2015 – The Year of the Garden

In 2012 and 2014 (I don’t know what happened to 2013), I wrote “3 Words” posts – a few choice words to guide me through the year. As much as I love the idea of the New Year as a blank slate and a time to start fresh, I’m just not feeling it this year.

At the end of 2013, I had 2 glorious weeks off. There were no office administrative hassles, no early-January manuscript or presentation deadlines, and I had time to garden, read, write, cook, and just be. I went into 2014 feeling rested, rejuvenated, and ready for the challenges and changes that I knew were waiting for me. On my second day back, while in the operating room, I received the news that my best friend had been killed in an accident the evening before. All of the New Years’ optimism was sucked out of me in an instant. 2 weeks later, I received notice that I was selected by the Nominating Committee to be the incoming President-Elect of the American Society of Breast Surgeons. It was unexpected and quite an honor. Completely opposite ends of the emotional spectrum.

I expected changes in 2014. And I got them. After nearly 20 years in private practice, I am now an employed physician. I thought it might be difficult giving up control of the practice that I struggled so hard to build, but it was the right move at the right time, and I’m fortunate that I can continue seeing patients in the style that I have become accustomed, while having additional opportunities for research and teaching. But change, even for the better, is stressful.

Change is a part of life. None of us stay the same physically, mentally, or spiritually throughout our lives, but the changes often occur gradually, so we have time to compensate and adjust – to the point we hardly notice the change at all. We expect significant life-altering change to come around only on occasion.

Monarch Caterpillar

Monarch Caterpillar

Monarch Butterfly

Monarch Butterfly


Having had a few days off and a little time to reflect on the year, I just don’t feel right about the clean slate thing right now. The change seems too abrupt. I could come up with new works, but the old ones still have meaning and inspire me. I already know I will have more change in 2015 – again, on balance all positive things, but I don’t feel I need to throw any new words into the mix.

But there is still something magical about the stroke of midnight, seeing a clean page on a calendar, and holding on to the hope that with another year of life-experience under my belt, I will have developed better decision-making and coping skills. And I do have a goal.

My goal for 2015 is to be more like my garden (hear me out…). The garden is constantly changing. It might look a little different year to year, but there is a definite cycle and that cycle amazes me. The change is effortless and without thought. I never worry in January that the snap peas are growing too slowly, because in March I will have enough to feed an army. Or not, if the weather doesn’t cooperate. I anticipate the first tomatoes of summer, but sometimes the June Gloom we experience here means only a puny supply. Nothing is alive in September – we’re often still in the high 90’s – but that’s ok – that’s the time to amend the soil, work in the compost, and get the dirt ready for the next generation.  I can go with the flow in the garden. My goal for 2015 is to go with the flow a little better in life. Accept that change, even major change, is going to happen – ready or not. Figure out how to gracefully adjust.

I will still wish everyone a Happy New Year (and mean it!). But instead of 3 words, I’m going to review my garden album. Marvel and soak up the good stuff. And try to do the same in my non-garden life.


Although the calendar says spring does not arrive for a few weeks, since the clocks have changed and we have had barely a hint of winter (2 nights of “frost” in December and rain last weekend), it’s spring as far as I’m concerned. Oh – and it was 80 degrees yesterday. I’ve previously written about how much I love this time of year – and 2014 is no different. While we don’t have the cold and dark winter that much of the country experiences, there is still something magical about how the garden just comes to life in early March. Everything is lush, green, and growing. It gives me hope and it makes me smile.

My “3 Words” for 2014 were Grow, Grace, and Gratitude. It has been a difficult start to the year, but the garden and I are both growing in wonderful ways. I am working hard at handling changes and challenges with grace. And I am constantly grateful for the wonderful people in my life.


Mom and I planted the bulbs in late October. My amateur photography skills simply cannot capture the stunning display – but you get the idea.

“Gardening is an instrument of grace” – May Sarton – Journal of A Solitude

Pain and Light – Remembering a Friend

As many of you know, my friend and colleague was recently killed in a tragic accident. This has been a difficult two weeks – raw pain and grief alternating with the desire to fully embrace the beauty and joy that life has to offer.

My friend was a big teddy-bear kind of guy, and he was known as a joker and a prankster. In just a few minutes, he could coax a smile out of anyone. He had a huge heart, and all who came into contact with him felt his warmth and love. He truly embraced and appreciated life. And he was one of those rare people who would actuality state how rich his life was – he would say that often, and with a big smile on his face.

I miss my friend terribly. That pain will continue. But with the pain comes the memory of his smile and his light. And the pain is a reminder to us all – take time every day to feel the joy of being alive.

3 Words for 2014

I joined the “3 Words” club in 2012, with this New Years Day post, followed a few months later by an update. I loved the idea of starting the year with a few words, a mantra of sorts, that would inspire and motivate me. I’m not sure what happened in 2013 – I think I was still stuck on Resilience, Rejuvenation, and Serenity.

