A Few Things You Should Almost Never Say to People

"Are You NUTS?!"

When I told people I was going to embark on medical school with a ten-month-old in tow, I got various versions of, "Are you friggin' NUTS?!" in response. See, I think you should only ask that question of someone who's about to jump off one of these (visited today at the Lake Placid Olympic Ski Area):

"We Think Your Child Might Be Retarded." [sic]

When I was four or five my kindergarten teacher expressed some concern to my mother that I might be developmentally delayed. After premature birth at 32 weeks in the early '70's, this wasn't out of the question, but when my mom asked why she suspected a problem, the teacher reported that I couldn't seem to pay attention and often looked blank.

"What are you teaching them?"
"Oh, the shapes and colors-"

"She already knows those."

"How to count to ten-"

"She can count to a hundred."

"The ABC's..."

"She's been reading the New York Times to us for weeks. Look, is there anything else?"

I don't think the meeting ended too well. Just for documentation my mom brought me to Clark Air Base to get psychometrically evaluated by the Americans. Everything checked out reasonably well. She put me in a different school.

"You'll Never Amount to Anything."

Sometimes I think conventional measures of ability and the tendency to judge people based on personality do little justice to the capabilities and gifts people actually have. I came across a wonderful letter to Stanford pre-meds by Michael McCullough, M.D., that I wish were required reading for ALL high school, college, and med school students and teachers. In it he reminds us: "Albert Einstein, Bill Gates, Winston Churchill, Thomas Edison, and Mother Teresa all had something in common: they didn't do well in school. Take home point: Don't rely on a grade point average to prop up your sense of self." We so often define our worth by our successes; it's high time we redefined success!

My favorite example of the school-"failure"-yet-genius is the story of Australian make-up artist Ann Maree Hurley. She kept telling people when she was growing up that she was going to be a make-up artist, and the best response she ever got was, "That's nice, dear." She failed her last year of high school and struggled through Wodonga Catholic College. But she persevered with her true love and has now worked as a make-up artist on all three Pirates of the Caribbean films. To that I say, you go, girl.

Oboist Caroline Plamondon posted a story on the Oboe BBoard relating how her school band teacher discouraged her from trying the oboe, because she was "too shy," then later tried to persuade her mother not to allow her to audition for the Montreal Conservatoire and two other colleges: "He called my mom and told her it would be a good thing if she discouraged me from entering those schools, because I didn't have any chance of getting in, let alone becoming a professional musician. Well, I got in to the 3 schools, chose the Conservatoire, studied there for 6 years before changing schools to obtain my Master's degree." SO THERE! Way to go, Caroline Plamondon!

***

When I was applying for pediatric residencies (before my anesthesia days) the chairman of pediatrics told me that Children's Hospital in Boston would be a "reach" and I shouldn't bother. In many ways he was quite right and the advice was practical. A couple of years later, after I had fallen in love with anesthesiology and switched my career track, I couldn't help laughing at the whole episode when I found myself practicing medicine at, guess where, the O.R.'s at Children's Hospital. The only way to know if you can reach something is to stretch for it.

This was the same chairman who, during my internship, after listening to me explain the molecular mechanism of hyperkalemic periodic paralysis, asked me in front of a roomful of pediatric interns and residency applicants to draw a diagram of the mechanism on the board. After a split-second silence, I said, "Sure" and walked up to the board and drew it. Then I left that program and started my anesthesia career.

But that's when learning became grueling.

During my first year in anesthesia residency I took an early leave-of-absence to help my husband and children move to the Boston area, and the day I returned, with my "skill set" still nonexistent (how I hate that phrase), or embryonic at best after only two weeks on the job, the attending physician I was working with sniped at me all day with insults before finally saying, "Maybe you shouldn't be doing anesthesia." When I looked at him in disbelief that a teacher could be so un-helpful to a trainee, not to mention in pain at being disparaged all day, he just emphasized, "Yeah. Maybe you shouldn't."

His labeling of me haunted me in various ways throughout my training, and despite some genuine teachers, like my residency program director, who were willing to judge me for the good progress I made and the expertise I attained by the time our training ended, there were still those who didn't have the capacity to look past that prejudicial incident and my early struggles during that challenging first year. Thankfully they weren't able to discourage me from taking good care of my patients - from the Peruvian child at Children's who put his arms around my waist and thanked me the day after I had to intubate him awake with a fiberoptic device, to the elderly Korean gentleman who spoke no English but conveyed his thanks with a squeeze of my hand. It was in these unseen, uncredited moments that I felt I was truly a physician my program could be proud of.

