Where is the senior?

Apparently my web presence has been missed.

Wellllll I'm here to deliver.

Tonight I decided to take some time ..listen to some music, light a candle and write.

Things have changed but in many ways have stayed the same. Still exhausted from work, still single and doing me, and getting my namaste on when i can. But never the less. Grateful.

The greatest change has been my growth as a doctor.  A new group of interns has hit the wards. For some the enthusiastic interns remind them of how thankfully close they are to the end of residency.. For me it reminds me how much I've grown as a clinician. It reminds me of how much I've learned from touching the hands, hearts and lives of sooo many patients. I honestly cannot remember many patients from my first 6 months of intern year. It is allll a blur. I remember having a headache EVERY day. Being upset about something EVERYDAY. I remember saying things on rounds...and still worry that it had no coherence, relevance or purpose. And then suddenly the clouds cleared... Things started making sense.

Now... somehow a midst the extreme physical fatigue. I smile more. I laugh more. I face fearful situations head on. I recognize and face antagonistic situations without anger or frustration. Folks come at me crazy and i refuse to give it the same amount of energy. The nurse asks "where is the senior?" and I no longer nervously answer..   I'm comfortable with saying I don't know. I recognize a great mentor and doctor quickly and continue to be an energetic student when I have a dynamic attending.

Thank goodness things got better.

Recently I've been lucky enough to have the time to take casual walks around the hospital with many of my patients and truthfully these walks are as much for the patients as they are for me. Yesterday I learned that my patient didn't think I should get a tattoo, I learned how to use checker board pieces as dye for tattoos, I learned that trust can be gained even from the most upset of the upset patients, one patient was one of twenty something children.... (thank God for birth control), and my patients LOVE when i wear my hair out.

I find these moments the most refreshing. I may never know every drug mechanism or rare disease but I know people. And that is irreplaceable.

I say all this to say.... Growth comes with patience. Great Doctoring comes with time. Stillness is a blessing.

So yes.. I'm the senior. One more year. Jesus be a fence cause I'm tired :) lol. But i'm alllll most done.

And I still love philly.

What are your views on texting?

Well well well. This post is long over due. Finally a good friend asked me this epic question...

"What are your views on texting?"

Let me get straight to the point.
I AM SO OVER TEXT MESSAGES.

I call it the "texting without a purpose" phenomenon. I wish I could go back 50 yrs and see what dating was like pre cell phones, facebook, instagram, twitter. All of it.
I can only speak from my experience as a young 27 yr old woman.... but I get more whats up texts then I would like to admit.

Not only do I get a lot of "whats up" texts.. I also get "Hi", "Hey", an occasional "yo" and "wyd"

I know what you're thinking. This cannot be what my dating life has come to...

Oh but it is. And not surprisingly the bored Mr. Texters all text at the same hours of the day. High volume times are Friday nights between 8-10pm and once again on Saturday night.. usually a little earlier... between 6pm and 10pm.  Sometimes I cant keep up.  But the real question is..... why even keep up. These bored texters, Instagram messengers and facebook messages never appropriately inquire about myself or my time.
oh! And I forgot how they text u one syllable... then when you respond they don't respond for hours. #icant lol. I really cannot deal. anymore.

So what has this overwhelming amount of whats up texts amounted too. Not much....

It HAS stirred up good conversation and questions when hanging with the crew. Some seem so simple yet...complex

- Can a person actually successfully date in these modern times without texting?

- Do men even call anymore?

Welllll for now I do not have the answers to the text message conundrum. I do know I'm over it...  For lent I'm giving up bread and texts :)

What are your thoughts ?!?!

reflections from a young doctor

Its been a while folks....

but these thoughts have been on my mind for awhile.

What do you really expect from your doctor??  Do you expect them to make you feel better, save your life, extend your life, take all your pain away, relieve suffering..?

And for my doctor friends...?? What are the limits of our roles. How do you reconcile the limitations of life and our profession with the expectations of society.


