Rose window example, San Antonio

“Can you tell me anything about your father’s medical history?”

“No. I don’t know him.” He shrugged as if it was no big deal but his voice said otherwise. 

Next patient…. 

“What about your father’s medical history?”

She scrunched up her face. “I think he’s still alive? I don’t know for sure. I never knew him.”

Next patient…

“So your mother is alive and has diabetes. Do you know anything about your father?”

“I’m not in contact with him.” The disdain came across loud and clear in her voice. “I hope he’s dead.”

If fathers ever think they don’t matter, they should sit in my seat and listen to the pain they can generate even when they are not there.

The Longest Ride

Columns on Alamo facade in San Antonio
“MOMMY! He hit me!!!” she wailed.

“No I didn’t!” he hissed back.

They both start hitting each other.

The elevator is full of men and women dressed in suits for some conference or another. Some turn and stare. Some laugh. Some pointedly avoid making eye contact. 

23 floors.

Just when you think they are old enough to get along in public, they prove you wrong. 


Because no one knows how to get under your skin quite like a brother or sister.

Monochromatic is Problematic

Boy looking out from a bridge at a world of black and white.
I hit print on the office visit summary.

“Doc, where do your kids go to school?” she asked casually.

I told her where and then explained that I was looking for a new place as they were outgrowing their current school. She mentioned where her kids attended, saying I should look into it.

“It’s strong academically and it is a multicultural place: Indian, Muslim, white, black…”


That is what I want. I want my kids to grow up understanding other cultures, not being afraid of them. 

I come from a long long of white trash, the kind of people the US government once wanted to keep out. My grandmother was a Polish immigrant. The rest of me is comprised of little bits from all over the world. Read American history. Over the years it has been the Chinese, the Irish, Polish, the Italians, Jews, Mexicans, Japanese, Catholics, among others, who have been feared, blocked, and vilified. They were stealing jobs, destroying the language and culture, threatening Protestantism…. it was always something. Who among any of us can say we do not have any immigrant blood running through our veins? 

It is the height of arrogance. 

We are too good for the likes of you. 

This is what the Third Reich said about Jews and gypsies and homosexuals. Keeping them out was not good enough. No. Why stop there? Kill them all.

We are forgetting, aren’t we? The survivors are dying and their voices are lost. 

So here I am. Just one little voice but I am telling you and everyone who will listen that I cannot be forced to fear or hate and as such, I do NOT support the current immigration ban. It does not make me feel safer. It makes me more afraid. 

Afraid for our future.

Marching and Madness

Statue covered in dozens of breasts
“I like how he responds to the media. I voted for him because of that. I hate the media…” she was watching video of the inauguration on her phone when I entered the room.

I moved to listen to her heart and then her lungs. 

“That sort of thing is how he won the election,” I murmured, careful to keep the judgement out of my voice. I quickly changed the subject back to her persistent nausea. 

My clinic is not the place for political debate. It is for healing.

At the end of the visit I picked up my computer from the counter across the room and caught his face leering back at me from the magazine rack again. I always moved him to the back of the stack but somehow, just like a bad penny, he kept turning up again at the front. How many pelvic exams had I done in this room with him looking on? I have tried to remain neutral publicly but I just could not take it anymore. I snatched up the magazine and threw it into the biohazard bin while the patient walked out of the exam room.

I wish he would shut up.

Does he even hear himself? The things he says? How he appears to others through his tweets?

“Watched protests yesterday but was under the impression that we just had an election! Why didn’t these people vote?” Donald Trump

I imagine there were women out there marching who did vote for him. That does not mean that they cannot stand up and protest. That march was not just about Donald Trump, even if he wanted to think it was.

I did not march yesterday but oh how I wish I had. Do I agree with everything the Women’s March was said to represent? Maybe. Maybe not. But I do stand as a woman who is more than a pussy, a woman who believes she deserves more respect and equal pay and better rights. A woman who believes that people have the right to kindness, love, safety, and respect regardless of religion, gender, sexual orientation, skin color, or country of origin.

This was how he should have responded from the first instead of as an after thought:

“Peaceful protests are a hallmark of our democracy. Even if I don’t always agree, I recognize the rights of people to express their views.” Donald Trump

Yes. That.

So I say this:

Unite us. Stop dividing and provoking. Be someone we can respect, even if we do not agree with you. 

Act like a president.


Fall colors on trees in the woods

We had some of our ugliest fights over that very thing.

Knock down, drag out, hurling insults at each other kind of fights. Back when I still saw the world in black and white, he saw gray. That made me see red.

This was long before Hilary. Long before Trump. 

How could I make love to someone who could vote that way? How could I eat and sleep and kiss someone who believed these things?


I decided to take it day by day.

