A Word on Burnout

National public radio provided my usual noise for the traffic-heavy commute from my home in Trussville to UAB in downtown Birmingham. I looked for my coffee mug only to find I had already drank it all and felt like it was never full. My head felt foggy, and my stomach churned as I tried to check all the mental boxes for today's responsibilities. The radio is often just background sound for my racing thoughts, but today, the psychologist talking caught my attention.

"Burnout is defined as the reduction of fuel or substance needed to keep going. It is a term for engines. In the late 1970s, this phenomenon became a psychological term to describe people in service professions who in essence "run out of fuel" in season of prolonged stress without sufficient recovery. The Covid-19 pandemic has increased the rate of burnout especially in the medical and education professions."

I closed my eyes and sighed, strongly identifying with the messaging. I listened closely as the psychologist continued.

"Burnout symptoms include physical and emotional exhaustion, compassion fatigue, reduced performance, and somatic symptoms. Physical manifestations of burnout are very individualized but often include headache, GI distress, and unexplained chronic pain."

Oh, for God's sakes. That's me. 

"The etiology of burnout is simple enough - prolonged stress without proper refueling. Our bodies, like vehicles, must be recharge and refueled to sustain the pace life requires. When the gas light comes on, you should slow down and look for a chance to refuel. But sometimes the driving stressor is relentless and difficult to evade - like in the case of being responsible for the needs of others chronically or trying to survive a novel crisis like a global pandemic. In essence, that is what we are seeing the most right now. Healthcare workers and teachers who have simply been doing what their patients and students need to survive as well as trying to meet the needs of their family - and what was acute survival mode became chronic and continues even now over a year later."

I felt numb as I heard these words. I certainly could identify as a full-time working medical professor with three young kids, and a partner in medicine. 2020-2021 required me to troubleshoot day and night to navigate rotations for 80 clinical PA students at a time when PPE was in short supply and preceptors were hesitant to allow learners. I tallied endless hours of phone conversations with anxious students as they dealt with sick loved ones, quarantine struggles, isolation, reduced academic performance and political tension. Simultaneously, I had to transition 73 didactic PA students online and provide the same level of virtual support as they navigated their own challenges. I slept very little often working at night since my kids were sent home from school and daycare for much of the year, and my partner's schedule as a physician did not provide any flexibility to help at home as he was confined to a room locked into telehealth visits and charting. It was hard to ask for help from family members or outside babysitters because of the mandates to socially distance and the risk of passing on any of my kids' germs to vulnerable populations. 

I kept pushing and praying and giving each day my all because that what resilience requires - I did it because I care about the students entrusted to me, I care about my kids, and I care about my community. And yet, the body keeps the score and has its limits. And now two and a half years into that outrageous pace, I ran out of gas. 

"The treatment for burnout is multifaceted and challenging because no one becomes burnt out acutely - and no one recovers quickly." the psychologist concluded. 

No one recovers quickly, indeed. 

I arrived to campus and parked my Rav 4 in a spot looking out on the city. I sat there a while trying to gather my focus and motivation to walk to my office and do this day. I felt sad that I am in this place of burnout, depression and chronic pain, and I felt a wave of shame over not being able to set boundaries somehow to prevent it. All the hype about self-care that I preach to others, and I was not able to figure out how to do it myself. 

I increased my SSRI. I made an appointment with my PCP. I filled out the forms for counseling. And now I have to walk the long, uncomfortable and somewhat lonely road of recovery. I am proud of the work I have done at UAB and the work I do every day for my family. I know much of this is not my fault but rather what difficulty unprecedented circumstances demanded. Even so, I cannot escape the grief of the cost. 

The Ironman

My alarm went off at 3:30 a.m. to pump breastmilk for 5-month-old baby Roman. I felt like I had only slept a couple hours. I drank my coffee and tried to convince myself I wanted the breakfast I sat out the night before. 16 weeks of early morning workouts, learning to fuel, and logging hundreds of miles of swims, rides and runs had prepared me for this day. I finished pumping, and I dressed myself in my tri suit and strapped on my watch. Today is the day. Today is the day I get to race my first half-Ironman triathlon.

One of my training partners Bri met me in the kitchen to double check our tri-kits.

Googles, wet suit, swim cap, and towel. Check.

Helmet, sunglasses, bike shoes, pump, gloves, two frozen water bottles with Nuun, and fuel bag with waffles. Check.

Running shoes, socks, hat, bib belt with gels, and hand-held water bottle. Check!

My husband David loaded our bikes and drove us to downtown Chattanooga and dropped us off near the transition zone. "Have fun, babe. Can't wait to watch you rock it," he said, and he drove back to the Airbnb to care for our 3 boys and ready the cheer team. Two days ago on May 17, 2019, we celebrated 10 years of marriage. The road to learning to love another person without conditions is not an easy one. Sometimes the hardest part is to believe you're worth it and that it's worth the risk of being vulnerable. I wanted David to join me today in racing this event, but he chose to sit this adventure out to support me and make sure that I had the time to train in the midst of our busy lives. But I am determined...the next 70.3 I do, he will be by my side because I know he would love it.

