Love, Despite


Before I married my husband, I told him to make sure that he was marrying me for who I was that day, and not for any future changes he hoped to have wrought in me through the “transforming” power of marriage. Though we were both young, I had seen enough unhappy marriages to make me wary of the institution, and who wants to be institutionalized, really?  I had no question that I wanted to spend the rest of my life with him, but I wanted us to start off with as little illusion as possible.  I wanted to know that he saw me, and not some airbrushed version of a girl to be placed on a pedestal.  It is easy to fall in love if you believe all the fairy tales and movies.  Beautiful women with flowing hair and flawless skin meet muscled men with pure hearts and chivalrous intentions and they ride off to his manor with servants aplenty to watch the perfectly well-behaved children gambol across the lawn.

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Real life, though, is grittier.  The muscled boy that you met at 18 will have to help you get to the bathroom after giving birth to an almost 9 lb baby, change that baby’s first meconium-filled diaper, and not comment on all the broken blood vessels across your face from pushing to get that giant-headed child out. Those flowing locks that you used to have time to tame into submission, will subside into their normal frizzy state, then fall out during pregnancy so you look like an alien who accidentally swallowed a giant watermelon.  The manor will actually be a tiny little starter home surrounded by other tiny little starter homes where you can hear your neighbors argue and flush their toilets. Those perfectly well-behaved children will kick a soccer ball right through your basement window after being sent outside so you can think in silence for 2 blessed minutes before you erupt into acid-spewing dragon mama mode, yet again.

What is not easy, is staying in love, loving, actually choosing to love, when face it, there are times when we are not lovable.  When we are angry at the burned beef stew and there is not a single, flipping thing ready to eat in the house and everyone is hungry.  When we are frustrated at piles of bills and broken car innards, and then the dentist says your child needs braces and it’s going to cost you exactly what you planned to spend on the car repairs.  When we are already late to church for the umpteenth time, and we scream hurry up at the child who has to go to the bathroom right now.  When we slam the phone down multiple times, because once is just not enough.  And does anyone else agree that hitting the end button on our cell phones multiple times is just not the same?!  We are so often not at our best, so often not that serene  image of our best self that we aspire to, and carry around in our heads.  And yet, and yet, we continue to love one another, despite. We continue to hold on, in a world that does not value the sanctity of marriage or family or friendship.

Last Sunday’s Gospel described Jesus’ tranfiguration on the mountain.  Every time I hear this passage, I giggle a little to myself at Peter’s response to the incredible change he is witness to, but then wonder myself at what I might have said or done in his shoes. In reality, though, we see one another every day transformed. We see past the imperfections and flaws–frizzy hair, receding hairlines, extra pounds, impatience, frustration, and love one another.  That is the tranfigurative power of love, and we do not have to look to the mountaintops, or what others refer to as those thin places where the divine is closer to us mortals, to see that transfiguration.  We see it everyday when we choose to love despite and not because. We do it everyday, when we call one another Mình ơi, or sweetheart, when we are definitely not being sweet nor acting like the best reflection of our selves.

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Today I am thankful for love that echoes the divine, that transforms us into our most ideal selves. I pray for the fortitude to keep trying to love despite and not because.  I am grateful for the lack of illusions that makes marriage a safe harbor despite all my fears to the contrary, and for books which not only enthrall us, but also give us inspiration through words of wisdom which are gifts unto themselves.

“It had flaws, but what does that matter when it comes to matters of the heart? We love what we love. Reason does not enter into it. In many ways, unwise love is the truest love. Anyone can love a thing because. That’s as easy as putting a penny in your pocket. But to love something despite. To know the flaws and love them too. That is rare and pure and perfect.”
Patrick Rothfuss, The Wise Man’s Fear


My Name is Not Lenny

Dear Mr. O’ Reilly,

My name is not Lenny.  I did not graduate from a community college, and even if I had, my master’s degree in physician assistant studies more than qualifies me to take care of you and the veterans that I serve.  Your off-hand comment about not wanting to be cared for by someone who is not a physician is revealing.  Perhaps you arrive on the set of your show, and perform all of the duties necessary to get on the air from running the microphones and cameras to making sure that your guests have water to drink, but that is not how it works in medicine.  We operate as a team. Your show has highlighted the shortcomings of our health care system, so perhaps that is why you have not discussed the quality care provided by physician assistants.  I would implore you to educate yourself and thus help to educate America about what physician assistants are doing and can do to bridge the health care provider gap that is present now, and that research shows will continue into the foreseeable future.  Saying that PAs are akin to “Lenny, who just came out of the community college” grossly misrepresents my education and the quality medicine PAs practice in every medical setting and specialty in America. The misleading information in your show does a great disservice to the millions of viewers who trust the information and opinions you provide.

