The Non-uniformity of White Coats

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Every time I see a medical student with a short white coat walking down the street I smile. The shorter version of the standard doctor lab coat looks almost silly to me now, but I remember wearing it proudly years ago. Hemmed to the hip, this version of the coat is meant to symbolize both membership to the profession but caution to the patient about the limitations of the wearer. I remember fondly my white coat ceremony, a rite of passage at the beginning of medical school where the white coats are first donned. Mine was ceremoniously given to me by my step-dad, who is also a physician, passing down of the icon of our profession and all that it symbolizes from one generation to the next. Over the next four years I would stuff the pockets with cheat sheets, patient lists, reflex hammers, tuning forks, and granola bars. I would pin a pink ribbon and the AOA honor society emblem to my lapel. I wore it with eagerness for its longer counterpart that would come with successful graduation and matching in a residency.

However, I chose one of the only specialties that does not favor the white coat. It is known that the white coat can be anxiety provoking for many patients, most of all, children. Therefore, most pediatricians opt for stethoscopes and ID badges adorned with stickers and animals instead of the starchy stiffness of a white coat. So my few long white coats lay neatly folded in closets, only to be worn for show on occasion.

But you worked so hard for the coat, some have said questioning the practice of avoiding the white coat. And there are some pediatricians who do still wear it. Some residents, tired of constantly being mistaken for the nurse, restarted wearing their white coats to counterbalance gender stereotyping. Others like to have the extra big pockets for stashing supplies. Some practices wear them uniformly, pun intended.

Although I spent four years in the short white coat dreaming about being a “real” doctor, eligible to wear the long white coat, I do not miss it. As students, we constantly sought validation that we belonged and that we were good enough. The short white coat seemed to call out that we didn’t and we weren’t. Once becoming a doctor, the coat just became a coat. I am trusted by patients after earning it, not simply on the iconography of my uniform. In terms of my own sense of belonging to this profession, my colleagues and patients fashioned this over time.

 

Further Reading About White Coats:

Doctors debate safety of their white coats, Boston Globe 11/19/15

The doctor’s white coat– an historical perspective, AMA Journal of Ethics 4/2007

A doctor wrestles with whether to keep wearing his white coat, NPR 11/21/15

Teaching Resilience When Divorce Comes to Clinic

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Divorce is never easy. I should know because I have been the child of divorce, twice. However, as someone who has been through this personally, I never imagined how hard it would be to watch my patients’ parents divorce. At the newborn visits things are usually great and I love watching parents become overwhelmed with love for their new family. Then at the next few infant appointments, I often only see one parent, which is typically the mother. I continue to ask about updates in the family and look forward to seeing how the families are growing and adapting with their child. We cover basic safety issues, like who is or isn’t smoking, and talk about major life changes, like new jobs or houses. Never though do I ask about their marital status and unfortunately, with a divorce rate in the U.S. anywhere from 15-50% there will be many of these families that do not stay intact.

I have had a few tearful moms sitting in a chair next to me telling me about their separation or divorce, and a few heartbroken fathers sharing tales of broken engagements or moms who no longer are involved. Each time, these stories rip at my heart. I remember fondly their happy days fawning over their newborn and think back to any signs of discontent that may have surfaced at prior appointments. Since I am a pediatrician and not a marriage counselor, families rarely confide their marital problems to me until it is over. This is appropriate, but makes the news all the more shocking to me when it is revealed.

Of course my focus for families dealing with divorce is how to help the child cope with this major life change and preparing the parents for how best to parent children living in and between two households. This is a complex, varied, and highly individualized discussion, however, there are a few points that ring true in most situations that I thought I would share here.

1. NEVER talk badly about the other parent in front of or to your child(ren). This parent is still their parent, even if not your partner anymore. Your child shares 50% of his/her DNA with this parent. Children can see similarities between themselves and their parents and so any insult to one parent is an insult that your child may hear as a reflection on themselves as well.

2. Even when you can not communicate with each other, you need to be able to communicate about your child. Avoid criticism about the other parent’s parenting style and stick to the facts. For example, instead of saying “you give her too much juice,” try saying, “let’s try to limit her juice like the doctor suggested.” If face-to-face communication leads to conflict, I recommend getting a small notebook and putting information about the child in writing, which can then be passed back-and-forth with the child when changing custody. This is also a nice way to share letters from school, artwork, and other paperwork that needs to accompany the child.

3. Keep the same rules and routines in both homes. It can be very hard to maintain consistency between two homes with varying schedules, however, all children need routines and children going through a major change like divorce need consistency wherever they can get it. Parents should be on the same page in terms of discipline, curfews, allowances, etc. Keeping the same traditions and routines provide comfort in a tumultuous time.

4. Even if you do not want a relationship with your partner anymore, maintain it for the sake of your mutual child. Fight the urge to push away, put aside your anger, and hang on to that connection so that someday your child can decide what relationship they want with that parent. This relates to #1 above in that this “deadbeat” parent is still your child’s parent and poor decisions will never change that. I recently read an advice column post on this topic that discussed this more eloquently than I ever could, so read it here— thanks, Cheryl Strayed!

After running through my divorce tips, one divorcing parent asked me if their child would be a “weirdo” based on anecdotal evidence that some children of divorce grew up to have psychological problems. There are a number of studies on this topic that I could have pointed him to, but since we were sharing anecdotes, I retorted that I was a child of divorce and had managed to escape becoming a weirdo, at least I hope. This exchange though reminded me that although divorce has been common for nearly four decades, there is still a stigma out there.