I found my bike rack slot - #1197 - and set up my transition zone. It felt so surreal. I pumped up my tires one last time and ate a second breakfast. I found my third training partner Breland getting her station set up. Breland is the reason I signed up for this event. It was a slow afternoon in my student health clinic at High Point University in early December 2018, and I was a few weeks away from delivering my third son Roman. Breland and I are both PAs, both played soccer in college, and get a thrill out of endurance events. "Are we doing this or not?" she texted me. "If so, we have to commit. Chattanooga sells out fast." I knew it would be a risk for me to commit to a 70 mile race only 5 months postpartum, but it was also a dream of mine to complete a half-Ironman, and I knew there would always be a reason not to try. I signed up and sent her the screenshot as proof. "Oh man! It's a go!" she replied. And we convinced my friend Bri who is medical student at Wake Forest to join the craziness soon after that. Now, here we are setting up our transition zones on race day.

What have we done...

The bus was starting to load athletes to take them to the swim start. It was 6 a.m. and the pro's would enter the water around 7 a.m. We made our way onto the bus and headed across the Tennessee River. The moonlight over the water was magical. We put on our wet suits and caps and talked to athletes waiting in a line of hundreds to start their swim. The diversity of ages, fitness levels and backgrounds filled me with a sense of awe. Men and women from age 18 to 70, some of them experienced triathletes and others novices like us racing their first 70.3, all stood anxiously anticipating the plunge. One fellow athlete named Kathryn from our city of Winston-Salem, NC was racing in honor of her husband Chris who died in his prime a few months earlier from a rare adrenal gland tumor. Her love for Chris and her desire to celebrate his life and passion for triathlon empowered her to train for this event. Most days, she fueled on grief, tears and faith. She was brand new to the sport, and had 3 kids to care for as a newly widowed single mom. Her courage inspired us all. Her story is one of hundreds of stories of why athletes do triathlon. We are all fighting tough battles. If only life did not require us to be so brave.

On my wrist in permanent marker I wrote RHE, the initials of a dear soul whose life ended way too short a month before this event. Though I had never met her in person, Rachel Held Evans became a close friend of mine as I devoured her blog and books over the past year while wrestling with many discouraging aspects of Christian subculture. Like Rachel, I grew up in the Bible belt and met God in the context of southern Baptist evangelicalism. We have both called Alabama home and learned about worldview and community at Bryan College in Dayton, TN. We each struggled through the legalism, discrimination and dogmatism of many of our leaders, and have mourned the times those concepts were the flags we waved ourselves.

The more we allowed ourselves to ask honest questions about the Bible, the church and Christianity as we knew it, the more we both realized the animosity and isolation it can cause among peers. As I began to allow my mind to truly hear views different than my own, I started to watch my whole world take on a shade of gray. It was uncomfortable and sometimes frightening, but the one thing that kept me treading water in that ocean of ambiguity was that I found that there's a whole lot of people hanging out there as well, and it just didn't feel right for me to leave them for safer waters or the shore. Rachel taught me how to tread the waters of doubt with grace. At a time when my spiritual family disqualified me from teaching the Word in a co-ed setting simply on the basis of my gender, my eyes were opened to the reality that gender is simply one of many categories that can be ostracizing in the church. Rachel has helped me navigate a trail that has no signs, no maps and no blazes. She helped me see that there is room for me in God's family, even when I do not fit the subculture's definition of godly womanhood or fight an ongoing battle with depression.

There's room for me, and there's room for you too. During the Ironman, every time I felt pain or fatigue, I saw RHE on my wrist, and I found the endurance to go on, because without her honesty and transparency, I would have quit a long time ago. Thank you, Rachel.

Our trio inched forward as music blared and athletes jumped into the water to start their 1.2 mile swim. We adjusted our googles, stretched and tried to take deep breaths as adrenaline rushed through our bodies. I closed my eyes and prayed, "Thank you God for this opportunity to see a dream fulfilled. Thank you for the gift of life and health and for all you have taught me about you during this journey. Thank you for all the family and friends that made this day a reality. And most of all, may I remember that you are my biggest fan. Keep us all safe out there and help us all cross that finish line. In Jesus name, Amen."

Splash! The water felt great - barely wet suit legal. Swimming is my weakest discipline, and my gang had no options for open water swimming near Winston-Salem, so most of my training was in the pool which is not ideal. In open water, there are no lane ropes to keep you in a straight line, no walls to kick off of, and there are arms and legs constantly hitting you as you try to find your stroke. Two physical barriers I deal with in the water are panic attacks and having a low threshold for migraines. As expected, about 3-4 minutes into my swim, I start having a panic attack. My heart raced, I struggled to control my breathing, and I felt dizzy and overwhelmed. I was prepared for this, and as planned, I switched from the American crawl to breast stroke to regain composure. Eventually, I put my face back down and resumed the crawl. The swim for Chattanooga was downstream, so I the current was in my favor. I found a groove at a comfortable aerobic pace and about half an hour later, I was pulled out of the water at the steps at Ross Landing. My favorite part of the race may have been what happened next - the wet suit strippers! I lay down on a black mat and two women literally ripped that thing right off me in a second. I jogged my way to the transition zone passing my family cheering my name. Whew, I survived the swim! It wasn't pretty, but it was over.

