Adventures at 101 Independence Ave SE


In honor of National Book Lovers Day, I thought I’d share with you the most nerdly adventure a book lover like me could have–a day spent at the largest library in the world, which is located in our own nation’s capital. If you’ve never had the luxury of exploring the Library of Congress, I’ll offer my portrait of a beautiful and wondrous place that could not have existed without one man whose quote all book lovers can identify with:

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In Washington D.C. for the day after a phenomenal conference on genetics and genomics where I was representing PAs, I started off the day getting off the Metro at Union Station, and headed to the U.S. Capitol Building, where I had signed up online the night before for a tour at 8:45 am (the earliest available). It’s free, but you must sign up, as the tours tend to fill up fast.  I’ll share the tour of the US Capitol in another blog post (one of those patriotic, sappy ones, so be forewarned now!), but suffice it to say, I was thrilled to see a sign that pointed to a tunnel between the U.S. Capitol and the Library of Congress.

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This tunnel, besides the cool factor of travelling underground between two very different buildings, had the advantage of bypassing security (though you have to pass back through security when heading back from the Library of Congress into the Capitol), as well as being literally cooler given the muggy D.C. heat even at that time of day.  For the members of Congress to have the Congressional Research Service which directly serves Congress in such close proximity is likely quite useful.

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Besides the sheer beauty of the frescoes and statuary there, the immensity of the Library of Congress and all it encompasses is astonishing.  It is actually 3 large buildings, the Jefferson, Madison, and Adams buildings which are all interconnected (yes, more tunnels!). This is the Great Hall of the Thomas Jefferson Building. Hours could be spent in this part of the library alone.

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At any time, numerous exhibits are ongoing at the library including one currently on Gershwin, another on World War I propaganda art, and another on a collection of maps including one of the first of America.  As part of their bible exhibit, which contains 18 from their collection of over 1500 in over 150 languages, I got to see the Gutenberg Bible, pictured here, and the Giant Bible of Mainz. Everyone knows about the Gutenberg Bible and its significance in regards to movable type, but to have it juxtaposed with the Giant Bible of Mainz which was hand lettered, and produced in the same time and place provided a great contrast.  Seeing first-hand the visible guidelines so that those lettering it could write in a straight, neat line, really brought home how time-consuming a process it was. It took the scribe 15 months, ending on my birthday in the year 1453 of all days!

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While exploring all the buildings, I came across the U.S. Copyright Office housed on the fourth floor, which I did not know was a department of the Library of Congress. It contains the world’s largest database of copyrighted works and copyright ownership information. In fiscal year 2015, it registered an astounding 443,812 claims to copyright.  So, there are definitely new things under the sun, though many would claim the opposite to be true.  An office where hearings regarding copyright are conducted is imbued with a modern art twist. By some strange chance, I happened to come when no one was present, and I felt a bit like Alice in Wonderland come upon some strange alternate dimension, as its decor was so different from the rest of the library.

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In my travels through the basement, I came across hallways lined with card catalogs.  I thought perhaps they had been abandoned for computer records, however, Carl from Engineering soon disabused me of this notion. Apparently, most resources can be found via computer, but they keep the card catalog because not everything has been put into the computer databases, and he still finds researchers standing with drawers open, writing on pull-out wooden shelves in the basement searching for hidden treasures.

I also came across a giant globe, and one of the engineering workers in hard hat stood studying the topographic map for a long time whilst I took a picture of this giant globe.  It allowed me to give a perspective of just how big it was, and the way he stood there just begged to have the picture taken.

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There’s an even larger one upstairs on the second floor in the Madison building, but I was told it was in an area of mostly offices, and the woman on the elevator could not tell me what its significance was.  In my very active imagination, I thought that perhaps they had to be separated because the force of gravity between the two massive globes would wreak havoc on mortal beings and delicate instruments betwixt them.  Either that or having 2 globes next to each other wouldn’t be structurally sound, but that seems a rather boring answer if you ask me.

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I did my part in rescuing our economy from financial ruin by making sure to visit the gift shop where I had to stop myself from buying a large scarf printed like an old library card, and one of these fun purses made from recycled Reader’s Digests. The children ended up with a keychain globe of precious stones, a parchment set with quill and glass inkwell, and accurate, readable copies of the Constitution, Declaration of Independence, and Bill of Rights.

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Lest you think the library is only for adults, the Young Reader’s Center is a cozy set of rooms on the ground floor with the requisite puppet theater, low tables for artwork, a television with DVD player in a small viewing room and a cushy sectional with large bean bags for curling up to read books and listening to Story Time. If I lived nearby, I would come here every day with my children.

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Windows everywhere fill the rooms with natural light. There are step stools throughout to reach the upper shelves (so thoughtful, says the short person), with whimsical carved animals like this one.

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All this walking began to make me hungry, and thinking I didn’t want to go back out into the heat, then come back in through TSA-like security, I asked if there was a place to eat nearby.  It turns out in the basement of the Madison building (far away from all the books), there was a Dunkin Donuts, Subway, and a small coffee shop, none of which sounded sufficiently adventuresome to me. On the 6th floor of the building, though, I also learned that there was a large cafeteria, which according to another man with a silver hard hat in the basement, “Is excellent. I mean, really outstanding.” So, of course, I had to make my way up to the Madison Café. Unfortunately, the elevators chose that moment to go out of service, so I earned my lunch by climbing up the stairs to the 6th floor. And the man in the hard hat was right. The variety of choices was a vision especially with my stomach growling loudly enough to be embarrassing.  It included a buffet with offerings included deep-fried oysters, stuffed cabbage, a salad bar, 3 different types of soups, numerous desserts including bread pudding, as well as a grill for made-to-order burgers and sandwiches, a sushi bar, an Asian section with phở, udon noodle soup,  a bibimbap bar, and a breakfast food area.  I chose a beef bibimbap with japchae and cucumber kimchi that was surprisingly good for $7.99. The Asian girl serving the food behind the counter ended up with a similar plate behind me in the checkout, so I knew it had to be at least palatable, or at the very least not poisoned. Perhaps it was because I was so famished, but it was, in fact, delicious.

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I couldn’t get over the fact that I was eating delicious Korean food in the Library of Congress while sitting looking out over the city, when a church bell from nearby St. Peter’s Catholic Church began to toll in the tower across the way from the library.  It was definitely surreal.  The glowing cylinders in the air aren’t ghosts of presidents past hanging about, just the reflection of the pretty light fixtures in the cafeteria which was decorated also with posters from all over the world, and photographs of children reading.

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Thus refueled, I went next to the Moving Image Research Center, where you can view movies, though you have to request it at least 2 weeks in advance as they store most of the films offsite.  They began collecting motion pictures in 1893.  Films are shown and open to the public in the Mary Pickford Theater which is within the Library of Congress itself. Seating is first come, first serve though. It was there that I learned that anyone over the age of 16 could get a library card.  So being the giant book nerd that I am, I had to get my very own Library of Congress card.  I’ve covered up the picture of me grinning like a fool and part of my signature with my Metro card, which I suppose I’ll save until I come back to D.C.

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The process to get a library card was surprisingly quick, starting with a line-up to speak to a lady who requested my driver’s license, asked me if I had requested a library card online, and since I had not, directed me to a set of computers where I filled out a form, then went to sit in line to get my picture taken.  The whole process with 2 people in front of me in line took at most 10 minutes, and was much more enjoyable than any visit to the DMV.

