Wednesday, April 30, 2014

Because I fail to reconcile the idealist with reality

I have conflict. I am a conflicted personality. I am an idealist living in a flawed reality, interacting with really flawed individuals. Usually this stays hidden, revealed only to my closest confidants - a list of people I can count on one hand; not because I am ashamed of my conflict but because I don't think it's interesting to anyone else. However, I then went and chose to be a parent. A parent that homeschools. A homeschooling parent that practices emergency medicine in the inner-city of Richmond. None of these professions have anything to do with a smooth, conflict-free existence. I have managed to stay out of politics, but I don't think I could have chosen many more discordant things to occupy my time. 

Notice, though, that I didn't state these are incompatible with inner peace. Peace and conflict are often juxtaposed as "Good" and "Evil". Or, they are formed into philosophy that peace is happiness and "Happiness" is derived from the absence of conflict. Perhaps it is my piscean nature or my inner revolutionary but rather than seeing these two things as opposites, I think its more useful to see them as one integral whole. Like the James and Chickahominy rivers; once they flow into the bay they cannot be separated out again. 

Conflict is a puzzle I allow myself to solve. And the things that I value: freedom, creativity, critical thinking and patience are the tools. Being able to use them gives me peace. These tools are also messy. They are very hard to control. Therefore they are infrequently taught. 

Many of you have had experiences as individuals or through your children where this higher-order processing was squashed. Or, at best, not rewarded. I remember going over a homework assignment Jake was asked to rework. He was in 1st grade -- and why children have homework in 1st grade I have yet to understand. (That's another rant.) He was supposed to fill a page with patterns of his own sequencing given variable shapes. This is the early math they teach now. It went something like this:

1. X O X O X O


3. O X OO X O X OO X 

4. O X O O X X O X X X X O X X O O X O

5.  X X O X O O X X X X O X O O X O X X X X O O X O X X

I read the teacher's note that Jake had to "fix" the solutions that were not patterns. Ha! I quickly smiled and ran to show Michael out of sheer pride -- and admittedly, a healthy dose of cynicism-laced judgment. Jake had developed mirror-image patterns. His brain was bored and boredom is conflict. So he instinctively began to solve his conflict by developing these new patterns. He was experimenting with parity. He created 2-D enantiomorphs. Oh, the budding organic chemist! 

Given that inner revolutionary I mentioned earlier, I didn't ask him correct his work. I wrote a note to the teacher explaining that indeed he had created patterns, they just weren't linear, superimposable ones. Soooo....that went over like a load of bricks. Which of course just fueled the conflict that was already brewing with where, how and why Jake would be educated. 

Now, in a homeschool environment, Jake is free to solve problems the way he sees fit. And I see the daily conflagrations -- or as the education-establishment would label them: "behavioral problems" -- cease. 

We even had the rare affirmation from the psychiatrist that we made the right move to homeschool. I'm not saying there aren't those days. It's just not that day EVERYDAY, as it had been in the past. There are still leftovers that Jake is working to resolve. Asperger's is like that. Life is like that. But the conflicts he's developing now are his conflicts. They are not superimposed on him by a system. The really cool thing is, he's starting to recognize them as his. Everyday he is able to voice them a little more. This gives me hope. This gives him confidence. He will never be a consequence of mass-production. This is unfortunate for those who don't get to be his mom. 

We are happy. We have conflict. But we have the freedom to solve our conflict with creativity, critical thinking and calm, patient endurance. Homeschooling is worth the conflict. Parenting is worth the conflict. 

Not sure about the ER thing yet. 

Wednesday, January 15, 2014

Homeschooling. Who me? Couldn't be.

Homeschooling. Just the mention of this word terrifies and excites me. The idealist in me jumps in with both feet and feels right at home. The realist knows that familiarity often breeds contempt in my household. Yet, like many things in life, we don't choose our paths but we can choose to be changed by our paths.

I have always loved education and am saddened and angered at the terrible misappropriation of our childrens' natural senses of curiosity, creativity and independence in mainstream education. Our children are told to sit down and shut up from the age of 5. No wonder we don't have adults who can think for themselves. Critical thinking is dangerous. I mean Karl Marx dreamed up public education for a reason, right? Had I average, quick-to-cope children who were content to go with the flow, I probably would be keeping my complaints to myself. But I don't. I have exceptional children. As do you.

Admittedly, the first feeling I had when our eldest was first diagnosed with high-functioning autism, was relief. It justified my intuition that he was developing differently than a "neurotypical" child. (For the sake of space and sanity, I will forgo my rant on labels and what is "normal" in child development.) It gave me a name for the unexplainable meltdowns, the dys-affection, the extreme interest in narrow subjects and the non-compliant behavior that arose from a pervasive sensory experience we couldn't see. But it didn't provide any answers or cures.