The 54 mile bike ride in Chattanooga was beautiful with rolling hills. Biking is in many respects the most important disciple since it is the longest leg of the race. This is somewhat frustrating because bike type and performance are closely related, and I do not have thousands of dollars to pour into my bike. I did upgrade this year from an aluminum frame Trek to a carbon fiber frame and had aerobars installed. My new bike fit me better too, which made the longer distances more enjoyable without having the low back pain I dealt with on my older bike. Once again, besides 4-5 outdoor rides, I mostly trained on my basic trainer and in cycle classes. Some Saturdays, while David was working in urgent care, I would put my kiddos in childcare at the YMCA and do 3 cycle classes back-to-back to log in around 45 miles. Bri and I did a 50 mile fundraiser ride a couple weeks before this event, and then I ran a half marathon the next day on my own, and that was hard to do even a day apart! So, I knew I couldn't burn myself out on the bike if I wanted to have the energy to run 13 miles in 90 degree weather afterwards. I was blessed to ride several miles with my friend Breland who happens to be a beast-of-a-rider and helped me stay focused.

Fueling has always been a struggle for me because I don't ever feel thirsty and drink coffee like its water, and I am used to shorter distances. In high school, I ran the 800meter dash and the mile in track and 5Ks in cross country. I also have irritable bowel syndrome ever since I dealt with 3 years of chronic parasitism I acquired overseas, so my stomach doesn't always play nice when I try to take in calories while exercising. but training for this event taught me the importance of nutrition and how to plan ahead to avoid bonking. On my 54 mile ride, I drank two water bottles of sports drink and ate 5 stinger waffles. After 3 hours of exploring gorgeous rolling hills, and smiling almost ever minute of it, I arrived back at the transition zone.

 



The run is my jam (see The Marathon post). Well, at least it's usually my jam when I'm not 5 months postpartum. Ha! Let's just say running is my most nature discipline. I have never been a swimmer, and I've been a nominal biker for 10 years, but I've been a runner practically my whole life. Running has been a special gift from the Creator to survive the harder trips around the sun. Through my parents' divorce, a life-long battle with migraines, having to withdraw from medical school due to illness, becoming a new mom and suffering with postpartum depression, showing up for long weeks of caring for patients with many ailments without remedies, and walking through numerous heart-bleeding blows with people I love...running has helped me cope and persevere. We ALL need something like that in our lives.

Triathlon training has helped me cope with a huge move our family is about to make next month from our home in Winston-Salem, NC to Birmingham, AL, my state of origin. As I ran each mile of the triathlon half marathon, I praised God for his grace in my life. During our 5 years in Winston-Salem, I grew up a great deal. I went from one child to three. I became a physician assistant (PA) and cared for patients in primary care and student health. I co-led a small group with David where the doing of life together created a community that truly became like family. I learned to let myself feel negative emotions instead of reframing or denying them. I learned to make space for others to do the same. I learned to listen to who God says I am over all the other voices, even when they say they are speaking on his behalf. And I came to this place in my journey where I wasn't looking backward or forward because I loved what was going on right in the present. Thinking about moving for David's job is more than I can bear to process right now because I have to leave the place where I feel most myself. I know I will make new friends, but sometimes, you don't want new friends. Friends are not made, they are grown. And I love my garden. Today, as I ran by family and friends with signs, and thought about all the people tracking me around the country on the app, I realized that I have a choice. I can be bitter that we have to uproot. Or I can be grateful for having the season of community God gave us in our little home in Winston-Salem. It will forever be the place the best version of me was built. I hope I can find a way to bring her to Birmingham.


My husband David, baby Roman, and my dear friends Becca, Lee, and Jenn



The heat on the run course was brutal. I tried to take in fluids at every aid station. I felt like I could go faster, but I also knew I could cramp up at any moment, so I took it easy. I crossed the final bridge and started sprinting to the finish line. Tears flooded my eyes and I felt so alive. Fists raised high, I crossed the line as an Ironman. My time was 5 hours and 30 minutes.

I immediately found my crew and hugged my very hot and sweaty boys. They were definitely over it. I asked about Bri, Breland and Kathryn, and excitedly learned they were each doing great. We all reached our goals of completing the event, having fun and no injuries!

Me, Breland, Bri

My sweet family

Cheering squad! Becca, Lee, Jenn, David with Jace and Blake, Me with Roman, Bri, Dad, Jerad, & Jessica

This experience was worth ever hour of training it demanded, and it was such a joy to train in community with others. Like life, I had good workouts and sucky ones. I had sick days and sick kids. I had nagging injuries and sore muscles to work through, and I had days I slept through my workout and had to cram it in between patients at lunch. We ran in freezing rain and doubted our training plan and our abilities more than we had confidence in them. But when we couldn't believe in ourselves, someone else believed in us in our stead. And when we didn't feel like showing up for ourselves, we showed up for the sake of others. This is certainly my favorite part of racing - that it's a team sport all day long.

