Just Listen

“Please start by telling me your name and what you do,” the woman requests in a clinically-intoned, French-Canadian accent.

“Well, my name is Celia Sprague and I’m a rural family doctor, ” I reply hesitantly. “I primarily do maternity care and acute care in our ER. I work for mostly Indigenous families and am employed by a First Nations Health Authority here in Sioux Lookout …” I trail off.

A pause.

“Right, and do you provide care for COVID patients?”

“Not directly. I mean, fortunately because of how isolated our community is, we are geographically protected. Our numbers are quite reasonable.”

The social worker continues. “This is a mental health program to support frontline workers affected by COVID. How do you foresee this service applies to you?” She sounds uncertain or perhaps I am fabricating the skepticism in her voice. Do I deserve mental health support? Presumably the focus should be on my southern Ontario care counterparts who are in the thick of the pandemic.

I falter. How do wrap up my clinical life, the stresses at home, the serrated edges of my ability to cope into a tight, clinical sentence that she can enter into the prescribed box on my intake form?

Weeks ago, when our Medical Director had forwarded around a flyer offering extra virtual mental health and psychiatry support services for healthcare workers amidst the pandemic, I had immediately signed up. In my six years of practice, not once had a similar offer been presented to me. Paradoxically, it was absolutely mandatory to maintain acute life-saving skills of various course acronyms: ACLS, ATLS, NRP, ALARM, etc. in order to be allowed to practice medicine, however, no one seemingly gave much consideration as to how physicians were to actually cope with the fall-out of these dire situations that we were being trained to manage. I always thought it quite bizarre that physicians weren’t similarly mandated to attend mental health sessions to shoulder the day-to-day burden of our clinical lives.

Into my iPhone, I exhale deeply and then launch into a description of the massive burden of social disparities that our patients face every single day: lack of running water, over-crowding, food-insecurity, sexual and physical violence. I tell the social worker about the pervasive addictions issues and disproportionate mental health diagnoses in our communities related to historical and intergenerational trauma. I speak of the social isolation of our patients and the multitude of challenges they face, exacerbated many-fold by COVID.

I can’t stop myself now.

I go on to describe caring for women whose charts are pock-marked with suicidal attempts and assaults throughout their lives. I describe the sleepless nights, haunted by the faces of women and their children stuck within the cyclical vortex of trauma and addiction. I share a recent story of a woman whose delivery had been high-risk, with multiple complications and her tiny newborn had required hours of life-saving intervention before being whisked off to Winnipeg’s NICU by medivac. I describe to the social worker how my patient had turned her pale face to the wall and had simply closed her eyes, shutting me and my words out when I had gently attempted to described how her little one was struggling to breathe. Freshly recovering from surgery, she hadn’t even had had the chance to meet her son before he was placed in an isoylet for transport to the big city.

Barely pausing for a breath, my voice is tight as I explain further that, no, I am not directly caring for COVID patients, but every single day myself and my colleagues bear witness to so, so much. Our job is an honour and I am grateful to be able to do what I do, but how can I continue, if I can’t even hug my colleague, console her with touch and care when carrying our patients’ stories in our heavy hearts?

I’ve finally run out of words and the space left hanging is filled quietly by the French-Canadian stranger on the other end of the line, worlds away in the nation’s capital. “Well,” she responds gently, “I do, in fact think you qualify for services. I can schedule you for your first session this week. It will be a series of six sessions of grief-focused therapy.”

Grief therapy? Not therapy for depression or anxiety? Grief. Presented matter of factly without any other option. I’m puzzled for a moment. In my clinical mind, I have always reserved bereavement or grief therapy for those who have been affected by loss of a loved one – my patient reeling from her second miscarriage in a row, a young man mourning the death of his grandfather, a family grappling with the end-of-life care of their mother. But me? Grief therapy?

“I’ve wondered if grief is transferable or whether, as physicians, we’ve witnessed and internalized so much secondary trauma that it simply takes a high-pressure situation (like a pandemic) and a slight nudge toward guilt and shock to completely undo us.”

Lalita Abhyankar, M.D., M.H.S., AAFP

Yet, in the seconds that my mind processes this proposition, I feel a surge bubbling through my body, erupting inexplicably and suddenly, I begin to weep. I cry non-stop for what seems to be a long, uncomfortable time. Each time I try to pull it together, I can only manage to squeak out an “I’m sorry”, before sobbing anew. Thankfully, my intake interview was scheduled for a full hour and so I cry for a large proportion of that time. It feels good, a relief to have someone else give a name to what I feel.

Grief in the form of anguish that I feel for my patients and their immeasurable suffering and the sensation of utter hopelessness that I can do so little to change it. The pain, in turn, related to the secondary trauma that I am drowning in. Sorrow over the loss of the little things that shape our social existences that this pandemic has ruthlessly stolen. Heartbreak in the absence of visits with our extended family and close friends. Sadness at the loss of Holiday rituals. Despair over the state of our environment as political and economic priority lists are topped by the pandemic. Grief, so acutely, hangs at the corners of every aspect of life – not so fully that the view is obscured completely, but heavy enough to pull at the edges.

As we prepare for the holiday season, of course, I feel that it is important, maybe more now than ever, to celebrate what we can. I celebrate that each day, I am awoken to tiny hands on my cheek and sleepy hugs. I celebrate my health by moving my body, building strength and relishing in the power that that euphoric feeling brings. I celebrate that each day I enter the hospital, I am honoured with patients’ stories and access to the most intimate moments of their lives regardless of whether I have known them for five minutes or five years, all based on the privileged, inherent trust between patient and physician. I celebrate the resiliency of our patients, families and communities and hold on to those witnessed, simple moments of joy between partners, grandparents and siblings as we help welcome new littles ones every day to the world.

Yet, acknowledging our good fortunes will never fully ease that tension, tugging at the corners, threatening to pull darkness over our vision. The holidays, at the best of times, are often fraught with difficult memories and recognition of those who are no longer with us. So if you, like me, find yourself unexpectedly splashing tears onto cheery Christmas wrapping or are struggling to lean fully into the presumed merriment of this season, put a name to those feelings and reach out for help. As for me, there is hope – my first grief session begins next week.

https://www.cbc.ca/life/wellness/virtual-therapy-how-to-find-the-online-mental-health-care-provider-that-s-right-for-you-1.5551424

https://www.ccmhs-ccsms.ca/mental-health-resources-1

Let’s Play

“Mommmmm!” Alice exclaims giggling. “What are you doing?!”

Eyes wide, with a huge smile plastered onto her face, Alice watches me in wonder. Her expression is caught between utter surprise and jubilation. Uninhibited and undeterred by Alice’s giggling protests, I shimmy across the hardwood floor, my sheepskin slippers moonwalking, twirling and prancing around the kitchen island in ridiculous imitations of the Funky Chicken and the Camel Walk. James Brown blasts from the speaker as my hips sway side-to-side to the beat. Just like my Dad, (nicknamed the Duke in his young life for his musical and dance-floor moves) who used to embarrass us as kids to no end with his guitar renditions of the Dukie Blues combined with his enthusiastic dance moves, I raise my spatula microphone to my lips and let out exuberant “Ohhh’s!” and “Yeah’s” while pointing to my audience of one. Alice responds in peels of laughter, unable to contain herself in witnessing the apparent unravelling of her mother. I laugh too, out of breath from my funk-induced impromptu dance routine. It’s a simple moment, unmentionable and insignificant to the casual passerby but means everything to me.

In this moment, I am wholeheartedly and completely present. Only a single thought surfaces into my brain: “I feel so happy!” It’s a curious thought in its rarity. I see it, feel it and turn it over in my mind with wonder. What is this thing that Alice and I are doing that has caused such joy?!

For those who know me, you know that I am often inspired, moved and challenged by the work of Dr. Brene Brown. Recently, I have been following her new podcast entitled, Unlocking Us and last month, Dr. Brown discussed a smattering of relevant and timely topics. As we all grind past the six (now seventh!) month mark of this ongoing pandemic, I don’t believe that I am alone in feeling COVID burnout. I couldn’t quite name it or put my finger on it, but certainly the past two months have felt like a slog to beat all slogs. Brown, however, nails it on the head with a gentle reminder of the concept of surge capacity.

In the world of medicine, surge capacity refers to the measured ability to provide care for a rapid influx of patients. Pre-COVID, this was a recurrent aspect of our practice. With far greater patients than hospital beds or other finite resources, as health care workers, we often have to find creative and innovative ways to not only create space but to continue to stretch resources to ensure care provision for the duration of the surge, be that until the end of your ER shift or the end of a multi-casualty trauma.

When we think of own lives, without a doubt, this idea must similarly resonate. You bring home a newborn into the fray of life with an already needy toddler and a busy kindergartner. A co-worker leaves unexpectedly and their portfolio lands in your lap without warning. You get sick, but the day-to-day running of the household remains on your shoulders. Demands outweigh resources time and time again. Often, though, this is temporary. You hire a housecleaner or a babysitter to lighten the load. You delegate tasks at work. You lean on friends and family for support. Balance eventually is restored again.

Brown reminds us that, “Surge capacity is a collection of adaptive systems, mental and physical, that humans draw on for short-term survival in acutely stressful situations such as natural disasters.” What is strikingly different when we consider the pandemic is that our natural coping mechanisms, such as social connections and the usual rhythms of day-to-day life which anchor us, have been unmercifully and abruptly eliminated. As Brown describes, “It is like as someone who lives on the Gulf Coast and has been through my share of hurricanes, it’s like the wind is breaking the windows and we’re in clean up at the same time. It’s too much to ask some days. So, our surge capacity is maxed out and we need to find a new source of energy.”

Our surge capacity is maxed out.

Over this past half-year, we have all grieved, then rallied and have mustered the energy to cling to resilience. But now, we face a six-month wall. How can we cope? How can we continue forward? For how long? How can we find light in the looming winter months?

Not to spiral here, but I struggle personally when widening my perspective. When grappling with major issues such as climate change, the political scene south of the border, decades-long boil water advisories in Indigenous communities in our Region, not to mention the current pandemic, it can just be too much.

While I am not advocating for anyone to put their head in the sand (although, I have to be honest, many days I wish I could), we absolutely need new ways to cope in order to continue to fight injustice, to advocate for others or to simply get out of bed in the morning.

Brene Brown’s suggestion is simple. Play.

Ok, stick with me here. If you’re like me, this is the part where I started to tune out. Play? Who’s got time for that. Sorry, I’m busy over here adulting. In Brene Brown’s podcast, she reminds us that play is defined as “time spent without purpose”. Time spent without purpose?! Are you kidding me?! Honestly, when I listened to this, I had a whole body cringe. It’s like the time Blake recently challenged me to sit on the couch and ‘do nothing’ for 20 minutes. He stood up, set a timer then watched me squirm for 20 full, uncomfortable minutes.