Our story is not unique. Especially when we encountered the school system. The response from educational bureaucrats are similar to those from any other bureaucrat and boiled down to: "Let's circle the wagons, protect our own and don't let this child get into the community coffers."

In the succeeding years we navigated the system blindly while furiously educating ourselves. We were steamrolled by administrators who told us they couldn't offer our son services because academically he was doing fine. You see, in Henrico County, accommodations don't fall into place until the child fails. (How is that ethical?) We were lucky to have a principal and teachers that did everything they could to help us and provide our son with challenging work and the space to be himself. We finally got a 504 before he started 3rd grade. This allowed him to be tested for the gifted program under accommodations - et voila! - he proved what everyone who knew our son could see within a minute of speaking with him. He tested at the 98th percentile.

Unfortunately, in Varina, our elementary program is divided in two -- with K-2 (Mehfoud Elementary) being in one building, with one administration and 3-5 (Varina Elementary) grades being another -- third grade was a bigger transition than usual. There is a lot of finger pointing going on between the two schools as to the reason why Varina Elementary is on the state's failing school list. (They are "accredited with warning".) Call me crazy, but I don't think adults should act like that. Where's the responsibility?  There are a lot of unhappy kids and unhappy parents at Varina. You see, Mehfoud does such a fantastic job at building their students' confidence which makes their kids excited to learn. (Imagine that.) Varina Elementary takes about 2 weeks to rip that confidence to shreds, under the auspices of preparing the kids' for SOL performance.  (Blah.) (See Varina Elementary's report card.) Again, our experience is not unique. Parents have come out of the woodwork to share their kids' stories with us -- gifted, exceptional learners, average students, bright students, 504/IEPers -- all types have expressed to us similar concerns that the culture of this school needs a cleansing.

In the end, we discovered our 504 was not being followed. Our son was being disciplined for behaviors the 504 explained and we had to remove him from school before he was expelled and developed a police record. The day they threatened this, I picked up my son with not so much as a polite "hello" to the principal. He should know better. He's being paid enough to know better. He should also know, that when a woman nags, or is at your school every other day to help with her child, it's because she cares -- when she is silent, she is plotting.

We could pursue legal action. My husband and I are not fully in agreement on this. "Once a marine always a marine" -- was an unspoken part of our wedding vows.  The marine in him would like to see the whole thing prosecuted to its fullest extent while the libertarian in me says we can do better without them in our lives at all.

This is how we've arrived at homeschooling. We are a two-career family. As I said, homeschooling has always been my ideal. I just could never figure out how it would work for me as a practicing Physician Assistant and for my husband -- who, as a legislative liaison, comes and goes as the winds of government direct. But where I find myself should really come as no surprise for me. A greater hand than mine has always shaped my life and directed me when I found myself on the fence. That's how I found my husband, that's how I found the PA profession, that's how I found myself reactivated in my faith. All of these things have put me in position to be an instrument in His hands to further His work. And all have brought me more happiness than I could have dreamed up on my own.

So...where does this blog go from here? It has admittedly been a mish-mash and certainly not an example of publishing exactitude. But, I thought it would be at least a good place to start sharing ideas amongst my homeschooling buds here in Richmond -- with a smattering of experiences from my first year as a PA. But I also hope to reach those of you in the DC Metro, the beautiful mountains of Virginia and the growing number of my family and homeschooling families everywhere I am lucky enough to know. There are so many places our kids can learn firsthand about most anything they choose. I am told that many of the historical sites in Jamestown, Williamsburg, Yorktown, etc. offer special days for homeschoolers. I can't think of many things better than the words "free" and "homeschooling" when put together -- except for maybe: "happy" and "kids".

I'd like this to be a resource for you. Let me start with my first suggestion: The Virginia Assembly is in session...
If you've never been to Capitol Square, I highly recommend it. Just like most historic, or political refuges, its full of surprises. Start with this activity book and Scavenger Hunt.

And don't forget to share your experiences! I'd love to hear what you and your kids found most interesting about your visit.

Saturday, August 6, 2011

Seeking Patients

As part of our new curriculum, we have an ethics class. I have been know to call it our "race class" - because that was what we talked about, A LOT. But it was really ethics as it relates to health disparities of different races, cultures, genders, classes, etc. I wish we had spent time discussing other aspects of disparities like religion, mental illness or more than the half hour we mentioned women and homosexuals. Anyway, these are my thoughts composed for my final essay:


When I was 24, I had decided I wanted to pursue medicine. One of my early formative medical experiences was shadowing Dr. W, my physician-mentor-friend at the hospice Acute Care Unit (ACU) in Arlington. I’ve related this story many times but I have seldom had reason to explain the emotional upheaval and personal revelations I had that day. Now it seems relevant.

