Dr-Mrs-Mom (MD MPH MBA)

On one Saturday afternoon, three women in three different locations, went to get their vaccination against the virus that causes COVID-19.

A college student with a pre-existing condition hoping to travel abroad in the summer.

Her mother, a professional working woman who is an essential worker hoping to have the basic protection as she prepares for the warm weather and crowded venues within which she works.

And her grandmother, a retired nurse, who had self-isolated from the rest of her family for over a year, knowing that with her advanced age and co-morbidities, she was at higher risk if she should get infected. She was doing this to be able to spend time with her kids and grandkids.

Three generations of women.

Texted each other on that unusually warm Saturday afternoon.

All extremely grateful for the opportunity to protect themselves and each other with hope to move forward in our new world.

Three generations.

The weather has been interesting here in the Northeast.

Some days biting cold.

Other days the sun is shining and there’s a gentle wind.

Someone mentioned we may get snow this week.

It’s ok. I have my layers that I put on and remove as needed. I remain agile. I try to enjoy the view outside my window whether it be brown leaves, snow laden shrubs, rain and hail pounding the pavements or patches of green struggling to break through.

And after the last 12 months that we have all faced, I am just grateful for each day.

As usual, a song pops in my head before I write, and this was truly out of the blue…

“If you’re lost and alone or you’re sinking like a stone, carry on
May your past be the sound of your feet upon the ground, carry on”

This from the group Fun. (Recorded 2011 and released 2012)

Reach out if you need help.

Be available to those who need your help.

Be kind to yourself and others.

And carry on, carry on.

I will confess.

Yesterday evening I gave myself a “time out”

I was not allowed to engage with others.

I was in my room thinking about all I have done.

Time to reflect and breathe.

I had been working 7 day weeks for a number of weeks in a row and my body was starting to give me signs.

So I told my family that I was having a time out.

I rescheduled other meetings/virtual meetups/activities.

And I spent time with myself.

A few hours.

It worked wonders.

Sometimes we need a self-imposed time out to reflect, recalibrate and better respond to what life has in store for us.

Give yourself permission to have a time out.

You’ll thank yourself later.

This morning I woke up, and as usual, had some thoughts before eventually getting out of bed.

So many ideas and plans that could be made into projects and processes.

I was tempted to jump up and start typing out my thoughts.

And the song that came to me was one from Hamilton (yes, that Broadway Show by Lin-Manuel Miranda),

“Why do you write like you’re running out of time?
Write day and night like you’re running out of time?
Every day you fight, like you’re running out of time
Keep on fighting, in the meantime- (non stop)”

Sometimes we have this urge to get things done because we realize that our time is limited.

Like the hourglass with the sand.

It runs from one receptacle to the other and eventually all of the sand is at the bottom. Then you flip it over and realize that you only have a few moments before this side, too, empties.

People race against time trying to complete what needs to be done.

And whatever needs to be done is determined by the individual and their perception of their purpose.

So with every day that passes, so does the opportunity to finish what you were meant to do.

For some it involves family, for others it is friends/colleagues. Some have job or career goals. Others want to do something for communities, countries or the world. Some have goals for their personal development (mentally, physically or spiritually).

And for few, it may be a combination of some or all of the above.

Running out of time.

As the sand continues to move through the hourglass.

So, I gave myself a little more time to rest.

Then I got up to fulfill my purpose.

I’m looking outside my window.

There was a snow storm over the weekend.

During the storm it was extremely cold and visibility was poor.

Those who had to venture out for work, appointments and commitments had to do so carefully.

There were a number of mishaps and delays throughout the storm.

Some people were left feeling frustrated.

But some were a little happy because they had the luxury of not needing to go out or, if younger, the possible joy of going out in the snow.

Some were worried because they knew they would have to deal with removing the snow in order to move around afterwards.

Others worry about the potential heat or electricity disruptions.

But what I find, time after time, is that moment of calm after the snow storm.

Everything is covered in snow.

The sounds are dampened a bit by this extra layer of material.

And regardless of where you are, there are snapshots of beauty.

So, I try to remind myself, whenever there is a warning of a snowstorm, or I am in the midst of one, that it will eventually end.

And I appreciate that brief moment of calm and beauty before I continue moving forward.

As a physician, I get a lot of questions about various health care topics both within and outside my clinical setting.

They usually range from issues relating to colds, rashes, surgical options, the latest diet and so forth. With the advent of the Covid19 pandemic- all the questions are pretty much in the same vein.

In the past, when asked medical questions outside the workplace I am always careful to remind the individual that they should really speak to their personal physician and that I cannot comment on any healthcare practice that has occurred since I am not their treating physician. I also am careful to say that I cannot offer an expert opinion unless we schedule an official appointment (as anything I say can and may be used against me should an adverse event occur based on said opinion).