I hope this Ironman race puts courage in people all around the world to say, "You are more than you think you are." What unfulfilled dream do you have that fear is telling you will never be a reality? What voice of discouragement, either yours or someone else's, are you still letting yourself listen to? Lean into your village and into your Creator God who loves you unconditionally and then take the first toward your dream. If I can do it, trust me, so can you.

The Marathon

I was created to be in perpetual motion. Eyes wide open, always hungry for the next experience - it makes sense that the adrenaline that comes with athletics has always been a part of my life. I am grateful for parents who gave me the opportunity to explore sports galore, but out of all the sports I played, I have always most identified as a runner.

My earliest memory of running was jogging around my neighborhood with my dad to train for a Thanksgiving Turkey Trot 1 mile fun run at age 7. A few years later, I had to run a mile for time for the fitness test during PE class, and I crossed the line before anyone else in my grade. During a time in my life where I was trying to figure out who I was and why I was alive, running became a part of me.

I ran cross-country in middle and high school, and on my basketball and soccer teams, I became known as the endurance athlete. I wasn't very quick, but I would outlast everyone. As a sophomore, I ran a 19:05 5K at the Jesse Owens state-qualifying invitational meet, and I entertained thoughts of a future in elite racing. Ironically, it was one of my last races that season because I ended up with bilateral stress fractures. I welcomed the sport of running to teach me discipline and perseverance, but it was an unwelcomed injury that taught me resilience and humility. Really, all these things in a proper balance are necessary for life.

In track and field, I excelled most in the 800 meter dash. It was awesome to run as hard as I could for two laps to test both speed and endurance simultaneously. My form has always been pretty awkward. I run very tense and struggle to keep a consistent cadence. My coaches always said it was my heart that fueled any success I experienced in racing. My heart is where the Spirit of God lives, and when I run, I can almost palpate his presence and pleasure.

Alabama State Meet 2002

I played collegiate soccer on scholarship at Bryan College (2005-09), but in my off seasons, I ran races. The stress of pre-med classes was intense, and running was literally medicine for my mind and soul. There was conflict within and conflict at home, and I did not know how to handle my negative emotions of sadness, anger and disappointment as I put pressure on myself to be strong for everyone else. I'd feel overwhelmed, and I'd just bolt for a long run. And then I was able to cope. I ran several half marathons during my college years with a personal best of 1:30 my senior year. It was that year I began to consider the marathon.

Nashville Country Music Half Marathon

I had always been fascinated with the 26 mile beast known as THE MARATHON. As the legend goes, the first marathoner was the Greco-Persian soldier who ran from Marathon, Greece to Athens with news of his army's victory and then he collapsed in death after delivering his message. That's enough content alone to make this distance daunting. The marathon became a part of the Olympics in 1896, and then only men were allowed to participate. As a female athlete born in 1986, I was shocked to discover that women were not permitted to compete in the marathon until merely two years before my birth in 1984. Why? Because women were not thought to be physically capable of long distance running. Not because they had tried and failed, but simply because they had no freedom to try. This really motivated me to get out there to put my body to the test considering how hard my female forerunners had to ask forgiveness and not permission to make this event possible for me.

So in 2009, I promised myself to train for and complete a marathon. But life is life, and many seasons passed that it just wasn't feasible. I graduated college and was married a week later to my better half David. We taught school for a year, and while coaching cross-country I started to train but ended up injuring my IT band and having to take several months off.

We started medical school together in 2010, but I withdrew after the first semester when my state of perpetual motion was traumatically halted by mental and physical illness. There was literally a time when I did not have the stamina to walk down the driveway. I was forced to sit still trapped in a couple decades of suppressed pain and deal with the negative emotions I'd always run from all my life. Some things, no matter how hard you run, will ultimately catch up to you somehow.

Once I was well enough to be released by my physician in 2012, I was surprised by an unplanned pregnancy with my first son Blake after being told for years I likely wouldn't be able to have children. After he was born, I was traumatized by intense post-partum depression, anxiety and panic as my husband slogged through his 3rd and 4th years of medical school.

After months of medication and counseling, I gained the health to slowly rebuild my life again. We matched at Wake Forest for David's residency and moved to Winston-Salem, NC, in 2014. I started physician assistant school and slowly gained the margin to take up running and racing again. I had my second son Jace my second year of PA school, graduated in 2016, and started my first PA position in family medicine. On my 30th birthday, I completed my first trail half marathon, Triple Lakes in Greensboro. When I crossed the finish line, I decided it was time. It was time to start training for the marathon. It was time to keep the promise I made to myself.

I fully expected it to be hard, but it was tougher than I imagined. As I increased my mileage, I found it incredibly hard to log all the necessary miles as I tried to juggle parenting my two sons with David in residency and working a full-time job. I fought one nagging injury after another and missed the chance to train with Fleet Feet, our local running community, due to having to take a couple months off from patella-femoral syndrome. At last, I started to gain ground the summer of 2017.

I completed 14 miles at Little River Canyon in Alabama.

Little River Canyon, Mentone, AL

I did my 16 mile run in Kona, Hawaii.

I completed 18 miles running Salem Lake and the Greenway in Winston-Salem, NC.

Blake and I celebrating after the Mistletoe half.

