remember the in-between times.”  This statement was exquisitely personal and struck me as exceptionally profound and insightful.

As I left him at his destination he said, “Thank you for listening. I’m lucky to have run into you.”  It was then I recognized the patient he was visiting.  I replied, “No, I’m the lucky one.  Thank you for allowing me to walk with you today.”  The entire walk I felt as if I should be comforting him, but instead, he was comforting me.  The reason I was having a rough day was because his grandfather was dying and we had just spent several hours trying to stabilize him.  I had somehow just randomly run into his grandson on my way to lunch.  Life playing out as it should…God’s presence was undeniable.  

It is so interesting how the circle of life works and how things can change so quickly.  Those of us in health care know this. Our jobs give us a front row seat for experiencing the best, worst, and everything in-between alongside the patients we serve.  However, I think this circle of life can catch many of us off guard.  That is why remembering the “in-between” helps. The same circle caught me by surprise that day.  A simple reminder not to dwell on the difficult, but instead reboot my attitude and reenter the in-between phase.

The best times in life can be found in-between the gifts we get from heaven and the gifts we return to heaven. In-between the wonderful days and the difficult ones are the everyday, ordinary, great and beautiful ones.  The days you make memories, watch a wonderful sunrise, experience great joy within your families, or find peace in quiet moments.  It is important to formulate your individual memories and stories.  These are what form a person’s legacy and enable your loved ones to remember you well.  

So, I will leave you with this:  In this in-between season, the time between Christmas and the New Year, do not waste a moment.  Love purposefully.  Live with intent.  Lengthen your dash.  Most of all, always walk with others to their destination.  You never know, you might need them more than they need you.

©2019 Inspired Pharmacist

Lessons From The Dying

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“You can look death right in the eye, tough as it is, and life lights up.” -Frank Ostaseki

My mom cautioned me not to write too much about death and dying in this blog. So, I felt I should clarify that I am not depressed, nor am I overly consumed by death. I remember the point in my residency when I really started to take note of the ways in which people approach death. It was at a point when I really needed something good to come from everything I witnessed that a preceptor encouraged me to write down three things I learned each day. I am sure this person meant what I learned about disease processes. However, I often wrote down what I learned about life. Luckily, nobody reviewed this notebook as part of my residency requirements! Within the pages of my “What I Learned Today” notebook, I started writing about what the dying said, how they acted, whether or not they accepted what was about to come. Through these observations, I have come to realize that death is a beautiful part of life, which is why a great number of my stories are about these patients and my interactions with them or members of their family.

I have been a part of more deaths than I can recount, so I realize that my comfort level might be higher than average. Often, how the patient spends their final moments can be a source of comfort. Take for example, my patient, who was telling jokes as he was dying. Steering the conversation in humor, as he had always done, was a great relief to his family. “He was ornery until the end,” they told me. There is also the patient who watched Maury until she could not any more. She watched and LOVED Maury for nearly 15 years and did not intend to stop before she needed to. The mundane eased her worry, a reminder that life would go on and as long as she was breathing she still had some control.

On the other hand, sometimes a patient spends their final moments in distress. We can try to mitigate the distress from disease processes. However, the emotional distress some patients feel often cannot be helped. One patient, through no fault of his own, had not seen his son in a number of years, and despite every attempt on our part to establish contact on behalf of the patient, we were not successful. The patient was distraught as he was passing because he was never able to reconnect with one whom he loved so much.

Most often, the way someone dies teaches me something. For example, from the patients above I learned that a sense of humor is key, one should do what they love until the end, and always maintain contact with cherished family and friends. These are life lessons I have usually heard along the way. Whatever the moral, these lessons imparted through observation certainly stick!

While some may believe these stories are not necessarily profound or breathtakingly beautiful in any way, I feel differently. I have realized that finding the goodness, and considering what is learned from the dying is probably the healthiest coping mechanism health care professionals can develop. I seek to honor my patients by speaking of them and gaining a better understanding myself. I desire to find beauty in and learn from my patient’s lives. I want to practice pharmacy in a way that integrates what is meaningful to me.