To the teachers who actually TAUGHT, I send out a heartfelt thank you, for bringing me to this successful place:

Success is a Neon-green, Glow-in-the-dark Monkey Around Your Neck and a Squishy Yellow Duck in Your Arms

What is success?

I've written elsewhere that for me, success is peace with oneself. Last night my family and I shared an evening at our town's annual carnival, and I can say without a doubt that I was at the pinnacle of what I call success.

The sky was overcast but not gloomy - grey overhead, but a soothing slate blue near the treetops. The air was pleasantly cool, just warm enough not to have to untie our jackets from our waists. The fairground, set up at the local high school, was not overcrowded. We saw a few people we knew, making for a nice, small-town atmosphere, the kind I loved to see romanticized in films like The Music Man. Our daughter had her fill of high-speed rides that made my stomach lurch just watching them. Our son went twice down the giant slide and happily bounced on two different moon-bounces. My husband got his turn playing Siegfried with a crossbow at one of the game galleries. Each child won a choice stuffed animal (for our son, a neon-green monkey, and for our daughter, a large, squishy, yellow duck).

As for me, I hungered for nothing. I had had some oboe time earlier in the day. We had just shared a simple dinner of seafood, salad greens, and strawberries. The aroma of fried dough was a pleasure but not a temptation thanks to our earlier meal. We were together and content, enjoying each other's company, laughing at each other's quirks and near-misses. After 11 years of marriage, my husband was still flirting with me and sneaking little glances and moments of affection here and there at the fair. His hand on my back was warm and sure. Work was faraway, and I would be able to return to it the next day and continue to help provide for this special family. We lived in a free country and were blessed with good health. Life was good.

A popular graduation-time greeting-card poem often mis-attributed to Emerson, but probably authored by a woman named Bessie Stanley in 1904, says you are successful if you have lived well, laughed often, loved much, and basically made the world a better place somehow. I agree, but I like even better the words of William Henry Channing (1810-1884):

To live content with small means;
To seek elegance rather than luxury
and refinement rather than fashion,
To be worthy, not respectable, and wealthy, not rich;
To study hard, think quietly, talk gently, act frankly;
To listen to stars and birds, to babes and sages, with an open heart;
To bear all cheerfully, do all bravely, await occasions, hurry never.
In a word, to let the spiritual, unbidden and unconscious,
grow up through the commonplace.
This to be my symphony.

No worries about getting tenure, publishing research, making it to the top of a pop song chart or athletic tournament, or winning a prize for beauty or talent. Instead: gratitude for the love in my life; kindness to the world; honest work; peace. Noticing the extraordinary in ordinary moments. This is the kind of success I aspire to and pray to fulfill every day.

People might think this a rationalization or lack of ambition, but I know from experience that although a Harvard degree or an award-winning article might bring a sense of accomplishment and a momentary happiness, they do not bring real joy.

***

Nostalgia moment of the day: a friend who has known me for 22 years finally found the Japanese anime characters I've been looking for, off and on, for at least that long. Richard and Erika. I bet no one outside of the Philippines, even the most diehard manga and anime fan, has heard of them.

Growing up in the 70's in the Philippines, I remember loving two TV shows. One of them was Candy Candy. Candy Candy, a cute girl with curly blonde hair in pony tails, was a Cinderella-figure in the home of a nasty girl named Eliza. They were both attracted to a boy named Anthony, and to my delight Anthony of course preferred Candy Candy and Eliza was unremittingly jealous and bitter about the whole thing. I remember I had a pink Candy Candy pencil case in school. After I moved to the U.S. in 1981 I didn't see Candy Candy again until I was on vacation in Paris during high school and found it dubbed in French over there. I was beside myself with excitement.