Lately though, I have been receiving hypothetical questions. Especially as relates to the new vaccines that have been rolled out under Emergency Use Authorization.

Why was the vaccine made so fast?

Because we had the entire world concentrating all resources on the same project, advanced technology was available, the number of volunteers for the study was in the thousands and we had a large number of sick individuals with whom to compare.

Will it change our DNA?

This is with regards to the mRNA vaccines (there are other types that will be released shortly as of this post). It does not alter your DNA. It sends a message to your cell to create a portion of the spike protein of the virus. Not the whole virus itself. Your body them creates antibodies to attack this foreign spike protein and creates memory cells so it knows what to attack should the virus present itself in the future.

Can someone be infected by the COVID-19 virus after the vaccine?

Yes. If you were exposed to the vaccine close to the first dose of the 2-dose vaccine, your body will not have built up its full immune response (which happens around 2 weeks after the second dose). So until that point you can still be infected by the virus. The expression as symptoms depends on the individual. You can complete your second dose after you are symptom-free.

Do we still need to wash our hands, wear a mask and social distance after we receive the vaccine?

Yes for now. Your having the vaccine means that your body is ready to fight the virus should you be exposed to it, which will help to keep you from getting sick. However we do not know enough about someone who is carrying the virus in their upper respiratory tract and the potential to spread it to others even though they themselves are protected by the vaccine. Remember, the regular mask helps you to keep your germs to yourself and not spread to others. Once we get to herd immunity (more than 70% of the population vaccinated) we should be able to ramp down those other protective measures.

Why not have a natural herd immunity?

Because natural herd immunity would require millions of people to be infected of which hundreds of thousands would be very sick and may die. It’s better to build up your immune system from a piece of the spike protein of the outer layer of the virus (current mRNA vaccine) than by being exposed to the live virus.

What about the new variants?

The new variants of the virus which are currently in the United Kingdom, Brazil and South Africa have spread globally – even here in the US. They appear to spread faster than the original virus but also seem to be affected by the current vaccines. The vaccines may not give the same 90% plus protection but any protection is better than none.

What about people with chronic conditions or other illnesses?

This is basically deciding if being exposed to the virus will put one at risk for a serious complication, hospitalization and/or death versus having your immune system built by the vaccine. That is a conversation to be held with your health care provider. The current teaching (as of this past week- depending on your source) is that every non-pregnant adult is eligible unless they have an allergy to the vaccine or it’s ingredients or has had Guillain Barre Syndrome).

What about kids and pregnant women?

Some vaccines are approved for 16yrs and up, others for 18yrs and up. Studies are underway for 12yrs and up and eventually for those younger. For pregnant women, current recommendations are that those on the front line should get the vaccine since being infected by the live virus could cause complications leading to hospitalization and other adverse outcomes. For others, they should seek the advice of their health care providers.

Is the vaccine mandated?

No it is not (as of this post).

What people need to do is have a conversation with their health care provider and with their family. Discuss any concerns. Do appropriate research. Ask questions and make a decision.

For health care providers- the key is to listen to everyone’s concerns. Address them based on information that we have at hand today. Allow people to process the information and discuss with their family. And do not bully or shame anyone while providing the education.

The bottom line is we all want to get to a place of normalcy where we can travel freely, congregate, visit loved ones, hug and smile without wearing a mask.

We can get there by getting this virus under control using all of the tools in our toolkit – washing hands, wearing a mask, social distancing and taking the vaccine if eligible.

When everything is under control, we can put our toolkit away. (Except maybe the vaccine which may become routine as is the flu vaccine).

Until then, please use the tools we have available.

Wishing everyone a safe and healthy week.

(Disclaimer – this post is a commentary and not meant as medical advice; please contact your health care provider for more information)

This morning I was going about my schedule for today.

Pray, exercise, decaf, shower, dress up, click open laptops, start the “to do list”.

Then I got a message that the sister of my schoolmate/friend had died.

Mind you, we were last together almost 30 years ago (medical school). This is actually when and where I met her sister.

My first recollection of this sister was that she was extremely graceful and elegant. She kind of reminded me of royalty. But she wasn’t snobbish or condescending. Just gracious.

I remember thinking that I wanted to be just like her.

And I made a concerted effort every day after that to do my part to be graceful and elegant.

I didn’t always succeed, but sometimes I would stop and look in the mirror and say in my head “I hope I’m getting this right” as I thought of her.

So for 30 years I have thought of this wonderful person off and on.

And I never told her how she inspired me.

And I never told my friend how her sister inspired me.

I am now just letting her family know through their memorial site.

But it would have been better to let her know while she was alive.

That is my regret.

So my task for this year is to reach out to those people from my past (and present) who pop into my head from time to time, and let them know how they have touched my life.