Upon leaving, I saw a curious sign and heard Barry Manilow and laughter spilling from the adjacent room.

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I peeked inside and saw an incongruous sight–couples waltzing, ranging from young to old, of all different races.  They beckoned me in, saying “Come on in and join us.” So I did.

My only previous exposure to ballroom dancing was a dancing instructor hired for Dana’s 30th birthday party, where I learned that I am awful at following and possibly born with 2 left feet, and resolved at that point to avoid any kind of structured dancing without more instruction.  Well, the more instruction day had apparently arrived, in the form of Dean. I could not tell if he was with the other 2 instructors, one a matter-of-fact early thirty-something Caucasian lady in pants and dancing heeled shoes, and the other a smiling tall African American man in polo shirt and chino, or just really loved ballroom dancing.

Thanks to Dean and his “big step, little, little” and “1, 2, 3, 1, 2, 3” I acquitted myself reasonably well with a “Well done!” from the tall African American man who asked if I’d done this before, and learned the twinkle step and the patty cake. The pictures are somewhat blurry because most of our time was spent dancing, as it should be.  I spent about 30 minutes in this slice of alternate reality, most of it smiling like a crazy person, because who goes ballroom dancing in the Library of Congress? Me, I guess.

Oh, and at the Library, there are also a bunch of books. Stacks and stacks of lovely books–in case you thought I only like libraries for all the other cool stuff. I once worked with a PA, and perhaps he was teasing me, given what he knew about me and my love of libraries, who said that he didn’t see the point of libraries, stating that if he wanted a book, he would just go buy one at the book store.  I sputtered, and tried to articulate all that libraries mean to me, a person who could count the number of books in the house while growing up on 1 hand.  My adventures at 101 Independence Ave SE just confirmed what I knew when I was just a little girl with a library card: Libraries are a portal to another world, a place where magic becomes reality if you can only open yourself up to all the possibilities and knowledge the world has to offer. I’m thankful for libraries, and for a country that believes that knowledge is important enough to preserve for everyone in a place of unsurpassing beauty and wonder.

 

 

 

 

 

 

 

 

 

 

Ode to Bánh mì


I had a very serious post planned for today, opening sentences poised, and paragraphs half-written, then someone told me it was National Sandwich Day, and my mouth started salivating.  Like one of Pavlov’s subjects, the word sandwich in my mind is irrevocably tied to Bánh mì which is a Vietnamese sandwich.  Now I know that a lot of these National Day of Whatever have been started for purely commercial reasons, but for a person who loves food and eating as much as I do, any excuse to eat one of these is good enough for me.  

Bánh mì thịt heo nướng with cilantro, peanuts, large cucumber slices, juillienned pickles carrots and daikon radish, and jalapenos.

Bánh mì thịt heo nướng with cilantro, peanuts, large cucumber slices, julienned pickled carrots and daikon radish, and jalapenos.

It wasn’t always like this.  In the small town outside of Detroit where I grew up, Vietnamese food was made only by people related to me. At home. And we were not a family who went out to eat at restaurants except for very special occasions, and then to a Szechuan place about 20 minutes away in Garden City.  The owner spoke Korean. My dad would start conversing with him, and ask for the special menu, meaning the dishes that weren’t found anywhere on the plastic printed menus with tiny red pepper symbols next to them.  Pretty soon all manner of delicious foods were paraded out and placed on the table, from fried mandu (dumplings deep-fried to a perfect crispy texture, with a slightly chewy inside layer, with seasoned meat inside, just hot enough to make you inhale sharply through pursed lips, but not hot enough to burn your tongue) to seafood dishes brimming with crab, sea cucumber, shrimp, and artistically cut, slightly crisp vegetables swimming in an oyster sauce. Delicately seasoned broths with crackling bits of rice, browned just to the point of crispiness were an entree and not part of the first course. And, at the end of the meal, my dad would not even raise an eyebrow at the bill, always leaving the owner a generous tip, which would then make my mother’s eyebrows shoot up alarmingly.

I don’t mean to say that we were deprived, as my mother has a knack for tasting a dish, and being able to replicate it, and most of us would prefer to have a home-cooked meal by her over any restaurant meal. But because of this, I grew up fairly unexposed to restaurant Vietnamese food, which is a little different from your home-cooked meals.  The only way to get these was in Windsor, Ontario, which in the pre-9/11 days, was a 20 minute drive across the Ambassador Bridge to University Street.  It felt like a foreign country, the sights and smells just like the Asian grocery store, but multiplied a hundred-fold.

This was where I first saw the classic dangling barbecued red ducks, held up ignominiously by their clawed feet.  We’d go into a number of different shops, through some algorithm in my mother’s head on who had the best prices for whatever she had in her mental list.  I never saw my mother write out a to-do list or shopping list, and constantly wish I had her memory. She mourns the fact that she has trouble remembering things now as she used to know by heart all the phone numbers for all the telephone exchanges for the military base where she met my father. I tell her her memory has subsided to normal human level now.

One of the visits was always to the herbalist, and the acrid, stinging scent brings back instant memories of the concoction she must have spent precious money on to try to fatten me up. The dark brown, murky liquid with various roots and leaves in it was brewed on the kitchen stove, then ladled into what looked to me like an impossibly large cup. A small piece of hard candy was laid next to it, as incentive to finish the entire thing, preferably without gagging or retching. The house would be permeated with the smell, and my brothers would watch me as I sat at the kitchen table, face resting on fisted hands, sympathetic but staying far enough away that they wouldn’t be noticed and possibly made to drink it, too. That was in the days when I was in such a hurry to get back to my books that food wasn’t such a priority to me, and I was, as my mother called it, “a toothpick”.

It didn't work, unless there is a delayed effect 25 years later.

It didn’t work, unless there is a delayed effect occurring 25 years later.

Unfortunately, or fortunately, I’ve learned since then how delicious food can be.  Part of that appreciation started with the Bánh mì sandwich.  The kind my mother always bought was what is known as either bánh mì thịt nguội, or bánh mì đặc biệt.  Bánh mì is a general term for all bread in Vietnamese, however, it is also synonymous with the sandwich, which is made from a French baguette made usually with wheat and rice flour (though I’m not able to taste much difference between those with rice flour and without). It is one good by-product of the French colonial times in Vietnam.  Thịt means meat and nguội means cooled or cold.  This is also sometimes known as bánh mì đặc biệt meaning a special sandwich, which seems more than appropriate to me.  It’s filled with Vietnamese cold cuts which may include what we called Vietnamese bologna growing up or chả lụa (pork sausage), head cheese (more delicious than the name sounds, trust me), and sliced pork roasted with the classic red seasoning, and sometimes liver pâté. Though delicious, the meat wasn’t the best part of the sandwich, as it could not be complete without pickled carrots and daikon radish, julienned fresh cucumbers and cilantro. A buttery mayonnaise added some moisture and helped to bind all the ingredients together.

