Ah, September. Back to school, and the end of summer – those three months of overheated bliss, where stress tops out at coordinating a weekend BBQ schedule and dealing with beach traffic.

Unless you’re me!* Hi, world. I just moved my entire family 3500 miles across the country.

I won’t bore you with the details – except to say that moving out of a house that you’ve filled with far too many personal belongings, driving across the country with two teensy kids, finding a place to live in one of the toughest real estate markets in the country from afar, and transferring all your various NP-related licenses to the most administratively labyrinthine state in the history of forever had me doubting my sanity in very real and discomfiting ways (/rant over) – but as I get settled in the new digs and come out of the fog, a few reflections:

1. Making a long-distance move? Drive it. And take your time. All that “flyover country” has a lot of awesomeness to offer. One example: It turns out that Sioux Falls totally rocks. Those falls (not just a name) are straight-up gorgeous. And some of the best Mexican food outside SoCal can be found in a tiny taqueria tucked in the shadow of a huge meatpacking plant. Who knew? I mean, besides the South Dakotans?

2. Traffic is bad everywhere; the badness just has different flavors. Boston has volume + poorly marked roads. California has volume + commuter rage. (she says from the comfort of her road-rage-free seat on public transportation)

3. Beaches are awesome. Never turn down the opportunity to live near a beach if it’s remotely possible. The sight of the ocean greeting you as you drive home makes #2 (see above) worth it. (Sort of.)

4. Starting over is hard. All the awesome stuff you did in that last job might have gotten you the new one, but it doesn’t buy you much capital on the clinic floor. You’re still the new guy. Hazing, mostly of the subtle variety, may or may not ensue.

And tomorrow? Actual patients. In my schedule. Because I have a schedule.

I may still find myself getting lost on the way to the bathroom, but I have a schedule.

Wish me luck.

*and, I’m sure, the majority of human beings… but a girl can dream, right?





I have this baby at home. He’s super cute, as babies tend to be. Fairly uncoordinated, as babies tend to be.

Not surprisingly, falls are a regular occurrence in this house. Maybe there was an unfair wrinkle in the rug, or an unattended Duplo sitting in just the right spot, or an imagined breeze. But whoever it is that’s to blame, the results are the same: you’re walking along, bothering no one – no one! – and all of a sudden you’re on the ground, and you hurt. Much high-decibel sadness immediately follows.

But do you stop walking?

Well, maybe for a few minutes. Hell, your head still hurts. Like, a lot. And who knows exactly WHY this terrible thing happened? It’s scary putting one foot in front of the other when something that seemed so routine ended in tears just a few moments ago.

But no. After a quick comfort snuggle, you get back up and keep toddling across the floor, with renewed zeal fueling your quest to plunge your hands into that ficus planter soil, maybe even tasting its earthy deliciousness one more time before the tall people catch you.

I think I know how he feels.

A year and 24 hours ago, we were bundling up the kids for a crowded T ride into the city, heading for a friend’s apartment on the marathon route to enjoy some fantastic company and a beautiful spring day, and to cheer on a bunch of runners we’d never met. They’d write their names on their jerseys in Sharpie, so we could call them out by name: “Go Sarah/Bill/Melissa! You’re doing great! Wooooooo!” (Our older kid is particularly good at this last part.)

And then a year and 12 hours ago, everything felt, somehow, fundamentally different. The fear of an unknown future following a major terrifying event can seem immobilizing. Even though we knew, deep down, the marathon would continue next year, and the year after that, and the year after that – because you can’t defeat the world’s oldest annual marathon that easily, PLEASE – would we go? As a random spectator, would it feel easier, safer, just to stay home and enjoy the day off from work?

But a lot can happen in a year.

This weekend, our marathon route friend was over for our baby’s first birthday party. She looks at me. So what are you guys doing for the marathon? I pause to think for a moment. Then, with a smile: Nothing…yet. She, also with a smile: Want to come over to our place? We can grill, the kids can hang out…

That sounds awesome. We’re in.

Human beings are pretty f-ing resilient creatures. It’s fundamental to our success as a species. When we stumble, when we feel pain, or fear, obviously we tend to react, at least immediately, with avoidance. Clear evolutionary advantage here: you don’t want the entire family sauntering back out of the cave when just moments ago Grandpa was eaten by the lion that’s still standing outside.

But once you have some time to take stock, reassess the level of risk, make your process a little safer if need be, we tend to get right back to it – whatever “it” might be – even more focused and determined than we were before. We can be capable of some pretty great things, and it’s our stubborn resilience in the face of adversity makes these great things possible.

I mean. It’s not like that ficus soil is going to eat itself.



