Memorial Day 2018


My father was not a traditional man.  He had issues with authority and hierarchy.  But he was adamant about respect for people in uniform.  Police uniform, fire fighter uniform, and especially military uniform.  He said “thank you for your service” to all of them.  

I was born on Fort Devins, in Massachusetts, in 1971.  My mother stuck McGovern buttons onto my stroller.  She was not on board with the Vietnam war.  She was not on board with the military.  And she was especially nervous that my dad would go to Vietnam.  He did not.  He used to say it was because I was born, that I was the reason he didn’t have to go.  Now that I am grown up I realize that this was probably not the case.  He was just lucky.  He was an orthopedic surgeon serving in the army, and he just lucked out.  His boss was a man named Michael Goldberg.  Dr. Goldberg took care of my brother the day I was born.  They kicked a mama cat and her kittens out of the delivery room.  And they gave my mother a hard time that her paperwork hadn’t been properly processed.  But they let me be born anyway.  

Memorial day was never a thing in my family.  But veterans have been a thing in my family.  I spent many months of my orthopedic residency taking care of Veterans at the VA Hospital in Houston, Texas.  The building was so large that my junior resident used to ride from one end to the other on a skateboard.  He got in some trouble for this, but not a lot.  There was also an expose on TV at some point, calling out the fact that us residents ran the VA orthopedic service without much help or input from our attending physicians.  This was partly true at the VA, but much more accurate of our county hospital at the time.  I loved the veterans.  They had stories.  They had opinions.  They did NOT want to be rushed.  They needed to connect with me as their doctor.  And I could always tell the ones that had seen combat.  They were always the most respectful to me.  They had a look in their eyes.  They wore baseball hats advertising the war they fought in.  They sometimes also had pins stuck to these hats.  Their stoicism and pride, especially the WWII guys, blew me away.  Never ever did one of them question that I was a woman, ask me if I was strong enough to do their surgery, ask when a male boss would be there, or harass me.  Some were addicted to medication, some had no homes, some had post traumatic stress disorder, alcoholism, and many medical problems.  But none of them belittled me as a woman.  One morning I was rounding, and came upon one of my patients 2 days post hip replacement (they stayed in the hospital longer then) on his phone in his hospital room.  I heard him say that he had an emergency, he was having chest pain.  I asked him who he was talking to.  He had called 911.  His hospital nurse had not answered his calls.  He was not experiencing a heart attack, just some indigestion from his breakfast. 

My middle daughter, Coco, is 8.  She is a Brownie.  That comes after Daisy’s and before Girl Scouts.  She wears a vest that looks eerily like the one I wore circa 1978.  Her brownie troop (well, 4 of the 17) gathered at 7:30 this morning to decorate the gravestones of the veteran’s cemetery with american flags.  They were supposed to read the name, rank, salute, say “thank you for your service” and place the flag in the grass.  I did not expect to be choked up.  Actually, I was kind of hung over.  I was on call twice this week, short on sleep, and physically tired from operating.  Last night I shared a bottle of wine with my mother and sister.  As I drove Coco and her friend to the cemetery, the traffic thickened.  The crowds were immense.  So many boycotts and girl scouts and their families.  There is no official connection between the military and scouts, but the relationship is just correct.  Patriotism.  Uniforms.  People doing their best to do what they think is right.  The swarms of children and adolescents paying their respects to our fallen heroes kind of blew me away.  There was particular sorrow when we noticed the double grave markers, those that marked father son pairs.  Some were WWI paired with WWII.  Some were sons killed in combat paired with fathers who died of old age.  We stood in the Vietnam section of the Veteran’s cemetery for a time today, amidst those that gave their lives around the time that my family lived on Fort Devins.  