Fixings for

Fixings for bánh mì thịt nguội

Thrown in like little red hand grenades of spiciness were the deadly red Thai chilies, sliced to such minuscule portions that they were nearly impossible to ferret out completely, inevitably leading to abandoning the sandwich briefly for several glasses of water, followed by careful eyeing of the sandwich yet again, before taking the next tentative bites.  Because it is so delicious, and you think you’ve been meticulous about catching all the peppers, a few more bites will lead to thinking you are safe, and then another ninja chili will cause your tongue or lips to blossom in pain, and the whole process will begin again. These were a special treat, and each of us would get one small baguette for our own.  

These may look like ordinary Thai chili peppers to you, but be forewarned, they are stealthy and wicked.

These may look like ordinary Thai chili peppers to you, but be forewarned, they are stealthy and wicked.

I thought perhaps at first that it was the novelty and scarcity of the sandwich which has also been called a Vietnamese po’boy or hoagie, which was the attraction.  As I got older and got a chance to try many other kinds of sandwiches including reubens, Cubanos, Philly steak hoagies, and calzones among others (can you tell I have no issues with gluten sensitivity?), the novelty of bánh mì wore off. Or so I thought.

Then when I was in the process of moving to this high desert place we now call home, I made a phone call to the physician assistant program here, in the hopes that they might have an opening so that I could continue to be involved in educating PA students as I had in Detroit.  The PA program director told me that she did not, but would be happy to take my name, and C.V. in the event that an opening came available. As I spelled out my name for her, the tone of her voice changed from polite interest to animated questioning.

“Are you Vietnamese?” she asked.

“Yes, well, half anyway,” I replied.

“Can you speak Vietnamese?”, she asked, her voice becoming more excited.

“Um, yes?” But what does that have to do with teaching PA students I wondered to myself.

“Did you know there is a very large Vietnamese population here? And some of our students are Vietnamese.”

“No, I assumed it was mostly Spanish and Native American,” I responded, wonder dawning in my voice.

In the end, I got to teach here, and not only that I discovered the proximity of not one, but several Vietnamese sandwich shops, Vietnamese restaurants, and even a Vietnamese church. I had gone from being related to the only Vietnamese people I knew (other than those I met in college), to a city filled with them, completely on accident.

And so I did the only thing I could do.  I went to every Vietnamese place I could find to try the bánh mì (and the phở, but that’s another blog post). Purely for research purposes, of course. I discovered bánh mì thịt heo nướng, what I now call the gateway bánh mì, filled with seasoned roast pork, a sandwich no one I’ve ever introduced to has ever disliked. And, like so many other things, I’ve discovered that there are many right ways to make a bánh mìall of them informed by personal choice, with variations in bread which is normally baked on site, fillings, types of vegetables included, consistency of mayonnaise (which is definitely not Hellman’s) and chilis used. Here in the Southwest, those red ninja-stealth chilis have been replaced by jalapenos, which when seeded and sliced, often look just like the much more innocuous green pepper.

Fresh, they could be green peppers in your sandwich. Except green peppers don't make your lips feel like they want to fall off.

Fresh, they could be green peppers in your sandwich. Except green peppers don’t make your lips feel like they want to fall off.

Same effect, different chili, but still delicious.  It turns out I was wrong. I’m pretty partial to bánh mì, even if I can have one every day.

Not that I do.

Or have done.

Not yet, anyway.

Though I'm not a tshirt collecting person, I would wear this.

Though I’m not a tshirt collecting person, I would wear this.

Liberation


Forty years ago today, Saigon fell.  It is a date engraved upon the hearts of many Vietnamese people, as well as many veterans. If you were old enough to remember, the images of helicopters, crying people with outreached hands, and flames are forever linked to this date. It is thought of as a symbol of leaving, of endings, and for some, of failure.  It has been called Black April and rebranded by those in power in Vietnam as National Liberation Day or Reunification Day. My veterans express regret and sorrow about leaving Vietnam like this, mixed with the relief of being able to go home. Some remain haunted by the images of those left behind, bound by the ghosts of the past, while the diaspora are reconciling the Vietnam they left in 1975 with the changes time, politics and money has wrought.

I am too young to remember leaving my birth country. I was a baby in my mother’s arms when we hurriedly boarded the C-130 that would take us to the refugee camps in the Philippines and Guam.  As with all immigrant stories,  ours is both the same and different from the thousands of other Vietnamese families that came to the US.  The date our family left Vietnam was actually April 26, 1975. My parents, grandmother, aunts and I were blessed to leave on an airplane, compared to so many others at the mercy of the seas who fled on boats, though this airplane had been stripped of all of its seats in order to fit as many people on board as possible.

My baby boy descending the ramp of a C-130.

My baby boy descending the ramp of a C-130.

When we finally arrived in the US, my parents set about making a life for all of us, though they had little resources.  My father’s first jobs were working for RCA as a repairman, and for a steel mill where he worked until he retired in his late 70s.  Because they had only 1 vehicle, my father would drop her off before the bakery opened before the sun rose, recalling today how hard it was to leave her there in the cold darkness alone so that he could make it to his 2 jobs.  She made so many pies, that to this day she refuses to make pies from scratch.

A pie made by me, and not my mother.

A pie made by me, and not my mother.

She then did back-breaking work in a nursing home, enormously pregnant with my little brother, lifting and bathing patients.  Under the watchful eyes of my grandmother and my mother’s two younger sisters, I learned English from watching Shirley Temple movies and Underdog cartoons, and reading Little Golden Books about Cinderella.

Eventually, our family saved enough money to bring my mother’s two brothers and their families here to the US, but not until almost 20 years later, after reeducation camps and deprivation at the hands of the Communists.  I had the advantage of growing up in America, with the constant reminder that I had cousins in Vietnam who were not as lucky, and so I, like so many other Generation 1.5 children, was pushed to succeed though hard work and education by my parents, who had left all they knew and loved behind with the hope for a better future for their children. Exactly 22 years later, surrounded by the entire reunited family, I was married on April 26, the date my wedding was changed to through a series of unplanned and unexpected events.  Now 40 years later, as a physician assistant, I am serving some of those same veterans without whom I would not have existed.  If not for the war in Vietnam, there would have been no need for a Korean firefighter to come to Vietnam.  If not for the American army base where my parents worked and met, there would not have been any seats for us on a C-130 to fly us all away from Vietnam.

Today, as we look back on this date, I was struck by the photos of this baby miraculously unearthed from the rubble of the earthquake in Nepal.  Pictures of helicopters, outreached hands, and flames are featured on news stories across the internet. Thousands of families have been separated, lost loved ones and their homes, and the date of the earthquake will forever separate their lives into before and after. And in the midst of all of this tragedy, we focus on the life of one small baby, liberated from the dust and ashes, surviving despite the tremendous odds against it.

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We rejoice in this story of life arising from the rubble and ruins because we all share stories of liberation, some more dramatic than others, but no less important in the way that they link us all–from the ashes of a fallen city, to a road not taken, a life left behind, and still we learn to build again.  True healing begins with that first turning towards the light of home, which is wherever we make it. This then is the true meaning of liberation, not that spun by those who would have us forget the struggles and the sacrifices of those who reached down and pulled us from darkness to true freedom.

Today I am grateful for my parents’ bravery and courage in the face of overwhelming chaos and tremendous odds.  I would not be who I am or where I am if not for all of their sacrifices. I am thankful for all of my family and for the astonishing grace of not having lost a single family member to the war.  And I pray for all those in Nepal, that someday, they will look back on these days, and be able to say they are stronger for having survived.