It was a snowy February Saturday. I was so excited I was even early. Dr. W often lectured on end-of-life issues – something I was curious about ever since an 8th grade debate class in which I had to defend euthanasia. Going to see what hospice was all about was exciting in a lot of ways for me. After Dr. W and I had got settled in and the charge nurse had given her report we saw our first patient. This man was gasping for air, eyes bulging, pulling at anyone who came near him for help. I had never thought the practice of medicine could be such a visceral experience. Our next patient was a cheerful lady with COPD who had set up shop in one of the private rooms. The ACU was for acute cases obviously; it was a place where people came to actively die. But she joked with us that even though she hadn’t been expected to live this long she like it so much here so stayed for four months. I secretly hoped it would be forever.

The next patients were all in a large room with six beds. At this point I could hear what Dr. W was telling me but I wasn’t listening. I was trying very hard not to act like a blubbering idiot. We made our way through the room. I think I started finally paying attention at the fifth patient. He was unconscious, but what seemed like his entire family was at his bedside. As he taught me how to palpate his abdomen – rigid with tumor – Dr. W told me he was an artist. I watched as one of his grandsons anxiously but absently rubbed a crucifix between his fingers. I thought about my own faithlessness and wished desperately I had something that I believed in.

The sixth patient I remember vividly. He was cachectic; not an image your mind erases. His friend vigilantly stood by. I remember him distinctly too because he asked Dr. W if he could give our patient “just a little extra” morphine.

I think Dr. W could see that I would be his next patient if we didn’t take a break. I sat desperately trying not to cry while he charted and chatted with me about how many times he gets requests from loved ones to put patients out of their misery. I don’t really remember what happened the last few hours of the day until our last patient. She was brought in by ambulance from Middleburg. I remember her dry, cracked lips and how anxious I was to help but was not allowed to. She was so gracious to me as I sat beside her. I talked while the IV was started and she began to feel a little relief.

We live our lives so divided. But we all die the same. I knew all people died, but I didn’t understand what a great equalizer it was until that day. I’ve always been compassionate. My mother called it a “broken wing syndrome” and my husband tells his friends I would pick them up off the side of the road if I thought they needed a home. But compassion is not the same as acceptance. The ACU reminded me to accept people as people because we all share the human experience. Should it matter in how we treat our patients that they are black, or eastern European? Or gay, dying of AIDS? Or a wealthy white woman?

Health disparities exist for a lot of reasons. Some of them are bound by the prejudices we hold and others are not as insidious. Race, gender, religious, status have never really been much of an issue to me, and while it is hard to predict how I may deal with a future, hypothetical patient, I do know that I will treat patients the way my values and experience have taught me to treat all people – with respect. When I think about addressing health disparities as a practitioner I hope I will treat my fellow human beings as such with an open mind to their distinct challenges. But there is a huge irony here, exemplified in my day at the ACU. The only thing that was missing that day were those who don’t have the means to die in hospice. The ones who were missing are the ones we don’t know about. I don’t know what I don’t know. And I can't help who I can't see.

Week Four through.....

Ok, let me sum up the past several weeks.

First, I take it all back. PA school can suck. But one thing got me through the rest of the first semester: Pictionary. I approach the huge volume of "stuff" I have to learn and remember with what I view as the cardinal rule of Pictionary: take a complicated concept and break it down to its gross parts. Oh, and be prepared to do this under duress.

Tuesday, June 7, 2011

Week Three: False Sense of Security Slipping Strong Sense of Self Gripping Fast

School is getting harder and scarier. But not because of the subject matter – it’s the sheer quantity of it. I still gladly, and eagerly, get up and gone before dawn just to get myself there. If the last six years of SHM-hood has stripped me of an identity then the last three weeks of school and being back “home” has almost completely returned it. Motherhood is hard. (Say that like a pull-string Barbie describes math.) It’s the hardest thing I have yet attempted – and I do mean attempted because I certainly haven’t mastered it. It offers no escape. There’s no amelioration for the condition. And, there’s definitely little sense of accomplishment. Not in this life and maybe not the next.

Maybe my approach to it was naïve. Ok. MY APPROACH WAS NAÏVE. I don’t have easy kids. And living in the countryside of an unfamiliar (and somewhat alienating) town was isolating and exacerbating to burnout. But those things didn’t wreak irreparable damage to my psyche. (My pride, most certainly.) These are all things from which I still have lots to learn. I hope for a change in perspective, but for now, I look at that part of my life as spinning my wheels.

