Sunday, November 26, 2017


Spring of 2014 I was finishing my intern year of Family Medicine residency.  I would be turning 34 in July, and I was FREAKING OUT.    You see I had gained enough medical knowledge to understand all the things that could go wrong in pregnancy and delivery.  I also knew because of my PCOS I had lower fertility than others my age; also I was 1 year away from the dreaded AMA.

-AMA stands for advanced maternal age.  The term for when you will deliver over 35.  Of course with the update of the diagnostic codes it has been changed from the sad but acceptable "Advance Maternal Age" to "Geriatric Gravida"  which is infinitely worse-

Thankfully I had a visit from a friend who just had her first child who helped put my anxiety to a little bit of rest.  "If you guys have kids you will be great parents and it will be wonderful.  If you don't have kids you will continue to be great people and it will be wonderful."  So I allayed my fears for a few more years and made a plan.   The main way I deal with my anxiety is by making plans.

I figured I'd give myself 18 months to see if I could conceive (by which ~91% couples do).  So in typical fashion I started to research.  I started Pintrest boards, a Amazon wish list for possible registry, and started following some blogs.  I had already been following my cycle since I had an IUD and I added a few more apps specifically for tracking.  There was a whole set back with the Nov 2016 election.  (see Nov 9 2016 330 am)  After that experience I realized that though attempting to have a kid may be a fundamentally bad idea (given the fact that the world is pretty actively terrible), If we the US was not in nuclear holocaust by July 2017 would try anyway.

Armed with 2 new apps I entered a new world of acronyms and short hand.  If you are not apart of this world I will give you a taste because they are truly non-intuitive:

  • AF - though I initially thought this was the more common "As F**k" it actually means "Aunt Flo" or period.   
  • BD - Baby Dance.  Why people can't just say sex, intercourse, nookie, or any other euphemism I don't know. 
  • Baby Dust - Not to be confused with BD-  It is wishing someone good luck, though I sometimes think of it as fairy dust and is therefore wishing more GLBTQ children into the world for fun. 
  • DPO & CD - Days post ovulation and Cycle day.  These actually make sense and are useful
  • DH - Dear Husband - I first came across this one in wedding groups.  Still don't like it. 
  • TTC - Trying to Conceive.  Which is what most people are trying to do on these groups anyway and I'm not sure why this is an acronym.  There should be one for the folks who are not trying.
  • BFN/P - Big Fat Negative or Positive in reference to pregnancy tests.  Why they have to be "big and fat'  I am unsure. 
  • TWW -  Two week wait.  Also known as the truest purgatory known on earth.  It's the two weeks after ovulation and before your period.  It is HELL.
  • EWCM - Egg White Cervical Mucous.  Yep it's what it sounds like.  
So now I'm apart of this very strange community of people actively trying to get pregnant and generally complaining about it/confused/wondering if they can check a pregnancy test 2 days after ovulation, "I mean I know it's really early, but. . . "  

I started out doing more stealth doctoring.  "You know the best medications for PCOS is Metformin low carb diet and exercise."  "There is no evidence to having your legs elevated after sex to insure conception." "No a BFN two days after ovulation does not mean that you have not conceived this month."

I've found that there are 3 large categories in these groups.  1) TWW screams from purgatory:  to check or not to check, how sucky this, I just checked but I can check again.  2) What to try next: better supplements,  fertility meds experiences,  should I go to the doctor?  (I generally answer yes) 3) Hoping: baby dusting, wishing they could by baby clothes, hoping this is the month.   

Then I realized this is a group of strangers who don't know I'm a doctor and I can ask stupid questions that I also already know the answers to.  I also realized that though there is a group of people going through the same thing, TTC is a very isolating experience.  Though my partner is amazing and there is a group (though sometimes questionable) of people going through the same thing, at the end of the day it's still what's going on with my body.   While I can track my basal temperature, check my cervical mucous, take my meds, try to exercise and fit in nookie with my new grown up doctor job which inconveniently schedules events every fertile weekend so far, it still feels wildly out of my control.  I'm still AMA, PCOS, in a high stress job, and my body doesn't seem to like to cooperate. 

It's a month to month rollercoaster over 4 weeks ultimately waiting to find out if I am infertile enough to get help or will it magically happen.  Using my planning skills I have kept myself on track with adding something every 2 months or so.  First adding cheap ovulation tests, then the expensive ovulation tests. 

(Can we take a minute to talk about how unreasonably expensive conception items are.  American consumerism truly makes all large events in life more expensive than needed:  Weddings, TTC, actually having a baby.  I mean really. It should not be 45 dollars for 1-2 months of ovulation tests and 39$ for one month of a supplement that actually has medical evidence.)  