Please pray for the many medical and relief workers as they work tirelessly for all those affected by the earthquake, as well as the family members of Marisa Eve Girawong, a physician assistant who was killed there.  If you would like to donate, check out the Better Business Bureau’s website which has a list of charities providing aid to Nepal that meet the BBB’s standards of accountability, as well as InterAction Nepal’s website which can allow you to direct your donations to specific needs, such as medicine, food, or shelter.

His Great-Grandfathers’ Boy


“Why in the world would you let your son buy a book about war?” This was the question posed to me at a thrift store by the well-meaning woman behind the counter.  I looked down at my son, then seven years old, gamely clutching his pick with two hands.  The World War II Encyclopedia cover was graced with black and white pictures of tanks, uniformed men, and flags, and looked heavier than my son, skin and bones that he is.  His large brown eyes looked back at me, unblinking, sure that his mother would persevere in buying him a book, because when had I ever refused any child of mine a book?

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What she didn’t know was that unlike his sisters, for whom words are the keys to Neverland, incantations to the spell of transformation that leaves you blinking not to see wings when you stretch out your arms, for him books were still mysteries.  For me, reading meant figuring out how to get my constant-motion machine to sit still long enough for the magic to enmesh him.  That he had picked a book, instead of a gadget with moving parts or a brightly colored toy was a revelation to me, at least until I saw the title of the book.

You see, though my husband was one of three brothers, thusfar the weight of carrying on the family name rests solely on my baby boy. He has always known of the meaning of his first name, which is actually my mother-in-law’s maiden name, just as my name echoes my mother’s maiden name. I believe strongly in the power of names, and the legacy bestowed by the double burden of carrying both of his great-grandfather’s names (and his father’s) is one I think was worth passing on.

I never knew the benevolent gaze only grandfathers can give until I met my husband’s.  Our family is blessed with strong-willed women, and my mother’s mother is ever-present in my earliest memories, but the towering legends of my grandfathers were passed down in bits and pieces through stories of their fierceness.  My father’s father was stoic, unsmiling in black and white photos, a patriarch in war when his sons were pursued by Japanese soldiers through the mountains of Korea.  My mother’s father was a religious man felled by a stroke, then lifted up by inner strength and determination to walk again to the church the Communists worked to take away from him.  I never met either of these brave men, dead long before I drew my first breath.

My husband’s grandfathers though, were kindly, white-haired men who patted my hand, accepting me into their families without a word.  The Vietnamese word for grandpa was not even in my immediate lexicon, and my husband had a nickname for one of his–his PaPap.  He was a quiet man, one who never spoke of his service until shortly before he died, of landing on the beaches of Normandy the day after, of being part of the “clean-up crew.” I knew him only as the very quiet man who opened his home on Christmas Eve. I always felt comfortable with him, as he was reserved like me, an oasis in the maelstrom of preternaturally good-looking cousins whipping quips and insults with equal wit and precision at one another.  I cherish especially 2 memories of him, one of dancing with him at my wedding, and the last in which I was able to bring my baby boy to him at the nursing home before he died, so my husband and I could tell him that our little boy shared his name.

In my everyday work, I meet veterans who have served all over the world in many different wars, but I have a special place in my heart for World War II veterans.  This is because of my husband’s PaPap, but also because they are a special breed.  One veteran who was in the Battle of the Bulge spoke of being lucky because he was able to get a warm jacket from one of his Air Force flying buddies, while everyone else had summer gear in the brutal winter that ensued.  He was seeing me for frostbite 70 years afterwards, being treated for the first time ever for the residual effects.  He had mentioned it in passing to his primary provider that perhaps the numbness and tingling might be from the frozen toes he had suffered while in Germany by way of explanation, and not complaint. I was mesmerized by his stories, of men and boys unprepared for the long battle. Seeking words of wisdom, I asked him, “How did you do it?  How did you survive?” His answer, like so many other WWII vets, underscores what sets them apart:  “We endured.” There was no drama, no entitlement, just a simple, succinct statement in which he counted himself as part of the whole, doing what had to be done.

When the boy who would become my husband told me that if he could be like anyone, he would like to be like his grandfathers, impeccable in actions and words, I wondered what it would be like to have flesh and blood heroes.  I wanted that for my son.  And knowing this, knowing that he chose this book to learn more about what his great-grandfathers had experienced, I would not have spared him a “a book about war.”  My girlfriend’s first child is a boy. In the way all mothers have, she wished to protect him from the evils of the world, and so asked family and friends to refrain from giving him any toy guns or weapons. In the mysterious way of many boys, he fashioned guns out of paper and ran around the house shooting at imaginary enemies despite minimal exposure to these things. Neither her son nor mine are brutes or sociopaths, both of them animal-loving, gentle souls who love to be snuggled by their mothers.

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My little guy standing in the back of a C130, the plane in which we fled Vietnam.

As I looked at this woman, I considered all of these stories, trying to figure out how best to answer her.  How did I tell her that if not for one war, I would never have existed? How to tell her that my parents grew up in war time, their parents figuring out how best to protect their families, and perhaps her parents doing the same, so that one day I might have the chance to stand here and debate with her about the appropriateness of reading material for my son? How to tell her that though peace is what we all crave and would wish for our loved ones, the reality is that war exists, and to pretend that I could shield him from this is to deny the sacrifices that better people than she and I had made?  How did I show her that though we have been blessed since the Civil War not to have war in the United States, it is through the remembrance of those battles and those veterans, that we can hopefully prevent bloodshed here?  Did I tell her that though I would never want my son to have to know what it is to spill the blood of another, I would proudly call myself the mother of a soldier if he so chose to follow that path?

Unfortunately, I did not. As is always true for me, the words sat in my mouth, angled edges weighing down my tongue. Instead, I said only, “His great-grandfather served in World War II.” She frowned disapprovingly at me, and reluctantly took it from my son’s hands to wrap it.  Today you can find this book on my son’s bookshelf. The pages are bent in some places where he has stopped to bookmark something compelling to his little boy brain. When he reads it, his brows furrow in concentration as he pores over the black and white pictures, and I can see the generations of men in the lines of those furrows, stretching far back into the past.

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Today I am thankful to live in a country where little girls like myself can grow up to carry on their father’s names, for grandfathers and great-grandfathers living and dead who inspire us to be impeccable and fierce, and for the unique gift of being the mother of a son who has been blessed to grow up under the loving eyes of both his grandfathers and grandmothers.

Has a stranger ever questioned your parenting choices? How did you respond? Have you had qualms about what is and isn’t appropriate reading material for your children? Do you have a story about your grandfather or great-grandfather that you’d like to share?  If so, I’d love to hear it.

Triskaidekaphobia


The first time I was truly afraid of a patient, I was standing in an outpatient family practice clinic in Detroit.  If you’ve ever felt mind-numbing fear, you know that it creates a dividing line between that moment and the next. Strange details imprint on your brain, like the heft of the chart in your suddenly damp hands, and the musty smell of an exam room suddenly grown tinier.  Grown men have told me that part of the attraction for going to war is learning if they have what it takes when confronted with the fear that is part and parcel of combat.  When we watch movie characters stumble into bad situations, we have the prescience that comes with being an observer, and tell ourselves that we would never, ever go into the dark house after the psycho or get in the car with the charming serial killer.  In actuality, how often do we do dangerous things and not realize how close we stand to the precipice?  As my childhood friends will tell you, I had what I considered a charming unawareness for these types of situations (until, of course, I became a mother), and perhaps it came from my innate belief that all people are good.  When I was younger, I traipsed into places and talked to people that now I would never let my children associate with, but again, I really didn’t think anyone wanted to hurt me, and I trusted that I would know it if they did, but perhaps that was hubris or plain dumb luck that I never got hurt.

