“The moment you claim you know everything is the moment you’ve created a ceiling at the level of knowledge that you’re willing to learn.”
“The moment you claim you know everything is the moment you’ve created a ceiling at the level of knowledge that you’re willing to learn.”
When I began my general surgery training five years ago as a lowly intern, it did not take long to meet “M”. M was one of the more senior registered nurses (RN) who worked the night shift on our surgical floor. On meeting M, I immediately liked this woman, and I knew that she would quickly became one of my favorite nurses. Tough and experienced, M is extremely smart and a better clinician than most interns, capable of picking up the slightest hint of something wrong with a patient before physicians would recognize anything was off. M is a “no nonsense” kind of nurse; she commanded respect when working the night shift and definitely did not put up with shenanigans from my fellow interns. She was particularly hard on other services that she felt didn’t “own” their patients as well as the general surgery residents do. But M also has an incredible sense of humor, and many nights during my night float month in February 2009 were spent laughing until our stomachs hurt.
After serving as a bedside nurse on a surgical floor for 25 years, M decided to make a career move. Our hospital is in the process of training nurses to gradually replace retiring operating room staff. M applied and much to her surprise was selected to be one of the new “intern” nurses. Leaving bedside nursing to jump head first into the world of the operating room can be daunting, inspiring, and incredibly rewarding – similar to what I remember experiencing as a surgical intern. M is beginning to chronicle her journey on her new blog, and so far I’m finding the nursing point of view of what I experience on a daily basis as a surgical resident to be absolutely fascinating. I can’t wait to actually work with her again in the operating room. Below is an excerpt from the first post on her blog; check out her journey if you like what you read.
The world of OR nursing takes a very special personality – a group that is not necessarily easy to break in to… who I am kidding… nurses tend to eat their young. This is a very sad, but very true statement. The fact of the matter is, if you cannot survive the stress of being a new nurse you won’t survive happily as an experienced nurse. The job never gets easier. You are put to the ultimate test on a daily basis. You need tough skin and to be able to think fast on your feet. Your decisions can be life altering to your patients. You will experience things no one outside the profession would ever believe. You will cry. You will question yourself daily. But, you will make a difference in every life you touch, in some way. You will be amazed and amused. You will learn to love cold coffee. You will develop a bladder the size of the Titanic. You may start swearing like a sailor. Your colleagues will become family. You learn to treasure life because you see so much tragedy… and you learn to celebrate the little things.
I am begging you to resist the pressures of pragmatism, of money, of the oily cowardice of diplomats and to stand up resolutely and proudly for humanity the world over, as your movement is pledged to do. Wave your Olympic flag with pride as we gay men and women wave our Rainbow flag with pride. Be brave enough to live up to the oaths and protocols of your movement.
~British actor/journalist/activist Stephen Fry, to the international community on the treatment of the LGBT community in Russia and the Sochi Olympics
If you ask me what I came into this world to do, I will tell you; I came to live out loud.
A positive attitude may not solve all your problems, but it will annoy enough people to make it worth the effort.
I think Herm and I would have been good friends.
Normally I would post a sarcastic someecard about turning a year old given that today is my birthday, however today’s post is a bit on the sad side since my 92 year old grandmother Gina passed away this past Thursday. Tomorrow’s regularly scheduled someecard will be post-poned until Tuesday, I promise it will be worth the wait.
Born in 1921, my nonna’s life is one for the history books. She first hand witnessed the tragedies of World War 2 and the Nazi retreat from Italy which claimed the lives of many in the Italian countryside. My mom and uncle were born during the aftermath of a depressed post-war Italy, which unfortunately claimed the life of their oldest brother and my nonna’s eldest son from a land mine that the Germans planted around Italy to stop the progress of Allied forces during the war. Emigrating to the United States and leaving behind the world she knew at nearly 40 years old was tough on my grandmother. I can’t begin to imagine the pain and heartache she must have lived with for the rest of her life, a feeling I’ve only glimpsed through the eyes of my mother on the occasions when we’ve returned to Italy. It’s a sorrow and a longing for a life that could have been but never was, in my opinion, a distinctly Italian feeling of loss for what never existed in the first place. If there’s a positive side, it’s that the experience served to harden her a bit and offered her the promise of a new life in America, one that has been filled with weddings, grandchildren and great grandchildren, good times and grand memories.
