Tiny Babies

Think of that large bottle of water you guzzle while working out in the gym or that big dictionary you used as a kid. Now think of a newborn baby that weighs less than that -- and survives.

Never seen babies that small? I have, many times in the Intensive Care Nursery (ICN) at Our Lady of Lourdes Medical Center in Camden. The 25-bed ICN is equipped to care for babies that are born at less than 32 weeks gestation and who weigh less than 1,500 grams. The dedicated neonatologists and specialized nurses care for 400 babies annually in the ICN.

Obviously, babies stay in the ICN for weeks or months. They reside in incubators until they're big and strong enough to be transferred to other units, and later go home.

On Friday, Dec. 8, the ICN staff brought Christmas to 25 babies who couldn’t go home for the holidays during its 18th Annual Christmas Party. The babies were dressed in their Christmas finery for their first photos with Santa Claus, who took time out from his busy schedule to pay a visit to Lourdes. Family members attended as well and posed with Santa.

Santa also paid a special visit to Bryaisha Simpson, now 2 ½ years old. At 12 ounces, she was the smallest baby to be born and survive at Lourdes.

The entire scene was one of the most touching I've ever experienced. I count myself lucky to have a child who was born 7 pounds, 8 ounces, and didn't have to go through what these babies and their families do in this unit.

The photo above was from the event. Also, check out the link for a slide show from the Philadelphia Inquirer. The unit is always accepting donations of baby blankets, hats and other items. Let me know if you'd like to donate.

Nothin' Left To Lose

Nothin’ Left To Lose*

Imagine feeling so trapped and scared as a young man in 1968 that you enlist to go to Vietnam because you feel your chance of living is better there than on the street in front of your home? One wintry morning in 1978, I met such a man in an encounter that shattered the arrogance of my youth.

The two of us sat there in that cold and unfriendly room, part of a veterans’ psychiatric hospital 30 miles outside of Philadelphia. We sat there, face to face: one white, one black. There were similarities between the two of us. He was 28, I was 22. He was from West Philadelphia. I was from Northwest Philadelphia. He remembered Ritchie Allen, a Phillie who routinely rocketed homeruns out of Connie Mack Stadium. And so did I.

But it is the contrast that gnaws at me. I was the doctor. He was the patient. My father was a prominent surgeon who, to this very day, I idolize as my greatest role model in life. He only remembered seeing his father twice. He dropped out of high school at the end of 10th grade. I graduated from an exclusive prep school.

In the fall of 1968 , as a boy of 12, I loved to watch the Dallas Cowboys. In the fall of 1968, as a boy of 18, he enlisted to go to Vietnam to avoid being shot and killed by a rival gang on the streets of West Philadelphia.

The session was meant to be one in which a young doctor polished his interviewing skills by speaking with a patient dealing with mental illness. The hospital was filled with Vietnam veterans, so all 20 of my other medical school classmates were also conducting their own interviews on that day. The young man opened up “I enlisted to go to Vietnam because I thought my chances of living would be better there than on the streets of West Philadelphia with the gangs. I knew that I had made a mistake when the plane was flying me into Vietnam and I saw all the bombs going off in the distance.”

He was quiet and very sensitive. His voice quivered and his words were somewhat guarded, all so consistent with his story of violated youth. On this day, the doctor had no words of wisdom. On this day the doctor did the learning.

Today, I am a physician in an urban health center. I have carried his words with me across 28 years in time. They have never gone far from me. Periodically I have thought of him, although his name I have long forgotten. He taught me great humility on that day and I hope that I have carried that humility to the bedside of every patient for whom it has ever been my privilege to care. I now remember him as one of my greatest teachers in medical school.

I sit here in my office in Camden, New Jersey. It is on one of the top floors of the medical center and from it I can see far across the Delaware River where I have a clear panoramic view of the City of Philadelphia. Through the eyes of a now 50-year-old man, I see off in the distance that city’s tallest building, Liberty Place. It stretches proudly into the night sky, a well-lit beacon symbolizing the spirit of man reaching to new height. And its name reminds us all of a declaration in support of independence from fear and need so bravely articulated 230 years ago. With the advent of this New Year, so many of us celebrate the wonderful blessings that freedom in America has made possible. I am one of them.

But as I look out my window I do see an expanse of low-income, and even abandoned, housing that unfolds before me. I see Camden, a city known for its poverty and crime. And, in the distance, the City of Brotherly Love which was plagued with nearly 400 homicides in this year. I think of 47 million uninsured Americans struggling in a land of plenty. And I think of the similarities between the Iraq War and Vietnam.