This time though, the analytical, writer part of my brain was coolly noting that, for once, I was actually not only assessing the situation accurately, but also responding in what I thought was a very calm and non-threatening manner, though the other animal instincts in my brain that had made the fine hairs on the backs of my hands prickle within the first 2 minutes of meeting this patient, were screaming “Run! Get out of there, right now! Do not pass go, do not stop! Get out!”  It was like, and I kid you not, the good buddy in movies, you know, the sensible one like Velma, or actually more like the hyper-panicky one Shaggy, tapping on my shoulder and whispering “I don’t think this is a good idea.”

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Having grown up in the suburbs of Detroit, in a town where everyone looked so familiar I would have trouble placing the face as being someone I knew from church, the gas station, school, or work, going to PA school in “the city” was exciting to me.  I knew I’d be exposed to situations I’d never experienced, and like my combat veterans, wondered if I’d have what it took. I wasn’t afraid of the crack addicts or gang-bangers. I was afraid that I wouldn’t know how to react, wouldn’t have what it took in the face of an emergency to do what had to be done–chest compressions, suturing, bandaging, reading EKGs accurately. I thought I’d be most afraid in the ER at Henry Ford Main, or during my psychiatry rotation where I was on the inpatient consult service for Detroit Receiving and Sinai Grace, because of the out of my control aspect of those situations.  In an outpatient clinic, I naively thought, at least you could kind of predict what kind of day you were going to have.  Appointments are scheduled, and you can predict what kind of patients you will see, unlike in the ER, when you can have a heart attack, gunshot wound to the hand, and head cold all walk in at the same time.  It was a controlled environment, I thought, and control of my environment is key.

All of us desire control. It begins when we’re learning how to talk and walk.  This is where the terrible twos (and threes and fours for some of us) get their name.  The desire to exercise our will on the environment is innate.  We want to be able to choose our path. We want to believe that we have control, though in reality, we have very little. Today is Friday the 13th, a day many fear, though most of us find it superstitious.  We scoff at people who would have “silly fears” of things like the number 13, but in reality, don’t we all pause for just half a second, if we have an interview or date that gets set for Friday the 13th or we’re placed in hotel room #13? It doesn’t stop us from continuing on with our lives, but given the choice, just to be on the safe side, wouldn’t we change the date or room number, if we could?

As children, many of the sayings that we grew up with enforce those beliefs: Step on a crack, you’ll break your mother’s back–so we avoid walking on the cracks, just in case. It’s part of the mistaken belief, these superstitions, that we can control our destiny. We believe that by following all the rules, we can control our circumstances.  As children we pray, if I promise to do all my homework next time, please let me pass this test. As adults we pray, if I promise to be a better mother, please let her be OK.  Fear is irrational, it compromises our illusion of control, because it shows us how little power we actually have.  When we see through the eyes of fear, nothing is in our control, and that is the most frightening thing.

The unkempt woman in the musty exam room looked right through me.  All of us want to be seen, truly seen for who we are, and when others do not see, it can be frustrating, and make us doubt ourselves.  When she did not respond to me, I wondered for a brief second, did I not speak loudly enough? I had read her chart before coming in the room. It was supposed to be a routine follow-up for her annual gynecological exam.  Her list of medications gave me clues to what was missing in the 1 sentence description of why she was there.

“Have you been taking your Clozaril?” I asked.

“My mother has blue hair. Do you see them? People walk on buses,” she said.

Being alone in a room with a schizophrenic patient off her medications is not a place for a green PA student.  My very first rotation was psychiatry on the inpatient wards. Ingrained in us were several rules: Make sure to always be between the patient and the exit.  Make sure that someone knows where you are at all times.  Make sure that you wear long hair pulled back so a patient cannot grab you.  I had seen schizophrenic patients on their medications, discharged them home to the loving care of family or friends, after seeing them admitted off their medications, when they could not distinguish between their reality and ours.  Most were not violent, but what was frightening was their inability to see us. To them, I could have been a 300 lb body builder threatening to take away their most prized possessions, and as anyone who’s ever been threatened knows, fear will make us strike out to protect ourselves.

Fear will take a perfectly reasonable person, and turn them into a knife-wielding, gun-toting, hate-speech throwing part of a mob like those we’ve seen on the news.  It turns off the reasonable, logical parts of our brains, and takes us back to the child we all were once, vulnerable and at the mercy of others.  When we point our fingers at others, tsk at the behaviors that we, of course, would never engage in, scoff at superstitions and phobias, we forget to look at what prompts them.  We forget to look deeper. We forget to ask ourselves what are they really afraid of–and what am I afraid of that I am too blind to see them for who they really are.

“You know what? I think I left your bloodwork outside. I’ll be right back,” I lied, and briskly walked out of the room, straight to my preceptor’s office, and explained the situation to him.  I never saw that woman again, but I’ll never forget her eyes or the trembling of my hands afterward.  Have you ever been truly afraid? Do you have any phobias or fears that may seem irrational to others? I’d love to hear about them. I discovered an irrational fear of heights when I climbed up on a ladder to explore an old B52 bomber, and could not make my legs work to climb back down the ladder I had just ascended 10 minutes prior.

Today I am grateful for reminders that all of us have fears that lie behind the facade of control we all cling to. I am thankful for the friends who kept me from making irrevocable mistakes in my innocence when I didn’t have enough fear, and hope my children will have such good friends as they make their way through a world filled with too many choices.

And because I’m a giant nerd who loves words:   Triskaidekaphobia is derived from treiskaideka, the Greek word for thirteen + phobia, fear of = a fear of thirteen.Pi

Holding Hands


My father has hands like bricks, reddened and hard, fired through years of tilling Michigan clay, lifting dirty tires in February winds on the narrow shoulders of freeways, and sanding smooth the doorways of the house in which he has lived since 1977. I never thought much about his hands, except as a kid when I’d done something wrong and feared his wrath. In the days before time-outs and worrying about self-esteem, my father’s hands were scarier than a belt or a “wisdom stick”. My grandmother and mother used switches we had to pick ourselves from the two oak trees in the front yard, but my father’s hands were tough enough to make us think twice. Punishment meted was swift and painful which we earned often enough between the four of us, mischievous and curious as we were. We didn’t view it as abuse, given the nature of corporal punishment at the time, in fact, preferring a swat on the behind to being grounded or other non-corporal punishments.