‘Doing Nothing’ is not a forte of mine. When Henry calls me to his room to play LEGO, after a mere 30 seconds of sitting on the floor, surrounded by blocks spilled in all directions, I often find myself sorting and tidying those millions of pieces rather than just creating. Watching Henry with his LEGOs, play comes so naturally; creating, spending time with no mind to the clock, uninhibited, just doing what he loves. I also remember a time in my childhood, when similarly, I would lose hours reading through stacks of books or endlessly painting abstract watercolours on rolls of newsprint. Where along the way did this childlike way of being slip away?

Henry’s room, at any given time 🙂

Recently, during a couples therapy session, Blake and I were circling a familiar conversation. Blake couldn’t understand why, after a full day of stressful work, I come home and start cleaning the house instead of falling onto the couch as he would do. In retaliation, I balked at the idea of letting the to-do list go – it would just be there for me to do in the morning! I turned to our therapist for support with a look that said, ‘Can you even believe this? Don’t you agree?!’ I was taken aback when he responded with a question; “Celia, I agree. It is hard to let some of these seemingly important things go. But I’m curious, what kind of a feeling in your home do you want to cultivate? For you? For your kids? For Blake?”

I thought back to a recent ER shift where a resident had been observing me in an encounter with a young, medically complex woman reeling from the sequale of advanced liver disease. It was a complicated case and her prognosis was poor. I had spoken to multiple specialties in trying to figure out the best possible medical management that I could offer her and had spent a great deal of time correcting the many imbalances of her breathing, her failing kidneys and strained heart. At the end of our encounter, I had ensured that she had felt comfortable, took a few extra minutes to tuck a warm blanket around her atrophied legs and collected an armful of snacks for her support person who had been by her side for hours. As I swished the curtain of her ER bay closed behind me, I turned to the resident. “You know, in medicine, it’s never what you did for the patient, but it’s how you made them feel. She will never know if I corrected her potassium appropriately or adjusted her meds as best as I could, but what she will remember was how I made her feel – hopefully, she felt heard, safe and cared for. It’s the most important thing that you can do.”

Shifting my focus back to our therapist, I began to understand what he was pushing me to realize. Of course we cannot shy away from the mountain of life’s responsibilities or the crushing realities weighing on our current global community, but when my children recall their childhood memories, like my ER patient, they will never recall if the counters were clean or if their LEGOs were sorted by size, but they will remember how they felt. Like all parents, all I want for them is to feel safe, happy and loved.

So, as we move into this next season with our collective surge capacity at its max, I have made myself a ‘play’ list – activities in which I can lose myself in, create a feeling of joy in our home and draw from for a new source of energy to get through this massive wall that I feel up against.

I’ll finish this post off with a quote from Brown, because she summarizes so eloquently the need for play for all of us right now:

“Play is this incredible source of energy that’s easy to forget about. And let me share something with you that’s really important for me, and we can have different opinions on this, we can… There can be dissent as long as it’s future thinking and playful. Some people might say right now, ‘This is no time for play. Our democracy is on the line. The world is falling apart. We’ve got work to do.’ Hell yes, I agree on all accounts, but… And I wrote about this in Braving the Wilderness, but our hearts are expansive and big, and as the poem goes, contain multitudes. We can’t fight on no energy, we can’t fight for love unless we’re experiencing it, we can’t fight for joy unless we know joy. And so I’m not saying back away from the revolution or the fight, because I don’t plan to do that, but I do need an energy source, not only for the fight, but just to get me through my day and keep me in loving relationship with the people I care about.”

Play on, my friends.

Summer Sisters

The moment my paddle hits the surface, everything changes. My muscles stretch and contract, lengthening and pulling against the glassy, indigo water. With every stroke, I feel the suffocation of my endless worries mercifully subside. Each apprehension is packaged neatly into its own droplet of water falling off my paddle’s tip,  outlining a perfect arc as I reach towards my next stroke. Stresses gripping my wakeful nights, now smoothed out into nothing but horizonless lakes, trees and granite. My breath aligns with my paddle’s cadence and calm takes the reins. Timidly at first, but bolder with each stroke, I lean into that small flame of joy that always awaits my soul in the backcountry. As my edginess mellows, the imagined catastrophe that never befalls brings new confidence. This warming always takes time, searching for someone or something to give me permission to truly let it all go. As the bow slices the velvety surface, the rhythm of my paddle brings peace and the lean of great white pines abound soothe my anxious mind. This is where I know I need to be.

Driven by my need to escape the busyness of life that can be all-consuming, I have heavily guarded a precious four days each July for our annual women’s canoe trip. Initially motivated by a yearning to restore a sense self during a time when I was held captive by cloth diapers and incapacitated by the constant demands of full-time work and the ceaseless needs of one-year-old Alice and two-year-old Henry, a group of my core girlfriends and I escaped into the wilderness for reprieve – Women in Wilderness was born. Since then, each summer, despite busy careers, commitments to partners and families and other competing interests, we have rallied in our canoes to paddle away from responsibility and back toward our selves. Our group has fluxed over the years, but our core group of women has remained constant, driving our escape to the backcountry

This year, after an extensive virtual group discussion, we settled upon a route which took us to Canada’s canoeing capital. An iconic and wilderness-class park, Quetico Provincial Park is recognized globally as the place for backcountry canoeing. Boasting over 2,000 pristine lakes and over 460,000 ha of (now) industry-free wilderness set aside strictly for canoeists, Quetico has a long-standing reputation for low-impact camping with bylaws that have stayed true to its original wild intention; no marked trails or campsites, no man-made structures, only the wilderness in its truest form with lakes so clean that a dip of the hand beside the gunnel to fill your Nalgene brings potable water. As each access point allows limited entry into the gargantuan space of undeveloped land, the magic of Quetico is allowing oneself to be intentionally and fully alone. Blake and I have been fortunate to have paddled in Quetico together over the years and have never been disappointed. This year, despite choosing an easygoing, popular route, our women’s trip was no exception; we had the park to ourselves.

For four blissful days, we paddled. Gone were our constant COVID worries – distancing outdoors in the expansive space was easily done. We laughed, we cried, we drank, we ate, we played and our cups were filled to the brim. Six fierce women with talents and strengths abound, all shamelessly putting themselves first and teaching me to lean fearlessly into that flame of joy. Thank you, my dear friends. I can’t wait to see what next summer’s paddling adventure brings!

Hitting the water on Day 1 on Pickerel Lake

Don’t let this picture fool you, just around the next point, we paddled into a super strong headwind for the rest of the day!

“The path of the paddle can be a means of getting things back to their original perspective.” – Bill Mason

On Day 2, we paddled through Pickerel Narrows through a few small portages to get to Buckingham Lake where we were the only souls around!

“Time is like a river. You cannot touch the same water twice, because the flow that has passed will never pass again. Enjoy every moment of your life.” – Author unknown

Starting Day 3 with cappuccinos made by our belle of a barista, Lucy. Ahhhh!

Portaging our way back into Pickerel Lake.

“There is magic in the feel of a paddle and the movement of a canoe, a magic compounded of distance, adventure, solitude and peace.” -Sigurd F. Olson

Rounding out our last day of paddling with this powerhouse!

Women In Wilderness: 2020, that’s a wrap!

“What sets a canoeing expedition apart is that it purifies you more rapidly and inescapably than any other. Travel a thousand miles by train and you are a brute; pedal 500 on a bicycle and you remain basically a bourgeois; paddle a hundred in a canoe and you are already a child of nature.” – Pierre Trudeau

back to school

Photo by Daniel Frank on Pexels.com

The shift is often subtle, but never unmistaken. The nights bring its refreshing cool air which then lingers past dawn like an unwelcome overnight guest. The vital rains that quench eager garden beds arrive more often, driving chubby beach babes indoors to smear glitter paint across counters. Evening ‘lake baths’ return to the confines of the lavender-scented, bubbling tub . School registration pops into mind. Pumpkin-spiced beverages top chalk-on-blackboard coffeehouse menus.

Ordinarily, I welcome the Fall; it is my preferred season. After hot, sunny days basking on the sand, I look forward to the colder, cozy evenings on the couch. While hastily, thrown-together meals featuring fare requiring as minimal dish ware and cutlery as possible have been the norm, I revel in the smells of one-pot meals, stewing in the slow cooker. Although I am not alone in my love for simple summer days, I excite in the shift in seasons and the second restart of the year. Long-sleeves and a pristine, crisp planner herald the launch of reenergized routines branching from our long, unstructured summer days.

This year, as the Northern Hemisphere tips away from the sun, my usual eagerness for Fall’s offerings are lacking. Much has changed for all of us during these past six months and the future stretches wide in a yawning abyss of more unknowns. Our kitchen hosts strained conversations as Blake and I struggle with decisions around our children returning to school. Laden with COVID-fatigue, these discussions repeatedly lead to tears as I try shed my grief and attempt desperately to come to terms with the forever lost image of Alice and Henry, walking hand-in-hand into their first day of school. Grade 1 and JK; what an important year! Hair brushed, skin scrubbed, backpacks gleaming, excitement bubbling and normalcy prevailing. I want this so desperately for them. And for me. Yet instead, Blake and I shout across the kitchen island, agonizing over every aspect of what lays in front of us, both of us hurling angry arguments while sadness simmers beneath. Should they do online school and ‘learn’, glassy-eyed in front of a screen? Should we try to homeschool with already stretched schedules and a long, isolated winter in front of us? Should they return to in-person school knowing full well that a second wave will surely befall us? Are we making the right decisions for them? For us? Kitchen conversations that are surely repeated in homes across our country.

Greeting Henry off the bus from Kindergarten
Last year’s back to school poses 🙂

It has been six years since our move to Sioux Lookout. Me, six-months pregnant and newly graduated out of Family Medicine Residency, I was impatient to sink my teeth into my rural medicine practice. Blake, always willing to walk into the next adventure with me had been on-board, but we had had a five-year plan. Sioux Lookout, although endearing in many ways, was not to be our forever home.

Pregnant with Henry, learning to fish on Abram Lake

So last year, after many agonizing debates between us, Blake and I became the proud new owners of 34 acres of land outside of Thunder Bay; a swath of property stretched below the Norwester mountains, across a farmers field, a beaver pond fed by a snaking stream and flanked by acres and acres of densely-treed bush. It was here, we had planned, to build a home for our family.