The other show, which I thought was called Richard and Erika in the Philippines, never turned up on my radar screen even after I started searching the internet. But my industrious friend finally clued me in: the real name of the show is Tosho Daimos. Filipinos, being entranced with starcrossed love scenarios, focused on the romance element of an otherwise robot-battle-filled series. In our dub we gave the name Richard to Kazuya Riyuzaki, the earthling hero, and the name Erika to his forbidden lady love, Miyuki Ueda, a winged princess from the planet Barm. Like many little girls back then, I wanted to be Erika, with her long black hair and gorgeous looks, and her Richard. And young as we kids were, we could sense that there was some intense feeling between those two that was not the stuff of most science fiction we were familiar with. There were schoolmates willing to play Han Solo or Luke to my Leah, but not Richard to my Erika (nor would I have welcomed the act from most of the boys at school who, if memory serves, would have been more interested in piloting imaginary giant robots and engaging in combat against rogue Barmians anyway). I've read on another site that watching the series now, in adulthood, is a very different experience, with too many characters sacrificing life and limb for the sake of the starcrossed lovers. Oh well..."when I was a child, I spoke as a child, I understood as a child, I thought as a child..."

I found new kids' shows and cartoons in the U.S. in the early 80's. 3-2-1 Contact, Mighty Mouse, He-Man, Inspector Gadget, even The Smurfs. But none had the drama and passion of those Japanese animated series! They didn't "make 'em like that any more..."at least, until the American public got clued in to anime. Now the love triangles continue...I hear Inuyasha's quite good.

Ah, the 80's. Peanuts was still in the funnies section of the paper. Everyone's hair except mine was big. There was no internet. I typed my college applications on a typewriter. I had a record player and a Walkman. To keep in touch with faraway friends, I wrote and received letters. Real, snail-mail letters.

It's interesting how music can so powerfully conjure up a particular period in life. My high school days were replete (of course) with 80's songs - Love Bites, Waiting for a Star to Fall, Never Tear Us Apart, Don't You Know What the Night Can Do, all the Chicago hits, U2, George Michael, Red Red Wine, I've Got My Mind Set On You. Every time I hear those I think of those sheltered days, of my cozy little home on Friars Road in Bethesda, Maryland.

In the O.R. today the nurses and surgeon played a CD that was a nostalgia walk back to their high school days, or so they joked. Big Girls Don't Cry, Stay, and the like. Those were popular in the 80's too, thanks to Dirty Dancing. What gives a song staying power? I wonder - will any of the songs that are said to be "great" today be familiar to my children when they have children?

***

My son's statement of the day, to his friend; overheard from the kitchen, during their playdate: "Shaman is NOT a weird name. It's a kind of DOCTOR for tribes in the AMAZON." You tell 'em, Little Sage.

If you don't like your D, don't go to C; or, The Gift of Imperfection

Today I had my fourth oboe lesson. I have been having trouble descending down the C scale. I'm fine till I get to E, then D, then C...I have trouble there, whether it's crooking my pinky finger just right to hit the low C, or getting the appropriate tone if I do hit it, or sometimes getting any sound at all. Kyoko gave me some pointers on where to position my finger and also how to rest my lips around the reed to make a fuller, rounder, more open sound in the low registers. "You have to have that full sound already at D," she advised. "If you don't like your D, your C will not be good either." So I worked on getting that whole, round tone before moving on. This will take some practice. She did say despite my struggles, "Don't worry, you actually have a nice, warm sound. Don't get stuck."

After she scraped at my reeds a little, things got better. "It's not you, it's your reeds!" she joked good-naturedly. We had a good laugh at my horror of blaming equipment rather than myself for bad form. As a doctor I can't ever say, "Sorry I didn't pick up that Grade III aortic MURMUR there, but it was a bad stethoscope," or, "Well, I couldn't get the airway and the patient DIED because my laryngoscope was broken."

Plus, I've heard my teacher play my "bad" reeds, and you know something - a really good oboist can get a good sound out of a "bad" reed. But I understand her point - as a student I probably need a good reed to achieve a good tone consistently, at least until all the mouth muscles and lumbricals get in better shape. "You so want to be a swan," she commiserated, noting my love of the oboe parts in Swan Lake, "but with oboe you have to be willing to be a duck first. I was a duck for years."

