Random Acts of Kindness

Since my surgery I have developed a fear of crossing the street or walking across a crowd of people. Something I had been doing for 30+ years on my own, is now an obstacle which causes me great anxiety. My neurologists have informed me this is common in individuals with movement disorders or those who recover from stroke or stroke like injuries. The thought of others waiting for me to get from Point A to Point B triggers my anxiety and worsens my spasticity, causing me to “get stuck” often in the middle of the street or in the middle of a room. I will watch my paretic side curl in towards the center of my body, making it difficult to step forward, often as if I am walking on my ankle. Botox treatments have been tremendously helpful but that period of time in between treatments can be particularly difficult. There is also no way to predict when the next “episode” will be beyond right before starting to walk.

Image by Pexels from Pixabay

Since moving to New York City, I have been “stuck” in the middle of a crosswalk twice, once with a bus, cab, and car waiting next to the line, patiently, as I dragged my foot quickly so as not to inconvenience others. I have started to rely heavily on Lyft and Uber as I battle this fear and eventually build my confidence.

A few weeks ago, I attended my first Hartford Yard Goats baseball game for the Connecticut Brain Tumor Alliance in Hartford, CT. I quickly discovered upon arrival that here too I would need to cross a street with significant traffic congestion as eager baseball fans rushed to enter the stadium. I felt anxious, sick to my stomach that I would be stuck unable to cross in front of all of these people. At first, I called my friend and Executive Director of the CTBTA, Chris Cusano, to inform him that I would be unable to cross the street and may return home. I felt embarrassed about being afraid of something as simple as getting from one side of the road to the other but I knew the consequences of not being careful. Eventually, I took a chance and approached a gentleman waiting by the crosswalk for the light to pass to walk. He was with his wife and kids and was wearing sunglasses. Awkwardly, I interrupted his thoughts and said, “I’m sorry to bother you, but I need to ask a favor.” I couldn’t see his eyes but I wouldn’t be surprised or upset if he rolled them. I suspected he expected me to ask for money. He said nothing, waiting for me to ask the favor. I quickly followed my intro with, “I’m having some trouble with my right side and wondered if you’d lend me your arm to cross the street?”. After a moment of letting my request sink in he exclaimed, “Absolutley!”He walked over to my side and said, “How do you want to do this?”. I felt relieved and thrilled by his response and positive energy.

A few moments later, I was walking next to a complete stranger, holding his arm while he carried my sweater. It was a slow, patient walk and despite the crosswalk indicating our time was up, the traffic and police officer directing them, waited as the gentleman helped me to the sidewalk. I thanked him and watched this complete stranger join his wife and kids who patiently waited ahead. It’s a simple story and I am thankful its not the first about “random acts of kindness”. There is no special day in my belief for doing these types of favors, but hopefully hearing the kindness of others can inspire someone to do a favor for another person today. I’ve also learned that no matter how grand and difficult the obstacles we overcome, life will continually challenge and humble us. I have overcome brain tumor surgery, paralysis, learned to walk and drive again, but at this moment its the little icon of a person or the word WALK that blinks from the other side of the street that challenges me most to be better and stronger. Sometimes fear wins, sometimes I do.

York Avenue and 69th Street Interesection by @WeillCornellMedicine- Graduate School of Medical Sciences

To end on a positive note, after a month of avoiding them, I finally crossed a busy NYC street again.

Here’s to progress and random acts of kindness.

Returning to Clinical Practice After Brain Surgery

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I remember him waiting patiently as I shifted nervously in my chair. He had just presented me with a golden opportunity, yet I hesitated. Looking down at his feet, I was avoiding eye contact, hoping to hide my anxiety. I contemplated his offer, wanting desperately to find the courage to accept. Only two years prior, I naively sought this very opportunity, ignoring the obstacles that were in my way after I underwent a surgical procedure to remove a benign brain tumor. After that surgery, I expected to return home and recover followed by my eventual return to clinical practice. Instead, I became paralyzed and was admitted into rehab and thus beginning my journey of recovery. Despite the significant deficit I experienced from paralysis, I considered multiple job opportunities for physician assistants, my profession and passion. I could not fathom departing from clinical practice, despite being told that I could not work with patients for at least two years after suffering what the physician at rehab described as a traumatic brain injury.

Yet that day, two years later, while I was walking with an assistive device, driving, and already employed full-time in academia, I was afraid. Afraid that maybe I wasn’t ready or good enough to provide patient care. The man that waited patiently for me to consider his offer was my employer, Dr. Daniel Cervonka, the Program Director for the Physician Assistant program with which I was employed. In addition to his administrative responsibilities at the program, Dr. Cervonka was also the lead PA for a drug and alcohol rehabilitation program, Recovery Network of Programs (RNP), which was seeking PAs at that time. Eventually, with his persistent yet gentle encouragement, I decided to take the offer.

