From Busty Ballerinas to Concrete Canoes

concrete canoeI did a double take as I passed a truck pulling a trailer driving south returning from Portland, Maine. While pick-ups pulling all sorts of gear or animals frequent this stretch of highway, I literally swung my head back around to re-read the back of this one. It was proudly painted with a large U. Maine black bear logo presiding over the words “Concrete Canoe Team.”  Concrete Canoe team? At first I thought it was some sort of inside joke that characterizes road trips with a bunch of college buddies. But as I passed by (what, they were in the slow lane…) I saw the side of the trailer which was painted with official looking logos that gave me pause. How often do we find that things are not what they seem? When I got home, I was curious, and fortunately curiosity is easily fed by Google, so in 0.43 seconds I had over 160 thousand sites to peruse regarding said concrete canoe. It turns out, for the uninitiated like me, that it is indeed a canoe made of concrete created by teams of civil engineering students for practical hands-on learning. Concrete Canoe competitions began in the US in the 1960s by the American Society of Civil Engineers and have since spread world-wide. The canoes are judged on design, innovation, and not just their ability to float, but their ability to win head to head co-ed team canoe races.

I kept staring at the photos online, trying to wrap my brain around the idea that concrete can float. Why was I having difficulty accepting the fact that I could see them sleekly racing through the water, but could not put that together with my idea of what I thought I knew canoe raceabout concrete? In a sheepish ah-ha moment, I realized I was demonstrating one of the main themes I think about with my patients every day, which is that simply because of their medical label, we have preconceived notions of what that means and what their limitations may be. What can’t a blind man ride a bicycle? What can’t a child with a heart defect survive infant heart surgeries and grow up to have the muscle and heart to win Olympic gold (see info on Shaun White here)? Why do we assume the impossible, rather than contemplate the possible? What if, like those civil engineering students, those of us on all sides of the health care “team” worked together to encourage a child to look beyond their medical diagnosis, see their potential, and thrive?

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Perhaps the antithesis of a clunky concrete canoe is a lithe and graceful ballerina. I was never a Barbie doll kind of girl, but those are what I picture when I think of the classic, impossibly proportioned dancer. Disciplined, elegant, slim figures with straight lines and pale skin. Diversity meant redhead, brunette, dark brown, or blonde hair. So how can it be that as I was flipping through a recent Time magazine, I saw the new face of the prestigious American Ballet theater: an incredibly muscular, petite, curvy, spunky African American named Misty Copeland, who is from a humble background and did not even start her ballet training until the ancient age of 13 years old? She sets a powerful example for all who were told their bodies were not good enough, their skin color was wrong, or their size or mannerisms were just not right. Why can’t a ballerina be athletic, busty, and have darker skin? As the model for the athletic apparel Under Armour, she has been photographed in an urban, rustic, sweaty setting that redefines the stereotype of the refined, genteel nature of classic ballet, and opens worlds of opportunity for aspiring young dancers behind her. The Time article was about a conversation Misty Copeland had with President Barack Obama, who is another example of redefining labels (watch the video on Time.com).

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Misty Copeland in Under Armour ad

The more time I spend thinking about this blog, the more I have become convinced that in medicine, our expectations are colored by our messaging and terms we use when classifying our patients. We need to really think about not only setting great expectations in health care, but also measuring whether we have achieved those lofty goals when we think about patient outcomes.

Changing the culture of medicine, and thinking in positive terms rather than the ubiquitous negative terms, will take time. But if we do not start the conversation, we will not begin to address it. We are all vulnerable, we are all culpable. When my boys were little, they were strapped three-car-seats-across in the back seat while I was driving them home one day, idly talking about a doctor friend of ours. That led to naming all of the doctors that they knew, like their dad, our neighbor, our other neighbor, their coach, etc. As we drove I kept prompting them for more, and finally as we entered our driveway, I hit the brakes, turned around and said, with a touch more hysteria than the situation required, “who, IN THIS CAR, do you know who is a doctor?” Silence. Then, several beats later, one of my now slightly shaken sons said, “Um….you, Mom? But I thought you were a nurse!” I never read them another Richard Scarry book again.

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I do not have any girls, so I had never really thought about female role models. But, just as a physician I need to think about finding role models to allow my patients to see their own possibilities, as a mom I should have been thinking about this for my sons too. They need to see what girls can do just as they need to see what boys can do. Boys and girls can be doctors or nurses. Or anything else. A good friend of mine is a former collegiate athlete, current coach and teacher, and mother of two daughters, and she has started a superb campaign “My Strong is Beautiful” to empower girls to play and be active and proud of their bodies and themselves. If I can get any momentum from these posts, then some day I hope to start a version of this for our children with chronic health conditions, and create an app or website that promotes this paradigm, provides the right message and resources to help them not just survive but to thrive, brings people together, tracks data, collects the right metrics, and empowers all of us to be collectively well. Together, I hope the medical team, the community, and the patients/families will figure out what it takes to help a child soar, or at least to float their boat. I fervently hope that there are others out there who feel the same.

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