Standing Together


Before my family stuffed ourselves with our delicious Thanksgiving feast, we took a minute to acknowledge what is happening at Standing Rock. Amidst the fun of family reunions, football, and eating pie it can be easy to forget the complex and painful history of Thanksgiving and Native Americans. So it seemed appropriate that our extended family chose to donate money to the Standing Rock Sioux tribe on Thanksgiving, acknowledging the importance of Native Americans in our past, present, and future, while honoring an aunt who exemplifies compassion and unity.

In the recent deluge of political articles and posts, the coverage of the North Dakota Access Pipeline seems to get buried, as no candidate has taken a strong stand on this issue. So I was excited to see that one of my favorite kid play spaces, Play Arts, is hosting a banner-making and supply drop-off event in support of Standing Rock. Their event is on Thursday, December 1st, from 10-11:30 AM. Anyone who brings a donation also gets to play for free in their amazing play space. There is a list of suggested donations on their site also. If you can’t attend this event, there are other ways to get involved and show support if you are interested.

November was a difficult month, but with all the gratitude flowing from Thanksgiving into #GivingTuesday, December is full of hope. When my aunt heard at Thanksgiving that we donated to Standing Rock in her name she said something similar to what President Obama said, that if you believe in something, you should make your voice heard. This is the message that I want my children to hear, who know nothing of fracking, climate change, or eminent domain yet, but are learning to assert their opinions in their own age-appropriate ways. As I walked my 5-year-old home from kindergarten today, I told him that his teacher complained he was too loud in class. He responded simply and confidently, “yes, I was loud.” And I smiled and thought, oh little one, now for what will you use your loud voice?


[Disclaimer: All opinions are my own and do not necessarily reflect those of my employer, Children’s Hospital of Philadelphia. I am not responsible for the content or quality of external sites and links are provided only for your convenience. I have no affiliation with Play Arts or any of the Standing Rock or Sioux tribe charities or organizations. You should use your own informed judgement when making donations.]

Thankful and Nostalgic at the National Dog Show


One of my favorite parts of Thanksgiving each year is watching the National Dog Show. You know, the one that comes on after Santa makes his appearance at the Macy’s parade and that is hosted by John O’Hurley from Seinfeld. Not everyone with me on Thanksgiving agrees, but I like judging the dogs from home and seeing if my favorite wins. Unlike the more pretentious Westminster show in February, the National Dog Show does a good job of condensing a full day’s worth of events into a two-hour special with family friendly facts about the various breeds. Ever since I have lived in Philadelphia I have thought about attending the show, which tapes nearby, and this year, thanks to winning tickets from PhillyFun4Kids, we made a new Thanksgiving tradition.

My interest in dog shows started a few decades ago, when I was around the age of my children and a neighbor started taking me to dog shows. Years later, I learned how to handle a dog myself and then started entering competitions at age ten. I showed our pet dalmatian for a few years before my interest in dog shows waned. Although I do not frequent dog shows anymore, I look back on those days fondly and appreciate the sportsmanship, poise, and confidence that they fostered in me. So bringing my young children to experience their first dog show was nostalgic.

In case you have ever watched a dog show and wondered how they pick a winner, let me break it down for you. The dogs compete first against their own sex, then escalate up to best of their breed, then best of their group, then best in show. The judge examines the dogs and ranks them as to how closely they compare to the standard described as the perfect dog in that breed. These standards take into consideration the function for which the breed was bred. The judge puts hands on the dog to see their form and temperament, then watches them move and assesses their overall appearance. The dogs win points for each dog they defeat and after 15 points, earn the title of champion.


We arrived at the dog show just in time for the Diving Dog Competition and watched the world record holder jump 29 feet into a pool. The kids enjoyed watching the dogs leap through the air and splash the audience. Thanks to MetroKids, they also enjoyed coloring pictures of dogs and bouncing in a Scooby Doo bouncy house. While they burned off energy, I sneaked away to watch the Pro Plan® Performance Team perform stunts. The National Dog Show is a benched show, which means the competitors need to stay during the day for the public to view and visit the 202 breeds represented. So we wandered up and down the aisles looking at dogs big and small to find our favorites. Influenced by my preferences, they squealed when they saw a grouping of dalmatians and pet a few named Henry, Logan, and Mystique.


Our day at the National Dog Show proved to be what I remembered from my own childhood: wholesome, educational, and family friendly. There were of course meltdowns and the children didn’t want to sit and watch the judging as much as I did, but it was a good start for their first show. I am excited to see it on TV on Thanksgiving and to attend in person again next year.


A new project: a podcast


If I haven’t written as much here lately it is because I have been busy launching a new project: a podcast. A few months ago I took on a new leadership position and was tasked with educating a geographically and professionally diverse group of physicians. My boss gave me the freedom to creatively tackle this challenge and I decided a podcast would be the best approach. It allows physicians to update their knowledge on current events and hot topics in primary care without being tied to their desk or being told when they need to do it. These 15-20 minute podcasts are interviews between myself and content experts at Children’s Hospital of Philadelphia and they will be published on average every other week.

 There are a few ways you can listen:

As this is a new venture, I look forward to hearing your feedback. If you have ideas for future episode topics, please leave a comment. I hope you enjoy listening to the Primary Care Perspectives podcast!