After a year of planning, pre-COVID, we had been set to begin the construction of a passively-heated house in the Spring of 2020. Gone would be our reliance on fossil fuels to heat our home. Specialty windows to keep the solar-heated air contained without possible escape were on their way from Poland. Walls, four-feet thick to insulate against the deep cold of the North, were due to be constructed and shipped from Southern Ontario. A crew was on stand-by to assemble the pieces together like a gigantic gingerbread house. A move-in date was circled on the family calendar. By the beginning of the school year, we had been slated to kick off a new chapter for our family.

Now, as I write this, our move-in date has come and gone and only a rickety trailer holds space for our dream home.

Our family has been enormously fortuitous throughout this pandemic. Our livelihoods have not been pulled out from under us, our health has remained sound and our day-to-day lives in our remote community have been minimally affected compared to our urban neighbours. However, although Blake and I speak of our good fortunes regularly as we scroll through the CBC’s news headlines, I still sense a guilt-laden despondence over the loss of our family’s plans. Comparative suffering, however, seldom brings relief. This year was supposed to have been a big one for us and COVID has, of course, changed everything. I remind myself that it is ok to grieve. To shed tears for the bright faces that will be masked for back-to-school photos. To feel sadness over the lost hopes, best-laid plans and dreams of new adventures. As our collective community moves through this change of seasons, the cool autumn air bringing new uncertainties and fears, we can only cling to hope and lean into our resilience as the way forward. Best of luck to all in this time of transition.

Photo by Gelgas Airlangga on Pexels.com

Fly-In to the Boonies

500 feet above the ground, the floatplane is jostled by the gusting winds as we fly directly into a front of driving rain. My stomach pitches and I close my eyes, concentrating on my breath. A bead of sweat lazily wets a trail down the back of my leg as I welcome the onslaught of rain droplets against my face, pelting through the pilot’s cracked window which is the only source of air conditioning on the 1950s Beaver. The soft-faced, young pilot turns to nod his head towards our window, the engine’s roar filling the small space of the plane’s body. Below us, two adult moose stand nonchalantly, knee-deep in the bog, ambivalent to our presence overhead. Their massive outlines appear toy-like from our vantage point. Beyond them, the tree-lined horizon stretches infinitely, dotted with endless clear-blue lake and swaths of black spruce stands. Cliffs of mighty granite jut obtusely from the earth outlining the contours of the bush. As far as the eye can see, there is emptiness, without a singular trace of human presence, yet there is abounding life in the land’s natural form. I feel small, humbled and grateful.

Beside me, Alice’s small body slumps against my side, tucked sweatily under my outstretched arm. Her sunburnt cheeks jiggle deliciously in rhythm with the engine’s hum, her lips slightly parted in a state of deep slumber. I smooth her tangled hair and smile. Her image is summer perfection: dirty feet, mosquito-marked little legs, sandy hands and a suncreen-scented neck. I am reminded of my own childhood self spent running barefoot across the rocky Canadian Shield shoreline, slipping naked endlessly in and out of the water on backcountry canoe trips with my family. Without consciously planning it, I realize how similar our summer childhood experiences have been and I am glad. How fortunate we have been to be able to gift our children these memories.

After three days of disconnected bliss, Blake, Henry, Alice, Ada and I were en-route home via floatplane. While waiting for the bush pilot to come pick us up at our outpost camp, I had polled our crew for their staycation highlights:

  • Blake: ‘Late fishing’ with Henry and Alice
  • Henry: No work days for Mom and playing with quick sand
  • Alice: S’mores
  • Ada: Endless creature-chasing at the beach
  • Me: No cell phone service

Inspired by Bob Allen’s children’s book ‘Fly-in to the Boonies’, we had jumped at the unique opportunity to get off the grid for a family getaway at a fishing outpost, tucked about 50 kms from our home on the northeastern tip of Lac Seul. As the second largest body of freshwater solely within Ontario’s borders, Lac Seul is a massive, 240km-long, crescent-shaped lake widely known for its legendary, world-class walleye and muskie fishing which draws largely American anglers year after year to its outposts in hopes of landing trophy-worthy fish. For locals, this experience is largely made off-limits by the cross-border tourists who book years in advance to access these waters. During non-COVID times, I would always mark the official start of summer as Wisconsin-plated pick-ups towed expensive looking fishing rigs into town and our ER filled with fishhook-related mishaps. This year, of course, has been different. With our southern border closed to American visitors, the fishing-related tourism that many local people rely upon for their livelihoods has all but dried up resulting in rare opportunities for local ‘staycations’.

The red marker indicating the massive lake, Lac Seul, north and west of our town of Sioux Lookout
Lac Seul

For me, fishing has never been a passion, however, I do love evenings on the boat with Blake and the kids watching the sunset, spotting eagles and local wildlife all the while wrangling the kids to stay put on the boat, untangling snarled lines, breaking up fights, handing out snacks and managing the logistics of potty requests while on the water. There is never a dull moment while attempting to land a few walleye with a four and five year-old onboard!

A few weeks ago, when owners of Anderson’s Lodge (a local fishing lodge and family favourite dining spot just up the lake from our home) had mentioned they had availability for all of us to stay at one of their outposts for a family fishing staycation, we had jumped at the chance. With the ever-present demands of my work, even on my precious days ‘off’, I am often dealing with emails, phone calls and meetings. I was desperate for the opportunity to get off the grid and melt into the silence of the bush.

So, packed to the gills with snacks, smokies and s’more supplies, we had headed via floatplane to Pickerel Narrows on Lac Seul. Pristine and remote, the solar-powered cabin had been nestled on a sandy beach with not another soul to be found. Without Wifi or cell-service, we spent three full days of uninterrupted time with the kids. Our mornings were consumed with hours of leech catching, toad hunting, and chipmunk chasing barefoot on the mossy forest floor and sandy shores of Lac Seul. We munched on chips, read and napped in the quiet of the sunny afternoons and spent the evenings on the water as a family in (often retrospective) hilarity of walleye fishing with our crew. As parents of littles all understand, vacations are generally just time spent parenting as usual with a different view. As predicted, the highs were higher than high and the lows were intensely low, there were meltdowns and chaos but amid the normal pandemonium there was something so precious and rare in the moments of absolute stillness, expansive silence and the shocking realization that there was simply nothing to do – no laundry, no cooking, no emails, no meetings and no to-do list.

We are ever grateful to Meredith and Rick at Anderson’s Lodge and to Matt at Slate Falls Airways in enabling us to experience this slice of local paradise and to create so many lasting summer memories with the kids – sunburnt noses, tangled lines and marshmallow faces galore.

Daring to be

Standing at the kitchen sink, I stare blankly out the window into the blue-sky, spring morning. My fingers feel cool as they grip the edge of the dark, stone bowl. I am holding on for dear life. My chest rises against an unseen weight of three decades worth of emotional baggage, a global pandemic, stories of violence and sadness seemingly at every turn and I can’t breathe. I feel like I am crawling out of my own skin.

My breath comes quickly and shallowly as I will my body not to fall off the edge into full blown panic. Behind me, something crashes in Henry’s room and the inevitable wailing and ‘MOMMMMMMM!’ requests follow. My frenzied heart beats thunderously in my chest, matching the frantic desperation that envelopes me. Everywhere I look, I see chaos. It rudely stares me down in the coffee grinds of Blake’s last espresso, scattered across the counter. It shows itself in the hundreds of ant-sized bits of paper sprinkled all over the living room floor, matched with a forgotten pair of scissors cast down by small hands as imaginative minds have careened on to the next 4 year-old adventure. It makes itself known in the layer of crushed Goldfish left behind from snack time, in the trail of dirty socks that pepper the floor in vicinity of the empty laundry bin, in the powerful scent of urine emanating from the wall next to the toilet, outing a certain 5 year-old’s inability to aim. I am surrounded, overwhelmed and defeated. Try as I might, I am losing this endless war in which I am seemingly the solo defender.

I clench my eyes shut and try to focus. “Drop your breath, drop your breath,” I remind myself, echoing my therapist’s words in my chattering brain. Like a toddler, I hold my belly and force it to rise as I draw in air. I let it go slowly. “Again,” I command to myself. In and out, my belly protrudes and flattens, forcing my breath to slow. Despite the ongoing, incessant ‘MOMMMMMMs’, I stand my ground and breathe with my belly until the worst of it is gone. I am now at least one step back from the cliff’s edge.

Today is a ‘home day’ as Henry calls it. A gift of time to be spent entirely at home with the kids after a series of gruelling, successive days and nights of call for our local obstetrics service. This day is what I had been looking forward to all week, but I am wound tight and overwhelmed, pushed to the edge in ways that I never experience at work.

My mind carries me to the night previous, where I had attended a delivery in our rural community hospital. It had been the woman’s first delivery and the excitement that she and her partner shared was palpable. Her pregnancy and labour had been straightforward but as she entered the pushing stage, her baby’s heart beat dropped precipitously with every contraction, heralding an ominous exit through the birth canal. As the babe was soon thrust to the outside world, sickly thick, meconium-stained water pooled between the woman’s feet; the babe had had a bowel movement in utero and now his lungs were full of turbid, tarry, particulate fluid. In a glance, I knew what was coming next. Severing the connection between Mom and babe, the cord was swiftly cut and the babe’s limp, pale body was silently placed into my hands to be carried to the nearby resuscitation warmer. “Heart rate less than 100”, barked the nurse as we worked to provide breaths into the babe’s lungs, my gloved hands slippery with the pea-soup coloured fluid that coated the baby’s body. “Heart rate less than 60 now,” continued the nurse. “Start compressions,” I responded. “Call a code. I’m going to intubate.” I grabbed the laryngoscope. The metal felt cold and hard in my palm as I passed the tiny tube into the baby’s airway. My hands were moving in a knowing, methodical way, but my thoughts floated far above me, distanced from the dire scene that was unfolding. “This baby is dying now,” I thought calmly. “He is dying in front of me.” The injustice of a life ending before it had even had had a chance to begin.

Days later, as I sit prickly with sweat in front of my laptop, I describe the neonatal resuscitation to my counsellor. 1,800 km away, she tilts her head subtly to the side, without responding. I know that she is urging me to continue. “I just cannot understand why I feel so calm in the worst possible situations at work, but the sight of peanut butter smeared across the counter makes me panic and rage! It’s so ridiculous!” I am angry now. Angry at myself and my need to vent over my god-damn inability to cope with the dirty floors in my house when rubber bullets are flying at protests, racial injustices scream from online news headlines, cities are literally burning while their tyrannical political leader responds with threats of military force against its own civilians, all during a world-wide pandemic that has lost the global community’s interest; apathy that will certainly result in more lives lost.