Those words are still important, but I’m ready to move forward. At the end of 2013,  I had the luxury of taking two weeks off over the holidays. Since I have not had a real vacation since 2009, this was much needed. I stayed put (easy to do – the temperature was close to 80 the whole time!) and I was able to clear my head, think and just BE. And (predictably), the ideas have been flowing. Many of the ideas are related to work, but delightfully, just as many are about ME. I will be returning to the office next week with some rejuvenation and serenity along for the ride. They will be welcome companions as I anticipate some challenges as well as some opportunities this year.

So here are my 3 words for 2014. This year, I’ve omitted the official definitions that I previously included, preferring to focus on what these words mean to me:

Grow – I have been pleasantly surprised how this past 2 weeks have allowed me to open my mind and release a side of myself, a creative side, that has been hidden for many years. I plan to nurture this new-found friend, and allow it to flourish and thrive. And of course, I plan to grow more delicious vegetables in my garden…

Grace – I know that I am in for some changes this year, both personally and professionally. Too often we have our heads set on a particular path that we think is the right one. But then life happens. If there’s anything I’ve learned over the past few years, it is that just because I want to be on a certain path, that doesn’t mean it’s the right one for me. I will work on being open to the opportunities that are in front of me, instead of stubbornly trying to push down the same road. I will work on being more open to change.  And I will try to have the faith that I will be in a good place, even if that place is not what I originally envisioned. I hope to exhibit and to truly feel grace under pressure.

Gratitude – I have so much to be thankful for, and will continue to express my gratitude, in my words and in my heart. Family, friends, colleagues, patients – there are so many wonderful, supportive people in my life. My circle continues to grow through on-line interactions. Taking the time to express the thanks that I feel is an essential component of growth, and of grace.

Hopefully all of this will lead to more serenity (still stuck in 2012…). And as I said previously, I do reserve the right to come up with more words, switch words, or develop another plan completely, but for now, this seems to be a good way to start the year. Happy New Year, everyone!

2013 – As seen through the garden

Yes – it’s time to assess 2013 – as seen through the garden…

The corn did well but got very buggy, so none will be planted this year. Also I’ve given up on cauliflower – the plants are huge and the heads always seem to bolt before they amount to much of anything. My sweet peppers were bitter 2 years in a row – done with them (not a fan of the hot ones). Tomatoes and cucumbers did not do as well as last year – apparently it is because our “June Gloom” lasted well into July, followed by the sweltering heat of August and September. But I can’t give up on those – yes – I will try again.

The eggplants thrived. And I had plenty of broccoli, sugar snap and snow peas, beets, carrots, Chinese red noodle beans, kale, and other greens. The butternut squash and the strawberries were absolutely delicious.

The sugar baby watermelons looked so adorable – but fried in the late summer sun. It’s ok – into the compost pile they went, hopefully to help out the next generation. But I couldn’t resist ordering another pack of seeds – one of these days, I WILL grow a watermelon! The rest of the seeds have also been ordered, and in a week or so I will be starting the tomato and eggplant seedlings inside, so they’re ready to go in the ground by March or April. So sorry for those of you that don’t see Spring until May or June…

Overall, it was a very good year – wishing you all a happy and healthy 2014!

Christmas Gifts

Look what I got!

Look what I got!

Just like a kid again (yes, that’s me!) this Christmas, I’m filled with the joy and wonder of the season. And just like a kid – it’s because of the many gifts I have received.

When I first delved into the world of social media, including this blog, Twitter, and Facebook, I had no idea where it would lead. The blog was meant to capture some of my more personal, non-medical thoughts, ideas, and inspirations. Twitter and Facebook posts started out as “medical” and are now a wonderful combination of personal and professional interactions. I had no idea that my life would be enriched beyond words by jumping into the online world.

The friendships that have developed are real and will be lasting. You all have opened me up to new points of view, have helped me find my voice in areas beyond medicine, and have helped me grow as a physician and as a person.

Thank you for these gifts – and wishing you all the joy and wonder of the Holiday Season.

Thoughts on Twitter, Community, and Loss

Today I had the privilege of attending a memorial service for a woman that I met only once. I initially got to know her on twitter. I attended the memorial service with 2 women who I also met on twitter.

Yes, twitter.

If you had asked me about twitter 2 years ago, I would have said that it was about celebrities talking about what they had for lunch. I wasn’t interested, and I certainly didn’t have the time. For various reasons I set up an account, started listening, and then started tweeting and interacting. And in doing so I stumbled upon the most remarkable community. Not just a group, and so much more than a chat – a real community. I got to know some incredible people. Online.  A common criticism of online interactions is that they are superficial and not “real”.  My experience has been the complete opposite. We’re drawn to each other on twitter due to common experiences and common goals. Those relationships and bonds are solid, made even more so when we have the opportunity to meet “in real life”. We are there for each other, during good times and bad, for better or worse. We are #FearlessFriends.