One day became two. Then three. And four…

Eventually I realized that politics didn’t matter so much in the grand scheme of things. Then, not only did I see the black and white and grays, I saw color. Glorious, fabulous color. And more than just red…

Love did that.

We can choose to move past disagreements, choose not to hate, choose to be adults who can love in the face of opposing views. We don’t have to mirror the hate we see in others. 

We can do better.

We will do better. 

Pushing Buttons

“This is none of your business!”

“Ma’am, I am trying to explain your benefits to you so you understand why you have the balance of $32…”

“Shut the F* up! I’m not paying anything. And you, little man, what the hell is your problem?” She turned from the front desk woman she had been yelling at to the office manager who had come to address the commotion.

Admittedly, he is a bit on the short side but who belittles someone to their face because of their height?

He identified himself. “You sounded upset and I thought I would see if I could help.”

“F* off!” She grew redder in the face and threw a clipboard at the check in window. “I am going to report you, you bitch!” Her voice rose, full of venom. “I am going to report the whole lot of you!”

Everyone stared, silent. Shocked. Finally, she turned and stormed out.

Later that day, she called the complaint line and raised holy hell. My staff and office manager were left to defend themselves to the higher ups, as if they were the ones on trial.

We have had a rash of verbally abusive patients over the past couple of months. I am not there to witness the interactions, but I do get to hear about them later in great detail. It is over silly stuff, like having to have a copy of the driver’s license of the person picking up a controlled substance prescription. 

Bullying. Almost daily. From new patients but also from people we have been seeing for years.

I realize that I talk about this sort of thing a lot. Healthcare is a tough field. You’ve got to have a thick skin or it will destroy you. Here’s the thing, though: I am used to these sorts of things happening from time to time, people are scared after all and there is nothing more frustrating than navigating the healthcare system, but I have never, in over twelve years of practicing medicine, ever witnessed the amount of abuse laid down over the past couple of months. I wonder why my staff even comes back every morning for another day of it. I am not sure we can ever pay them enough. The attacks are incredibly mean and ugly, more over the top than I am used to witnessing in past years. People are becoming more abusive, more hateful with each interaction and I don’t know where it is coming from.

If you work in healthcare, you are expected to maintain a perky and yet calm and meek facade at all times. We are to be patient, kind, respectful and never let our emotions show even in the midst of a brutal onslaught. If we crack, even just a little bit, suddenly the whole event becomes our fault. Let me tell you, that it is extremely difficult to maintain calm when you are getting beaten down every single day. I feel for my staff who absorb the brunt of it.

Why is this behavior even necessary? 

Is it a symptom of the political climate right now?

Passing Away


“This time of year, my mother’s birthday, I am always so sad.” She choked up and dabbed at the tears again. “My momma died ten years ago but I still just can’t get over it. We were so close.”

I handed her another box of tissues as she continued crying.

It was a strange mixture of emotions I felt sitting there watching her sob away. I hurt for her and yet at the same time I felt an odd guilt and jealousy that stuck in my throat and filled my mouth with bitterness.

How do people do that, get close to their parents? What would that feel like?

It has been six months since I have last seen her, my mother, despite the fact that we live less than 50 miles away. She hates to talk on the phone so I don’t ever call her. We play Words With Friends every day so there’s that, but I am not even following her on Facebook since I am not on Facebook in the first place.

I wonder how I will feel after she dies?

My mother and I are such different people. It strikes me that I can get along with a wide variety of individuals, mainly because I can give them the benefit of the doubt, open my heart, allow forgiveness. I can do that for a stranger, for someone I have never even met, but I cannot do that for my own mother.


Why do we judge our family, the people we love, so much more harshly than we judge the rest of the world? 

At this point, I don’t hate my mother. I don’t even dislike her. I simply don’t understand her. Allowing myself to try to understand her hurts too much. I have to take what I have believed about my own childhood and accept that maybe there is another side to things. Understanding her side may invalidate what I have come to believe about myself and about her and that prospect frightens me, as if it would be taking away part of who I am. 

Which then begs the question, who am I anyway and why does any of it matter to me in the first place?

Sometimes it feels even now as if I am a toddler on the verge of throwing tantrum, clinging to their crumbling binkie-blankie because they don’t want to let go of their childhood. 

It is all I know.

I want to ask her why she married my father. I want to ask her why she stayed with him even through his terrible emotional abuse. Did she love him? Does she love him now? Is she proud of me? But I am afraid of the answers. 

Maybe it is none of my business? 

Maybe I just want it to be none of my business? 

So I don’t ask….


You make me feel pain. You help me remember. You move me from here to there. You control my reflexes. You arouse me. You put me to sleep. You make my heart race and then make it slow down. You even help me to see more clearly. 

You can do so very many things to this body of mine.

But…. you cannot make me hate.