In so many ways, brain surgery has changed the landscape of my life. I feel stronger as an individual knowing that I am able to overcome such an obstacle yet weaker because I am now far more susceptible to the devastating effects of fatigue and stress that many healthcare professionals battle on a regular basis. I am more empathetic having been on the other side of the white coat, experiencing anxiety regarding one’s diagnosis and prognosis, and frustration with the lack of communication or what I as the patient deemed inadequate time spent with a health care provider during my patient encounter. I took these valuable experiences with me, nervous with anticipation yet excited with hope. A stethoscope in one hand and an ID badge in another, I entered the clinic and started a new chapter one year ago, exactly two years after my surgery as the doctor had advised.

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At first, I was slow, very slow. I fatigued easily carrying patient charts from one end of the hall to the other. Patients lined in the hallway, waiting to be seen by the nurses would shoot puzzled glances at the woman walking down the hallway with a cane in one hand and patient charts in another. The walk down was exhausting and embarrassing. After two years, I still struggled with a new identity of being “disabled”. In between patient encounters, I would rest my legs and my hand. We were still paper charting in the beginning and of all things fatiguing, writing was my nemesis. The physical exams were done without hesitation or difficulty. I had mastered my own technique and by following a regimen of head to toe, I developed a routine. After my first day I felt invigorated, thoroughly satiated by the experience. The fatigue both mentally and physically, would rear its ugly head the next day. I realized soon that I would need to space my shifts to accommodate my disability. After a while, I realized that I could also ask for help with carrying charts or calling on patients. Often, counselors would help in these areas or patient techs and I began to rely on them. This greatly minimized fatigue and helped speed up patient flow.

Interestingly, patients too are helpful and empathetic. These patients are undergoing detoxification from substances ranging from alcohol, opiates, to benzos and despite their own struggles, they never cease to amaze me with their concern for my well-being. These are underserved and underestimated individuals, many of whom grew up in and out of prison, suffered exploitation, years of physical and sexual violence and yet, when they see me, they are concerned for my health. Curious, they will stop me in the hallway to ask about my disability and how it came to be. I distinctly remember earlier on, one particular patient, emaciated and weathered by years of battling a heroin addiction and poor nutrition, appearing far older than “their” 50 or so years of life who was genuinely concerned about me. Seated in the hallway seeking comfort in solace, as many patients do, “they” rose to their feet as I was passing by and gently grabbed my arm . “Honey, what happened to you? How come you have a cane?” Caught off-guard, I hesitated. How much I should share, I wondered. Should I even share? Eventually, I thought, maybe it will help “them” see that there are struggles we can overcome.

Unsure, I responded, “I had surgery for a brain tumor and became paralyzed. As you can see, I’m still recovering, but have come very far.”

“Honey, I’m going to pray for you. I’m so sorry, too young for that. God bless you. That’s amazing.”

I remember feeling stunned by this response as I was not expecting such kindness. If anything I thought it would satisfy “their” curiosity. A few others had gathered and also echoed their prayers and well wishes. I looked around at their sympathetic smiles, overwhelmed by their acknowledgement.

“I guess we’re all recovering from something” I said.  I remember this statement striking a chord with them. I realized too the power of what I had just said. It was true, in life, we are all recovering from something. I stood there in the hallway with them for that brief moment not only as the clinician, but as a patient myself. One of my favorite quotes comes to mind as I often remember that moment, “Be kinder than necessary, for everyone you meet is fighting some kind of battle.”

Since my return to clinical practice, I have successfully recertified my boards this fall and have been able to share my many patient care experiences with my students, in hopes that all the things I am blessed to have experienced can one day guide them into becoming more sympathetic and well-rounded clinicians. After practicing again, I feel validated teaching young aspiring PAs the values I hold dear in regards to patient care and also, I feel complete. For two years, something was missing, something which I only found upon returning to clinical practice. As I continue to grow in my profession, benefiting from the help and support of my colleagues, I make sure to remember to take each step down that hallway and in life, one step at a time or as we say in medicine, “all things in moderation”.

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From Paralysis to Professor: Returning to Work after Brain Surgery

Excited to have my article published online at philly.com Diagnosis: Cancer! Thank you to the American Brain Tumor Association for their efforts in sharing my story and for helping me edit my final piece. 

http://www.philly.com/philly/blogs/diagnosis-cancer/Returning-to-work-after-brain-surgery.html