While no one enters into a marriage and family intent on getting divorced, there can be some positives to come from this difficult situation. I often remind parents how resilient children are and how they can learn from adversity. Through divorce, I learned to have a one-on-one relationship with my father that I might not otherwise have forged as early on in my life. We had to learn about each other in a way that otherwise my relationship with mom would have overshadowed. I also would never have met my step-father, who ended up a formative person in my adolescence. He stoked the academic side of my personality, broadened my cultural horizons, and encouraged my passion for city-living. I would not have had a sister, which is an inconceivable loss. I learned at an early age that my parents are humans… imperfect, vulnerable, and struggling, as we all are. And in that, saw that my future would not always be smooth, which was enlightening for a concrete-thinking tween finding my place in the world.

There are many ways in which divorce has complicated my life and I would be lying if I did not admit that there will always be some tender wounds, but ultimately, each divorce has taught me a life lesson that made me grow. I often feel prematurely akin to friends who also have divorced parents and while we joke that we are both somehow broken, we know that we are also made of some tough glue. So as I look at my little patients and their wounded parents bearing their family pain with me, they touch a piece of my heart that makes me both recoil as a victim, yet rally as an ambassador of hope.

 

[The above does not constitute medical advice, but rather my opinion. All opinions are my own and do not necessarily reflect those of my employer, The Children’s Hospital of Philadelphia. Patient details have been changed so as to protect their identities. I am not a therapist, so please seek mental health services if you need them. Crisis Centers in Philadelphia: http://dbhids.org/contact/crisis-response-centers/]

DIY Plate Wall

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I inherited my grandmother’s Lenox china, except with two small children and a paucity of dinner parties, I have no occasion for using it. It is over a decade later and it has sat untouched in a bureau that my grandmother used to store it in as well. Unlike me, my grandmother was known for her hostess skills. She set an impeccable table with flowers and home-cooked food atop her beautiful china that she picked out while living abroad with my grandfather. She hosted my grandfather’s business associates, her bridge group, and many of our family holidays. I have fond memories of tagging along with her daily trips to the butcher, produce stand, and bakery as she planned her meals and parties. Having her china hidden away in my kitchen makes me sad, so I wanted to find a way to incorporate it into my home.

A large blank wall in my kitchen called for a plate wall display and having my grandmother’s china there would serve as a daily reminder of a powerful woman in my life. Below is the way I went about creating my custom plate wall.

First, I searched Pinterest for configurations of plates that I liked and made a board of my favorites. Then, I went through my china collection to find shapes of plates that I think suited this configuration. Next, I wanted to add some other elements to the display, so I picked up a soap dish and cake plate from West Elm and a whisk to add dimension. I work with a very talented artist who does calligraphy and she helped decorate the cake plate with one of my favorite Julia Child quotes. Finally, to incorporate another piece of my grandmother, I framed one of the recipes cards she wrote me for my wedding shower, just before she passed away.

cake quote

The first step in hanging the plates included tracing each on a piece of construction paper and hanging the papers to get the right arrangement on the wall without making any holes yet. I took a few pictures to see if the layout was correct. Then I attached adhesive plate hangers to each plate. Lastly, hanging the plates was the easiest part!

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Now every time I am in my kitchen, I see my grandmother’s beautiful plates and her elegantly written recipe card watching over me and I am so grateful that I found a way to make this formal inheritance a casual part of my everyday family life.

DIY plate wall

 

[Don’t forget to check out Bridget Maley of Writing Home Designs for custom calligraphy and illustrations! I have no affiliation with Writing Home Designs other than that Bridget is a coworker and friend. I was not compensated for this post and all opinions are my own.]

Gearly Beloved

robots

I am determined to help my children not only have a strong sibling bond but friendship. When one complains about the other, I am known to say things like, “but he/she is your best friend!” often to a perplexed looking little face. To avoid too many battles in their playroom, I have attempted to balance their toys and keep things as gender-neutral as possible. Each of their artwork lines the walls. For every fireman outfit there is a Tinkerbell costume in the dress-up bin. There are stuffed animals, trucks, dolls, and balls mixed together in the toy box. The room is intended to be for both of them equally and so the contents of it are as well. However, when I decorated the room, I only had a son… a truck-obsessed son. So the walls were plastered with transportation-themed decals when my truck-oblivious daughter arrived. So when Lions & Lambs, custom children’s murals and decals, told me they had custom children’s decals, I thought it was time to redo the playroom decor to suit both of their interests.

There are few things that both of my children like: minions, robots, and ice cream come to mind. I picked robots, as they are more tolerable than minions and less likely to give me the munchies. In the spirit of fostering sibling love, I asked the Lions & Lambs designers for 2 robots, a boy and girl, with their respective heights corresponding to my older son and younger daughter. The designers then created two options for me (both now for purchase on their website) and although I loved the one with a dog, my children both picked the one with the stars and planets. I loved that they agreed, and that they chose such a tender image. I read a study recently that people blindly follow the directions of robots, so I hope that this robot decal inspires my children to lovingly share their toys in the playroom as the robots do the stars.

Lions & Lambs, a company created by two working moms, created a beautiful and easy-to-install decal for us. My children were ecstatic to see it up in the playroom and it brings new life to what was previously a boring white wall. My 4-year-old son even helped with the installation! Every time we come downstairs the robots are the first thing we see and it makes us smile each time. “Look at how much they love each other,” I not-so-subtly suggest, hoping that my indoctrination will stick. After seeing them cooperate in picking a design together and loving the outcome, I know that it will.

 

[All opinions are my own and do not necessarily reflect those of my employer, CHOP. I was not compensated for this post, however I did receive a free decal. I have no ongoing affiliation with Lions & Lambs and I do not benefit from sales of the Gearly Beloved robot decals.]

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