Whether by phone call, text, email or snail mail.

And I will continue to reach out to others I encounter to hopefully inspire them as well.

So the song that comes to mind (because I always have a playlist in my head) is Diana Ross singing the 1970 song…

“Reach out and touch, somebody’s hand, make this world a better place, if you can.”

Who will you reach out to this week?

“Hello darkness, my old friend
I’ve come to talk with you again
Because a vision softly creeping
Left its seeds while I was sleeping
And the vision that was planted in my brain
Still remains
Within the sound of silence”

This tune is actually the ringtone for my phone.

I love the haunting melody, it doesn’t make me sad, just reminds me of my childhood.

For those not in my age bracket, the song was originally by Simon & Garfunkel in the 1960’s (gasp!) To be accurate it alternated between Sounds of Silence (album) and The Sound of Silence (song).

The current generation may know the remake by the group Disturbed done in 2015 (now that version is dark).

Anyway, let me get to my main point.

Silence.

It can be comforting or it can be torture. And there are times where we have no control over its presence in our life.

But if our days are full of noise, there are times when we need a bit of quiet.

The song continues…

“And in the naked light, I saw
Ten thousand people, maybe more
People talking without speaking
People hearing without listening
People writing songs that voices never share
And no one dared
Disturb the sound of silence”

Kind of reminds me of where we are today with people saying things for the sake of talking and people hearing others but not truly listening.

And with all the noise, sometimes one needs a moment of silence.

To think.

To reminisce.

To grieve.

To reflect.

To plan.

To just be.

So I’m starting my week with a moment of silence.

For me.

It’s been an interesting week to say the least.

Someone posted a meme on social media with the Joker (as 2020) showing the clown from It (as 2021) around, helping him navigate his new workplace (the world). I actually chuckled a bit for that one.

Anyway- the common theme that came across during this past week for me was “sacrifice”.

I had recently joined a book club and the book of the month is “Too Heavy a Yoke” detailing the sacrifice black women make to be strong and resilient.

Yesterday I watched the first few episodes of “Bridgerton” (yes I am a Shondaland fan- no shame whatsoever- don’t worry, no spoilers here) and it kept referring to the sacrifice different people would make for their personal honor, for their families, for their community.

Then I was going over my schedule for the week. My vacation was supposed to end yesterday but I ended up cutting it short by 3 days because of the current upsurge in Covid-19 cases. Will I really get those days back? It’s hard to say when you are involved in healthcare- we cannot predict the rest of this year.

Sacrifices.

For the greater good.

For our loved ones, friends, colleagues, communities, states, country and the world.

But one has to also remember that sacrifice goes both ways.

One can sacrifice something today or in the future for the greater good of ourselves.

We need to be aware that some things must be given up in order to create room for our betterment – be it mentally, physically or emotionally.

The difficult part is being astute enough to discern what you are willing to sacrifice for yourself and for others. Making sure it balances out in the end.

If you are not whole, it’s difficult to do better.

So please remember to be smart as you sacrifice.

Wishing you safety and wellness.

Admit it.

Every year around this time we start writing down all the things we resolve to do by the end of the year.

Lose weight.

More money.

Learn a new thing.

There is absolutely nothing wrong with having resolutions for the year. The key is making those resolutions manageable strategically.

Oh, you thought I was going to say “make them reasonable”?

It is absolutely reasonable to have goals that may seem unattainable to some. Your job is to figure out a way to make them happen.

Step 1 – write down one to two goals you have for each category of your life (you, family, friends, career, health, fun, other things important to you and the “just because”)

Step 2 – Now divide your year into quarters (Jan-Mar, Apr-Jun, etc) and write down what you can accomplish in each category for the first quarter. (Don’t map out the entire year! Things change and you need to be able to adapt).

Step 3 – For the first quarter, break each goal into the tasks needed to get there. Assign one task per month.

Step 4 – Each week work a little bit on the tasks. Can be once a week or 3-5 days a week. It’s up to you and you must allow yourself room to slack.

Step 5 – Tell someone else your plan so you can report out weekly and be held accountable.

An example would be the inevitable “resolve to exercise more”.

Quarter Goal: workout 30 min daily by the end of March, so maybe work out 5 x week by the end of February, therefore start by working out 3 x week by the end of January.
OR 10 minutes a day in Jan, 20 minutes a day in Feb, 30 minutes a day by March.

Break it down.

And forgive yourself for missed days.

And at the end of the quarter reassess. What you wanted to accomplish in January may have adjusted in April. Make the necessary changes for the next quarter and keep going.

Resolutions are supposed to make you feel good not guilty.

Give you a sense of purpose.

And it is for you.

Wishing everyone a safe new year with health and prosperity.