I have learned more about myself, my husband and my children by being away from them these past three weeks then I ever learned being tied at the hip to them for six years. And it’s not an appreciation for something after it’s gone that I feel. I simply didn’t like who I was then. I was a burned out B---h, let’s face it. (I know three other people who will second that.) Now, I get the opportunity to again be the person I want to be. To lead a vita diligentissima and embrace capacities in myself and my children instead of trying to contain them in some misconceived domestic ideal. I get to ride the (still civilized) train. I patronize used bookstores, because without little fingers to chase after, I can. I am anxiously engaged in learning skills that will concretely benefit society. I get to have conversations about social injustices in medicine in the most powerful city in the (still, for now) most powerful nation and take part in affecting those changes. I sit, study and sometimes waste time in sidewalk cafés where words like “amorphous” are overheard to be used in neat little sentences that don’t require definition-laden appendices. All in all, I get to be intellectual but remain without the attitude. Because there’s nothing wrong with being refined when you also know how to drive a tractor and clean a chicken. The snake killing I will leave to my beautiful and refined mother. (See Week Two.)

Week Two: or, All I Ever Needed To Know For PA School I Learned at Meridian School.

Two things struck out at me this week. First, the review week is over and I’m still feeling, albeit anxiously, a false sense of security about subjects at school. Mostly because the stuff I’m learning is not new. Even the new stuff is just extensions of things I learned long ago, e.g. glycosidic linkages are straight out of AP Bio. And thanks to a much maligned, former marine-corps medic, 9th grade biology teacher I had at Meridian, I learned and memorized the structures of all 20 amino acids, major carbohydrates, the 4 nucleotides, glycolysis and the Calvin Cycle. By the time we were through, we could replicate, translate and transcribe DNA and carry out plant and animal metabolism with our hands tied behind our backs – literally, because he let us write on a t-shirt for every exam. I loved biochemistry before I knew what biochemistry was. So it’s no surprise that it’s my favorite class. Thank you Dr. Treadway.

What I also incorporate into PA school, is the sociology and philosophy I learned in senior seminar. We learned to think logically, write coherently and pull in different disciplines to discuss problems. It’s no coincidence that I see medicine as an art because of my liberal education. It’s also no coincidence that what I take from biochem fits into anatomy/physiology which then fits into clinical assessment. They are all integral to each other – may my scientist friends forgive me, that’s just the humanities talking.

The second thing I learned this week is that I still need my mommy. Mom was always good at allowing me a “mental health” day, as she called it. A day off from high school for no apparent illness or anything other than she thought I needed a break. I still take those days for myself – and allow my kids the same when the opportunity arises. She instilled in me, without trying, that balance is important. I’ve forgotten that – of course it’s hard to take a day off from being a mom and still have a house at the end of the day. Been there. Done that. And the proof is on the walls…the porch steps…the lawn…I think the cat has recovered by now. Anyway, I never would have adapted to school so well without her help and who knows where my kids or husband would be without her. For the past two weeks, she kept us all fed, clothed, cleaned and oh, yeah, she very heroically killed a snake for me. That was beyond the call of duty.

p.s. the train is still civilized; even when it is six hours late.

Tuesday, May 24, 2011

PA School - Lessons from Week One

People on the train are happier.

One of the things I do not miss about living and commuting in DC is the traffic. Traffic makes the Metro necessary and the Metro is inhumane.

I don't mean to say that the Metro robs one of individuality, forcing one into cattle herd action. Though it does.

I don't mean to say that the conditions are insufferable, like when the a/c goes out at 4:30pm on a friday afternoon in August and you'd rather swim in the Anacostia than continue to be pushed up into the armpit of your fellow Washingtonian who insists on holding the upper handle bar after running past everyone on the escalators just so he could work up a fresh(er) sweat. Though it is.

No. The Metro lacks the kind of humanity where strangers become friends, even for just a few minutes. Where people move their bags on a full train to allow another rider to sit down. It misses eye contact and friendly smiles with people who sit down or pass by. But when these same riders ride the train -- they are human once again.

Train-riders offer you their paper in the morning. They share information with strangers about late, broken down trains. They laugh. They offer directions. They joke with the conductors by name. They (mostly) respect the Quiet Car.

The train is civilized. Transportation from a more refined era. It has a cafe what if the white table cloths and Cary Grant are no longer waiting for me there. I can still see it that way.

Perhaps it is the stability of a train rather than the incessant swaying and jerking of a light rail that brings out their humanity. Or is it the fresh air? The beautiful scenery? Maybe because train riders regularly escape the city they are kept sane and thus, humane.

In any case, what I have learned from the first week of PA school is that I like being back in DC. - oh, and school, of course. I like having expensive new toys (and soon, an expensive new education) with purpose and I love that I am one of those happier people that ride the train.