Like most Italian families, my grandfather was clearly the king of the castle and the one who wore the pants in the family, yet my nonna clearly picked out the pants – but I’m pretty sure she also ironed them and decided which shirt and shoes my nonno would wear with them. My nonna’s soft exterior and gentleness with her grandchildren often masked a core hardened by life and a tongue that was both quick and sharp. My grandmother was not a woman to be messed with; get her riled up or on her wrong side – and you best watch out. The rules in my grandparents’ house were clear, and spoiled brats wouldn’t be tolerated.
As is probably true of most Italian families, my fondest memories of my grandmother all center around family and food. Nonna Gina’s house was the glue that bonded us with my cousins on my mom’s side. The house was her castle, and her kitchen entirely her domain. When I was very young, my parents both worked, and my nonna and nonno served as daycare. My parents also felt it was important to retain our Italian heritage, and spending time with nonno and nonna was critically important. My sisters and I picked up the occasional Italian phrase from them during those days at their house, and spent a lot of time with them during the summers when school was out. From an early age, my sisters, my cousins and I were brought up on “pane e burro” and “peacock” (raw egg yolks whipped with sugar to which toasted bread is dunked in. I know it sounds gross – but it’s actually delicious, so dont knock it until you try it). In my very biased opinion, her pasta sauce and meatballs rival that of any Italian restaurant. My grandmother’s kitchen was small and her food simple but satisfying. Lasagna, pasta e fagioli, and pasta “stufata” were the staples of my childhood.
When my grandparents emigrated to the United States from Italy, they tried to assimilate my mom and my uncle as much as possible into American traditions. In the spirit of Americanization, my nonna always made a full traditional Thanksgiving dinner complete with turkey, stuffing, mashed potatoes – the whole nine yards. Thanksgiving was almost always celebrated with my grandparents, and the tradition continued even after my nonno passed away from lung cancer. The controlled chaos of those Thanksgiving Thursdays is one of my fondest memories, and the smells emanating from nonna’s kitchen will linger in my memory for the rest of my life. Dessert included many of the American staples like apple, pecan and pumpkin pie, but my nonna always made “cheesecake” on holidays, and Thanksgiving was no exception. Her cheesecake was actually a more light and fluffy lemon-ricotta pie, a recipe my nonna closely guarded. My grandmother did not keep recipe cards, and measurements were always “a pinch of this” or “a little of that”. If you asked her to tell you how much flour or sugar to add, she would say “about a cup” – but my nonna never owned measuring cups or spoons. No matter how hard we try, nonna’s recipes are nearly impossible to recreate.
I will be forever indebted to my grandmother for the care and compassion that she showed for my father, especially while he was sick. The love she showed for a son that wasn’t her own flesh and blood amazes me to this day. During my dad’s last hospitalization, she stood watch in his hospital room with the rest of us, and the pain, sorrow, and anguish on her face when he died and during his funeral highlighted the depth of her love for him.
Throughout her life, my grandmother faced hardship and suffering and continually rose to the occasion, experiences that shaped her into the soft on the outside but tough on the inside woman that she was. She is fondly remembered by her son and daughter, her six grandchildren and her five great grandchildren.
To Nonna Gina, may she rest in peace.
“DOMA undermines both the public and private significance of state-sanctioned same-sex marriages; for it tells those couples, and all the world, that their otherwise valid marriages are unworthy of federal recognition. This places same-sex couples in an unstable position of being in a second-tier marriage. The differentiation demeans the couple, whose moral and sexual choices the Constitution protects, see Lawrence, 539 U. S. 558, and whose relationship the State has sought to dignify. And it humiliates tens of thousands of children now being raised by same-sex couples. The law in question makes it even more difficult for the children to understand the integrity and closeness of their own family and its concord with other families in their community and in their daily lives.”
“The federal statute is invalid, for no legitimate purpose overcomes the purpose and effect to disparage and injure those whom the State, by its marriage laws, sought to protect in personhood and dignity. By seeking to displace this protection and treating those persons as living in marriages less respected than others.”
“There is a ‘careful consideration’ standard: In determining whether a law is motivated by improper animus or purpose, discriminations of an unusual character especially require careful consideration. DOMA cannot survive under these principles.”
I sat around Saturday at Villa Francesca feeling frustrated and defeated, and annoyed that I couldn’t be helping as much as I should be. I mean, this is Haiti after all! I came here with a skill, people at St Luke’s knew I was coming, and yet things were essentially a giant dead end cluster.