In 2018 Dr. Michael Goldberg, the man who was my father’s superior officer when I was born, has become a treasured mentor.  He and I work together striving toward physician mental health and wellness.  We were “introduced” by the president of the Pediatric Orthopedic Society of North America, tasked with creating a physician wellness platform, and away we have gone.  As our work begins, we have sadly found that 39% of our pediatric orthopedic surgery colleagues are burned out.  We are worried about them and their patients.  As I think about memorial day, and the strong history of our military in our world of orthopedic surgery, I am humbled by the challenges our Veterans have in terms of mental well being.  We have made such great strides to improve the recognition of stress, anxiety, depression, and mental challenges in our Veterans.  I am hopeful that we can begin to do the same for our physicians.  

On this Memorial Day, I intend to pay attention to our fallen heroes.  And although Memorial Day is not Veteran’s day, I intend to pay attention to our Veterans struggling with their mental well being.  And although Memorial Day is not Physician’s day, I intend to prepare for June 1, which has been declared the day of #crazysocks4docs in awareness of depression, mental well being, and suicide among physicians.



My Path to Orthopaedic Surgery

My Path to Orthopaedic Surgery

I became an orthopaedic surgeon because…

When I think about how I decided to become an orthopaedist, I am tempted to pull out the essay I enclosed with my applications to residency. The problem is, this essay lacked 2 things: honesty and humor.

The short answer is this. My father was an orthopaedic surgeon. I have known few people to be as happy about their profession as he was, and he did not stop practicing until a few months before he died two years ago. But my father was an imposing man. He stood 6 feet 6 inches tall and wore size 14 and a half shoes. He filled up a room in physical size and in conversation. So my natural inclination was to choose a career as far away from his as possible if I had any hope of creating a reputation for myself that was not influenced by him.

When I was in college, I spent the first two years pursuing a degree in Art History. I reluctantly filled my math and science requirements with pre med classes because they came easily to me. There was a program through my alma mater, Williams College, and the Mount Sinai School of Medicine, called Arts and Humanities. Liberal arts students from Williams, Amherst, Wesleyan, Princeton, and some other liberal arts schools that were eligible for early admission to medical school provided that we spent two summers at the medical school focusing on science and pre med work. I applied for this program with two hours to spare on a whim, deciding this would keep my options open. Somehow I was accepted, and the rest was history, sort of.

I began medical school convinced that I would become a pediatrician until I did my pediatrics rotation at the beginning of my third year of school. General pediatrics was not for me. My general surgery rotation was next. I felt closer to home. I decided that I would be a surgeon, but NOT an orthopaedic surgeon. Until I did my orthopaedic surgery rotation. Here I felt at home. Knowledge that had previously felt extraneous to my medical career became relevant and useful. The anatomy came easily to me. The concepts seemed familiar. And I found myself feeling more useful. It just stuck.

Many orthopaedic surgeons are athletes, as was I, although not a particularly good one. Many orthopaedic surgeons are strong and tall, as am I, although not particularly strong. Few orthopaedic surgeons are women, but our presence is growing steadily. My niche as a pediatric sports doctor could not feel more congruent with my personality and strengths as a person and a doctor. And now that my father has been gone for two years, I feel fortunate to feel close to him and the passion he had for orthopaedics for the majority of his 69 short years. Coming to work every day feels right.

What is the most rewarding part of being an orthopaedic surgeon?

I think I am sending a good message to the next generation… In the morning when I leave for work, my 6-year-old tells my 3- and 1-year olds, “It’s okay guys. Mommy will come home soon. She has to go fix the kids.”

What do you like to do in your free time?

What free time? As a mother of three kids age 6 and under, free time is scarce. I make the most of it, though. I love to run, hike, and play tennis. My yoga practice has become near and dear to my heart in the last decade–it helps me to keep in shape and to breathe through the challenges of being a surgeon.

In what volunteer activities or efforts do you engage that mean the most to you and those you serve?

I volunteer my time working with professional societies such as AAOS, Pediatric Orthopedic Society of North America, and the California Orthopedic Association. I spend a half day every other week volunteering in my children’s schools. I find that nothing compares to the work that I do with my patients as a surgeon, however.

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