But I digress

After 4 months I added Pregnitude which actually has evidence of supporting ovulation for people with PCOS. Then after 6 months I officially get to go get the whole fertility work up as appropriate for people over 35 TTC.   I am hoping that with the work up that more things keep getting added, because I need a plan, and my plan runs out in January. 

I realize I'm only 5ish months into this journey and I'm already over it.  I would like to know if my body will cooperate or not.  I also feel comfortable with my limits.  I'm not doing IVF or any truly invasive procedures.  If I'm in that 9% then I shouldn't be having kids I can just get an IUD and a dog. 

Wednesday, August 23, 2017

Dear LeVar Burton,

Caveat:  This is a reforming and updating of a previous letter I wrote while I was in Peace Corps Namibia (Group 20 Represent) approximately the spring of 2003.  I wrote the letter and literally had no place to spend it.  It had been years since I saw the PO Box that came up at the end of Reading Rainbow and the internet was not where it is today.  I'm not entirely sure what happened to this letter.  I think I tried to send it to PBS, but it also could be in some of the Peace Corps boxes I still haven't completely unpacked.  (I was warned this would happen literally and figuratively.)  I've thought about this letter repeatedly and how to possibly get it to him.   Should I do a series of tweets (a long series)?  Maybe on Facebook it could work (too personal or impersonal)?  This desire was rekindled as I started listening to "Levar Burton Reads".  When he showed up on my favorite podcast "Another Round" I figured I had to do something.  As this is a testing ground for my memoirs someday I figured . . . 

Dear LeVar Burton,

  Like many children born in 1980 I remember coming home from kindergarten and first grade and watching Mr Rogers, Reading Rainbow and Square One TV.  I was excited to get any book that had the stamp of approval "Reading Rainbow Book."  I loved watching all of the shows new and old. I still remember the plot from "A Chair for My Mother," and all the words from the song in the Team Work episode.  The concepts of "Ty's One Man Band," that everything can be music (not to mention Ben Vereen's song), continues to enhance my daily life.   At one point in my childhood (maybe when I was 7)  I wanted to be a book refurbisher, an idea I got from the library of congress episode.  

I took for granted that every afternoon I could go on a new adventure to find out what happens at fashion week, or on a farm, or all night in New York City.  As a teen and I caught a rerun here and there (at one point I wanted to work for PBS [also wouldn't life be better if we all lived by the things we told children to do?]).  Watching Reading Rainbow as a teen I started to realize who the readers of the books were.   Finding out that Phyillis Diller read "Ludow Laughs" and Hoyt Axton read"Meanwhile Back at the Ranch,"  I started to appreciate Reading Rainbow on an whole other level.  

As a Star Trek fan raised on TNG you were one of  my favorite characters.  The only collectable TNG characters I had were a small Enterprise NCC-1701-D and Geordi LaForge. My short lived - incomplete TNG fan-fiction was about Geordi LaForge finally getting his love story. (Even as a 14 year old my Trekkie friend and I could tell that this was an injustice.  Yes there was that episode or two with the designer of the engines but that really doesn't count.)   I was elated with the cross-over episode between TNG and Reading Rainbow. I didn't realize how much I took your place in my life and the things I loved for granted until I was in Peace Corps.  

 I was a Peace Corps Volunteer in Namibia in a small Ovambo tribe about 20 km from the Angolan boarder.  In order to get to my homestead you had to drive about 1.5 hours from the nearest town.  After the tarred road turns into a dirt road you travel about 30 more minutes then walk another hour and fifteen minutes into the desert until you get to the village of OshiKuKu and my homestead.   Namibia has 3 desserts that converge and the landscape is fairly barren save a few bushes, anthills and the occasional tree.  The water was a public tap where community members can collect water in 5,10, and 20L jugs and take it back to their homesteads.  There was no electricity to the village though the school was wired for it and did have a telephone. 
The Leaning Tree landmark on my walk from the dirt road to home

The folks at the water tap my last night in my village

As a Peace Corps Volunteer at the Illonga School I taught English and Science to grades 8-10 as well as art classes.  I was also raised in a house that fostered a love of reading and books.  I was surprised to find out that the school library was stored in the teacher's office and had a very small selection.  I was even more shocked when I saw an occasional book weather-worn just laying in the sand.  Children treated their books roughly and without the respect and care I was taught.  What was sadder to me was the lack of imagination.  I would ask my English students to make up a story or write poetry and all of the responses were very concrete.  Rarely would I have a student write about something that had not actually happened.  If we had just read a story they would mostly repeat what they had heard or understood.   This limitation in imagination was more obvious in art class.  When I asked them to draw items it was mostly copied from what they saw in front of them be it a magazine, picture, or item in the classroom.  