And I did my longest run - 22 miles - in Cascade, Idaho, on snow-covered paths.

Then I did my 3 week taper.

My chosen event was the BIG BEACH MARATHON in GULF SHORES, AL, January 28th, 2018. My rock-star husband David, my super-awesome father Warren, and a dear best friend from college Ely all decided to cheer me on. Gulf Shores was the race I chose for two main reasons: it was on a warm beach in the middle of the cold winter season (and I HATE the cold), and it is a beach rich with memories from years of family vacations.

The expo was so surreal. This is happening! I was finally here. I got my bib and shirt, and ate out with Dad and Ely at The Gulf bar on the beach. Unfortunately, David was feeling sick and decided to stay home and rest. Soon we got a call from David's mom Anna who was keeping our two boys back in NC. She told us my youngest son Jace had a fever. She took him to urgent care, and as we feared, he was + for influenza A. We realized that David likely also had the flu as well. A feeling of doom started to settle into my gut. I continued to be optimistic as fatigue started to settle into my bones. I laid everything out for the race that night hoping for the best, wondering how I'd know whether or not I should run considering the flu virus was likely also in my system. But the flu decided for me. When the gun went off the morning of January 28th, I was sweating in bed with a massive headache, fever, and my least favorite emotion...sadness.

We flew back to NC with masks on as I searched the internet for another marathon to register for. For days I had no appetite and could barely rise from the couch, and then, the coughing started. And increased. And worsened. A week after the initial symptoms, I went to urgent care and the chest XR showed lobar pneumonia, and I was out another week after that diagnosis. By mid-February, my motivation to find another race had deserted me. I was so burnout and discouraged. I surrendered to the reality that this goal would again not be realized, at least not right now.

Today, JANUARY 28, 2019, is the 1 year anniversary of the Big Beach Marathon, and I wanted to take the time to process the sorrow and express gratitude for the joy that the marathon training journey brought to my life.

First of all, as Jesus said, "In this world you will have trouble..." Life is completely unpredictable and full of unexpected hardships. Endurance running has been a true of gift from God in my life because the marathon is very much a metaphor for life. Some miles you feel great, others, you hit the wall. Some days the future is as bright as the sun, and other days, all you can see or feel is deep darkness - in yourself and in the world around you. Disappointment is a part of life. But it can be a blessing if you lean into it. It's not our strengths and achievements that connect our souls to others. No. It is our weaknesses and shattered dreams that open our hearts up to be fully honest with ourselves and others, and most importantly, with God who came and made his home in our mess.

In retrospect, I can see how God allowed the flu virus to hit with epic timing because it placed me in a position of deep dependence on him at a time when he planned to use my brokenness for something much better than the accomplishment of completing the marathon. 2018, post-sickness and failure, may have been the best year of my life. The void this disappointment created in my life made room for making new friends who entered my life with great heartaches that my circumstances helped me be attuned to. And I deepened some of my older friendships as I allowed myself to stop running from pain and be present with others in it.

Salem Lake 7 miler, 29 weeks pregnant

Ardmore Rah 5K, 31 wks pregnant

December 13, 2018, I had my third son Roman. And this pregnancy was the healthiest and happiest pregnancy yet, and I believe coming off 6 months of marathon training gave me the foundation to stay active all 9 months. Currently, I am 6 weeks post-partum, have already run my first 5K race and have commenced training for my first 1/2 Ironman. My friend Bri, who also happens to know the frustration of unaccomplished marathon goals, is my brave and brilliant training partner, and we are registered to crush the Sunbelt Bakery Ironman 70.3 in Chattanooga, TN, on May 19, 2019.

 

My marathon saga also taught me the need I have for community. Running can be quite an individual sport as we each strive to get faster and beat our personal best, but there is a greater joy than reaching personal goals. It's the joy that comes with doing my race and my life with others - making their goals a part of my goals. Feeling their pain and allowing myself to let them feel mine. We all deep down desire to be fully known and fully loved, but you cannot ever truly be fully loved if you do not let others see your whole self. No one actually cares how fast you are. They do care, though, about what battle you're fighting that makes you get out there at 5 a.m. and train. People do not care about your PR. But the story behind that PR - what you had to overcome to make it happen and why you even set your goals to start with...That's what makes us human. The marathon has taught me this and so much more.

Will I ever be able to keep the promise I made to myself to complete the 26 mile beast? Only time will tell. Right now, I'm just grateful for God's faithfulness to me, to give me always what I need more than what I want.

Souvenirs

I ran a 10K trail race at Hobby Park just down the road from us over the weekend, and it was the first morning in months that felt cool and crisp. The leaves were rustling, some were shedding, others morphing to gold. As a deep breath of newborn autumn air filled my lungs, a wave of nostalgia filled my mind as memories of high school cross-country meets and college soccer games freshened my tired muscles and weary soul. The night before, Blake was sick. David and I arose with each cry to clean, comfort and calm. Blake being just shy of 5 years old took the illness in stride. “I hate this night,” he moaned. “But I know everyone gets sick sometimes. It’s a part of life,” he lamented bravely yet bitterly between episodes of vomit.  His tearful eyes interrogated, “Right, mom?” I pulled him into my lap and held him closely. “That’s right, baby. You will get through this. You are not alone. We are in this together.” I promised, eyes locked with his.