Strive for a beautiful life, that your dying might also be beautiful.

©2019 Inspired Pharmacist

Living Deliberately

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“Do not be afraid of death; be afraid of an unlived life.  You don’t have to live forever; you just have to live.” –Natalie Babitt

At least once a day, I am reminded of my own mortality, and it awakens me.  It has been almost three years since I met Ms. M*.  She came to us because she was becoming progressively short of breath.  She was nearly my age, newly married, and had just moved back to the area.  When I arrived that day, the physician alerted me to her presence.  She was very rapidly and mysteriously deteriorating, and would need to be placed on a ventilator very soon.  

When asked if a ventilator is what she would want, she was understandably scared.  I recall her telling the nurse she knew she was dying, but that she could not because she had too many things left to accomplish.  Almost immediately, and right after her husband stepped out of the room, her heart stopped beating.  Despite our best and most valiant resuscitation attempts, she did not survive.  She had an endearing personality, that all of us could see shining through despite her severity of illness.  

In the aftermath of ‘time of death,’ as I sat at my desk taking a mental break, I was once again confronted with the need to live deliberately instead of just passively filling my days.  In this case, the patient’s life so similarly resembled my life, and in my moment of pause, I could feel a ton of bricks set squarely on my shoulders.  It could have been me! The weight of it was profound and heartbreaking.  

It is uncomfortable to think about death in general, especially my own.  However, I have found that allowing myself to linger within the unpleasantness, if only for a moment, can be truly liberating.  For me, considering my last days also helps to reshape the present.

I often ask myself the following set of questions.  A spiritual mentor originally gave these questions to me; I have adapted them along my journey.  

If you were no longer here tomorrow, who would notice?  Further, what would they notice? Would they notice the absence of your kindness? Would they notice the somewhat mundane tasks you performed; daily acts of love now profoundly absent?  Do you have any regrets when you think about the answers to these questions?  If so, what can you do TODAY to change course.

If one is truly living, I believe the above questions can be answered with no misgivings.  To live, simply requires a search within for something more.  Bigger dreams, more passion for the things that occupy our time, the desire to continually learn and do better and the creation of memories with loved ones that will last long after death are required.   I certainly do not want my life to end until I have reached a wonderful old age, but witnessing death serves as a reminder that I am not the one who chooses. While I may not have a vote in how things turn out, everyday I wake up and plant my feet on the floor, I receive the opportunity to live deliberately and take control of the options available.

Moreover, one does not have to witness death to have a wake-up call that serves to increase motivation to take control and create change.  Use my lesson as your alarm.  Do what can be done today, no matter what else is happening, to create a life course that will not be viewed with retrospective regret.  Do it today before the choices run out.

“Tell me, what is it you plan to do with your one wild and precious life?”

The Summer Day by Mary Oliver

*Name changed for patient privacy.

©2019 Inspired Pharmacist

Who Heals The Healers?

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“A healer is not someone you go to for healing. A healer is someone who triggers within you the ability to heal yourself. ” -Unknown

“You up for a hug today, honey?” “Always,” I exclaimed. My favorite “lunch lady” was up to her usual tactics of cheering everyone she encountered, or at least trying. Sometimes, I long for her job. She is seemingly unburdened as she listens to everyone’s life story, pausing a moment here and there in the hustle of the day to really connect with coworkers and patient family members. I feel I sometimes do not have this luxury.

As I was preparing to write this week, I came across a staggering statistic from U.S. News and World Report. One-third of physicians report experiencing burnout at any given point. I know my blog is entitled Inspired Pharmacist, but one can imagine that these statistics at least somewhat translate across any profession involving high stress and high stakes. So, I went looking for the data. There it was, I found a similar rate reported among clinical pharmacists, especially those working primarily in critical care areas. I have not looked into contributing factors, but I can imagine burnout results in less empathy toward patients and increased feelings of being overwhelmed.