A few things I’m thankful for on a rainy, windy Thanksgiving eve:


Rhinestones and glitter, for making the world a little brighter (what with all that additional light they reflect into our eyes)

My daughter’s unyielding commitment to the concept of spending the evening hanging from our ceiling in a climbing harness

Our annual Thanksgiving viewing of Anchorman: the Legend of Ron Burgundy

Warm sweet baked goods a la mode – always, always a la mode

The snooze button

Pre-holiday clinic days, when most students have left behind the health center staff with enough free time to spend the afternoon watching music videos from the ’90s and online shopping

Movie musicals

Coffee with flavored creamer, for turning a necessary chore into morning dessert


Footie pajamas

Thanksgiving is seriously the best, right? Just keep in mind: be sure to overeat right up to the point of moderate gastrointestinal distress but not beyond, limit yourself to no more than two uncomfortably passionate discussions about politics with your aunt’s husband, and hug your loved ones at the end of the night.

A lot.



Disordered thinking


Dear Future Teenage Daughter,

A new patient came to see me today.

She had the front desk describe the reason for her visit as “question about eating disorder”. As it turns out, the question was, Do I have an eating disorder? Spoiler alert: the answer was yes.

The shocking thing about this visit was that she had to ask the question at all. Here she was, with far too little weight hanging off her lanky frame, over 15 pounds down from when she entered college two months ago – an inverted Freshman Fifteen. She hadn’t had a period since summer. She’d been spending enormous amounts of precious mental bandwidth coming up with ways to keep her daytime calorie count below 200 until allowing herself to “eat whatever” at dinner – as long as “whatever” didn’t include carbs, meat, or human portions.

While her weight had fluctuated over time, this wasn’t even the lowest she’d been; she’d actually hit 5 pounds below this about a year ago. While she was still in high school. Living at home, under her parents’ watchful (?) eyes. Surely they’d noticed the fact that their daughter was wasting away. And, um, not eating. Two big clues that something’s wrong. Right? I mean, one would think.

Nope! In fact, dad suggested she start exercising. Because she was always complaining about feeling tired and dizzy. Surely, exercise would help. No comment from the peanut gallery over here, but… REALLY?

The sad fact is that most anyone working with adolescents and young adults will become a de facto eating disorder quasi-expert. It’s just that prevalent.

And disordered eating is a sneaky, pernicious thing, because most of the time, it’s not even named. Instead, we all talk semi-obsessively about dieting, and exercise, and ideal weight, and relative thinness and fatness and blah blah blah, being absolutely HORRIBLE to ourselves and to each other with our impossible standards of weight acceptability. That is, until someone somehow ends up with a diagnosis, in treatment, and then suddenly everyone’s all “Oh, how absolutely tragic! That poor thing. Eating disorders really are the worst!” Like it’s this thing that only affects “other people”.

So why am I telling you about this visit? I mean, I just told you about how common it is. “So then who cares, mom? Gawd, you’re totally embarrassing me. Can you just drop me off down the street and we can pick this up some other time?” (Don’t lie – that is SO future you. I can see it now, eye roll and all.)

Well, it’s a funny story. I happened to have discovered my diary from high school last week. I easily lost an entire evening escaping into the past. And in between complaining about my totally unfair geometry teacher and crushing on the boy in summer school whose name I couldn’t remember, I’d somehow found the page space to devote to bemoaning how fat I was. Good times.

It made me wonder how much of my life I’d spent being unhappy with my weight. A lot, I realized. Too much. This despite the fact that I have always been a strong, healthy, curvy, feminine and fabulous female. (WOW THAT FELT GOOD.) I may not have engaged in disordered eating – apart from that sad month in high school where I ate nothing but oranges during the day – but I have most definitely engaged in early and ongoing disordered thinking about eating.

This is Not. Okay.

So here’s what I want for you. I would like for all those brain cells that could be devoted to thinking about how fat that cupcake is going to make you to be spared for more important things, like playing, and living, and learning, and maybe saving the world (a little).

I have to be honest. I don’t even know if this is possible anymore. Society is pretty terrible right now when it comes to weight imagery. It’s inescapable, even for kids. Seriously, every girl doll on the shelf at Target has these bizarrely narrow twigs where the arms and legs should be. It’s like the toy designers looked at Barbie and thought “UGH, what a heifer.” And I didn’t even mention the everything else, everywhere else, on TV and beyond.

But I know one thing I can do. I change the way I talk about myself. I can talk about exercise making me strong, and how I like shopping for different clothing colors and patterns, all without using the words “fat” or “skinny”. I can model strength and confidence as independent of my pant size.

I can teach you to be a critical consumer of media, and celebrate what it means to be and feel healthy, and tell you how beautiful you are, just exactly the way you are right now.

If my patient’s parents had done these things, would she still be sitting in front of me, asking me whether starving herself is normal?

I don’t know. But maybe it would have at least made her parents a bit more aware and perceptive. And maybe they’d have noticed something was wrong a long time ago. Maybe they could have even answered her question themselves.

It’s a decent goal. But for you, I want more. Let’s aim for never needing to ask the question at all.