Lettuce help you find your niche



As she inches closer to college graduation, my daughter and I were talking about finding her niche today.

“You don’t need to have a niche yet,” I told her. “I am still finding mine.”

“No way,” she texted back. “You found yours.”

She’s right. I did find mine. In fact, I was there this afternoon, kneeling in my muddy niche beside a bunch of four year olds with runny noses and dirty hands.

My niche is otherwise known as the local school garden. It’s where all the things I see as insurmountable challenges in my work and my community–the complexities of family mental health, childhood obesity, food insecurity or malnutrition, children who struggle in school, lacking strong advocates at home– suddenly meet with their solutions, there in the sunshine and the dirt, with the lady bugs, bees, and fish emulsion, the seeds and the seedlings, the order and the chaos, the frustration, the expectation, the hope and the hope and the hope.

Gardening is for the overachievers, the future leader people who want to grow orchids or feed the world. It’s for the underachievers, those who want to toss out some seeds, hang out with their friends,  make a mud pie and maybe pick some lettuce in a few weeks for their moms. It’s for everybody in between, the mulchers, the composters, the snap pea snackers. It’s for all my people.

I learned to appreciate gardening as a child by watching my mother, “watching” being the operative word. She planted. She weeded. She watered. She harvested.  I watched. She walked in the door, hands full of vegetables, excited to share them with us, and I ate as few as possible. But years later, my love of vegetables grew, perhaps because each bite reminded me of the joy in her face as she hauled in another ridiculously overgrown zucchini. I tell families in my pediatric practice that setting an example for children is more important than expecting immediate results from them. They may not eat a single vegetable on their plates for years, but the experience of sitting down to share food with family  plants brain seeds for a lifetime of healthy habits. Our palates are influenced by taste buds and genetics, yes, but also by the faces and the love for those who share meals with us.

Childhood obesity and malnutrition go hand in hand. Busy parents know our growing children need calories, but it’s a challenge these days to find time to prepare meals, sit down and eat them together, and clean up afterwards. So our children slurp their calories in the backseat of the car, from a squeezy container or a spill-proof sippy cup. They bypass chewing, utensils and mess. They bypass sitting down with people they love to enjoy a simple family meal.

Before the children went out to the garden today, the teacher asked who among them had never eaten a salad. Well over half the hands in the class were raised high.

By the end of the class, 100% of the children had eaten a school garden salad, many asking for seconds, with their friends, at a table, with no background TV, using forks and good manners. They made small messes, nibbling on pieces of a peppery radish, discussing which kinds of lettuce or dressing tasted best, then enjoyed some local strawberries for dessert.

It took five minutes to prepare this healthy snack for 20, five minutes to clean it up.

The cost, for 20 with leftovers? About two cents and some time.



If you have not yet found your niche, maybe you can find it in a school garden. Ask a local elementary school near you if you can help tend their garden this summer (or create one if there isn’t one yet). Take home some produce. There will always be more than you can eat yourself.  Donate those extra tomatoes, baskets of okra and peppers to Dorothy Day Soup Kitchen, Pilgrim’s Inn, Children’s Attention Home,  ROC–or a local food pantry near you.





Reason # 5064 why I love my husband: because he puts everything else aside and takes the time to google “how to make your computer run faster,” then makes it run so much faster when he hears me softly cussing at mine for being so slow on a Sunday morning.

(And Reason # 432: because he never offers to help clean up after a dinner party at someone’s house on a Saturday night. He just does it).


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Longtime friends know that my young life was shaped by many things, and most of all by a spinal cord injury at age 15. (Gymnasts, Beware). My biggest concern that day was how I would study for Dr. Hughes’s European History test the next day if I was going to be under anesthesia for a few hours. “Nerd” does not even begin to cover it.

The test concerns were soon history as I began to realize I’d have to figure out how to get dressed independently, pee by myself again, sit again, and after months of inpatient physical therapy, walk again with the help of crutches, amazing friends, and the best physical therapist the world has ever seen.

Fast forward 35 years.

If you have ever practiced yoga with me, you know I always grab a spot near the wall.

I am always just a little self conscious about my relationship with the wall.

But today, this mantra popped into my head: “Embrace the wall.”