My hands look more like my mother’s, slim with longish fingers for the small hands that I have. I always wanted bigger hands with longer fingers, thinking them elegant and more agile for things like playing piano or building things. Having small hands can be advantageous though, as I discovered the first time I participated in an exploratory abdominal surgery. Surgeons will frequently talk and joke during surgery, but during this one, as I stood very still trying not to contaminate the sterile field while holding retractors, one of them asked who had the smallest hands in the room. Surgical gloves are sized from 5.5 to 9 and specific to right and left. OR techs and nurses know what size and type a surgeon prefers to wear and everything is set out prior to the procedure. If you are new, they will ask you what size glove you wear, then help you to put them on to maintain sterile fields. I wear a 5.5 or 6 depending on what is available, and so the nurses pointed to me. Because I had the smallest hands, they asked me to insert my hands into the patient’s abdominal cavity to break up adhesions around the liver. The feeling of sliding my hand around someone’s liver was incredible, smooth and strangely slick, and thrilling to me.

I never thought much about anyone’s hands until the day my future husband asked to hold mine. When I was young and dreamed about the man I might someday marry, I never thought much about what he would look like, let alone what his hands would look like. As little girls, my next door friend Amy and I would hum the marriage song as we processed across the family room, holding a worn bunch of plastic flowers. The husbands we married were incidental, a necessary part of the process to get to the next step which was stuffing a baby doll up our shirts to pretend we were going to be mothers. This would be followed by pretending to be Princess Leia or Lady Jane from GI Joe. Our summers were filled with acting out fanciful scenarios of heroines and heroes with our brothers. I never pretended to hold hands with anyone though, never realizing what a lovely part of being with someone that it is.

In romance novels, a lot of the descriptions center on kisses between the main characters. Rarely do they talk about the sweetness of holding hands.  It is said that the handshake evolved from the ancient custom of a showing of hands empty of weapons. I think the knowledge ascertained from holding another’s hand in yours can be greater than just knowing they do not hold weapons. In my present work, I check hand-grip strength on patients regularly. It is a part of our diagnostic tool set, telling us if there is weakness or tremor, but patients will look at my hands, concerned that they will squeeze too hard.  I’m learning not only about grip strength though when I hold their hands. I can tell what kind of work or hobbies they do, if there are lesions that haven’t healed, if they bite their fingernails, or if nerve damage is present, among other things.

When I held hands with my husband for the first time, I was struck by the similarities between his hands and those of my father’s.  Though we were largely strangers to one another, his hands were familiar to me.  I understood instinctively what kind of person he was, though I could not have put it into words at that moment as young as I was.  Once while we were dating, he apologized for the state of his hands, rough from the work he had been doing.  I told him what I still believe today, that there is no shame in hard work.  His hands are never raised in anger to our little ones, though they are just as mischievous as I ever was.

The church in which we worship holds hands during the Lord’s Prayer, an act which always makes my children a little wary.  They don’t want to hold hands with someone who is not part of our family, and I never force them to, but they are frequently rewarded with a smile from an elderly person who might be sitting near our less-than-angelic children.  Some might call this practice unhygienic, and in fact, there are times when they are ill or someone else is that we don’t hold hands, but in that there is still a lesson about how we care for others in the community by respectfully declining.   They are learning too what it is to be connected, to know the feel of someone else’s hand, to be gentle in the way they grip arthritic fingers, and not to fear the unknown.

There is something powerful in the act of holding hands. It is an act that literally and figuratively connects us. As mothers we have known the secret feeling of children dancing within our wombs, like stars slowly spinning within the nebulae of our own personal gravity, but for our men, it is the grip of their baby’s tiny hand around their finger which shifts time and space.  As I watch my children grip their grandfather’s hand walking with him on a mountain hike, his other hand gripping the walking stick shaped with loving care by my husband’s hands, it occurs to me that I stopped holding my father’s hands after childhood, when I no longer needed his help to walk.  I remember the feeling of my hand in the crook of his arm as he walked me down the aisle of our church and the way it felt when he put my hand in my husband’s, like a blessing and an absence all at once, and I know it is too soon to let go.

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My little guy hanging onto his grandpa.

Today I am thankful for all the hands that shaped my life along the way. I am grateful for silly internet pictures of otters holding hands to remind us that we are all connected, and pray for the strength to hold on, for as long as we are blessed to have those we love in our lives.  I’m wishing my father a blessed 80th birthday, and praying for many more birthdays like this.

Do What You Love: Top 7 Things You Never Knew About Physician Assistants


Growing up, my dream list of future occupations was varied: Supreme Court justice, Shirley Temple stand-in, crime-fighting assassin/journalist, astronaut, and finally, Nobel Prize-winning brain researcher. Alas, Sandra Day O’Connor took my seat, Shirley Temple grew up, being Catholic put the nix on the whole killing people gig (even if you only kill the bad ones, the Church frowns upon that–see Commandment #6), my 5 foot even height makes me too short to be an astronaut, and no matter how much I loved studying the brain, I found I really dislike research. However, I was blessed to work with stroke patients in my research work, and it turns out, I love people. So in 2003, I became a physician assistant (PA).

If you know any PAs, this is a logical conclusion. As a whole, PAs love people–helping them, taking care of them, and making a difference in their lives. I had never heard of the PA profession until shortly before I applied to PA school, when I met one while working with a surgeon who did not particularly like people (but that’s a story for another blog post).  That PA was, and is, a paragon of compassion and competence. She said and did all the things I had always associated with physicians, and her patients loved her and asked for her by name. Not by doctor but by Jennifer, because as she said, “If I cared about titles, I wouldn’t have become a PA.” Inspired by her quiet example, I researched the profession (all that time in research wasn’t wasted), and was astonished by what I learned.

1. PAs have been taking care of Americans since around the time of the Vietnam War.  The first PA class graduated October 6, 1967 from Duke University. In fact, PA training was based on the fast-track model of training doctors in World War II because of the health care shortage at that time, and the fantastic Navy corpsmen and their wealth of knowledge from the Vietnam War–necessity being the mother of invention and all. And in a time of civil unrest, one of the examples Dr. Eugene Stead used for the PA-physician team model was a white physician and his African American assistant, Henry Lee “Buddy” Treadwell, who capably managed the clinic while the physician was out of town, and whom “the richest man in town would rather have. . . sew him up than [the physician] because he can do it better. . .” as quoted by said physician.  As a female Asian American PA, I can’t think of any better testament to the founder of our profession than that he was progressive enough to recognize quality health care and not care who was delivering it, in a time when Jim Crow laws still existed.

2. PAs work collaboratively with physicians and other members of the medical team to provide quality health care in all fields of medicine. Yes, all.

3. PAs can write prescriptions for what ails you. And when there is no prescription, you can count on us to listen and be present, and fight like hell for you. I mean, advocate strongly for you.

4. PAs not only work in all branches of medicine, they can be found in a variety of settings. We don’t just deliver health care in hospitals, operating rooms, and private practices, we also teach at universities, work in prisons, practice in schools (not the same thing, no matter what you might recall about middle school), perform research (I suppose someone has to), lecture around the world, serve our country in the military and in the White House, own our own practices (in some states), publish in medical journals, care for nursing home residents, and work in industry. The sky is the limit in terms of opportunities available for PAs–literally. I’m still trying to figure out how to work the astronaut angle–first astronaut PA anyone?