I’m ashamed, lost and confused. My desperate need for perfection in every realm of my life, including in my own home is eroding my relationship with my husband, interfering with my ability to enjoy my kids and is suffocating my home life.

“How did I get here?” I wonder aloud, but there is a quiet knowing underneath. I know. I know, because this perfectionism dance has been my armour for my entire life. It has been my hustle for as long as I can remember, a hustle for love, a hustle for acknowledgment, a hustle for validation, a hustle for self-worthiness. When life got hard, instead of calling out for help and revealing my struggle and vulnerability, I put my head down with the belief that if only I could work that much harder, all would be well again. But I am tired, so, so very tired.

A year ago, while mindlessly surfing through Netflix, I stumbled across a thumbnail linked to an on-screen lecture by professor, researcher and storyteller, Brene Brown. I had heard of her work before through an online network of fellow Canadian female physicians and I knew the main topics of her work were shame and vulnerability. Ironically, I had passed over recommendations to read her words because I didn’t think they had really applied to me. Why did I need to learn about shame and vulnerability? This didn’t seem to relevant to my life nor did it seem to speak to me in any way. I had been raised to highly value hard work and independence; ‘when the going gets tough, the tough get going’. No time to waste with fluff, if life got hard, you put your head down and you worked harder.

This familial culture had been I’m sure, in part, passed down by my maternal grandfather who had gone from a working-class farm hand to an accomplished lawyer, member of parliament and city mayor by sheer hard work and determination. These hardwired values were apparent to me from my early childhood. I worked doggedly on school projects with an overabundant worry about my report cards from the get-go. As a teen, I participated in every high school sport, played clarinet in the school band, ran student government, skated competitively in our community and stayed up late into the night hammering out study notes on our clunky family desktop computer. I expected only the best from my teammates and from myself. I was independent and focused. I graduated with multiple academic awards, acceptances into three Canadian Ivy League Universities and received the ‘Best All-Round Female’ award – a culmination of all of my high school efforts. These traits continued to serve me well as I pushed through an academically rigorous pre-med degree at Queen’s University while working to support myself, continuing to skate competitively, volunteering at the local hospital, working with student-run organizations in health education and in Indigenous health, as well as chairing an environmental advocacy group.

Yet below the surface, I was struggling; my mental health crumbling underneath the mountain of self-ladened, unachievable expectation of perfection. My parents would call, asking me how I was doing and I would respond with generic answers, fight back tears and hastily hang up the phone as to not show them what I thought was weakness. This only fuelled the fire and made me work harder. If I only achieved more, all would be ok.

Eventually, I was accepted into medical school then into residency. In the culture of medicine, where diligence, hard work and zero regard for self-care was dogma, my ingrained notion of work ethic were only more positively reinforced. There was simply no room for fragility, emotion, or vulnerability. I was spat out on the other side of my exhausting years of training as a newlywed with a baby on the way, starting a job as a rural family physician in an isolated community serving Indigenous patients.

I had achieved ‘success’ in all senses of the word in my personal worldview; perfect family, perfect house on the lake, perfect job that I had always dreamed of, a perfect life. It was the finish line. I had done it! Years and years of sleepless nights, tears, emotional turmoil and work had resulted in these achievements. I looked around frantically. Could anyone see me? Was anyone proud? Was this enough? Was I enough yet?

With Mom & Dad at my NOSM Medical School graduation in Thunder Bay, 2012
Blake and I at my UBC Family Medicine Residency graduation, 5 months pregnant with Henry, 2014
Ada and I hiking at in our new hometown of Sioux Lookout a week before Henry was born, 2014

Opening the door into Brene Brown’s research was like painfully holding a mirror in front of my face. After watching her Netflix presentation, I immediately powered through three of her audiobooks, then bought hardcopies to re-read them, underlining ‘Aha moments’ on every page.

Dr. Brown’s research speaks about human connection and communication, how we foster a sense of belonging and become shame resilient in our lives through courage and vulnerability while working towards what she calls Wholehearted Living. Brown is a master storyteller and presents her work with captivating hilarity, yet will bring you to you knees with the simplest of truths of how all humans so desperately need to connect and to be loved. It is not an understatement to say that Brown’s work has completely revolutionized the way I parent, lead at work and connect with Blake. But most importantly, it has been the impetus to begin the journey toward myself.

When reading Daring Greatly, Brown’s 2012 book on using the tool of vulnerability to inform how we live, lead, love and parent, the margins had become scratched up with a multitude of light-bulb moments as I saw myself in her words. I realized that somewhere along the way in my life, I had switched from working hard, striving for my goals for ME, to completely hinging my self-worth on my ability to achieve for OTHERS. I was a middle child, wanting everything to be perfect and everyone to be happy and I would work my damnest to make that happen. Don’t rock the boat.

Please. Perform. Perfect. Repeat. Please. Perform. Perfect. Repeat.

Daring greatly means the courage to be vulnerable. || Brene Brown. Quote.

What I have come to realize through reading Brown’s research, however, is in this debilitating dance, I have spent my whole life ‘armouring up’ and preventing myself from truly being seen. I knew that if I let anyone peek behind the curtain, I believed that I would be certainly subject to harsh judgement and criticism and my secret would be out; I just wasn’t good enough to be truly worthy of love.

“Perfectionism is the ultimate fear… People who are walking around as perfectionists… They are ultimately afraid that the world is going to see them for who they really are and they won’t measure up.” – Oprah, in a 2013 interview with Brown

“Perfectionism is not self-improvement. Perfectionism is, at it’s core, about trying to earn approval. Most perfectionists grew up being praised for achievement and performance (grades, manners, rule following, people pleasing, appearance, sports). Somewhere along the way, they adopted this dangerous and debilitating belief system: “I am what what I accomplish and how well I accomplish it. Please. Perform. Perfect.”

Healthy striving is self-focused: How can I improve?

Perfectionism is other-focused: What will they think?

Perfectionism is a hustle.”

– from Daring Greatly by Brené Brown

Almost forty years into my life, I am only now coming to this realization that I have, and continue to live with an outside focus. I have been hustling all my life.

Of course, changing one’s core belief system is not an overnight job. To dismantle the framework upon which you have built your entire existence takes an incredible amount of work and I am literally only just taking my first steps. It is uncomfortable to say the least! I still squirm in my seat during my therapy sessions – deconstructing and examining your true, unhidden self is sometimes paralyzing. Writing these words has been beyond agonizing, but I desperately want to live my life differently, to be loved by Blake and connect with him in a deeper, more authentic way and to regard myself with compassion and empathy. Most of all, however, I want my children to know that they are loved just because they ARE and not because they DO. I have realized that the most impactful way to do this is to model these behaviours towards myself and this will be the most difficult hurdle to overcome.

Finally, in the chaotic, uncertain, terrifying world in which we all currently live, it is not shocking that Goldfish crumbs are thrusting me towards near panic. I know that I am not alone in this. Now, more than ever, Brown’s work is relevant to all of us. We need to reach inside ourselves to be brave, choose courage over comfort, demonstrate authentic vulnerability to those we trust to bring hope, true connection, resilience and healing to our own lives, our families and our communities, both big and small.

Let’s get started.

10 Guideposts for Whole Hearted Living {free printable} | Brene ...

Let her Fly

Like many of you, since arriving back home to Abram Lake, we have been slowly adjusting to our new ‘normal’. Just four weeks ago, Blake, the kids and I were blissfuly enjoying our much anticipated family ski vacation in Nelson, BC. Tucked away within the Kootenay mountains, this small community, with its free-thinking, hippie vibe was the quintessential place to literally and figuratively disconnect. With absent wifi access and lack of cell phone towers at the local ski resort, our days were screen-free and simple with the sole purpose of enjoying as many hours chasing the kids down the slopes as possible.

Halfway through our month-long family retreat however, the world seemingly upended overnight. Within a 48-hour timespan, restaurants, gyms and shops were abruptly closed. Gaping holes were left on shelves which usually contained canned chick peas and pasta. Toilet paper, of course, became the new currency. The most unsettling blow came with the swift announcement of Whitewater Ski Resort’s closure. This sealed the deal. Within hours, our car was packed, our flights home were cancelled and we began a comedic, yet arduous and very impromptu road trip across the country to get home with two young kids, a dog and gear packed into every nook and cranny of our aging Honda Pilot. Twenty-two hours. Twenty-two hours of driving, of picnics in the car, of endless demands of snacks and of continuous Netflix. Twenty-two hours, five provinces, two $60 motels, and one shockingly intact marriage at the end to it all. We had finally made it home.

Weeks later, we are now finishing our fifth week of physical distancing. I have been back at work full-time, but haven’t been out of the house except to go to the hospital. Blake has only left the property twice to go grocery shopping and the kids haven’t been in a car for weeks. I honestly have no idea how Blake has been coping being a full-time, stay-at-home parent with no reprieve in sight. Yet, despite the challenges, each day, he is up to something new. Last weekend, over Easter was no exception when he re-discovered our kite.

Five years ago, we had gone down to Costa Rica with then six month-old Alice and 22 month-old Henry to learn how to kitesurf. It had been a blast and upon our return, we had bought a used set-up to fly on the lake in the summer. After one very unfortunate kite-launching attempt during which the kite had ended up pinned and tangled in a massive red pine, one year-old Alice crying in the sand, and Blake and I screaming at each other, the kite had been packed away for good.

Easter weekend in Sioux Lookout had brought balmy spring weather; snow squals, 30-km/hr winds and temps well below zero. Ahh, life in Northern Ontario. While our friends and family in Southern Ontario had outdoor Easter egg hunts in their PJs, Blake, I and the kids had dressed up in our parkas to brave the elements and break up the tedium of our physically-distanced existence. The ice had been perfectly flat and the winds were steady, whipping across the frozen lake. While most of us would have been perfectly content with a permanent location on the couch consuming carbs in our sweats, Blake had come up with the idea of rigging up our kite to ski across the frozen expanse. After a day of relearning the subtleties of managing the monstrosity of our kite, which spanned ten-feet at it’s length, Blake booted up and effortlessly began to race at top-notch speed up and down our bay on his skis.

In the following days, however, a new plan was hatched. Blake convinced Henry to hold tightly to a rope knotted onto his harness and soon, those two die-hard, adrenaline junkies were carving across our lake, maxing out at a speed of 51k/hr! “More, more, more!” was all I could make out from Henry’s outline out on the horizon. Two peas in a pod; a passion for skiing and a constant need for speed.