As I look off towards Liberty Place, I think of my teacher and what he taught me that day. We hear so much about freedom these days. In this Holiday Season 2006 there are hundreds of thousands of Americans who will be in far off lands away from family for the cause of freedom.

For a moment I look out my window and think back to the fall of 1968. I see a young black man in the streets of West Philadelphia and he is tired and scared, trapped in a jungle of youth violence and poverty. He makes a decision to go to Vietnam in search of a better life? Perhaps Janis Joplin sung it best: “Freedom’s just another word for nothin’ left to lose.”*

Beautiful Sunsets,

Strawberry Fields


*From “Me and Bobby McGee”- sung by Janis Joplin, 1971; written by Kris Kristofferson

My Beautiful Mind

It’s 7:40 a.m. and I am driving south on Haddonfield Road. As I pass the Cherry Hill Mall, I get caught by two red lights, despite the fact that the mall is closed and there is no cross traffic whatsoever. So there is a line of cars sitting, idling, wasting gas, for absolutely no reason except that for some reason we do not have the money to fund an intelligent traffic control system. However, we do have the money to burn gasoline while uselessly idling.

Multiply this by millions of traffic lights in this country, and you get an idea of the amount of gas we waste every day. The irony is, addressing this by improving traffic flow would hardly be a painful solution. On the contrary, it would make everyone’s commute faster. Seems like a win-win situation, especially in view of the fact that dependence on foreign oil is hardly a good thing, right?

The problem is … every time I hit these lights I repeat this same argument in my head. And despite how forcefully or brilliantly I argue the point to myself (I try to keep my lips from moving while I am in the car) the light steadfastly refuses to turn green any time sooner.

It has taken 53 years for this fact of life to sink in. Most of the running commentary in my mind is useless. Now I can certainly write my representative, my local newspaper, or join a conservation group, and take some action. But most of the energy I spend grousing over this matter is purely wasted.

So why don’t I do these things, take some action, but when I am not in control of my immediate situation, learn how to just let it go?

Sometimes when I am in traffic, I picture a long line of ants doing … well … whatever it is ants do. And I picture one of those ants grousing about how slow the ant in front of him is, and why are they building this ant hill anyway, and did you see how that one ant cut him off. The image is so absurd. How self-important that ant is, considering how powerless he is. Of course, I am that ant. That image always brings a smile to my face and I relax.

It all comes down to the serenity prayer: “God grant me the serenity to accept the things I can not change, the courage to change the things I can, and the wisdom to know the difference.”

Studying Studies

One of the tasks I do often here is read about medical studies. Have you read the latest medical study released in the news today? If you haven’t, don’t worry. Another contradictory one will be out momentarily.

The problem I’ve found with most medical studies I read about is that they deal with specific drugs or devices treating (or not) such a small number of people with a specific condition, you’re not quite sure what to make of the results. Another study of the same drug looking at a slightly different condition could come up with the opposite result. Therefore, within a short period of time, you could have contradictory headlines: “X drug Reduces Cancer Risk” and “X drug Does Nothing for Cancer.”
Which study do you believe? Your guess is as good as mine. Go with doctors (affiliated with major health systems like Lourdes) and treatments you believe will work and hope for the best.

Not so Jaded

As a journalist for 10 years, I reported on just about everything. I got to see and talk to people at their best, but more often, at their worst: following the deaths of loved ones or through some other tragedy; during heated exchanges at a school board meeting over some passionate issue; or when they read something in the paper they didn’t exactly like.

I talked to family members of loved ones who died in the Sept. 11, 2001 terrorist attacks who remained in denial, thinking those missing individuals would walk through the door again in a few moments. I even visited Ground Zero in New York two weeks after the attack, getting closer than most reporters, inside a building next door, picking up business cards and other personal effects blown in from God knows where.

Over the years, I think I got pretty jaded. I thought I’d seen it all. That’s until I joined Lourdes as writer/editor of publications in October 2005. One of my duties is interviewing department leaders for features in the Our Lady of Lourdes Medical Center weekly newsletter. I was interviewing the nurse manager of Critical Care I, a unit where the sickest of the sick people go, when a “code” was announced. Just like on medical TV shows like “ER,” that’s a signal for everyone to drop what they’re doing and proceed to a patient’s room to respond to an emergency situation.

The nurse manager and I got up, but shortly thereafter, the code was canceled. That’s not totally uncommon, I was told; the situation was probably under control. We concluded our interview and we walked toward the exit of the unit. There, outside a room, I quickly found out why the code had been called off. A family was gathered, and a woman was sobbing uncontrollably, crying, “Mommy! Mommy!” She collapsed onto the floor, and two relatives tried to pick her up and escort her out of the unit and into a waiting room. Her elderly mother had apparently just died. I discovered that the woman was in kidney failure, and was quite ill.