And then something magical happened. I can imagine it is much like discovering an oasis in the desert. A whole new team of people arrived from the United States. And everything changed.
An ER physician and an anesthesiologist from Indiana. A general surgeon, a vascular surgeon, and an urologist from the Mayo Clinic in Arizona. Critical care, long term care, and outpatient urology clinic nurses from Mayo Clinic in Arizona. They arrived, with large suitcases filled with supplies, and were eager to get to work. We marched over to the hospital, barged into the surgical suite, and began to organize what would become our supply area for the week. The urology team went off to set up their clinic, and the rest of us inspected what was available and what would be needed.
The “team” brought with them such enthusiasm that was quite frankly – infectious. We figured out how and where we would patients would be held pre-op, where all the IV start sets were, where patients would go post-operatively. The ED doc (Donny) and the anesthesiologist (Art) got to work on the anesthesia machine, getting together supplies and medicines to perform spinal blocks, and gathering endotracheal tubes for general anesthesia. The general surgeon (Alyssa), the vascular surgeon (Jim) and I made quick work of what was in the OR and what the team had brought with them for supplies. Sutures, drapes, sponges, instrument kits, prep kits… organized and arranged quickly and orderly.
We accomplished together what I would never have been able to do by myself. And I felt that in the end, the day had not been all together wasted. We arrived at Villa Francesca to a feast of pasta. It turned out the urology team had finished early, went to the market to shop, and started on dinner while we were organizing in the OR. I guess sometimes life really does hand you some lemons… and you need some helping hands to make lemonade.
I quickly want to thank everyone who has been following my trip to Haiti on Facebook, Twitter, and here on the blog. Your comments have been both touching and inspiring, so thank you very much for your kind words.
I haven’t been able to blog as much this trip as I would have liked. The 12-hr days in the operating room have been long and tiring. After quickly getting food and a beer or two, bed time rapidly approaches – especially when you are waking up at 6am.
I’m heading to Toussaint L’Ouverture airport shortly to begin the trek back to Boston, but I have a few more Haiti posts tucked in the recesses of my mind to share with you. This trip has been extremely productive and holds great promise for future surgical trips to Haiti.
In the meantime, I highly encourage you to visit the St Luke’s Foundation for Haiti page as well as the METI Project homepage to get a better sense of what these two fantastic organizations are doing here in the Tabarre neighborhood of Port-au-Prince. If you have access to hospital/medical supplies or work in purchasing or central supply for a hospital or medical practice, I highly encourage (read: begging) you to contact me to see how we can get desperately needed supplies to Haiti. Even though the earthquake was 3.5 years ago – the need is still here.
This morning, I’m hopping on a flight from Boston to Miami and continuing on to Port-au-Prince (PAP) for the second time this year. I last traveled to PAP in January as a “fact finding” mission, to see if St Luke’s Hospital could recruit and support rotating surgical teams at its facility. This week will be the first test, as I’ll be joining physicians from Pennsylvania and the Mayo Clinic.
I’m eager to get to St Luke’s and begin working. In addition to seeing patients and operating, critical work involving cataloging supplies is necessary in order to gain a better sense of what supplies are most in demand at St Luke’s. Getting supplies is difficult at St Luke’s, in PAP, and in Haiti in general. Despite the funding and donations received immediately after the January 2010 earthquake, much of the funding remains out of the hands of Haitians, and there have been other disasters and tragedies. People have moved on and forgotten.
I plan to update while I’m in Haiti as well as after my trip, but in the meantime, I want to encourage you all to do three things.
Never be so faithful to your plan that you are unwilling to consider the unexpected
- Senator Elizabeth Warren to the 2013 graduating class of Framingham State University
Give more than expected; love more than seems wise; serve more than appears necessary; help more than is asked.
This weekend marked the culmination of my graduate education as I accepted my Masters in Public Health degree from my undergrad alma mater, Boston University. The university hosted its campus wide graduation ceremony on Sunday, with keynote speaker and founder of Teach For America Wendy Kopp and honorary degree recipients Morgan Freeman and Boston Mayor Tom Menino.
With nearly 6,700 graduates, Boston University’s commencement ceremony is the city’s largest each year. On such a joyous occasion, President Robert Brown stopped and reflected on what has been a trying year for the university. Since last spring, Boston University has lost 11 students in a series of tragedies including an apartment fire, a biking accident, and the Boston Marathon bombings. Each of these tragedies struck hard for a large urban school that often lacks the sense of community feeling that is far more common for smaller colleges and universities with a backdrop of rolling green hills and ivy-covered halls.