The long days that compose the short years of parenting young children can be staggeringly exhausting. It’s like being on 24 hour call, 365 days of the year, most of which you get called in and work full time with no pay. It takes all of you – soul, mind, heart and strength. You question daily if God made a mistake entrusting you with such an impossible responsibility. I never dreamed of being a mom as a young child or teen. Motherhood was gifted to me unexpectedly as a young adult while I was sitting in a pile of ashes. Much of my life was put to the flames in my early 20s, and I wasn’t sure what to make of what was left. My family of origin, once my firm foundation and security, was in shambles. My plans for career as ministry were derailed by a tempest of prolonged physical and mental illness, to which I finally succumbed. I was drowning, barely making it up for air, and I was handed a baby. No one could have been more unprepared.

My first born Blake and I have worked over 4 years on loving one another. I’ve truly grown to know and enjoy this wide-eyed red-headed wonder. He did not ask to be born into the most unstable season of my life. He was the child who transitioned me from maidenhood to motherhood, and no doubt he suffered through such education. No one is naturally equipped with enough health and selflessness to meet the demands of parenthood. I have friends who fear having children because of this reality. Still, on my hardest days of caring for my littles, I do recognize by God’s grace that someone did in fact mother and father me as well, and it was not easy for them either. As a mom of two boys now, I find myself reflecting more often on my home of origin for better and for worse. Over time, my lenses of judgment and critique have been replaced by a perspective filtered by grace and understanding as my demons threaten the abundant life my God died and rose again for me to have and give to others. I have scars from the wounds of a mother who had too many hurts herself to truly be honest with her condition and submit to the Surgeon's knife. Even so, she gave me paradise compared to the life she knew.  

My dad came from a middle-class family where he was loved and cared for, however, in the end he witnessed his father’s exodus to marry another woman. My mother was the last of eight, the daughter of a child-like mother and an absent father who was mostly away for military service. They met on a blind date and my dad was smitten. She was planning to move to FL, to leave her AL traumas behind, but he asked her to stay, to be his. Some say love is blind. I’d say my father knew exactly what sort of cherry bomb he was choosing. He was the logical one, she brought spontaneity. He was shy and reserved, and she offered an alluring form of chaos that he could not resist. Out of logic and spontaneity, I was birthed. They were married 25 years, and then my mother walked away. The reasons are complicated, deep, multi-faceted, and really, it's their story to tell. Still to the day, I rarely come upon a marriage more enviable than theirs was in its prime.

Their divorce took motion only months after David and I exchanged our vows. That was 8 years ago now, and I still mourn the loss. David and I went to see Switchfoot in Greenboro this past week, and after a long day at work where I seriously thought I'd quit my job, my soul drank deeply from hearing their songs live. They have been the soundtrack of some of the darkest, most trying seasons of my life. One song called Souvenirs speaks to the finite nature of all things, even the best of things.

“And I close my eyes, and I go back in time. I see you smiling, you were so alive.”

The whole song really reminds me of my parents' relationship. When Jon sang this song, I closed my eyes and I searched through my memories to find my souvenirs of their happiest days…back to when I would leave my cartoons and search the house for my parents, and find them laughing together in the shower drinking from the romance that fueled their team-approach to life. I can hear Chicago playing in the kitchen while they cooked together and talked about their day. I remember all my sport teams they co-coached and how they gave me the freedom to make my own choices, to fail, to adventure and explore, and to be me unapologetically.

Tears form, as Jon's lyrics continue, “We were so young, we had no fear. We were so young, we had no idea that life was just happening. Life was just happening.”

It still surprises me every time how much their severance has affected my soul. Perhaps it's because their love is the reason I am alive, so when they stopped dancing, a part of me died. Or maybe it's because their divorce echoes the theme of the larger anthem playing all around me – “That nothing lasts forever.”

As I ran the trail, I prayed for Blake, for him to be well soon. And I prayed for myself, to not lose heart, to chose to be grateful for the good and to trust that the bad in fact makes us relevant to each other. Another Switchfoot favorite, "The wound is where the light shines through."

My wounds, my scars, my vices, my demons...all of this, and yet, I am the mother of two littles, and there is no one else who can be that for them.

These present days of “Mommy, look!”
These days of scrapes that actually mend with a kiss,
And splashing in puddles is the highest level of bliss…
These days of explaining the “whys” a thousand times.
And constantly spending yourself to meet their needs.
These days feel so long, 
But they are in actuality very short.
One day, the real world will crash down,
And I know I will miss the kisses, and the puddles.
We are making memories that will one day be only souvenirs.

I close my eyes and go back in time. I can see you smiling, you're so alive. I close my eyes and go back in time. You were wide-eyed, you were wide-eyed. We were so young, we had no fear. We were so young, we had just begun. A song we knew, but we never sang. It burned like fire inside our lungs. And life was just happening ,and nothing lasts, nothing lasts forever. I wouldn't trade it for anything. My souvenirs.                                                                                   
                                                                                                                -Jon Foreman "My Souvenirs”

Tis but a Moment in Time

The treadmill has slowed, and I look around. I've been running so hard for so long now - has it really been two years since I last blogged? 