The scene hit me like a ton of bricks. I could totally put myself in that grieving woman’s situation. I have elderly relatives. In fact, most of my larger family gatherings are for funerals.

Because the code had been canceled, no chaplain was present. I quickly left the unit and walked through the Chapel and into the Pastoral Care Department. I told the secretary that someone was needed in CC1.

I couldn’t stop thinking about that incident for weeks. It still brings back memories and sad feelings. I never knew the deceased woman’s name, and I’m sure the nurses and others who work in such hospital units don’t recall everyone who comes there. However, I admire their courage for dealing with life and death situations every day.

At Least You Can't Outsource Massage

When people ask me “How long have you been doing massage?” and find out that, at age 53, I will just be graduating from the massage program at Lourdes this month, they usually ask what I did before, and why I decided in mid-life, to change careers.

I used to be a project manager for a secondary publisher with many research-based databases as well as Web-based search engines to access this database. It was no secret that the company was trying to cut costs…all companies are, and “human” resources are particularly expensive. So we all knew that we were all looked at as being a necessary expense, a drain on the company’s profits. One day, in a meeting, we were trying to determine which of our programming managers would be able to take on a project. Someone said: “John’s area would be the logical place for it, but he doesn’t have the bandwidth.” At first I thought they were talking about computer resources, but as the topic was discussed, it became clear that the word “bandwidth” was the new buzzword for “people.”

How convenient, I thought. I could picture the next company layoff, and the announcement which would refer to a “reallocation” in “bandwidth” to some third-world country where they could pay employees a fifth of what they paid us. It seemed as though the company no longer even pretended to care about its employees. That certainly wasn’t the only reason I decided, after 23 years with that company, to quit, but it does symbolize what I think is the ongoing devaluation of the human factor in today’s competitive business world.

When someone asks me why I ditched a corporate career to do massage, I sometimes go on and on about how satisfying the human contact is, or what a blessing it is to be entering a field where the primary purpose is to make people feel better. Other times, I give the short answer, “Well, at least you can’t outsource massage…”

I Just Want To Wake Up Happy

When asked what I want out of life, a lot of different things come into my mind. When I asked a recent client this question, her response was that she would just like to wake up feeling happy for once. After hearing what her life has been like, it’s not a surprise that she has never had that experience.

I’ll give you all a quick glimpse into what her life is like. I’ve changed her name and some small details to protect her identity. "Roberta" is originally from Pennsylvania, where she suffered serious head trauma at a young age. Molested by her brother growing up and physically abused by her father, she dropped out of school at age 16, when her father died, to work and help support her family. Her first drink of alcohol came the day after her father’s death. Marijuana came next, followed by cocaine and heroin.

Unfortunately, her story doesn’t have a Lifetime Television ending. There are no miracles or saving graces. Julia Roberts will not portray her on any screen. Roberta now lives in a trailer in Camden with no running water. Her "boyfriend" with whom she lives makes her prostitute herself for money to pay for his drugs. When asked if he ever abuses her she said "no." When I asked if he ever hurt her, she said "sometimes he gets angry." When I finally asked if he ever hits her she said "yes, he punches me when he’s upset." But she doesn’t consider this abuse.

Roberta is 37 years old. She looks like she’s about 55. There are so many things that I’d like to happen next. So many issues to address. So many challenges. So many barriers. So much potential. So much life still in her, despite everything that’s happened.

My first step is just to get her to come back to the office to see me again. My second step is for me to view her as a wonderful person. Despite all my education and experience, I still sometimes first look at a person as a laundry list of issues and disorders. But she’s not. She’s simply and wonderfully human. I don’t know yet what the third step will be.

Eventually, I hope that when she does "wake up happy" for possibly the first time in her life, that she’ll be able to recognize it.

Only Beautiful People Need Apply

In spring of 2006, having completed my Therapeutic Swedish Massage course at Lourdes, I started my student clinic hours at the Lourdes facility on Collingswood, and also started offering my friends and acquaintances free massages so that I could get more practice and experience different body types as well as people with different specific complaints.

At the same time my instructor encouraged us to work on as many friends as possible, and in fact, we had many homework assignments that consisted of giving friends massages. When I would mention to someone that I was studying massage, more often than not he or she would say: “Well if you ever need a guinea pig….”