I’m incredibly proud of my alma mater for awarding posthumous degrees to two of those students who would have graduated this year. A world class move Boston University; classy indeed.
The arc of the moral universe is long, but it bends toward justice
I am extremely excited to announce the launch of the METI Project. If you’re wondering what I was doing in Haiti back in January, this is it.
METI stands for Medical, Education, Training, and Infrastructure. The first METI team just arrived in Port-au-Prince today. A long week of work is ahead of them.
The METI Project is a non-profit organization whose mission is to promote sustainability in healthcare through medical education, training, and improved infrastructure in under-served areas of the world. Launched in 2013 by Professional Ambulance (Pro EMS) and Pro EMS Center for MEDICS, The METI Project’s first initiative addresses critical medical needs in Haiti, one of the world’s poorest countries.
In conjunction with the St. Luke Foundation for Haiti, The METI Project will send a team of medics, paramedic students, and emergency department staff to Haiti to provide medical training and needed clinical services.
I look forward to future work with The METI Project in late June and again in October!
Hello, Boston. Scripture tells us to run with endurance the race that is set before us. Run with endurance the race that is set before us.
On Monday morning, the sun rose over Boston. The sunlight glistened off the State House Dome. In the commons, in the public garden, spring was in bloom. On this Patriot’s Day, like so many before, fans jumped onto the T to see the Sox at Fenway. In Hopkinton, runners laced up their shoes and set out on a 26.2-mile test of dedication and grit and the human spirit.
And across this city, hundreds of thousands Bostonians lined the streets to hand the runners cups of water, to cheer them on. It was a beautiful day to be in Boston, a day that explains why a poet once wrote that this town is not just a capital, not just a place. Boston, he said, is the perfect state of grace.
And then, in an instant, the day’s beauty was shattered. A celebration became a tragedy. And so we come together to pray and mourn and measure our loss. But we also come together today to reclaim that state of grace, to reaffirm that the spirit of this city is undaunted and the spirit of the country shall remained undimmed.
To Governor Patrick, Mayor Menino, Cardinal O’Malley and all the faith leaders who are here, governors Romney, Swift, Weld and Dukakis, members of Congress, and most of all, the people of Boston and the families who’ve lost a piece of your heart, we thank you for your leadership. We thank you for your courage. We thank you for your grace.
I’m here today on behalf of the American people with a simple message. Every one of us has been touched by this attack on your beloved city. Every one of us stands with you. Because, after all, it’s our beloved city, too. Boston may be your hometown but we claim it, too. It’s one of America’s iconic cities. It’s one of the world’s great cities. And one of the reason(s), the world knows Boston so well is that Boston opens its heart to the world.
Over successive generations, you’ve welcomed again and again new arrivals to our shores; immigrants who constantly reinvigorated this city and this commonwealth and our nation. Every fall, you welcome students from all across America and all across the globe. And every spring, you graduate them back into the world — a Boston diaspora that excels in every field of human endeavor.
Year after year, you welcome the greatest talents in the arts, in science, research. You welcome them to your concert halls and your hospitals and your laboratories to exchange ideas and insights that draw this world together.
And every third Monday in April, you welcome people from all around the world to the hub for friendship and fellowship and healthy competition — a gathering of men and women of every race and every religion, every shape and every size — a multitude represented by all those flags that flew over the finish line.
So whether folks come here to Boston for just a day, or they stay here for years, they leave with a piece of this town tucked firmly into their hearts. So Boston’s your home town, but we claim it a little bit too. I know this — I know this because there’s a piece of Boston in me. You welcomed me as a young law student across the river — welcomed Michelle too. You welcomed me — you welcomed me during a convention when I was still a state senator and very few people could pronounce my name right.
Like you, Michelle and I have walked these streets. Like you, we know these neighborhoods. And like you, in this moment of grief, we join you in saying: Boston, you’re my home. For millions of us, what happened in Monday is personal. It’s personal.
Today our prayers are with the Campbell family of Medford. They’re here today. Their daughter Krystle was always smiling. Those who knew her said that with her red hair and her freckles and her ever-eager willingness to speak her mind, she was beautiful, sometimes she could be a little noisy, and everybody loved her for it. She would have turned 30 next month. As her mother said, through her tears, this doesn’t make any sense.