“Celia, you’ve GOT to try it!” Blake cajoled, referring to his new-found love of kiteskiing. But despite his encouragements, I repeated turned him down citing innumerable excuses: emails, laundry, meal prep, vacuming, keeping the kids alive etc. Again and again, I told myself there was simply too much to do for me to go off frolicking back and forth across the lake. I complained that I couldn’t recall how to manipulate the beast of the kite. I lamented that I would most certainly hurt myself which would NOT be a responsible thing to do at this juncture. I complained that I wasn’t strong enough and wouldn’t be physically able to do it. “I just don’t WANT to!” I griped to Blake as he persisted.

It was out of character for me to not jump at the chance to try something new, to get on board with the latest outdoor adventure, to accept a challenge, but honestly, I wasn’t feeling it. I just wasn’t feeling ANY of it. Not the sleepless nights, turning over the grotesque numbers of COVID-deaths on the Johns Hopkins University map in my mind. Not the inability to seek comfort with a hug after a difficult case in the OR with one of my best friends and colleagues. Not the infinite numbers of emails and online meetings directing my attention to the ever-changing COVID-related workplace policies. Not the daily uniform of scrubs, cap, mask, goggles that have replaced my closet full of dresses. Not the fear in my kids eyes when they now see a neighbour approaching them on the street. Not the inability to gather with friends and family during Easter holiday weekend while seeing others disregard public health recommendations. Not having the words to answer my kids’ daily inquiries into when the ‘Sickness’ would go away. Not the nights staying up late learning the ins and outs of how to manage a COVID-positive patient in my rural ER. I wasn’t feeling ANY of it. I felt angry, resentful, disheartened, overwhelmed, despairing and listless. I felt utterly defeated.

“Can I try the ski trick?” a small voice had interrupted my stormy mood during that Easter weekend. I had looked down. There Alice stood, her darling belly protruding over the waistband of her fleece jammy pants, barefooted with hair all astray and her chubby face peering up at me. “Of course! Let’s do it!” came Blake’s automatic, enthusiastic reply, always excited to have ANYONE on-board with one of his crazy ideas.

I had been surprised. Alice was definitely more cautious than Henry when it came to sports. When she had seen the force of the wind, the size of the kite and the speed at which Henry and Blake had been hurtling across the ice earlier that day, she had adamantly declined to give it a go and had requested instead to go inside and read a book. Fair enough, girl! But here she was, out of the blue, asking for her turn to fly.

After gearing her up, I watched her as she marched determinedly down the little path that lead to the frozen beach and onto the ice towards the kite. Unaccompanied, she walked straight for that kite without hesitation. I couldn’t peel my eyes away from that image; her small figure, the flapping blue kite, and the immense space that surrounded her.

Her courage floored me.

I soon was watching her buzz around the ice with Blake while tears stung my cheeks. She was amazing.

Then, in face of all of the fear and uncertainty, I held tightly onto the tenacity of my four year-old and grabbed hold.

And soon I was flying too.

You can’t act right if you don’t feel right.

“Dr. Sprague, call from the Regional Phones doc! I’m transferring it back to you,” shouts the ER clerk. I grab the receiver as my cellphone concurrently alarms in my scrub pocket. ‘Shit, it’s the radiologist likely calling me about the CT head results for Room 5,’ I internally grumble. Tethered to the landline, I toss my cell at one of the nurses, “Tell him I’ll just be 3 minutes.” Head pressed to the phone, I listen to my physician colleague on the other end tell a familiar story: “Sending a patient down to you. 35-year-old male, IV drug use, presenting with fever, back pain. Doing labs, starting him on Vanco, but he’ll need a CT to rule-out an epidural abscess.” “Ok, got it. Sounds good,” I reply, my eyes trained on the Trauma room ahead of me. Through the glass window of the doctor’s charting area, I squint to make out the stats on the monitor above the bed. Numbers in blue and red tell another story of the patient lying in the gurney below. Her expression is obscured by an obscenely large mask that covers her nose and mouth, strapped tightly against her face. A tube connects the mask to a ventilator, pushing oxygenated air into her lungs with her every breath. Uncontrolled diabetes, end-stage kidney disease and congestive heart failure – a deadly trifecta so often seen in our ER. As her kidneys fail, fluid builds up in her lungs and the already stressed heart slowly packs it in. She’s sick and I’m worried. I do my best to manage her failing body and pray that the ICU calls me back sooner rather than later.

I take the next call from the Radiologist. A subdural hematoma; bleeding between the layers that envelope the brain. ‘Well, shit,’ I curse again, ‘that will need a call to the neurosurgeon in Thunder Bay and likely transfer out.’ I grab the patient’s chart off the rack and quickly scan the department before I get back onto the phone.

The doctor’s charting area in our ER

As usual, the ER is full to the brim. As the receiving centre for our local community of five thousand, as well as our catchment area which provides service to 33 Anishinaabe communities and some 40,000 people living in fly-in-access only Nations across Northwestern Ontario, our rural, family medicine-run hospital sees it all. From the North, our patients are triaged in the nursing stations to be the sickest of the sick. These patients fly in a near-constant stream via air ambulance to our little ER. The result is a high volume, high acuity department staffed by three nurses and one family physician. No consultant physicians nearby, no ICU, no respiratory therapists, no mental health specialists. Our nearest tertiary care centres are hundreds of kilometres away; to the East, in Thunder Bay and to the West, in Winnipeg. It’s a rewarding, but also challenging and often terrifying place to work.

Fly-in communities across Northwestern Ontario funnel into our hospital
Our little hospital, smack-dab in the middle of nowhere, surrounded by lakes and trees as far as the eye can see

Stretchers line the hallways of our tiny shop: a kidney infection in S1, alcohol withdrawal in S2, back pain needing morphine and likely admission in S3. The isolation room holds a young woman actively miscarrying at twelve weeks awaiting a lifesaving OR procedure to stop her heavy bleeding. The nurses cajole and beg her to not leave for a smoke. She’s indifferent, marching to the exit with a cigarette at her lips dragging her IV pole behind her. The nurses look at me, ‘Do something about this,’ they appeal with their eyes. I motion for the security guard to accompany her and continue to take stock of the flooded department.

Room 1: Elder, failure to cope at home, needing admission. Room 2: 5-month-old baby with a fever. Waiting for me to assess. Room 3: A hockey-loving teen with a possible broken wrist. X-rays ordered. Room 4: Another patient on a BiPap ventilator; her diaphragm unable to overcome the weight of her morbidly obese frame as carbon dioxide builds up in her bloodstream. Waiting for repeat labs. Room 5: Subdural hematoma. (Shit, I still have to call neurosurgery!) Assessment Room: a suicidal 15-year-old girl with a hard gaze. On a Form 1, awaiting transfer to psychiatry. The list goes on.

The ER on a MUCH different kind of day

To my right, the box that holds patient charts awaiting to be seen by me overflows, clipboards piled high, spilling onto the floor. My stomach grumbles and contracts. I can tell the nurses are tense and patients are angry at the wait, lashing out at the support staff. “I’ve been waiting here for hours! When am I gonna get seen!? This place is fucked,” I hear someone yell as the door to triage opens to the full waiting room.

I feel my own anger boil up. I’m overwhelmed and recognize the familiar sense of burnout as I shift the blame of a struggling system onto the patient for their illness. Before I can make another move, the clerk grabs my attention yet again. Another phone call from the Regional Phones doctor requesting another Medivac to be sent to me. This time, it’s a young woman presenting to the nursing station after her third near-fatal suicide attempt in as many months. “She needs physician assessment and then probably can just go to out-patient counselling,” my colleague suggests.

Then, I break. It happens swiftly, uncontrollably. “Out-patient counselling?!,” I bark. “She’s going to need to be Formed! And obviously sent to Psych. Have you even called them yet?” I’m yelling into the phone, my face flushed. “You don’t have to be angry, you know,” my colleague retorts. My knuckles are white, gripping the receiver. “Just send her,” I manage to sputter as I slam the phone down, instantly feeling the shame wash over me. I have never spoken to a colleague this way before in my entire career. I squeeze my eyes shut and plead for the universe to swallow me whole.

The beeping of the two ventilators continues to fill the space in my brain, incessant.

Backtrack to the summer of 2019 and I am on a glorious solo trip in Toronto to attend a wellness conference hosted by the Canadian Women in Medicine Association. The conference boasted a very non-conventional agenda focusing on leadership, sex, parenting and self-care. I had also chosen to attend a pre-conference workshop specifically on parenting of little ones. Up until that point, I had been fumbling along in my journey as a parent to Henry (then 4 years) and Alice (3 years). Unlike my role as a physician, there was no lengthy training, no years of study, no exams and no dedicated immersion into the topic; one day I wasn’t a mother and then the next, I was.

Moments after Henry was born

In front of me stood a slight woman in her 50s, unruly brown hair framing her expressive face. Speaking enthusiastically with a New York accent, she bounced around the stage, arms waving wildly. At that time, I was (and still am!) thick in the season of daily parenting battles with my littles. I clung to her every word like a lifeline. I had no idea that the next few hours would drastically change my approach to parenting.

Over the three-hour workshop, Joanna Faber, co-author of ‘How to Talk so Little Kids Will Listen’ dropped pearl after pearl as I scribbled furiously on scraps of paper. One statement, however, struck me profoundly:

“Kids can’t ACT right if they don’t FEEL right”.

It was so simple but the clarity of her message was like an awakening. Kids aren’t inherently bad when they are acting out. Instead, they may be struggling with big emotions, hungry or tired. “Think of how difficult it is to keep your cool when YOU are tired/hungry/under pressure,” Faber carried on. I nodded empathically. I thought of all of the times I had lost my temper on the kids while gripped with anxiety about work or when I hadn’t acted my best with a colleague or patient when I was simply burnt out; exhausted, out of empathy and out of patience.

Joanna Faber & Juile King, co-authors of “How to Talk so Little Kids will Listen”

Up until that workshop, my approach to getting through the daily grind was a combination of pleading, bribing and threats (depending on how desperate I was feeling at that moment). If you are a parent of littles, you can empathize with the sheer frustration and anger that arises with the constant ‘No’s’ that you face at every turn.

“Henry, can you please go for a pee before bed?”

“No! I need to finish my LEGO creation. I don’t want to go to bed! Nooooooo!”

“Alice, can you please eat your dinner? Alice, please eat your dinner! ALICE, EAT YOUR DINNER PLEASE!”

“No, no, no! I don’t want to! No! It’s yuck! I don’t like it.”

Every. Step. Of. The. Way.

I often think of what life would be like if I just asked once, and they just miraculously did what I asked. Imagine! But alas, with two young spirited kids, life wasn’t as smooth as I wanted it to be.

These daily struggles with the kids were causing much frustration amongst all of us. Every relationship in our family was being affected. Blake and I would fight, exhausted and wound tight after 45 minutes of begging, theatrics, threats and bribes just to get a few bites of dinner into them each night. Even the dog would run off to the neighbour’s to escape the chaos of the morning hustle out the door.