Consequently, I began to ask myself the question “who heals the healers?” Who are the ones who take the time to care about the ones caring for everyone else? Who are the ones who help restore empathy to health care professionals? Who are the ones who help restore depleted compassion?

The first person I thought of was the “lunch lady!” Many may not realize it, but she is part of the heart of the hospital. Whether she knows it or not, she carries a heavy burden. In fact, she carries a very important load, healing the healers. She, and others like her, are vital members of the patient care team. In a way, she mends the leaking wounds of other staff members and boosts morale as they go about their days. While I know and understand that a lot of healing comes from within, someone like her adds another layer of nearly impenetrable strength to our emotional armor.

We can all play a role in healing each other both emotionally, spiritually and mentally. When situations are viewed honestly and with a willingness to help, doors open and the healing process begins. In the course of healing, the one being healed and the healer both thrive.

While this lesson may be repetitive…be kind. Be the “lunch lady” to those you meet each day.

Kathryn Joy

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Gratitude unlocks the fullness of life.  It turns what we have into enough, and more.  It turns denial into acceptance, chaos into order, and confusion to clarity.  It can turn a meal into a feast, house into a home, a stranger into a friend.” – Melody Beattie

We are blessed daily, starting with the fact that we get to wake up in the morning and face the day ahead.  Sometimes the things we are grateful for are big, like a new job or the birth of a child.  Other times they are small like enjoying a cup of coffee to start the day.  Sometimes it is hard to be grateful, especially when the not so good things start to weigh us down.  I think this is why on October 3, 1863, in the midst of the civil war, President Abraham Lincoln issued a proclamation announcing the final Thursday of November would be set aside to express appreciation for all of life’s blessings.  Thanksgiving.

Usually when I think about Thanksgiving, it reminds me of my Aunt Kathy.  She was an artist.  She dressed in the most unusual way…in vibrant colors, flowing skirts and usually had fun earrings to match.  She exuded Joy, appropriate since this was her middle name.  She was so kind and generous, and I would be shocked if she had any enemies.  

Most of my childhood Thanksgivings were spent at her house, and before we sat down to eat, we would go around and say something we were thankful for.  I DREADED it.  I would think for days before hand, trying to come up with something more creative than “I’m thankful for my family.”  I knew I had much to be thankful for, but somehow it all seemed trite. Nonetheless, my turn would always arrive, and she would prompt “How about you Ab?” and smile at me, as only she could, somehow giving me the confidence to speak.  She made me feel like the most important person in the room.  

After I moved away, she would send me letters; letters I still like to read.  In her letters, she would describe the scene from her morning walk, the music she was listening to, the trinket she found while shopping, the antics of her beloved grandchildren, and the goings on of the world.   The letters she sent me came in the middle of a difficult life transition and I was focusing on all the things I perceived as negative.  Her letters were the bright spot in my weeks.  Among other things, they allowed me to see how much I was loved and supported, even from far away. They were encouraging, and confirmed goodness in the world.

 She never said life was perfect, or free of burdens and hassles.  However, looking at life through her letters encouraged me to identify the beautiful things in my own life.  If you think about it, I think you will find that this is the true definition of gratitude; an affirmation of the good and wonderful things in the world and a recognition that the source of this goodness often involves the love and support of others.

Years later, on this Thanksgiving morning, not unlike most mornings, I considered what I am grateful for.  My family, the friends who have stuck by me, the roof over my head, my work, even my puppy who got muddy footprints all over the bathroom this morning.  I also thought of my Aunt Kathy, and all the things she taught me.  My practice of gratitude started with her.  What I now realize is that in her letters to me, she was probably just writing all the things she was grateful for, in a much more eloquent way, and sending them to me.  Somehow, she knew I had much to learn about recognizing life’s small blessings and exhibiting immense gratitude for them.  She realized and appreciated God’s beautiful life design, and passed that on to me.  This year, as I contemplate my many blessings, I am so thankful for her beautiful heart and her wonderful example of a life well lived.  

Happy Thanksgiving!  I hope you enjoy a day filled with love, laughter, delicious food, and most importantly gratitude for life’s multitude of blessings.