Halloween in Philadelphia


The neighborhood I grew up in as a young child had only a few houses on each block separated by thick patches of pine trees. Trick-or-treating became tedious, so it was common for moms to drive kids around in the back of an open station wagon trunk, hopping in and out at each house (I do not recommend this! It was the 1980’s!). Over time, we would seek out other neighborhoods where the houses were closer together, making it more fun to walk around with friends. There were always streets that developed a reputation for high-quality decorations or king-sized candy bars too.

For the first eight years that I lived in Center City Philadelphia, I probably had a collective eight trick-or-treaters venture down our small side street. Since moving to a more residential area of the city though, we have had a steady stream of costumed children. We also have experienced more Halloween parties and public gatherings at parks. It has been great joining in the festivities as parents and neighbors.

This year, Zillow ranked Philadelphia #1 in their 20 Best Cities for Trick or Treating statistics. Although I love trick-or-treating in Philadelphia, my first thought was, really? Zillow created their top 20 listed by looking at home values, how close together homes are, the number of children under age 10, and crime rates. Knowing this made me even more excited that Zillow found Philadelphia to be #1! See if your neighborhood ranked in the top 5 and the rest of the cities on the list here.

No matter where you are trick-or-treating this year, it is important to think about how to make it safe for your children and others. Halloween brings with it many dangers, whether it be from the costumes themselves, taking candy from strangers, or walking the streets in the dark. See these tips from the CHOP Poison Control Center about how to make your Halloween safe!

So have fun this Halloween, Philadelphians, and be safe! And remember, I’ll eat any Whoppers that you don’t want.


[Some material provided by Zillow. I have no relationship with Zillow and was not compensated for this post. I am not responsible for the content of external links.]

Just Keep Swimming, Safely


Growing up at the Jersey shore it was unfortunately not uncommon to hear about children and adults drowning. It was often blamed on many things, such as a strong rip current, drinking alcohol, or swimming without a lifeguard. Sometimes the victim was even an experienced swimmer. Once it was my classmate. I was in eighth grade when one of my friends was swept out to sea while swimming out to save another classmate. The memory of this friend and the tragic early loss of his life is something I reflect on often, but always when I am thinking about water safety.

As a resident in the Emergency Department or Pediatric Intensive Care Unit (PICU) I knew that each summer there would undoubtedly be patients being treated for complications of their drowning. Some would die, some would have life-threatening complications, and most would be forever changed. The location of their drownings would vary: pool, bathtub, ocean, lake. The stories though almost always started with “I just looked away for a second.” A life changing second.

Now in my primary care practice, I talk about drowning risks with parents, whether it is with infant parents and bathtub safety, toddlers and safe-guarding pools, or school-aged children and swimming safety. It is a topic I hope parents realize how important it is, even when raising city kids. Here are a few of my tips:

  • never leave your children unattended around water. You should always be within arms reach of your infant while in the tub. You should always have your eyes on a child who can swim independently, even if you aren’t in the water with them.
  • children should wear life jackets when on boats, even if they can swim. (Not floaties!)
  • swim when there is a lifeguard on duty and stay between the flags
  • pools should be gated with a 4-foot fence and a latch that is out of reach of the child.
  • make sure pool drain covers are in place
  • never swim alone!
  • teach children over the age of 1 to swim
  • caregivers should be trained in CPR

I recommend swimming lessons for children over the age of 1 based on some small studies that suggest even children age 1-4 may benefit from formal swim instruction in terms of preventing drownings. However, it is important that parents are not over-confident about their child’s abilities after teaching them to swim and remain vigilant while their child is in the water. Also, not every child 1 and up is ready for swimming lessons, so parents should decide whether or not they need lessons based on their exposure to water, emotional development, physical abilities, and health conditions.

Where I grew up, everyone knew how to swim. The question was usually how well you knew how to swim. There were those on the swim team, those who could pass the lifeguard test, and those who were surfers. We swam in pools, the town lake, and the Atlantic Ocean. I had a boating license before my driver’s license. And I spent just about every Summer I can remember taking swim lessons before the pool opened and then swimming, diving, and likely annoying the lifeguards with incessant chatter about my technique until the pool closed. Even though I am now a city-dweller, I am appreciative of this lifelong skill and when I am lucky enough to be in the water again, I feel confident. This is why I am passionate about spreading the message about water safety to my patients and instilling it in my own children.

I started my oldest in group swimming lessons at the YMCA as a way to expose him to the water and get him used to blowing bubbles and kicking when he was an infant. More than anything though, it was a bonding activity for us. When my children were 2 and 5 though, we decided to enroll them in private swim lessons to advance their skills. I knew that they were ready to learn more and that if I wasn’t in the pool they would be more likely to learn from an instructor. My 2-year-old, who thinks she is a mermaid, made a few bold attempts to jump into pools unattended, so making sure that she developed some skills to orient herself in the water and get her head to the surface became a necessity. We took lessons this past Summer with Holly Waters of Fitness Alive, who is the perfect balance of enthusiastic cheerleader and disciplined coach. She had patience with both my reluctant, anxious 5-year-old swimmer and over-zealous, determined 2-year-old mermaid simultaneously. After a few weeks, both were moving themselves in the water in a fashion that some could call swimming. Most importantly though, they developed a respect for water safety while also growing in their love of a new hobby.


For more information about drowning prevention from the AAP, click here.

For more information about Fitness Alive swimming, click here.

[I have no affiliation with Fitness Alive and was not compensated for this unsolicited post. The above is for informational purposes only and should not be used as individual medical advice. Please contact your physician for individual guidance on whether or not your child is ready for swimming lessons. See full disclaimer here.]

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