There had to be a better way. How could I engage the kids to encourage connection and cooperation? How could I resolve the constant conflicts without punishments, threats and yelling?

The following tools from Faber and King’s “How to Talk so Little Kids Will Listen” have been instrumental in navigating the minute-to-minute outbursts from Alice and Henry. I hope that in sharing Faber’s pearls from her workshop and from her book can help you as they have helped me.

Faber’s method is grounded in the acknowledgement of the child’s feelings. “Without acknowledging,” Faber explains, “you’re working against yourself.” Seems simple enough, but how often do we truly support our kid’s perspective? In our house, our constant morning struggle with Henry is always centred around him not wanting to go to school. So engrossed in building LEGO ‘creations’, each morning is the same. “I don’t want to go to school! I hate school!” How quickly do we default to our immediate gut reactions: “You love school! Don’t say hate” (denial of feelings), or “Your friends all love school!” (comparisons), or “Why don’t you like school!?” (questions), or “Life is hard, sometimes you have to do things you don’t want to do” (advice/lecturing), etc.

Think of when you get home from a shitty day at work. You bust through the door and let it all out to your partner and he or she counters with similar responses – lectures, advice, telling us to suck it up, other people have it harder, etc. We would be PISSED OFF and likely storm away. What we often need is someone to just simply acknowledge how we feel. Responses from your partner which might be better-received could be: “Man that sucks! What a crappy day. Sounds brutal. Ugh!”

A mega pearl from Faber’s workshop that has stuck with me was that if you’re not sure how to respond to your child’s emotions, try it on yourself first. Remember, nothing is more infuriating than being told to calm down when you’re angry or being subjected to a philosophical lecture when you’re losing your cool about how a colleague acted at work.

How to handle emotions:

  1. Acknowledge feelings with words. All feelings must be accepted, some actions must be limited. Resist the immediate urge to counter. Sit on the BUTS! Try, ‘The problem is…’ instead. Name the feeling. Be DRAMATIC. Match the child’s emotion. Be genuine and real. Resist the urge to ask questions while the child is in distress.
  2. Acknowledge feelings with writing. Have your little one write a wish list that facilitates acceptance of feelings while limiting actions. Our kids are still too little, so often they dictate and I write it down.
  3. Acknowledge feelings with art. Have your child draw a picture of how they feel.
  4. Give in fantasy what you cannot give in reality. I often will take a picture with my phone for their ‘wish list’. I don’t actually manifest this wish list into anything, but they always feel validated when I do this.
  5. Acknowledge feelings with (almost) silent attention. “Ugh!” “Mmmm” “Ohh”

Although I’m far from perfect, I use ALL of the above tools on the daily. When Henry starts up, whining, “I don’t want to go to schoooooooool!” although I’m irritated and annoyed, I often grit my teeth, force my face to smile and say, “Man! You really don’t want to leave your LEGOs. You’re in the middle of creating a cool jet plane. You wish you could play LEGO all day, all night and NEVER go to school EVER. You’re so ANGRY (with an angry face, hands clenched) about having to go to school every day! UGH!!!!!”

Often this results in an empathic nodding and a big hug, then we carry on with the morning routine which goes much more smoothly than had I responded with, “Henry, just pull yourself together. You know that have to go to school! Why do we have to go through this EVERY SINGLE DAY!” It’s not perfect by any stretch, but it does help.

So much LEGO!

But, beyond learning how to navigate these huge emotional eruptions, what I really wanted to know from Faber’s workshop was how the hell do I get my kids to listen to me?! I feel like my mind is literally going to explode if I have to ask them to get their boots on one more time.

Pertaining to getting our kids to do as they are told, Faber initially described the reality of the child vs. the reality of the parent. To us, we are CONSTANTLY nagging our kids to do all of the things that they just have to do! But think about your kids. Their whole day is filled with being told what to do by adults. No one likes to be ordered around, myself included. Anytime someone tells me I have to do something, my immediate reaction is to balk and do the opposite. Sound familiar?!

Here are Faber’s tools for Engaging Cooperation:

  1. Be Playful. Turn a task into a game. This sounds exhausting, but Faber gave a life-changing point – kids are inherently exhausting! It’s more fun when we’re all tired and cheerful instead of tired and irritable. Why not try to make it a bit more enjoyable?
  2. Offer a choice. We all like to feel that we have some control and autonomy!
  3. Put the child in charge. Delegate! You’ll be surprised at what they will be able to accomplish. Kids are generally wired to please.
  4. Give information. Not a lecture, but explain simply why you’re asking them of something. Keep it brief.
  5. Say it with a word or a gesture. This saves the lecture that no one wants to listen to. Try to use a noun, not a verb. Jacket! Hat! Toothbrushing gesture.
  6. Describe what you see and forego the command. Appreciate the progress before pointing out what is left to be done.
  7. Describe how you feel. Express your anger or frustration with using ‘I’, rather than ‘you’. I love this one – it helps me when I’m so irritated. Instead of yelling “Don’t hit Alice! You are acting terribly tonight!” I try, “I DO NOT LIKE TO SEE KIDS GETTING HURT! I GET VERY UPSET TO SEE HITTING!”
  8. Write a note.
  9. Take action without insult. This one is huge. I’ve been reading a lot of Brene Brown’s work on shame which is inherently linked to one’s self-worth. Of course, we must limit some actions, but instead of shaming our kids (“You’re so bad! You’re a bad listener!”), try taking action without insulting your child (“I see you’re having a hard time containing all of that energy. Let’s read together rather than jumping from the couch onto the counter.”)
Just last week, the kids refused to get ready for Can Skate. It didn’t matter how much demanding and pleading I did, they were just not having it. Then, I put Henry in charge of the getting ready for skating process. He suggested Halloween costumes (it was February) on top of their snowsuits. Eureka! It worked, we got out the door and to skating on time.

In real life, these tools don’t come easily. I’ve attended Faber’s workshop, listened to the audiobook AND have read the text twice and still I struggle. Two nights ago, I was at the dinner table with the kids. Blake was away so I was already feeling slightly overwhelmed. Henry was pent up with energy from his chaotic day at school. He was all over the place, jumping around in his seat, putting his feet on the table and generally pushing all of my buttons. HARD.

While writing this blog, I re-read Faber & King’s book for the second time having already also listened to the audiobook. It has a semi-permanent spot on my bedside table now!

I have to be brutally honest here. There are times like this when I have to actively resist the physical temptation to grab him, haul him into his room and hit him. Yikes. It’s so scary to admit that in writing. But I do feel this way, especially if I’m not ‘feeling right’ myself.

At this particular occasion, I was doing all of my default parenting moves. “If you sit and eat quietly, you can watch ‘Wild Krats’ after dinner!”, and “If I see your feet on the table one more time, there will be no more dessert for you”, and “Please sit down! On your bum! Henry, on your bum! HENRY!” Nothing was working and I was losing… losing the battle and my mind along with it.

Then, I literally got out my phone and swiped to Faber’s “How to Talk” app, outlining all of the aforementioned tools. I took a breath and tried a different approach.

“I see socks on the table. I feel upset when stinky socks are on the table!” (describing how you feel), then “SOCKS!”, “STINKY FEET!” (saying it with a word). No luck. I tried again. “Henry, your feet are so full of sillies tonight. The problem is, feet do not belong on the table” (giving information). Still no luck. By this point, I’m seriously gritting my teeth and wishing that I had more of a stockpile of wine in the house. I went at it one more time. “Oh my goodness those socks are being so silly tonight. Henry, can you be in charge of keeping them dangling down?” (putting the kid in charge). Finally! The ticket. He pretended to be the ‘parent’ and scolded his feet and kept them off the table. Whew.

The ‘Pocket Parent’ App

Next, after learning about dealing with big emotions and getting kids to cooperate, Faber went on to speak about resolving conflict. As parents, we are always disciplining our kids. In our house, that often looks like time-outs and removal of privileges (i.e. ‘No show tonight!’, ‘No dessert for you!’). But Faber had lots to say about those techniques. Oops. Guess I won’t be up for parent of the year!

“Punishment,” Faber explained, “can achieve quick results, but not without pitfalls. Punishment can cause escalating use of force. With punishing, your only recourse if it doesn’t work is punishing HARDER. Punishing doesn’t allow the child to fix the behaviour. When we put a child in a time-out, they don’t learn, instead, it allows for fixation on selfish thoughts that breeds resentment. They generally stew, feel angrier and more upset. Finally, kids who are bullied often become bullies themselves. We have to ask ourselves if we want our kids to use these methods on their peers and siblings. Remember, children will do as you DO, not as you SAY.”

This hit very close to home. I am constantly at our kids to treat others as they would want to be treated themselves. But, if our discipline strategy is focused on punishment, they are learning that when faced with a conflict, their only strategy is to inflict hurt or sadness on another. Faber also went on to empathize that if we train our kids that anytime they do something wrong, their parents will come at them heavy-handed and they will be much less likely to reach out when something bad happens in the future (i.e. teen years).

Hmmmm, ok so what are different strategies to handle things with your kid does something clearly ‘wrong’. I feel like I’m constantly disciplining one of the kids for fighting with their sibling. It’s exhausting.

Here are Faber’s tips to Resolving Conflict:

  1. Express your feelings strongly. Again, I love this, because it does allow me to get some of my own irritation out. “I DON’T LIKE IT WHEN I SEE KIDS PUSHING!” Focus on using ‘I’, rather than ‘you’.
  2. Show the child how to make amends. Instead of making the child feel worse by lashing out, teach them how they can make their sibling and themselves feel better.
  3. Offer a choice. Tell them what they CAN do instead of what they can’t.
  4. Take action without insult. Above all else, protect people and property. Remove the object causing the conflict or leave the environment causing the fight.
  5. Problem solving. This is a tool to use after the storm has passed. Maybe on a completely separate day when you have time and space to sit down with your child as this is a more involved process.
    1. Start by acknowledging the child’s feelings
    1. Describe the problem (briefly, don’t lecture)
    1. Ask for ideas, make a list and include them ALL
    1. Decide which ideas you can both agree on
    1. Try out your solutions

Again, this all seems to involve a LOT of time and energy and it does. There are definitely more circumstances in which I find myself resorting to inflicting time-outs than patiently working through the steps of a brainstorming session. BUT, the thing about parenting is that you can mess up and still have ENDLESS opportunities to try again. At our house, I mess up seemingly hundreds of times each day, but when we do get it right and things work out, it feels like the highest victory a parent can achieve.