Recently I was working in a hospital ward that was primarily for the care of the elderly. I felt myself realizing that I was encountering most of these patients in the last days or months of their lives and wondering what I was actually doing for them...  Everyday rounding on frail adults that could not communicate, make eye contact, did not know whether I even entered the room, a few knew their names and even fewer had the strength to feed themselves. Each day I entered, listened to the heart of 90 yr old ms H and the lungs of 94 yr old mr S and avoided the bed sore wounds of 85 yr old mr L. Wondering more about the earlier lives of my patients, the children that they raised, the burdens that they carried..the things that they've seen. But now... none of them could tell me. I'm left to wonder......    I continue to do my job, ask phlebotomy to access veins for labs, treat infections, in my heart begging families not to ask me to do cpr in their 90 yr old loved one...   and still I wonder if this is what the last days of these sovereign lives is supposed to look like. In a cold uniform room with a food tray waiting to be fed to you.

I also thought I would one day help people feel better and not endure suffering. I honestly can say sometimes I'm not sure if that's what I'm doing. Each of us is to leave this earth at some point... and is this the infection that is to allow you to rest and meet God. Am I the reason you continue to lay in this bed... unable to see your maker. Questions I ponder. When does the natural process of life become impeded by the "Do everything you can doctor" way of our society.  Last week I had a patient say to me..."I just want to rest."  One week later I'm watching doctors replace heart valves in 90 yr olds....

And who is responsible for this culture that we the doctors can prevent death... We usually don't respect a treatment unless it changes "mortality"... or are the patients responsible... who often sue when a loved one unexpectedly dies..... I'm not sure. Chicken and the egg maybe..

I will close my thoughts with the beauty in the end. Hearing about the vibrancy that once was someone's life. Seeing the love that they shared with their spouse since the age of 20... seeing the love and appreciation their descendants have for them.. one 90 yr old told me she wanted some weed... (that made me smile). I think she can have all the herb she wants. lol. And one 87 yr old put her fingers in my sternum when I told her she should go home and not spend the night with her 92 yr old hospitalized husband... and again the next day when she had no food tray... Sometimes patients are package deals lol. She was all of 5ft and ready to take me out.

Although I don't know the answer to these questions... these are just the thoughts I ponder...
I pray we can give our frail and elderly the dignity they deserve and allow them to rest when it is time.


Ecclesiastes 3:1-8
To every thing there is a season, and a time to every purpose under the heaven:
A time to be born, and a time to die; a time to plant and a time to pluck up that which is planted
A time to kill and a time to heal; a time to break down and a time to dance
A time to weep and a time to laugh a time to mourn and time to dance
A time to cast away stones, and a time to gather stones together; a time to embrace and a time to refrain from embracing;
A time to get, and a time to lose; a time to keep and a time to cast away
A time to rend and a time to sew a time to keep silence a time to speak
A time to love and a time to hate a time of war and a time of peace

Upcoming posts...  a feel like speaking on dating soon.. :) stay tuned. 

Blackness, Faith, Medicine

When I think of the three things that define my life right now there are three words that come to mind.

Blackness, Faith, and Medicine.

All so familiar but all so new at the same time. Let me explain. Although I have known these themes all my life in some way or another never before have I been so aware of them.

Let's start with my blackness. I mean don't get my wrong. I've always known I was black. But being a doctor has brought new life to the word. Everyday there are moments for me that I'm reminded that I am a black doctor: The excitement or anxiety that comes across my patient's face when I say I'm the doctor. The gentleness that I must approach non black patient's with when I say I'm the doctor. Almost giving the moment of shock a chance to settle. The moment when the patient says, "Where we going?" Cause of course they always think I'm transport taking them to xray. The worst feeling is the sense of resistance that you feel from nurses, techs, fellow doctors who simply do not want to respect you, take orders from you or listen to you because you're black. It's something you can't explain. For example, yesterday I made a concerted effort to greet all of my nurses, ask them how their night was going and to include them in the plan of action but then later on in the shift it was reported to the senior that I was "rude." I would be lying if I said I wasn't upset. I was so angry I could have cried. I have no idea how people in the civil rights movement were so strong and stoic. Being non violent and having the strength to love. The unfortunate thing is that these moments happen all the time. Some days are significantly worse than others. But why didn't anyone tell me!! Was I living in a bubble of protected blackness? I think I walked into this thinking that being a black doctor would be fine. I thought at the least it would be comforting for my patients not actually fearful for others. Who knew I would deal with craziness on a regular basis. I find the biggest challenge is not letting the anger and subliminal racism not damage my spirit. Protecting my heart. Continuing to love. Fighting for my sense of kindness despite the world wanting to crush it. I shall continue to fight for my tender heart.