My school first thing in the morning

My 10th Grade Class - I'm in the center with my dog Nando

I started to seriously consider why students'  imagination was so limited.  I figured the landscape was one reason  Though the landscape could be breath taking during the rainy season, during the dry season (which was most of the time) it's pretty bland
My walk to school in rainy season
I then started thinking about my influences as a child.  Though I lived in Cincinnati, OH I had seen what New York and New Orleans were like, because of your show.  I knew about different careers in aerospace as well as farming because of your show.  I realized that through Reading Rainbow I had an understanding of vast worlds beyond that which was in front of me.  This is an advantage my students did not have.  I had book donations to the library and encouraged reading, but I wish I could have shown them your show. Though I come from a family of readers you show made it clear how transportive reading could be.  

Moreover I saw all of these things hosted by a Black man.   I can not state the significance of this enough. 

 Every afternoon I had a Black man on my television taking me on new adventures and teaching me We would laugh, learn, and I always knew I would  "see him next time."  I had a pretty stable childhood with two loving Black American parents; I can't imagine what you meant to those who did not have this.  I never wondered if there would be people of color in space because of you (and Mae C. Jemison.)  As I grew up, I realized I had a very revisionist history of my childhood TV.  I found out: "Benson" was not the governor, "Gimme a Break" was not about a Black woman adopting three White children, and "Sliver Spoons" was not about the friendship of a rich White kid and rich Black kid.  However you and your roles stayed true and genuine.  

I know you are a human being and I appreciate you letting us see that side of you as well in your interviews and conversations.   I remember on one of the PBS promos you mentioned your own children.  It was kind of like when you see your teacher at the grocery store and you realize they are a person. When I got back from Peace Corps (and India, and had enough people bug me to do it) you were the first person I followed when I joined twitter.  I was so excited to hear that you had a new podcast. When I got to listen to your first podcast it brought tears to my eyes.

Thank You LeVar Burton.  Thank You for showing children worlds beyond what they can see in front of them.  Thank You for being an example of a Black man that much of America pretends does not exist.  Thank You for teaching our past showing our present and the possibility of our future.  Thank You for continuing to act, teach, and inspire.  

Thank You for being You.

Honestly &  Sincerely,
 Margarette MD, MPH


Wednesday, June 07, 2017


I saw a white dude with a t-shirt that said Mzungu.   Now most people would not know what this shirt meant.   It's probably just a funny word to them.  I -- having worked in Southern Africa -- knew this was the word for white people said by Africans.   As I continued to look I noted that the shirt was in fact from Tanzania. So it probably did mean what I thought it meant.   Being that I live in Asheville -- Home of hippies, hipsters,  and people who will sing along with you at the gas station (that actually happened) -- I figured I would ask.

"Excuse me,  I noticed that your shirt says Mzungu and is from Tanzania.  Since I worked in Southern Africa I know that means white person.   I was just wondering why you would wear that shirt."
White guy looks awkward "Yeah it's from Tanzania,"
"I was just wondering why you would wear a shirt that pretty much just says white guy."
He now looks even more uncomfortable and starts to ramble.  "Oh well, it reminds me of being in Tanzania when I was at this awesome snake ranch, we were hiking,  and this kid bought me this shirt . . .  It reminds me of good times I had there . . . It's not racial."

At this point I could tell he was feeling pretty uncomfortable.  He probably had never thought about his shirt before or that someone would ask him about it. I could see clearly one of the Peace Corps Guys wearing a T-Shirt that said OshiLumbu ironically. (Actually I think the group before us did make those shirts ironically.)  They would've probably noted that's what they were called all the time and laughed.  I tried to give him an opportunity to let him in on the joke.

"I just saw the shirt and knew the meaning and wondered if you were wearing it ironically, or if you were wearing it just for the memories."
"Just for the memories."

So he was not in on the joke.  This is was probably a white male who had never thought about it.  I realize that most of the white men in my life have had to recognize their color and privilege at some point. My husband who wears "Not an accurate representation of a white person" T-Shirt ironically.  My best friend who I had frequent debates with in High School.  While he was coming out and we discussed our disadvantages, I told him that walking down the street no one could tell he was gay, but everyone could tell I was black.  That statement pretty much ended the debate.  All of the guys in Peace Corps had to deal with their whiteness on a daily basis.  But this guy had probably never really thought about it.