So, Godspeed to all of the parents out there. You’re not alone. It’s ok to struggle but I hope some of Faber and King’s tools can help you to struggle just a tiny bit less. Good luck!

They sure are cute when they are asleep and I’m feeling all sentimental from our Summer 2018 photo session with Athena Marie Photography 🙂

The Bounce Back

The ribbon retractors glint in the harsh OR lights as I pull back abdominal skin, fat and muscle to reveal the pearly white fascial layer. My colleague dives his arced needle through the fibrous connective tissue, running the suture along the incision, closing the hole, bite by bite. From the anesthetist’s speaker, an eclectic array of Pop 40 and classic rock music drifts through the otherwise quiet operating room. At the head of the OR table, on the other side of the blue drape, soft murmurs of wonder emit from the lips of the new parents whose lives were forever changed when their newborn was gently pulled from the mother’s womb. It’s the Friday morning scheduled c-section at the Meno Ya Win Health Centre and the case is proceeding routinely. As usual, the scrub nurse, my physician colleague and I chitchat as we work; the conversation drifts from grandkids, recent trips and to upcoming concerts in Winnipeg. At our small hospital in Northwestern Ontario, our personal lives are intertwined with our work; one of the best, and sometimes most challenging aspects of living and working in a small, isolated community.

As we chatter about our lives outside of the hospital walls, the scrub nurse eventually inquires as to how I have been doing lately. Just six months prior, in the same very hospital, I had had the immense privilege of creating a new family for our close friends as a surrogate when I delivered a perfect baby girl named Claire. After reassuring the nurse that I was well, and that Claire and our dear friends, Amy and Adam were also thriving, the scrub nurse went on to comment how I had so quickly ‘bounced back’ from Claire’s birth. Of course her comments were incredibly kind and well-intentioned, however, in that moment, like an opening reel to a film, hundreds of raw images flashed through my mind: me struggling to even sit up, so freshly post-partum; me tearfully realizing my inability to fasten my snowpants; me switching off my 5am alarm morning after morning to drag myself to the gym; me glaring angrily at the wall-sized gym mirrors, casting back my doughy reflection; me cursing and struggling into my pre-pregnancy jeans… It seemed almost comedic that my so-called ‘Bounce Back’ had apparently appeared effortless when in fact, it could not have been any further from reality.

In the months in which Claire had became my constant in-utero companion, my body had naturally softened and stretched in all of the ways that a woman’s body shifts in its efforts to host a growing life. Prior to Claire taking up residence in my uterus, I had been working diligently to regain my strength after having given birth to my own two children. Growing and giving birth to Claire will forever be a part of our family’s story and will be an experience that I truly will treasure forever. Although I will never regret my decision to help Adam and Amy become a beautiful family of three, I would be lying to say that the months that followed Claire’s departure from my body were days without adversity.

This photo means the world to me; all of the minor complaints I had in my journey as a surrogate for Adam and Amy pale in comparison to the beauty and love of this moment.

I am certain that, although I cannot truthfully speak for every post-partum woman, there are very few new Moms out there who truly revel in the wake of one’s physical self after giving birth. Stretchmarks, jiggling bellies, maternity pads, painfully engorged breasts, hemorrhoids and the true feeling of fear that one experiences when going to the bathroom for the first time. These war wounds, however, are usually negated by the finest eyelashes that you have ever laid eyes on, the impossibly minuscule toenails, those first incredulous smiles and the continuous and overwhelming sense of wonder that you cannot help feeling when you gaze into the face of your newborn. Who will she grow up to be? What will he look like as a teen? Who will be her first love? What will fuel his future passions? Despite the tortuous, sleepless nights and wreckage of one’s post-partum body, there is nothing sweeter in the world than snuggling your baby close.

Sadly, in the months following Claire’s birth, I secretly dragged around a sense of humiliation about the status of my post-partum body. Because there was no beautiful newborn to deflect my attention, it became a daily internal struggle. My delusion also extended to everyone around me. I assumed that in every encounter, people were quietly critiquing my pillowy abdomen, my perpetual dress in Lululemon leggings and baggy tops and my breathlessness from simply walking up a few stairs. I remember feeling the constant desire to ‘excuse’ my physical appearance by blurting out a qualifier every time that I met someone new; “I don’t always look like this! I swear. I just had a baby, only, the baby wasn’t mine… Which is actually why I don’t have a baby with me! Really, it’s not because I’m a terrible, neglectful Mom. Well, it’s just a long story really…”

As I write this now, I feel physically pained for that woman. After undertaking one of the most selfless tasks that a person could possibly do, instead of celebrating her strength, she was drowning in shame.

Within weeks of Claire’s birth, our family took a short leave to Nelson, B.C. to escape the lingering Sioux Lookout winter and to enjoy a slice of rare, uninterrupted family time. During those four weeks of pregnancy leave, I fell deeply into the gratitude of purely being with the kids and with Blake. When your job constantly takes you away from your family at any given time, day or night, I was overjoyed to turn off my phone and say a simple ‘yes’ to every request to play LEGO or to read a book. As the kids were old enough to do a half days of ski school, Blake and I also had the opportunity to have a number of ski dates, bombing around the mountain and acting like teenagers. Under Blake’s tutelage, I even landed my first 360 at the age of 35 and just six weeks post-partum. It was so much fun!

Beautiful Nelson – the view from our Air Bnb
Morning LEO with Henry, ever day
Snuggles

Despite the joy of those weeks together, I was internally struggling on the daily, embarrassed to even speak about my challenges to Blake. At one point, I was at the bunny hill with Alice; it was a beautiful, sunny day and I had ditched my ski jacket revealing my snowpants, gaping open at the front and held up by a pair of Blake’s suspenders. As I proudly watched Alice independently go up and down the rope-tow, I chatted with the liftie. ‘When are you due?’ he asked, pointing to my unbuttoned snowpants. ‘My wife has to ski like that too,’ he continued. ‘We are having a baby in a few months!’ I paused. Where to start? Do I just lie and say yes, I’m pregnant? Do I tell the truth and reveal that I’m only a few weeks post-partum? But, then I will also be inclined to explain that I was a surrogate because where the hell will he think that I ditched my six-week old? Do I honestly want to dive into my life story with a liftie? I simply smiled and nodded, feeling crushed.

I write this not for pity but to honestly lay out where the start line was for me. At the bottom. Right back at the start, in fact, it felt even MILES behind the start. Although, I wouldn’t admit it at the time to anyone, I felt physically and emotionally broken. Yet, despite it all, I was determined. I know that I am not many things, but having been raised by my mother, I do have resilience and work ethic down pat. So, I set a goal and got to work.

Weeks of workouts went by. Weeks of getting up at 5am, walking in the dark down the mountainside while the people of Nelson slept, just to get to the gym as they opened the doors. Weeks of learning how to move and challenge my body again. Weeks of fighting the constant self-judgements of how little weight I could lift and how soft I still looked in the changeroom mirrors. Weeks of those 5 am workouts, followed by the walk home straight UP the mountain, followed then by a day of carrying Alice around the challenging runs of Whitewater Ski Resort. Weeks of mindful eating, when all I really wanted to do was indulge in daily hot chocolate and freshly baked cinnamon buns. I literally was working my butt off. I couldn’t have possibly worked harder.

Starting anew at the Nelson Rec Centre gym
My on-mountain workouts of chasing these two crazies around Whitewater Ski Resort

Four weeks later, back at home in Sioux Lookout, I weighed myself for the first time since our departure to Nelson. I had lost one pound. A SINGLUAR point on the scale. One minuscule little number. I felt enraged, defeated and beyond frustrated. I wanted so desperately to throw in the towel, to say ‘Screw this!’ I wanted so badly to just give up, to give into silencing my alarm, to give into the deserts, to give into those feelings of unworthiness and self-hate.

But damn it, I was determined. I kept at it. Mindful eating. Four workouts a week. Every week. For months and months. Despite long, continuous stretches of OB call and all of the demands of motherhood, I rarely missed a workout. I sank my teeth into my goal of feeling stronger, regaining my sense of self and losing the shameful self-talk around how I looked. I ploughed on.

I stopped focusing on the scale and started sitting up and noticing the benchmarks of what I was achieving. I started to lift more and more weight. I became excited for my 5am alarms. I started to walk around the gym like a boss, indifferent to how others may or may not have be perceiving me. The squat rack became a place of comfort, not a place of intimidation. I stopped glaring at my reflection and started feeling a sense of pride for those baby triceps that began to emerge. I stopped sweating in the effort of pulling on my skinny jeans. I started taking the stairs at work two at a time, bounding up without losing my breath. By the time I was nine-months post-partum, all of my non-scale victories had added up. In a celebratory shopping spree at Lululemon, kindly financed by Amy and Adam, I realized that I had even dropped two pant sizes.

Lululemon shopping spree: the most exciting day! I had been envisioning that day for months.
Working out in the rehab room at the hospital while on-call, as I had need to stay close to a labouring patient.
Working out during our vacation in Mexico – even though I definitely indulged in mai tais, I kept my workouts up in the hottest gym ever 🙂
Finally hitting one of my goals of 2019 – getting 8 x 45lbs plates (360lbs) on the leg press just last week!

All of this was exciting, but more importantly than the size of my Lululemons was the disappearance of that ball and chain of shame I had been previously dragging around. Along with over 20 lbs of weight lost, I had also ditched the constant narrative that I wasn’t good enough and that my physical appearance wasn’t up to the societal standard of what a woman should look like. Believe me, it’s much harder to give into that nagging voice of negativity when you just put 360lbs on the leg press and you’re feeling like a total badass. This has been the true victory of my ‘bounce back’ and I am damn proud of myself for achieving it.

In reflecting upon and writing this journey down on this page, my goal is certainly not to martyr myself. Just like you, I am a mom, a wife, a full-time working parent who has endless ‘to-dos’, limited time, and never ending demands on my time. And I am tired, oh so, so tired.

But, I got an app, I envisioned a goal, I gritted my teeth and I worked. I made my workouts a priority and fiercely defended my time in the gym from the creep of other demands. There was no magic of my ‘bounce back’. It was hard, full of pitfalls and struggle. But bit by bit, with just a little consistency and a whole lot of determination, I reached a place of physical strength and self-worthiness and truthfully, it is a journey that is ongoing and likely will be for the rest of my life.

Recently, I had a heart-to-heart with a close friend and physician Mama about wellness and self-care. There is an incredible amount of guilt attached to prioritizing oneself and engaging in a pleasurable act, whether that be taking an afternoon for yourself while your kids are in daycare or getting in a killer legs workout. As women, we lay victim to the notion that we must be selfless and devote the entirety to ourselves to our partners, children, extended families, communities, workplaces, etc. (and the list goes on) or we are simply not a ‘good’ Mom/wife/sister/colleague/daughter, etc. Unfortunately, this widely held belief causes many of us to be constantly fighting against an anxious state of ‘not good enough’, regardless of how much we do at the expense of our own selves.