Our prayers are with the Lu family of China, who sent their daughter Lingzi to BU so that she could experience all that this city has to offer. She was a 23-year-old student, far from home. And in the heartache of her family and friends on both sides of the great ocean, we’re reminded of the humanity that we all share.
Our prayers are with the Richard family of Dorchester, to Denise and the young daughter Jane, as they fight to recover. And our hearts are broken for 8-year-old Martin, with his big smile and bright eyes. His last hours were as perfect as an 8-year-old boy could hope for, with his family, eating ice cream at a sporting event. And we’re left with two enduring images of this little boy, forever smiling for his beloved Bruins and forever expressing a wish he made on a blue poster board: No more hurting people. Peace. No more hurting people. Peace.
Our prayers are with the injured, so many wounded, some gravely. From their beds, some are surely watching us gather here today. And if you are, know this: As you begin this long journey of recovery, your city is with you. Your commonwealth is with you. Your country is with you. We will all be with you as you learn to stand and walk and, yes, run again. Of that I have no doubt. You will run again. You will run again because that’s what the people of Boston are made of.
Your resolve is the greatest rebuke to whoever committed this heinous act. If they sought to intimidate us, to terrorize us, to shake us from those values that Deval described, the values that make us who we are as Americans, well, it should be pretty clear by now that they picked the wrong city to do it. Not here in Boston. Not here in Boston.
You showed us, Boston, that in the face of evil, Americans will lift up what’s good. In the face of cruelty, we will choose compassion. In the face of those who would visit death upon innocents, we will choose to save and to comfort and to heal. We’ll choose friendship. We’ll choose love. Because Scripture teaches us God has not given us a spirit of fear and timidity, but of power, love and self-discipline.
And that’s the spirit you’ve displayed in recent days. When doctors and nurses, police and firefighters and EMTs and guardsmen run towards explosions to treat the wounded, that’s discipline. When exhausted runners, including our troops and veterans, who never expected to see such carnage on the streets back home, become first responders themselves, tending to the injured, that’s real power. When Bostonians carry victims in their arms, deliver water and blankets, line up to give blood, open their homes to total strangers, give them rides back to reunite with their families, that’s love.
That’s the message we send to those who carried this out and anyone who would do harm to our people. Yes, we will find you. And yes, you will face justice. We will find you. We will hold you accountable. But more than that, our fidelity to our way of life, for a free and open society, will only grow stronger, for God has not given us a spirit of fear and timidity, but one of power and love and self-discipline.
Like Bill Ifrig, 78 years old — the runner in the orange tank top who we all saw get knocked down by the blast, we may be momentarily knocked off our feet — but we’ll pick ourselves up. We’ll keep going. We will finish the face.
In the words of Dick Hoyt, who has pushed his disabled son Rick in 31 Boston marathons, we can’t let something like this stop us. This doesn’t stop us. And that’s what you’ve taught us, Boston. That’s what you’ve reminded us, to push on, to persevere, to not grow weary, to not get faint even when it hurts.
Even when our heart aches, we summon the strength that maybe we didn’t even know we had, and we carry on; we finish the race. We finish the race, and we do that because of who we are, and we do that because we know that somewhere around the bend, a stranger has a cup of water. Around the bend, somebody’s there to boost our spirits. On that toughest mile, just when we think that we’ve hit a wall, someone will be there to cheer us on and pick us up if we fall. We know that.
And that’s what the perpetrators of such senseless violence, these small, stunted individuals who would destroy instead of build and think somehow that makes them important — that’s what they don’t understand.
Our faith in each other, our love for each other, our love for country, our common creed that cuts across whatever superficial differences there may be, that is our power. That’s our strength. That’s why a bomb can’t beat us. That’s why we don’t hunker down. That’s why we don’t cower in fear.
We carry on. We race. We strive. We build and we work and we love and we raise our kids to do the same. And we come together to celebrate life and to walk our cities and to cheer for our teams when the Sox, then Celtics, then Patriots or Bruins are champions again, to the chagrin of New York and Chicago fans. The crowds will gather and watch a parade go down Boylston Street. And this time next year on the third Monday in April, the world will return to this great American city to run harder than ever and to cheer even louder for the 118th Boston Marathon.
Bet on it.
Tomorrow the sun will rise over Boston. Tomorrow the sun will rise over the — this country that we love, this special place, this state of grace. Scripture tells us to run with endurance the race that is set before us. As we do, may God hold close those who’ve been taken from us too soon, may he comfort their families and may he continue to watch over these United States of America.