What you need to know is that the majority of today’s PAs are educated through intense, graduate-level medical programs wherein we are trained to diagnose, treat and prescribe. In contrast to your comment, 94 percent of PAs hold bachelor’s, master’s or higher degrees. We are often trained right alongside physicians in medical schools, academic medical centers and residencies. These programs are modeled on the medical school curriculum with a combination of classroom instruction and a minimum of 2,000 hours of clinical rotations. That means I share diagnostic and therapeutic reasoning with physicians. PAs are nationally certified and licensed to practice medicine and prescribe medication in all 50 states, the District of Columbia and all U.S. territories with the exception of Puerto Rico. PAs are authorized by the State Medical Boards to practice medicine, meaning I can perform physical examinations, diagnose and treat illnesses, order and interpret lab tests, assist in surgery, perform procedures, provide patient education and counseling, and make rounds in hospitals and nursing homes among many other medical services.

I have to admit that I do not watch your show, other than the March 4, 2014 broadcast in which you stated that “If I want a strep throat diagnosis, I don’t want Lenny. . .,” in references to clinics that are staffed by physician assistants and nurse practitioners.  Mr. O’ Reilly, can you please clarify your statement as to why the care received from a physician assistant or nurse practitioner, although good enough for  millions of Americans, is not good enough for you?  I took my son today to an urgent care clinic for what I knew to be otitis media, and he was seen by a nurse practitioner who provided excellent, compassionate care.  My children receive all of their routine care from a physician assistant who specializes in pediatrics.  I did not go out of my way to choose them as these were the providers chosen by my insurance, but given the choice I would pick both again.  This is the reality of medicine in America today, and I and many patients, especially those living in rural, under-served areas are grateful for my fellow physician assistants and nurse practitioners.  Physician assistants are increasing access to high-quality healthcare. We know better than anyone that our health care system is broken, but instead of making disparaging remarks about the people doing the work, we just roll up our sleeves and do everything we can to make sure that we take care of everyone who walks through our doors.  Please join us in our fight to make our medical system better by highlighting what works, including the 95,000+ physician assistants working in hospitals, clinics, and nursing homes. I look forward to your response.



To everyone following my blog along this Lenten journey, I hope you know that I write only about those topics which inspire me and which I hope will inspire you.  For my gratitude journal, I am blessed to have found my life’s calling as a physician assistant, and I love what I do every day.  What I try not to do is participate in discussions that denigrate others or are polarizing, and I am thankful for the opportunity to live in a country where it is still permissible to freely voice our opinions, but when misinformation which is harmful is disseminated, I have a hard time not speaking up.  Please take this as fair warning that this may happen again 🙂 .  I welcome any comments you may have about your experiences with PAs, and am aware that there are bad eggs among us, just like with any profession.  Also, please feel free to tell me how you are doing with what you have given up as we blaze on. I am still working on that fear of failure, but have to admit it is getting a little easier with each blog post.  Please pray for a speedy recovery for my  little guy and his bilateral ear infections.  He is sleeping now, as we all should be.

I am providing a link to the clip of the show solely for the purposes of accuracy:

If you are a physician assistant and would also like to respond to Mr. O’Reilly, please check out this link from the American Academy of Physician Assistants (the italicized parts of my letter were copied from a template provided on this link). I could not, of course, resist adding my own touches:

Ashes & Smoke

On this Ash Wednesday, my thoughts turn naturally to fire and smoke.  Did you know that the ashes smudged on our foreheads come from the burning of Easter palms? I don’t pretend to be familiar with all that goes into the preparation of these ashes, but I picture an enormous conflagration burning white-hot, shriveling green and yellow palms into the black ashes with which we are marked, billowing white smoke surrounding those tending the flames.

Smoke can tell you a lot about a fire.  It seems intuitive, but something I never thought about until I became a firefighter’s wife.  In my life, and probably yours too, my only contact with smoke was innocuous and annoying at most, like when the wind blows campfire soot and embers toward you, or perhaps a signal that it’s time to get rid of the $10 toaster you bought on sale.

Now, smoke is always bad, in this land where the Rio Grande no longer lives up to its name, and a cigarette butt thrown from a truck window can set flames greedily licking up the wooden stairs to a freeway bridge.  Like settlers in the Old West, my husband and his crew scan the horizon, reading smoke signals.

White smoke on the horizon tells them that a knock-down is occurring. Steam and residual smoke from a fire are mixing,  and the fire is on its way to being contained.  Not surprisingly, black smoke is a harbinger of a poorly contained-fire, likely burning toxic materials, one that is not yet under control.  Either way, firefighters see smoke and a curious mix of trepidation and excitement charges through them.  This is what they train every day to do.


In the same way, Ash Wednesday heralds the beginning of a fire for me.  It is a time of change, burning away the old, and each Lent I am filled with a similar mix of trepidation and excitement.  When I was a child, it was a time of deprivation: what could I give up, so I could mimic those 40 days in the desert?  I did not understand then what I know now.  The challenge is not just emulation, but true change.  Can we burn away that which makes us toxic?  Will the fire that lies within us be enough to leave nothing but the ashes of renewal?

This blog is part of that renewal process for me. The drive for perfection stalls me before I speak, before I write, before I start any new project, as a protection against failure. I am giving up my fear of failure for Lent, and thus I will be posting every day, fighting the urge for perfection in every line, and I’m sure my hands will be shaking before I hit the publish button. And so, on this first day of Lent, I begin this journey and invite you to be a part of building this fire with me.2012-11-24 16.48.31What do you want to set ablaze?