I could tell he was uncomfortable; in retrospect I wish I had let him sit with his discomfort.  Why shouldn't he think about his whiteness, or how what he wears means something.  But on instinct if rushed in to make him feel better.  I joked about how I was called Oshilumbu myself even though it means white person.  How my Namibian students told me I was not black.  His female companion joined and we laughed it off has he left the area and I could order my coffee.

But I wish I had let him sit in his racial discomfort.  I wish as a Black American Woman my training and instinct was not to make sure that the white guy is okay, even in this small moment of discomfort.

Monday, March 27, 2017


Today in the shower I had a reconciliation of sorts.  I said "yay thighs."   Now for most people such a statement may not mean much, but for me that was monumental.  I have not had the best relationship with the top half of my legs.  It probably started around the age of 10.  As I started to develop, having a little bit of curves was something I wanted.  Mostly I wanted breasts (irony), but a booty was okay too.  However what I did not forsee was the mental havoc that would be wrought by my legs.

Honestly it may not have even been a thing, if it wasn't for Shane Parish. (That's right I just name dropped) My parents moved from the country to the suburbs of Cincy when I was 9.  I went from inner-city (primarily Black-American) elementary school to E. H. Greene in Blue Ash (primarily white).   This transition was hard enough (changing classes every 2 weeks because they put me in remedial classes, working my way back up to gifted classes, trying to find new friends, riding the bus for the first time instead of walking), but gym class made it that much harder.

 We had gym on Tuesdays and Thursdays.  We were all working for the presidential fitness test: running a mile, sitting up, pushing up, trying to do pull ups.  You know all the "up" things.   Over the summer I had started to wear a bra (ooh) and had more weight on my legs.  I honestly did not think about my thighs much other than wearing cords or track suits that now made sounds as I walked.  But when I stepped into the gym I now heard every step echo.  The green gym shorts were not the most flattering either. However what made it life scarring was Shane Parish calling out "Here comes Large Marge with Thunder Thighs," every time I walked into the gym.   It was terrible.

Even now my heart rate increases thinking about the anxiety caused by trying to figure out when to walk into the gym.  Was there a way to walk in without him noticing?
With a group of girls - nope.
Right before the bell - nope.
Maybe super early before anyone else was out - well I just never changed that quickly.
Suddenly for the second half of the year I came down with a terrible illness Wednesday night which would cause me to miss school for Thursdays and many Fridays.   If I went to school I would be sent to the nurse before PE with a fever up to 101.9.  My parents took me to my pediatrician, Cincinnati Children's and specialists trying to figure out what was wrong.  I had tons of lab work done, which I enjoyed more than walking into the gym.  Suddenly when I started the summer and then went back to school in 6th grade when Shane was no longer in my class I didn't have the end of the week illness.

Only when I was in medical school did I learn that this is a common and normal coping strategy for children.

Though I no longer had to hear him say those words; the image and the sound stuck with me.  I stopped wearing shorts in the summer and only wore long baggy pants.  Luckily it was the 90's and this was the style.  I gave up on wearing women's clothing and shopped in the men's section where I could buy a 40+" waist which I knew would go over my hips.  All of my skirts or dresses had to go below the knee.  That experience started anxiety, stress, and dislike of my thighs which so far has lasted over a quarter of a century.

In college I came to terms that my thighs were never going to change size and get smaller (my hip bones are actually set wider than others) and they were either going to be fat or muscle.  So I danced and worked to make my thighs as much muscle as possible.  But I still didn't like them.  I actually managed to lose weight in Peace Corps, but still didn't like my thighs.   I did yoga and jumped rope in India, and fortunately saris and most Indian clothing covers the entire legs so less worries.  I was getting my legs waxed regularly and there are few things worse than holding your fat taut so someone else can remove hair.

In pubic health school I started volunteering at Shadowbox.  (If you live near Columbus Ohio and don't know what this is do yourself a favor and go)  Shadowbox (Sketch Comedy and Rock & Roll) is known for having people of all sizes in all costumes.  So I had some fun and got into the spirit.  I forgot my pants one day and needed to borrow the skirt from one of the cast members.  I was amazed to find the skirt fit when I always thought she was way smaller than I.  So as a volunteer with fishnets I showed my thighs for the first time in years.

I still pretty much only show above the knee for performance or costume.  But with continued exercise and time I got to the point where I don't actively hate my thighs.  I can appreciate what they do for me on a daily basis; start to like them.  I can even say "yay thighs."