Now let's talk about faith. This one is complex. Especially when dealing with my patients. If I ever were to get a tattoo it would say, "faith in the unseen." I mean that's what faith is. It's believing in what you can't see. How does this affect me in medicine... ? It's that feeling that I can see what my patient's can't see. I often feel so torn when I see my patient's praying and hoping for a miracle. Although they cannot see what I see.. They believe. For me I almost feel like I can see too much. I have too much information. I can see that the cancer has infiltrated every organ in their body, I can see that we as doctors have no cure for this disease or that this heart has not beat in over 30 minutes and that there is no activity in this brain. How do you reconcile this as a believer?  I often wish I could go back to the time when I didn't have the MD. Someone last week asked my why does it seem like the black patient's never want to let their families go and seem to be very spiritual. I simply said, Faith and hope is what being black in the USA is about. Hope got us through slavery. Hope got Obama elected :) Hope is what I have when I see all my beautiful single educated friends still out here. Hope is what I must have when I see another young black man in the ED from a gun shot wound or that all of my incarcerated patients are black. So yes my people have a lot of faith and hope. Its what we need to survive. You loose this faith and you might end up the crazy man on the septa bus yelling everyone is racist. No one needs that. I remember how unwavering my faith was in college and med school. There was absolutely nothing that could tell me things I couldn't see weren't going to happen. I gotta get back to that. I blame it on me "seeing" too much. Gotta get back to that believing what I can't see.

Finally good ol Medicine. This one will be brief. I gotta figure this medicine thing out. It consumes my life. I give it 80plus hrs a week, I give it my quality sleep at night, I've given it the last 9 yrs of my life, might've been wifed up by now if it wasn't for this md thang and I still at times don't know. I know. You're thinking. Bri you better figure it out and quick. Working on it. Somehow my journey is telling me that medicine might not be the most interesting chapter of my book.  The major question right now is do I specialize or not? To be determined...

Alright... enough contemplating for one night. Maybe some colorful posts coming soon about dating in philly or the lack there of.. :)  coming soon.

warm room and a sandwich

Its been awhile... I know. Lets just jump right in.


Today I had that moment where I asked myself.. Have I lost myself? Sitting next to an excited, enthusiastic medical student I realized in that moment where my spirit used to be and where I am currently headed without rapid, solid intervention.

Tonight I started my shift with dread, darn near tears. I just couldn't understand why I was being forced to walk away from my cozy home through the snow to the hospital and this after doing absolutely nothing all day. Walking to the hospital I kept wondering.. I hope no one comes in super sick.. I'm praying for sore throats.... runny noses... even a dog bite.. diagnosis that take relatively no thinking and I could treat in my sleep. And don't let them be old I prayed.. smh. With each decade I must use more areas of my brain..
I know this is bad...
I sign up for my first patient... And wait a minute.. She was just in the ED less than 12 hours ago. She must be cold with nowhere to go. I walk in... She has her suitcases.. and her flight of ideas are bounding off the walls and the frustrations of everyone in the room. "I need my meds, Can I get some tea, do I get a sandwich.."
What do I do...
Fine. Its cold. We let her stay overnight I say..
First the primary nurse says.. "Are we really letting her stay?"
Then another nurse comes to me to say, "did you read about this lady..? She was just here."
Then the primary nurse from yesterday with more frustration and anger then I expected says.. "I explicitly told her what to come back for.. She is crazy and needs a psych eval. I don't even think she left the waiting room when i discharged her. Why does she have her bags?"
Just having read my little devotion... I had just enough patience to make it through her frustrated speech.
I walk around the unit thinking the situation has passed. The attending said she is saying so its done.. right? Wrong.
Then there is the huddle of nurses... All glaring in my direction. I stop and say "What?" (WRONG move..)

To say the least everyone was heated with me for letting this homeless woman stay in the ED overnight. I would have been the hero and favorite resident of the night for putting this poor woman in the cold overnight. As I walk away from the huddle of frustrated nurses... I am disappointed in so many things.
Disappointed that they did not realize their frustrations were displaced. I'm not the enemy. I'm just the one tasked with telling them.. because we have no resources for this lady, yes I'm sorry you are left with more work for the night. Disappointed that after going to medical school to "help people".. On a Saturday night in West Philly I have nothing more to offer this poor woman than a sandwich and a warm room until 6am. Letting her stay until 6am didn't take any critical thinking on my part.. No complex problem skills were needed. No assertiveness was needed.. She would require no more thinking of myself for the rest of the night.
The former not burnt out self before residency would have given the nurses a passionate speech back and demanded to the attending that we come up with a more thought out solution.