5. PAs have to bring similar prerequisites for medical school to the table when applying to PA school, and to be competitive they usually need 2-3 years of healthcare experience to even be considered. My dual degrees in biology and neuropsychology from the University of Michigan were not sufficient. I had to go back and take more classes than I needed for a medical school application, just to be able to apply to PA school. Suffice it to say, I would have taken those classes in medical school if I had gone, but PA school expects you to come loaded for bear so you can be out practicing medicine upon graduation. The time I spent in the healthcare field before PA school was helpful in navigating through the intensive onslaught of information during PA school, and has made me a better PA now that I’m practicing because I had already worked as part of a healthcare delivery team prior to becoming a PA.  The PA who has helped clean patients in nursing homes before PA school knows to be on the lookout for decubitus ulcers from first-hand experience, just like the PA who was a paramedic before PA school is acutely aware of the possibility of tension pneumothorax in a patient with blunt chest trauma from an MVA.

6. PAs can be found practicing medicine internationally. Besides those serving in the military for the United States, the PA concept has spread to Canada, the United Kingdom, the Netherlands, Ghana and South Africa. The Russian feldsher was a forerunner to the physician assistant profession dating back to the 17th and 18th century and introduced by Peter the Great to the Russian military in the setting of a physician shortage–not a new problem as you can see. PAs also work in disaster relief and with medical mission groups across the entire world, and many PA schools offer international rotations. One of the best experiences I had in PA school was going on a medical mission to Honduras. Nothing makes you more grateful or humble than knowing that patients have walked miles carrying their shoes just to see a medical provider in order to show up wearing their best clothes. Seeing ingenious providers treat patients in a clinic without reliable electricity inspired me to be more aware of how I allocate our health care dollars, and to hone my physical exam/diagnostic skills.

7. PAs are required to have both national certification and state licensure, and must recertify every 10 years by passing a national exam covering the following areas of medicine: surgery, pediatrics, cardiology, pulmonology, orthopedics, dermatology, psychiatry, neurology, infectious disease, hematology, genitourinary, gastroenterology, endocrinology, and otolaryngology (see #2 above).  In addition, we must remain up to date by earning 100 continuing medical education credit hours every 2 years. So even though patients ask us frequently when we are going to finish our schooling and become physicians, the answer is never, because we will never stop learning and we love being PAs.

National PA Week starts today. Even though I never did win a Nobel Prize, travel to outer space, or learn to dance like Shirley Temple, I am blessed to do what I love. Being a PA has been a more rewarding career than I ever dreamed possible. I am thankful for all the patients who have allowed me the privilege of caring for them, listening to their life stories, and sharing their journeys. I am humbled by the incredible trust they place in my hands, and strive like all in the medical field, to be worthy of it.

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Groundhog Day


I’m laying in bed wishing my life were a movie, and unfortunately Groundhog Day is the one that keeps coming to mind. Today was a day when I could not get it right. I could not be kind or patient or even grateful for all the blessings I have. I walked out of the house this morning without even kissing my family goodbye, distracted by all the things I needed to accomplish before the day began, and tired, instead of rejuvenated by the weekend. This Monday felt like the end of a long week, instead of the beginning, after six days with the husband gone elk hunting, and then headed back today on shift at the firehouse, and I could not see my way to Tuesday. If only we could hit the rewind button, or live the day again, but do it better. This is what comes of being a perfectionist, wishing to do things over and over again until I get it right, instead of letting today go, so tomorrow can begin.

Haven't we all wished once we could be Bill Murray, and live our day over again right this time?

Haven’t we all wished once we could be Bill Murray, and live our day over again right this time?

Perfectionists don’t look like you think they might. They are not all perfectly-pressed pristine paragons of pulchritude (wordies of the world unite!). The first time I read that most perfectionists are procrastinators, I felt someone had opened up my half-empty diary and read the scribblings within. This fear of imperfection stops up creativity and progress. This folly is what has my blog littered with drafts “that just need a little more tweaking,” languishing in the junk drawer of my mind. I don’t blame Pinterest or all the other parenting blogs with their professional-looking pictures of crafts I could never master or perfectly clean homes that don’t have piles of clean laundry that still need folding. I was born this way, and have unfortunately passed this trait on to my kids, with Daughter #1 wailing at age 3: “But I can’t make it perfect”, while trying to tie her shoes. I can’t be Bill Murray today, so in an effort to let go of this ideal of perfectionism, I am sharing this sad, largely unedited tale of how I picked my self-pitying self up and kicked myself (metaphorically, of course) in the dupa as the Polish say. (You can’t grow up where I did in Michigan and not pick up a few useful Polish words, another useful one being paczki).

Sometimes, we live the Pinterest life, or at least give the appearance of doing so. Last night we dined on bone china eating grass-fed husband-hunted grilled elk steaks with a side of organic brown quinoa, and garden fresh-picked kale stir-fried with onions and nitrite-free bacon. Here is a picture of that lovely meal.

Pinterest-worthy, don't you think?

Pinterest-worthy, don’t you think?

Most times we don’t though. Today, I picked up dinner from Wendy’s (by request from my little guy–not sure if that makes it better or worse) on the way home so we could get started on the hours of homework I knew lay ahead of us. My kids ate their Kid Value Meals (“with toy from Dreamworks!”) while I prayed that the fumes in my tank would get us through the line at the gas station, hoping the gas light would not start blinking like the robot in Swiss Family Robinson. I’m sure the bacon on the Junior bacon cheeseburger was not nitrite-free. There is no picture of that meal.

When we got home, Dragon Mama reared her ugly head, and the battle of the homework began. My middle daughter has no great love of math, and a summer in which we did not review multiplication tables is bearing all of its tearful fruits now. As I sat there, wishing the husband was home so I could tag out for a few minutes like those old WWF wrestling matches, I wondered if perhaps I am the cause of her dislike of math. Not a great motherhood moment. I walked away to sit on our patio swing, in the hopes that it would give me some perspective. This would be the moment I discovered the dog had found something delightful in the compost to string all over the yard. I have to admit, there was nothing Zen-like about this outdoors experience, and the swing would likely be more calming if it weren’t powered by angry feet, rocking wildly off its foundation.

This is me on a bad day.  Note the mouth made for spewing fire.

This is me on a bad day. Note the mouth made for spewing fire.

My spirits thusly fortified by the brisk swing, I felt up to the homework battle, in which the phrases “No, it would not be easier to add it 36 times, just MULTIPLY!” and “Yes, it is still wrong! Add it again.” were uttered. This is why I would be horrible at home-schooling my children, and why I believe teachers should be paid exponentially more than they are. At the end, we negotiated how to dole out the last 6 problems of Sunshine Math for the rest of the week given a full schedule of baseball, soccer, dance, scouting, and, of course, work. That was when my middle daughter said, “I really hope Daddy will be home for at least some of those days.” “Me, too,” I thought to myself.

In the middle of this, my husband called back to apologize for our earlier conversation in which I had retorted, “I don’t understand why we’re yelling when we agree with each other.” I had the good sense to also apologize, though not very graciously, and then he shared the news which made every single grumpy moment seem ridiculously banal. Our friend has cancer, and the outcome is uncertain.

On a day when I managed to yell at my kids just trying to add and multiply, my husband while trying to agree with him, and the dog for doing what dogs do, this news made me drop my head in shame. I looked at my self-pitying soul, and resolved to live better. We get no second chances, this not being a movie set and all, and so, we said our bedtime prayers, I apologized for being a dragon Mama, and we had a cuddle session which put them past their bedtimes, in the hopes it will all balance out in the end.