My wall allows me to try things I would otherwise never try, keeps me from falling, helps me stand taller, bend further, stretch deeper, allows me to let go sometimes, if even for a millisecond (proud milliseconds for me), and then it is always there when I need it to regain my balance. 

Then I thought that I am surrounded by walls. Thank you to all my walls. You know who you are.


Love and Swimming



When we were dating back in medical school, Nat and I used to study until about 10 pm, then head to the pool to swim some laps. It was a good way to get our exercise in, a good way to release stress, a good way to do something together that we enjoyed.

Stroke, stroke, BREATHE. Stroke Stroke, TURN. Sometimes we’d tread water. Sometimes one of us would hang on the side and wait for the other to finish a lap.

A foreshadowing of our lives together. A metaphor for our marriage.

This Friday night, well over 25 years later, we went on a swim date.

It was a perfect way to end the week—hearts pumping, lungs inhaling, exhaling, bodies turning, treading water, floating and gliding, hanging on the side, waiting for the other to finish a lap.



To HPV or Not to HPV…that is not a question

It was not unusual for our head nurse to enter a room ten years ago with a vaccine for an 11 year old girl. Nurses in pediatric offices give vaccines all day, every day.

It was unusual for the nurse to weep as she administered this vaccine to that child on that day. The patient’s mom, in a wheelchair and on oxygen, was dying of cervical cancer. This vaccine was one of the first doses given in our office to prevent cervical cancer. To this mother, this child, this nurse, this vaccine was miraculous.

But to many others, the human papillomavirus (HPV) vaccine, given to prevent transmission of a virus that can cause genital warts, cervical cancer, or head and neck cancers, is mysterious and scary. Because of constant misinformation on social media, parents fail to focus on the 27,000 new cases of cervical cancer which are diagnosed annually. They do not process the fact that over 4,000 people die every single year in this country from cervical cancer, or that having genital warts removed via multiple painful treatments is a common and quite unpleasant experience for many young women. They are not aware of the lifesaving potential of this vaccine or that the vaccine is very safe, with over 200 million doses distributed in the last ten years.

Perhaps some parents focus on the way the virus is transmitted and think that they can promote morality in their children by refusing to vaccinate them for this common virus. They are not aware that by age 18, about 80% of people in the US are already infected with a strain of HPV.

They forget that part of growing up is learning to make good decisions, often after making bad ones. They don’t understand that pediatricians relish the opportunity this vaccine offers to educate a young teen about the risks of having sex in an uncommitted relationship: “I want you to understand,” your child’s doctor might say, “that this vaccine does nothing to prevent HIV, herpes, chlamydia, gonorrhea, syphilis, trichomonas, or pregnancy.” Hormones might prevent your child from making good decisions, but this vaccine will not. It WILL help to prevent cancers in both boys and girls.

They have not met the mother who pulls the doctor aside to tearfully explain that she just changed her mind about administering the vaccine because her pap smear just came back positive for abnormal cells due to HPV. The mother has been in a committed monogamous relationship for the past 20 years, but HPV can be latent for at least that long. “Please start the series today on my son,” she says. “I am bringing my daughter in next week. I don’t want her to go through what I am going through right now.”

They have not been contacted by the old friend on Facebook who expresses her appreciation for those posts about the importance of the HPV vaccine. She did not vaccinate her daughter when it was first recommended because she was understandably concerned about the possible side effects of a new vaccine. But now her daughter is undergoing treatment for lesions caused by HPV on her cervix, and it is terrifying for her, on her own in a new city at age 22.

They have not been contacted by another physician whose father is dying from throat cancer and wants to say thanks for speaking out about the importance of HPV vaccine.

They have heard about brain cancers and skin cancers, leukemias and lymphomas, but friends’ early cervical cancers in the form of genital warts are not usually discussed over glasses of wine or cups of coffee, and so they seem less common than they really are.

The AAP and CDC recommend this vaccine be given in just two doses for both girls and boys starting before age 15 (they will need three after age 15). Like any vaccine, it works best if given well before exposure, and, like any vaccine, it works best if most people are immunized. All three of my children, two girls and one boy, have had the HPV vaccine. As a pediatrician and a mother, I strongly recommend that your teen get it too and here’s why:

The only thing worse than a sick child is a sick child with a preventable illness.

And the only thing worse than getting cancer is having your child get a cancer that could have been easily prevented.