I choose to believe there is good in everyone but before you decide that I am some wonderful, loving human being you should know that I choose to believe this for very selfish reasons. I choose to believe it because I want to believe there is good in me and I choose to believe it because it helps me find peace when dealing with difficult people in my life. 

When faced with these people, I take a step back and ask myself what is their motivation. What are they afraid of? Then, it is no longer about me. 

It is about their fear. 

The bigger the attack, the bigger the fear.

I cannot control what anyone else does to me but I can choose my own response.

I choose not to hate.

The Fast Lane


Barb Taub asked: Parenting, doctoring, partnering, blogging… My question is how? And I don’t mean in smile modestly, Superwoman kind of way. But more in a what do you get back that makes it worth it to do all those things?We are the lucky ones—your readers/patients/admirers. But what do you get out of all of it?

I am going to start with blogging. What do I get out of blogging? Sanity. And craziness. But mostly sanity. If I did not have a place to put my words where someone would read them, I would go stark raving mad. I was close once. Writing for me is like cutting is for others. The tension builds until I cannot stand it and then I open the wound and bleed all over a page or two. You all save me. Sometimes life hurts so much you have to have somewhere else to put some of that hurt so you can walk away from it. Once I write something here, my fictions or my truths, I can let it go and set it free…. then bury it in other posts until it suffocates and dies. 

I also started blogging to see if I was any good at writing. People close to you will pile all kinds of flattery on you to keep you happy, but strangers? If strangers liked what they read, then maybe I was actually good at it.

I read a post at Barnraised this morning that started off with this: “Have you ever hit a wall? Wishing it could be a mirror that would reflect back into the world everything you know to be true in your soul?” Blogging is my mirror, so I don’t have to hit the wall. 

Parenting. Once you have a kid, as it turns out, you are kinda stuck raising them. The alternative is jail. Avoiding jail is very rewarding in and of itself, but to be honest, my kids have saved me on more than once occasion. The well placed hug, the “I love you, mommy!”, and cuddles…. They are salves for the wounded soul. I dread the time when my kids no longer want to do these things. 

Partnering is a matter of survival. Love aside, I cannot do this alone. I don’t want to do this alone. I have been alone. Alone terrifies me. Also, partnering makes blogging possible. So does a housekeeper.

Doctoring. I love medicine. I love patients. I do NOT like the non-medical and non-patient parts of medicine. Fortunately all of the crap has not crowded out all of the joy. Yet. Yesterday was a particularly tough day at the office. I’ll blog about that soon enough….

So, there it is in a nutshell, folks! Thank you so much for reading and for sticking around. 

Just So

black amd white gerber daisy
We were discussing her sudden weight loss. Fourty pounds since her last visit just five months before. Very few patients lose significant amounts of weight like that without something else almost catastrophic going on in the background. 

A death. A divorce. An affair. Zombie apocalypse. Or chemotherapy.

For her, I knew it wasn’t chemotherapy. I was pretty sure no zombies were involved, either.

In her case, she told me, it had been her husband. He had died four months before from a massive heart attack, collapsed at the dinner table over a plate of her roast beef.

“I loved him. He could make me so angry. He made me terribly happy. He made me feel things. My first husband never did that. We never fought. Ever. We were good friends who enjoyed hanging out but we were never lovers in the full sense of the word.”

That comment struck me and I have been mulling it over ever since.

Is it possible that we as humans do not crave peace so much as we desire to feel alive?

To feel things.

Relationship dynamics fascinate me.

I have had occasion to consider that more this past week. 

Growing up I witnessed the bull in the china shop kind of rage in my house. My father, mad at the slide projector, would lob it across the room to shatter on the floor. He broke a coffee table once right down the center. I see that in myself only I don’t throw things. I throw words. Words are my violence. I can use them to hurt you more than my fists ever could. You hurt me or someone I care about, I will lash out until the fire burns down and I can finally stamp it out. 

The thing about anger and fighting is that when it is someone whom you care about, their opinion matters on a level so much higher than anyone else’s.

A patient can tell me my breath stinks and duck their head and I can laugh it off and move on after a breath mint. If my lover were to say the same thing in the same way, perhaps in the context of explaining why he did not want to kiss me right then, it might dig itself into my heart and lodge there like broken piece of glass. It would mean so much more coming from him.

There is so much power there. Power to tear down and hurt and destroy. How can you contain that? How do you have enough conflict to feel alive without burning down the house while you are at it?

I watch my daughter’s rages and see myself mirrored there as she is flailing about, kicking, hitting, and scratching anything that gets too close to her.

Oh, baby girl. 

I am afraid she is going to hurt herself if I cannot teach her how to control her emotions. I pray every day that she finds someone who loves her enough to have the strength to stand up to her onslaught.

Meanwhile, I continue to work to recognize my own shortcomings….