Blake - 3.5 years old

My oldest is almost 4. He has a will as strong as...well, my own. You "pay for your rais'n," as the saying goes. He challenges every command, has to always know why, and his energy level has been full-throttle since birth. He hates to sit still for very long, as do I. The main thing that distinguishes Blake from me is that he is not a people-pleaser. You're not going to convince Blake to do a thing - unless it's his idea. Nothing in my life has exhausted and challenged me quite like parenting this red-headed wonder. We don't choose the means by which God makes us into the image of His Son, but he'll get the job done! 

In the summer of 2015, only two rotations into clinical year, we were blessed with our second pregnancy. It was planned, but it certainly happened faster than we anticipated. To think there was a day when I questioned my ability to have children with all my problems growing up. Ohh, we make our plans, but the Lord guides our steps. This pregnancy brought me so much healing. I still struggled with migraines and depression, but I took care of myself, took my Imitrex and Zoloft after weighing the benefits vs the risks, and I had a much better experience. Motherhood and all the sacrifices that come with it were already in place. The hard work in some ways had already been completed. I'd learned what it means to surrender my desires when necessary to care for another human being. I was ready this time. 

Big brother Blake

A healthy baby Jace ("healer") was born March 18, 2016 - and we did not take his health for granted, Our dear friends' baby girl went to heaven shortly before Jace's arrival. Baby Mila had congenital heart disease and a rare genetic syndrome that complicated things even further. Her short 4 months here were spent battling for her life at Boston Children's Hospital. Her life made my postpartum time with Jace so sweet because she helped me choose to love every moment no matter how tired I was. Mila's picture is on my fridge, and she reminds me that every day is a gift I have not earned. Her precious eyes speak to me, as if saying, "To live is Christ - every breath of it - and to die is GAIN. This is not our home."

 Jace's easy-going temperament has made the transition from 1 to 2 pretty seamless.  From the moment Blake emerged, it was like he was shaking his fist at anything and anyone that tried to appease him. He wouldn't nurse, hated sleep, refused pacifiers, screamed in the carseat/swing/bathtub, and he had an opinion about everything and voiced it readily. Jace, on the contrary, is very smiley, laid back and content. He loves pacifiers, sucking his thumb, swings, sleeping in the car, being held, nursing, and baths. If he's hungry or tired, he might go, "mah." Oh, man, they are like night and day. It will be quite interesting watching them grow up as brothers. 

Villanueva Fam

 In May 2016, 2 months after baby Jace was born, I walked the graduation stage at Biotech Place. I didn't get my diploma for another few months as I completed what I relinquished for maternity leave, but I eventually became Jana Villanueva, PA-C, nonetheless! I start my first job this fall in family medicine. 

Wake Forest PA Class of 2016

My rock-star husband David

David just started his 3rd and final year of family medicine residency this summer, and he is considering a fellowship thereafter in obstetrics. As a family, we can hardly believe the light is visible at the end of our medical training tunnel. We celebrated 7 years of marriage this year, and medical training has consumed the majority of our time. We are now starting to pray more specifically about what God has for us when David finishes.

What a stud!

 I could not be more proud of my husband. No one could balance the responsibilities he's had the past 6 years of training better than he has. He is an excellent physician, yet he has not sacrificed our marriage or his fatherhood in becoming one. When he has time away from work, he's with us - serving and loving us well. He leads our home with humility, bravery, integrity, and sacrificial love. I cringe when I hear other men talking about how their wives are too "strong-willed" and need to learn to "submit." I'm as strong-willed as they come, but it's a joy to be on David's team because I know he is motivated by our greater good. He lets me be me, with patience and long-suffering, and he entrusts my growth to the Lord. 7 years into our marriage, I have never been more in love with this man. I only wish we had more time to spend together, but as my daily teammate in parenting our boys and striving to love our community well, I couldn't be more blessed.

Jerad and Jessica's Wedding

Other pertinent news of 2016 includes my younger brother Jerad marrying the love of his life, Jessica, and my mom graduating from South University with her DNP!

Babies - graduations - weddings - family reunions...it has been quite a jam-packed summer indeed!

 As I write this, the dust has settled from all the excitement, and I'm drinking a glass of wine on the couch, dark chocolate close at hand, trying to wind down from a long day of caring for the boys without waking David up as he sleeps preparing for his night shift. I rub my legs with muscle gel as I try to recover from yesterday's 7 mile run around Salem Lake - my longest run since motherhood. Autumn is fast approaching, and with it comes my 30th birthday this year. My celebration plan includes running the Bull City Half Marathon with David and some awesome friends, getting my wedding band tattooed onto my finger, and transitioning to the beginning of the rest of my life.

Life is short. Even when it's long by human standards, it's still short. I just want to live it well. I've been poured into by so many people, God most importantly, over the last 3 decades, and now, I just want to spend myself for as many days as I have left. 30 is young, yes, but David and I have already lost two friends we played collegiate soccer with to unexpected deaths, and no one is immune. God blesses us as our Father because he loves us and he loves to give us good gifts, but what truly glorifies him most is when HE HIMSELF is our greatest gift and we have open hands with all that he has given us.