The great thing about all this is I can LAUGH about it. Hear me quack. We spend half my lessons in stitches over my playing. For someone who's been a perfectionist all her life, for whom patience has never been a virtue, whose psychological self-flagellating capacity rivals that of St. Augustine, this relaxed attitude to imperfection - in fact, to being really BAD at something - is a HUGE deal. It feels great. Maybe that's why I feel so comfortable blogging about all this and have the audacity to name myself an "anesthesioboist." My definition of success is true peace with oneself, and I'm so at peace with my own imperfection at the oboe that I feel I've already succeeded, in a way.

Oboe is helping me with my spiritual homework. Here's what I mean. I think "the meaning of life" is to learn how to be more loving and more complete each day, but I also believe that under that umbrella-meaning, each person has little "homework assignments" to work on. I think some of mine are to learn about human worth - what defines it, and how to honor it; to learn patience; and to learn enough humility to accept imperfection (my own as well as others'), and also to forgive and let go when imperfection causes me pain. I have other homework assignments, but these seem to be the recurring themes, I think because I am a slow learner. I try, I fail, I try, I fail - "I'm all... 'this is hard!' " as the speech-impediment girl on Will & Grace said. Oboe helps me slow down and work on learning these lessons.

So if I'm playing badly because I haven't developed sound technique or muscle strength yet, so be it. I'll just keep working. If the reed really is at fault, ok then. We'll scrape it and try again. Patience, patience, patience. No need to fixate on blaming something.

I believe, like so many self-help books and gurus have expressed one way or the other, that assigning blame is one of the most immature and unproductive human tendencies (speaking as someone who has succumbed to it many times). People seem to NEED to point to someone who's at fault, and also NEED for themselves NOT to be found faulty, as if imperfection were the end of the world (again, guilty).

I had a very recent experience of this latter phenomenon when I pointed out an instance of unequal treatment to someone, and that person bent over backwards trying to find outside explanations for the event rather than taking responsibility for it, however unintentional it may have been, as if admitting a mistake or a failing or an imperfection were going to destroy some precious, unblemished identity. But people are intrinsically precious; if we could all really, truly believe that, no matter what, then dealing with our own imperfections and mistakes, and those of others, would be so much easier. We wouldn't be wound so tight. (This was actually what my NPR essay was about.)

I think Jesus was probably one of the most relaxed people on earth. Heal on the sabbath? Sure, why not. Hug a leper? Absolutely. Tell a person caught in adultery that she wasn't condemned? No problem. I think one of the reason's he wasn't wound so tight is because of what HIS faith was made of. He KNEW people were pearls of great price - all of them. "You are the light of the world," he said. I think this "good news," in fact the whole point of his life and the reason he was willing to enter fully into our human experience, was to help us learn this about OURSELVES.

So many of his teachings are precisely about the worth of each human being. No, don't sit in the place of honor, because EVERYONE has dignity and value. Wash each other's feet. Trust like a child, live simply, be generous. If someone asks you to walk with him a mile, go for two. Do not judge (if only people would take THAT one literally more often). Don't lord it over others. Don't just love when it's easy - love when you don't feel like it either. "Be perfect as your father in heaven is perfect." (Matthew 5:48)

But wait, isn't this post about imperfection? What happened to, embrace your own imperfection?

In the koine Greek of the New Testament, as I understand it, the word translated as "perfect," teleios, implies not sinlessness or faultlessness but completeness. Being whole (whole, holy, same root, I think), fully integrated, without missing parts, mature, having no need for external honors or affirmations. If you believe every person is precious, including YOU, then there's nothing to be afraid of or envious of, not a movie star's beauty, not a businessman's wealth, not an academic's accolades or publications, none of that. You're already worth the world. You can be at peace. You can also stop thinking, or needing to think, that you're "all that," more deserving than others, superior to others. I repeat: you can be at peace.

I remember recently hearing an ad on the radio for a summer program for high school students being offered by a well-known Ivy League university. It was inviting young people with talent, vision, "leadership," etc. to apply. I had to roll my eyes. If EVERY child were a leader, where would all his or her followers come from? Why is "talent" so important? If our children were "average," would I love them less than if they were prodigies? DUH, of course not. This is why I love the movie Little Miss Sunshine so much; the idea that life is a beauty contest in our society, but SHOULDN'T be, is so true and so humorously rendered in the film. I'll be thrilled if our kids grow up to be loving, kind, happy, hard-working people with good judgment and integrity. Integrated, whole, holy, teleioi. For all their imperfections, I already think they're pretty perfect.