Well ladies, listen up. 2020 is upon us and THIS. IS. YOUR. YEAR.

Put on your own oxgen mask. Schedule in your self-care time and then defend it like it’s your job. Stand your ground and prioritize yourself. Protect that time fiercely and give zero f*cks about those who make you feel shamed for not spending that time with your kids, or at work, or doing laundry or any other item on that infinite to-do list.

I used to carry so much guilt around spending time away from my kids to hit the gym, but here is the honest to God truth of what I have learnt over the past two years of defending my ‘me time’; throwing around weights and blasting ridiculous pop music for an hour makes me a better Mom, a better partner and a better doctor. It gives me more patience, more self-confidence and more strength to get over that next hurdle that lies in front of me. Most importantly, it empowers me and has changed my internal dialogue to one of more self-compassion and grace.

So to my dear friend Lianne, and all of the other Mamas that this may resonate with, YOU ARE WORTHY of being a priority. Put yourself on TOP of that to-do list. It may not be hitting the gym, but find something that fills your cup. Maybe it’s meditation, maybe it’s painting, maybe it’s walking your dog in the quiet of the evening. Whatever it is, make a plan, commit and get to work. I promise you that time you put invest in yourself will return to your family many-fold.

All the best for the New Year!

Pointing Pines

Her feet dip into the cool waters of Lake Joseph. Ankles crossed, her toes emerge at the surface, then drop below again creating miniature whirlpools in the sapphire water. Her cotton drawstring pants are rolled up, the cuffs tucked away from the gentle waves while her relaxed, linen top flutters lightly around her petite frame. She is perched at the side of the weathered dock, her torso canted toward the water’s edge. One arm wraps around her lap, the other supporting her chin pensively. Although her face is shaded by the shadow cast by her wide-brimmed sun hat in the late morning light, I can conjure up her profile in my mind perfectly. Wisps of her fine, red hair move in the breeze, peeking out from under her hat. Her pale blue eyes are closed, deep in quiet thought.

On that same dock, I am a child in my one-piece bathing suit, my back pressed against the warm brown siding of the boathouse, lake water dripping down my skinny arms. I am a teen in a sundress, feet propped up on a chair, cradling an open novel in my lap. I am a twenty-something in running shorts, my strong legs swirling in the water, sweat dripping down my spine.

Regardless of my own age, either eight or twenty-eight, the image of my Nana is always the same. Her ninety-pound frame leaning towards the water as she silently sits on the front dock of our Muskoka cottage, gently lifting her feet in and out of the water, in and out, in and out.

My Nana was the strongest lady that I will surely ever know. Strong in will, strong in spirit and strong in body, I always said that if I ever aged half as gracefully as she did, I would be content. She was the family matriarch, the reason that my parents met, the reason that I grew up in Muskoka and the reason that I spent every privileged summer of my childhood at our cottage, the Pointing Pines on Lake Joseph.

Born in Hamilton, Ontario in March 1920, my Nana grew up in Steeltown where her father became the president of Hamilton’s steel manufacturing company, Stelco in the post WWII era. Looking to escape the city during the hot summer months, my Nana’s family began annual treks to Cottage Country as Muskoka’s tourism industry grew at the turn of the century. As a child, my Nana would take the train from Southern Ontario to Gravenhurst, then travel by steamship from Lake Muskoka, through the docks at Port Carling into Lake Rosseau and finally into Lake Joseph. There, my Nana would spend her summer days at the Pointing Pines happily playing on the shores of the then-pristine and quiet lake. Nana used to tell me stories of that time – buying fish from Indigenous people who came to the cottage’s dock, gliding across the late in the cedar rowboat and filling the ice box with large sawdust covered blocks.

My Nana as a young woman at the cottage
My grandfather at the cottage
Pointing Pines in the 1950s

Summers at the cottage continued for my Nana as she married my Grandpa, Henry Sprague after WWII, then later as a Mom of three trouble-making boys – my Dad and my two uncles. Muskoka is where my parents met as my Mom waitressed at a nearby resort, Elgin House on Lake Joe. The story goes that my Dad would court my Mom by canoe in the moonlight. Soon, with a family of their own, my parents moved to Muskoka to raise their young children – my brother, sister and I.

My grandparents on Lake Joe with the Launch in the background
Back in my grandparents’ younger days, before tubing or wakeboarding, the high-adrenaline activity was Aquaboarding. Basically, it was a solid wooden board that you’d stand on while being pulled at top speeds around the lake. Something as kids we also had LOVED to do!
Grandpa showing off his skills on the aquaboard
My grandparents on the front steps at the cottage
My Nana’s parents enjoying life at the lake
My Dad as a kiddo at Lake Joe
My Grandpa – always ensuring everyone had a drink in hand!
More of Grandpa’s tricks on the aquaboard 🙂
My Dad in the crib on the dock!
My Nana in the Launch

As kids, we simply had no concept of the good fortune of our childhood in Muskoka. Growing up in Bracebridge, we spent our entire summer holidays each year at the cottage, just 20 minutes from our house. With the final days of school behind us, we’d toss our shoes aside and would run barefoot for weeks along the flat stone paths throughout the expansive lake-side point which housed the main cottage and it’s sleeping cabins. The point was flanked by two shallow, sandy bays where we spent every waking minute in and out of the water, picnicking on the dock, waterskiing behind the green, 1980’s style motorboat, sipping Canada Dry ginger ale during the adults’ Happy Hour, gorging on barbecued flank steak during family dinners that often included a grand total of thirteen people or more, boat rides in the beautifully restored wooden Launch and ending each day skinny dipping with our cousins, the water slipping over our naked backs as the sun dropped slowly over the horizon of white pines. A true Muskoka cottage – rustic and full of charm. It was a place of joy for all of us, including my Nana. I have so many glorious memories of our truly carefree summer days on Lake Joseph, all of them intertwined with memories of my Nana. Although the Pointing Pines now rests in the hands of another family, the precious memories of our days spent with our extended family there will forever be ours.

The cottage then…
… and just before it was sold in the early 2000s
The cottage was named after a beautiful stand of white pines that stood on the point
The boathouse and the white pine stand
The cabin that our family stayed in together at the Lake
My Mom & Dad and my niece Rosalie. Sadly, my kids will never know the cottage in the way that my siblings and I enjoyed it.
The large, sand-bottomed bay where we spent many hours as kids swimming. Here I am with Rosalie floating the afternoon away.
The kitchen
The ‘bunky’ where Leah and I slept during our childhood and teen years at the cottage
The slap of my bare feet as I ran along the flat stone paths will always be in my memory
My grandfather’s bar where we mixed cocktails for all of the adults every late afternoon for Happy Hour
Rosie, traipsing up to the main cottage

Nana’s final trip up to Muskoka came in September of 2012 when she was 92 years young. Blake and I were married that fall at a small resort called Sherwood Inn right across the lake from our family’s cottage. My Nana looked truly radiant that night. She revelled in the festivities, danced with my father-in-law and even stayed up past midnight, long after Blake had hit the hay. I hold that evening so close to my heart.

My Nana at our wedding
One of my favourite photos of my Nana and I

Well into her late 90s, my Nana had lived independently, playing bridge with friends, going out and about in Dundas to carry out her daily errands and visiting the Royal Botanical Gardens with her great-grandchildren. In medicine, we test an Elder’s mobility and balance using a tool called the ‘Get Up and Go’ test which essentially entails asking a patient to rise from a chair and walk three steps under a timer. Blake always laughs at the memory of one our last visits with Nana when she had heard the kettle boiling. At the age of 97, she had jumped up and had gotten to the kitchen so quickly that she had beaten Blake’s offer to help by a mile! On another occasion at the age of 98, while assisting Nana on an errand, her walker had started to roll down a slight decline away from her. Without skipping a beat, she had chased it down before neither Blake nor I could reach the escaping device.

Meeting Henry for the first time
Meeting Alice for the first time
Nana and Alice (3 months)
With Henry (2) and Alice (1)
The last time the kids saw Nana in January of last year

Nana’s physical strength and agility weren’t the only memorable aspects about my Nana. I will always admire Nana’s liberal perspective on many issues, her deep generosity, her pragmatic nature and her forward-thinking environmentalist ways. In her condo, she never had a garbage. Every single piece of waste was either composted, recycled or reused! She was a truly inspiring woman.

Last month, just a few months shy of 100 years old, my Nana was admitted to hospital and diagnosed with pneumonia after a fall at home. So consistent with her practical nature, she lamented the fact that she was ‘taking up a bed’ in hospital – a much needed acute care bed in an overly stressed health care system, she had complained to my sister who sat at her bedside. Declining medical treatment, my Nana instead requested a physician consult for medical assistance in dying (MAID). She had had enough of this world as her body finally began to fail her. ‘Come now’, my sister had urged. ‘I’m not a doctor, but I have a feeling this will be the end’. When I told Blake, he kissed me, then gently nudged me towards the exit of our local arena. ‘Go now’, he encouraged, the kids flailing on the ice during Can Skate behind him. My colleagues without hesitation stepped into the void I left behind at work as I raced to Thunder Bay, then onto Toronto and finally to Hamilton, anxious to say good-bye.

In medicine, as physicians, we are privileged to bear witness to so much pain and suffering, but also to joy as we see life come into existence and also see it let go. Observing the monitor flatline after removing life support in the ICU, calling the end of resuscitative efforts of the tiny neonate after only three hours of life, standing at the back of the palliative care room, where a family collectively grieves – I have witnessed death arrive many times in my professional life. Yet, it is never the same experience when it is your loved one, when it is you and it is your family at the bedside. Although, my Nana, as I will always remember her had long left prior to my arrival at St. Joseph’s Hospital in Hamilton, I am so fortunate to have been able to say good-bye and to have helped see my Nana pass. Those hours spent waiting and waiting as her body, resilient to the end, hung on long after my Nana had left us were incredibly crucial, in my perspective, for all of us – it gave us an opportunity to collectively shatter at the realization that she was truly leaving us, but also the chance to remember her, to laugh together and most importantly, be overcome with happiness and relief on her behalf that she was finally able to go.

These days, when I stare into Alice’s pale blue eyes and stroke her red hair, I cannot help to fight tears. She is a living memory of my Nana. Born 97 years and one day apart, Alice Harriet is my Nana’s namesake. I can only hope that Alice will grow up with the tenacity, resilience, intelligence and strength that my Nana possessed. Nana, you will be so dearly missed.