Lord, help me run the race you've set before me and throw off anything that hinders. You know my vices well. With open hands, let me hold my plans. With a bowed heart, help me trust you in joy and in pain. And even though busyness and exhaustion are my primary struggles in the present, tis but a moment of time...when the suffering comes, be my anchor, oh Lord.

Green Pastures

A year has passed since I last wrote a blog entry. I realize now more than ever that it's the hardships of our lives that write good stories. So much of this last year has been a much needed season of green pastures. When the race is easy to run, and I'm breathing fine, I don't feel the need to pour out my soul, which is usually why I write.

Don't get me wrong. I'm thankful for this period of time that God has gracefully bestowed...a time during which I don't have to fight for joy or struggle to be in the present because I'm too busy looking backwards regretfully or looking forward idealistically hoping for better days. Lately, my only complaint is being tired, but I'm tired from my life being absolutely full of doing things that I love.

I wanted to catch this blog up on this past year of my life, but not without recapping what the race looked like for me before this year of green pastures arrived. David and I have been married 5 1/2 years. And about 75% of our marriage has been clinging to each other in the rain.

Year 1: My parents' marriage of 25 years dissolved. Anxiety and depression set up camp in my soul, unresolved medical problems plagued my body, and I felt as if I had no idea who I was anymore.
                                             
Year 2: we started med school together until I withdrew a few months in due to illness of body, mind, and soul. Pain, panic, suffering, silence from God...the worst year of my life...and David had med school on top of it all. I went through a lot of counseling, saw a lot of doctors, took a lot of meds and supplements, and cried a lot of tears.

Year 3: I finally felt well for the first time in years. I decided to pursue medicine again but this time through PA school. I got accepted in December 2011...2 months later, I found myself staring at a + pregnancy test with a migraine in shock.

Year 3 was a hard one for our marriage. I wasn't ready to be a mom. My body was barely well enough to handle such stress, and I didn't really even know if I could have children with all the problems I'd had growing up. David was in his 1st year of rotations, studying for boards, and stressed without relief. My labor was long, and my postpartum period was even longer. It was so hard to see the light. So hard to just keep walking.

Year 4: We saw the sun again. David's year was lighter. We applied to residency and PA school together, and even though staying at home with Blake was exhausting, I could sense God's presence again. I led a Bible study, shared a home with some wonderful friends, and I decided that happiness is a choice, and it's up to me to pursue it. No matter what people say or think, who I am is up to me and God.
                                                     

Year 5: David graduated from med school at last, I got accepted to my favorite PA program at Wake Forest, and that's where he matched for residency. We went to Africa as a family, and I faced my fears of serving overseas after all that happened to me in India so many years ago where I picked up the parasites that wrecked my body. That was also the place I lost my rose-colored glasses through which I used to see the world.

When we moved to Winston-Salem this past May, I remember feeling so much relief to be leaving Virginia behind us. I couldn't believe how good it felt to watch the snows of winter melt from my life and to feel the heat of summer. There was a large part of me that wanted to hate the years I spent sick and lonely in Virginia, but it wouldn't be fair. God matured me in that desert in ways I truly needed to grow. He provided for me every step of the way, and I developed some amazing friendships in that furnace. I read many amazing books, learned to serve in obscurity, and I learned so much about who I am and who I want to become. And of course, as the name of this blog implies, all those trials reminded me that this is not my home. I am here running the race God has laid out for me, and he will help me finish strong. I know the next uphill is coming. But for now, I am just enjoying the view from the mountain, looking back on all God has taught me and looking forward with a renewed enthusiasm for what he has planned.

Winston-Salem, to me, has felt like a refuge in comparison to the last few years of my life. We've found an amazing church with a Bible Fellowship group provided truly by the hand of God, and we are close to David's parents and receive lots of help from them with Blake. Our training is vigorous, but we are in it together, and it's easier for me to smile than frown these days, and I haven't been able to say that for a while.

                                     
PA school is time-intensive, but because of all God has taught me the hard way, I know the limitations of my body and have pursued balance from day 1. I have not neglected my time with God, my sleep, my husband, my son, or my calling to serve those God puts in my path. His perspective is the perspective I strive to seek after and maintain even with all the busyness.

I absolutely love my program, and I know that being a PA is the best career for me. And it feels good to learn medicine simply because I enjoy it and want to use it to provide for our family and to serve others with the talents and gifts God has given me. Medicine is NOT my calling, although I used to think it was. My calling is to follow Jesus by dying to myself daily. My calling is to be like Him in every area of my life and to glorify Him with whatever I'm doing, whether it's cleaning up Cheerios, changing diapers, folding clothes, or studying with a friend. Because the reality is, like Job, anyone can lose it all in a second. The only true assurance we have in this life is that Jesus is Lord and he is MY Lord and Savior. He knows suffering as Immanuel, "God with us," he has walked this earth and knows the horrors thereof, and he said he will never leave us...and he will get us home.