So, I had no problem finding people to work on, right? Well… not always. When the time came to actually schedule people, I started to hear “Well, I really do want you to work on me but I need to get to the gym first”. “I would love to but no way am I gonna let you see my fat thighs”. One of my friends is battling cancer and mentioned a number of times how he wanted me to work on him sometime, but I sensed reluctance whenever I replied “Ok, when?” One day he acknowledged that his cancer, as well as other health problems, had caused muscle atrophy in both legs as well as large tumors on his right leg, and that he was very embarrassed for anyone to see this. Medically, he was cleared for massage, and was in-between chemotherapy treatments. Massage would clearly be beneficial in releasing the toxins that had built up in his muscles due to ongoing chemo, not to mention relieving the enormous amount of stress he was under. Despite all this, his shame over his body stood in the way of him availing himself to a very pleasant and healthful experience. (I’m happy to say he overcame that fear and I will discuss my first experience of giving a massage to someone battling a life threatening illness in a future essay).

Then I started to have a friend work on a promotional brochure for me and he began to look for images of people getting massages. When he showed me a rough draft of the brochure, I complained that every picture he used was of a young beautiful model. In response, he said he was having trouble finding any images of overweight, or older people getting massaged. I started looking and had the same experience.

Let me say that only about 5% of the people I have worked on look anything like models. Being middle-aged myself, I seem to attract older clients, and most of the men and women I work on have bellies, and body parts that jiggle and sag! I have had clients who weigh as much as 300 pounds, as well as one client who weighed less than100 pounds. However, these people have sought out massage DESPITE the implied message that much of the massage world has been giving them. Which is: massage is for the young and beautiful only. Fat people need not apply.

Many of us hate our bodies. We notice them only when they rebel, and cause pain or discomfort. We don’t notice them or appreciate them when they are working properly, (even when we have been abusing or neglecting them). In addition, the older we get the more we benefit from massage. Those of us who are inactive need stretching and movement, not to mention the improved circulation that comes with massage.

Yet we don’t avail ourselves of something that is not only beneficial, but extremely enjoyable. I believe it is because our desire for health and comfort is outweighed (excuse the pun) by our fear of being judged. So it does boil down to being a trust issue.

I’ll talk about trust in a future essay. It is a central issue when working with clients. There are many things a therapist can due to foster trust, but for those clients who struggle with self-acceptance, it sometimes requires a leap of faith and a bit of risk taking.

Your comments or questions are most welcome!

Lourdes Blog/Blog 2

This is like learning to ride a bike and twirl saucers at the same time.

I'm anxious to get some blogs up here, but I haven't figured out how to use this site--certainly not enough to lead the others in our team. I'm not understanding how the draft feature works. I don't know why you can't find us if you search for Lourdes. (Am I supposed to add key words somewhere? I didn't see that on the dashboard.) Oh, yeah, and one of our bloggers can't access the blogger.com right now because our security system won't give him access. (That--I'm working on.)

I neglected to mention that this experience is occurring right in the middle of a major overhaul of our website. It hasn't been updated for quite a while, and it has taken me the last year (my first year here), to get up to speed on the things that need to go and stay. Plus we have a new design, so we are making major renovations.

So I'm in a mad dash to get the website looking presentable for any additional company we receive.

But I digress.

I think in the first post I overlooked the part of the process where I checked with our IT folks about the blog. They had no problem with it and thought it would be fairly easy to do; however, as I reviewed the original e-mail, I realized that they thought the blog would be for internal consumption only--something they would connect to our Intranet. My fault for misreading. We have an outside agency that handles our website, and I went to them to assist us, and to help us fast since time was ticking away. Options were tossed around, but this is where we wound up. We'll see if these features work for us, but they need to work for now.

Welcome and congratulations on reading the first of many exciting blogs by me. This post has nothing to do with creationism or evolutionism, but is instead the purposeful and directed beginning of what I hope will be a provocative and educational opportunity. This blog will serve many functions and will address numerous issues. So to start out, I think it will be helpful to have an FAQ (frequently asked questions) section. I will develop this by posting a new FAQ at the end of every post for the next several weeks and compiling them together when finished. I think it will be helpful when new readers visit the site. I’ll have the next post out in a few days with some good content. The first few post will probably be somewhat explanatory.

Q: What is the purpose of this blog?
A: Great question. I am a social worker at a medical clinic in Camden, NJ. I will be writing primarily, but not exclusively on issues that I see in my daily work. I’ll discuss issues around housing, poverty, medical problems, stigmatization the homeless, social work intervention, etc. I’ll include links to various websites that I feel are important.