I simply let the moment pass... trying to conserve as much of my energy as I could for the 10 hours left in the shift.
.
Would things be better if I worked less and had more energy for these moments.. or is it the system? We have multi million dollar research buildings for cells and rats to run around in. But no where for me to send this lady to sleep...

I left this shift wondering where my sense of self and hopefulness about medicine had disappeared too..
I think 2014 will be dedicated to finding the sense of hope in medicine that led me to choose this profession.

These are just the thoughts in my head at 1am on a Saturday night..

Made in America: We did that!

Once again I've seen the light that is vacation. And everyone that knows me... definitely knows I LOVE summer vacations and holidays.

This weekend goes down in history as one of my most memorable Labor Day Weekends ever. It started with my partner in crime Candice coming to enjoy Philly from Raleigh North Carolina.

Once Candice arrived we found Emo and hit the streets. We started with some prepping.. mani pedis and eyebrows. Then we went to some of my favorite restaurants in the city. For dinner we went to Barbuzzo and for brunch my favorite Morning Glory.  There were sooo many stories packed in the weekend... The turn up event at wawa Sunday night, the moment my dress strap broke getting into the cab. Smh. It couldn't handle the thickness I guess. sigh...  Oh and how can I forget Kung fu necktie. Best party ever.


And I cannot even begin to tell all the stories from made in america. The first 10 minutes of arrival Candice and I were feeling hella old.. we were silent. Everyone was turnt up, high on grass and half naked. We were hot, sober and confused. Thank goodness for a few strawberry ritas or there would have been NO hope.
All hope was not loss. We turned it up just a little bit as they say. Music highlights were 2 chainz, calvin harris and it goes without saying beyonce. Other surprises were emeli sande. Miguel was awesome and solange is always grooving.  Oh I cant forget about wiz khalifa. he was fun too.

We packed sooooo much fun in these 3 days.  I'm going to let the pics speak for themselves.

This is the best I could do for my Beyonce shot... I know.

Brunch @ Morning Glory. This was made in america day 2

The festival set up was pretty cool.

Being Grown at Barbuzzo. Love that place!

Bored waiting on queen B. #selfie.

blame it on the ritas...

The sweatbox that was kung fu necktie.

roof top sipping at the hyatt 

Cab shot

kung fu!

still waiting for B..

Thinking about the future ratchet and basic moments that were to come.

from the hyatt

I mean B... Really. We were ready.

Idk whose glasses....

selfie :)

call

8:30 am The day started out hectic. One of those.. I should have arrived 10 minutes earlier type of days.

4pm: The afternoon started with a VIP patient whose family didn't want anything to do with me. Not surprising. It's not the first time. Care gets bumped up the food chain. (see previous post)

8pm: The night continued with the awkward feeling of... Am I really a resident.. And how do I teach an intern when I was just one. shrug.. .here it goes...

3:30am: let me lay my head down. Call door closes. "Bleep Bleep" (text page: ED admit) Darn.

4:30am: Well atleast the admit is super nice and cute.

5am: foggy. I hope everyone has labs... Cause if they don't.. its too late.

6am: rude call from phleb.... After I sent a friendly text. SMH.

630am: Unit clerk, Bri why are your eyes so red. Oh honey she says....  My thought (I hope I don't see anyone cute today ;)  )  and yeah I let a few folks call me Bri :)

7am: Day team is coming in.. Updates, this is what I got. "oh you would've done what? Oh... " :/

8:30am: rounding. Of course we start with VIP.

11:30am.. still rounding

1:00PM  Last patient says... "you come back here. ME: Yes mam. Patient: You know I'm proud of you. Me: You are? Patient: You know why? Cause you look like me :) as she squeezes my cheek. " 

At the end of the day there are always subtly reminders why I do this. 

Lord keep my compassion fresh and passion pure while I deal with the craziness of this job and remember that my people need me. Simply because I look like them. In a country where that is enough to offer comfort before I even open my mouth I hope I continue to walk with confidence, humility and integrity.