Donna Peach passed away due to metastatic breast cancer on March 26, 2013.  I initially got to know Donna her through her blog. She was a gifted writer, as well as a dancer and so much more.  One thing that was clear from her writing was that she loved life and everything about it. When we met approximately 2 months ago, even though she was suffering due to the progression of her disease, we were all struck by her beautiful smile and her incredible spirit. She touched us all – I made the comment after we met that it seemed like Donna had done a little bit of everything – and all of it with a huge smile on her face. Lori wrote about the meetup, capturing Donna’s spirit.  I would never have met Lori if it were not for twitter, and we live less than 10 miles apart. Carmen also accompanied us to the service today – another lovely addition to my life. Jody, Alicia, and too many more to mention. All because of twitter. They have touched me personally and professionally.  I cannot imagine my life without these women.

The tears we cried today at Donna’s service were real. The hugs we shared were real. The sentiments expressed today by those that knew her well were the same that Lori, Carmen and I expressed. Don’t let anyone tell you that online relationships are not real. Some of them are. I only knew Donna for a short time, but I am grateful for the interaction that we had. I will treasure the memories and will remember her spirit.

Rest in peace, Donna Peach.

2012 – Year In Review

Anyone who spends just a few minutes with me knows how important my garden is – it’s my inspiration, my therapist, and my friend. I’m still relatively new to gardening – just 2 years in – but I’m fortunate to be able to take advantage of the mild Southern California climate and a fair amount of beginner’s luck.

I am clearly a very amateur photographer (sorry a lot of the pictures are blurry) and since I changed computers halfway through the year many of them are also out of order. But the video makes me smile and I hope you enjoy it as well.

Happy New Year!

The music is “Celebration” by Jonathan Butler

What Motivates Me

A few weeks ago, I was approached by a contact on Twitter who asked me to participate in an online “blog carnival.” The theme was motivation and how it plays into our roles as patients, providers and caregivers. The deadline for submission (which I just looked at) was September 17th.

It is obvious to anyone who reads my blog that I am an infrequent writer. I find creative writing very difficult, yet I purposefully avoid using this blog for breast-cancer related posts, which would come easily for me. There are many physicians, patients and advocates who write incredibly moving and well-researched posts related to all aspects of breast cancer. So I started this blog with the intention of writing about “other stuff”. However as I’m known to say, “life gets in the way.” I need a strong smack of inspiration coupled with a large chunk of free time to put together a post. Rarely do free time and inspiration co-exist in my world.

However, the topic of motivation has been rolling around in my head for a few weeks now. And while I missed the deadline for the contest, I’m really not one for competitive writing anyway. So what motivates me?

Being a physician is hard. I’m not complaining – this is my chosen profession – although I think it actually chose me. The responsibility of taking care of patients and performing surgery is physically and mentally draining, the hours are incredibly long, and my life is never my own. I am a surgeon focusing on women (and some men) with breast-related problems, and a large part of that is breast cancer.

We have made much progress in the detection and treatment of breast cancer since I started medical school 26 years ago. However I still see women presenting with advanced and metastatic disease. I am still puzzled and frustrated by the patient who presented with a favorable early-stage cancer, but who then develops metastatic disease. And I still take these and many other stories home with me each and every night.

We have made much progress, but we have a very long way to go. Yet one thing, thankfully, has not changed – what to me is the essence of the physician-patient relationship. One of the reasons that I decided to focus on the care of patients with breast disease was that I recognized early in my career that I actually enjoyed talking to my patients. Getting to know them and their families. Having a kinship with them in addition to a professional relationship. And this came much more naturally with my breast patients than with patients who were seeing me for a limited time, for example to have their gallbladder removed or hernia repaired. I noticed, as did my staff, that I spent more time with my patients than did my colleagues. And my patients recognized this as well.

So I put up with the increasing financial and administrative pressures. The challenges of running a small business that is being increasingly legislated and regulated. The frustration that we’re not where I would like us to be in terms of our science.

What motivates me? It’s simple really – I can’t always cure, but I can always care.

My 3 Words – An Update

Or maybe this should be titled “life gets in the way”…

With the first day of Spring just past and Easter just around the corner, it’s time to finally shake off winter (or what we call winter here in Southern California) and move forward. But I don’t think you can properly move forward without reflecting – note I said reflecting, not dwelling – on the past. So I went back to my New Year’s Day post, and came across Resilience, Rejuvenation, and Serenity. How am I doing?

Well, life gets in the way, and things have been hardly what I would call serene. I am being pulled in multiple different directions; all things I want to do but as I get older I realize that I can’t continue to do it all.  Getting older is fine. For me, the difficult part is trying to accept my limitations while at the same time balancing all that I still want to accomplish with the expectations that I and others place on me.



Spring is a beautiful, promising time of the year – to me even more so than January 1. My garden is doing wonderfully. The daffodils are in bloom. I’ve already harvested some baby beets and kale, and have enough sugar snap peas to make lunch for my entire office building – all started from seed! Summer crops are going in this weekend and next. The nice thing about gardening here is that there is always something growing – you don’t have to wait until after the snow melts. It’s a reminder to me that we are also constantly growing – changing with the seasons and wiith the events that occur in our day-to-day lives.

So while life has gotten in the way, and I have not started the New Year in the zen-like state that I envisioned, all is good. I’m not looking back, frustrated that I am struggling to keep my “resolutions”. I’m looking back to remember what I started out to accomplish and am looking forward, knowing that I will get there.