Tonight I’m thankful for second chances and forgiveness. I’m grateful for Wendy’s Junior bacon cheeseburgers and elk steaks. And I’m thankful for all the teachers who spend hours a day teaching our children with patience and skill. I’m praying for all the other dragon mamas (and papas) out there who have to parent alone all the time. I’m praying tonight for our friend, and for all of us out there who are struggling to live each day with grace, whether it is our last day or our first, again.

7 Reasons Why I Love Working at the VA


If there is a word that means the opposite of a news hound, that would describe me. I get my news in small bits on my drive into work, but lately because I work at the VA, the news has been coming to me. People I barely know have been asking me with furrowed brows, real concern and almost prurient curiosity in their voices, “Sooo, how’s everything going at work?”

The funny thing for me is that not much has changed. I still listen to my patients’ stories and examine them with the same amount of care I always have. In fact, I would say, other than the comments I get from others because it is all over the news, there has not been much change in my practice. For everyone else I know that works at my facility, I would venture a guess that this is true for them as well. We are all doing the work we came here to do, despite news media reports, despite protestors, despite changes in leadership, despite insufficient staffing and budgetary concerns, because it must be done.

Coming from private practice, I will admit I had some trepidation about coming to work at the VA. As with any large hospital system, I was worried about fitting in after coming from a small community office. My fears were allayed on the first day of orientation. I knew very little about the military before coming to the VA even though my parents met on a US Army Base in Vietnam. I expected to get educated about rankings and how best to address people. In fact, none of this occurred. Instead the emphasis was put on serving veterans, those who have put their lives on the line for our freedom and our liberties. It didn’t matter where they served, in what capacity, what their rank had been, if they were a part of our military, they had in the (paraphrased) words I heard for the first time in orientation, “in effect, given the United States a blank check, payable up to and including their very lives.” Sobering, isn’t it? I have always admired those who were in the military, but after working here I have an even greater respect for them. As a PA, I owe my career to those who served in Vietnam and World War II. With the job market for PAs in its boom phase, I could get a job anywhere, so why do I work at the VA?

I work at the VA because:
1. There is nowhere else I’ve ever been where patriotism is not only seen everywhere, it is expected. I believe despite all the detractors, sarcastic comments, and negative reports, that this is still the greatest country in the world. There is a reason everyone still wants to come here, a reason why people risk their lives trying to cross borders and flee across seas filled with pirates and rapists to get to this country. Are there countries with less crime? Yes. Are there countries with better educational standards? Yes. Are there countries with less poverty? Yes. Is there any other country in the world, where we can have people protesting outside the gates of a hospital where we are taking care of our wounded warriors, and the only comment made by hospital administration is, please don’t stop to talk to the protestors as it will impede traffic through that gate. Why? Because these wounded of ours fought for our rights, including the right to free speech, even if it is to used to say they think you are wrong. As an immigrant, I am proud to call myself an American, and proud to serve our veterans.

2. I love working at the VA because I am surrounded by others who love taking care of veterans. I am blessed to work in a place where people are happy to be here. Many of them will be even happier once we get more providers to help take care of the many veterans who are signing up every day to be seen, but even despite being overworked, patients tell me everyday that they can sense how happy everyone is who works here. These patients talk about the smiles on the faces of workers here, the friendliness of all the people who stop to ask them if they need help. It is bred into the culture of this hospital, from the very first day of orientation, that it is our job to take care of all veterans, whether they are sitting in front of us in an examining room or wandering looking lost in the hallways. Many of the employees here are veterans themselves, so patients feel a kinship with them, bonding over stories of boot camp and battles.

3. History comes to life at the VA. From World War II veterans who endured the Battle of the Bulge to Gulf War veterans who were there when they pulled down the statue of Saddam Hussein, I’ve met so many people who were part of history from patients to administrators. Just walking through our hallways is a history lesson. Though we have our fair share of generic abstract hospital artwork, these are far-outweighed by the pictures of veterans, memorials and other landmarks that commemorate their accomplishments. And if you are willing to listen, there is nothing like hearing first-person accounts of what really happened behind the scenes by the men and women who had boots on the ground

4. The world becomes more global at the VA. Hearing their personal stories of exposures to radiation on Bikini Atoll, trudging through days of pouring rain during the monsoons in Vietnam, and life on board ships in the Pacific brings the world into my little office. Most veterans have been stationed in places I’ve never had the pleasure of going, and just asking them their favorite place to be stationed always yields surprising answers. I’ve learned about clear cockroaches on Marshall Island, hamlets in Germany found intact after the bombing ended, and blinding dust storms in Iraq.

5. Good quality health care is given here. When I worked in private practice, it was my responsibility to keep countless algorithms and guidelines for clinical practice in my head. A 65-year-old man with any history of smoking? I had to remember to schedule his abdominal aortic aneurysm screening, EKG, and cholesterol check. Here at the VA, electronic alerts for recommended screening pop up to remind us. Providers with years of experience are coming to the VA, tired of the same dwindling fee for service, pressure to succumb to the almighty dollar, and rising malpractice costs that are driving people away from and out of medicine in general. People forget that innovative research and groundbreaking discoveries were done first at the VA, including the first implantable cardiac pacemaker and the first successful liver transplant. In the wake of all the negative media attention, I’ve had countless veterans making a point to thank me (!) for helping them. Two of these veterans shared their stories of how their lung cancer and colon cancer was diagnosed early here, after coming from private practice, essentially saving them from much worse outcomes. Our hospital is a teaching hospital, like the one in Detroit where I did my internal medicine rotation, and the one in Ann Arbor where I did my first undergraduate research with the University of Michigan. Everyday, eager students from nursing, medicine, OT, PT, psychology and countless other disciplines come here to learn from people who are taking the time to teach others how best to care for our veterans.

6. The electronic medical records system here actually helps me to get my job done as opposed to impeding it. That is not to say that I love EMR, but being able to easily access records for a veteran who is sitting in front of me makes my life and the patient’s life a lot easier. I get alerts about patients’ labs, imaging, and consultations sent directly to my account on my desktop. This is more efficient than keeping a list in my head of all the patient results I needed to check on throughout the day. Veterans also can sign up for a program called MyHealtheVet which allows them to look at their own labs, notes, and reports through a secure gateway, enabling them to take charge of their own health.

7. And most importantly, I get to help heroes every day. In the grocery store, you and I might walk by these men and women without a second glance as we run in to pick up a gallon of milk. Every day I have the privilege of meeting, talking, and hearing from people who though most of them would not call themselves so, are heroes. They have saved lives, built bridges both literal and figurative, done acts of diplomacy under scrutiny in foreign countries, and done this for those of us who get to sleep peacefully in our beds. I look at the world very differently, realizing there is a story inside every one of us ordinary-looking people.

I know there will be many, and have been many who say this system is damaged. My answer to that is that all of medicine needs to be revamped, and if closer scrutiny is what it takes to make our healthcare system more efficient, then it is a good thing and I am thankful for it. This scrutiny involves recognizing what works and fostering this, especially so those who are doing the work don’t lose courage to keep fighting for good healthcare for our veterans. What does not help, and will never help, is negativity without action. And so, I ask all of you to share your stories of what works and what does not, and perhaps then we can use those pointing fingers to lift the burden instead of making it harder to bear for those of us doing the best we can.