The Line We Shouldn’t Cross

“When we fail to let the dying die, we harm the living in us all.”
— Unknown

There’s a man I can’t stop thinking about.  He returned to our ICU again and again for a month, not because he was getting better, but because we couldn’t let him die. His only request was simple and human: “I want to go home and see my dogs.” He never got to.

 Instead, his body became part of the system, a system that often values procedures over peace, intervention over mercy. His wife, struggling to accept his decline, refused comfort care. She didn’t want to hear the word “dying.” She only wanted to hear “positive things.” So, we kept his body alive while his soul slipped further away.

On the day he returned, barely conscious and breathing like a fish out of water, I was assigned to his care. The team began planning for another central line, pressors, fluids, all the things we do when we pretend we can still fix what’s already terminally broken.

And I froze.  I didn’t want to place the line.  I didn’t want to cause another moment of pain.  I didn’t want to be complicit in cruelty disguised as care.

This wasn’t burnout. It wasn’t fatigue. It was moral injury, the quiet trauma that occurs when we as providers are repeatedly asked to act against our most profound understanding of what is right.

Mercifully, the man’s wife came in that morning. With the help of a compassionate nurse, she finally agreed to comfort care. He received a small dose of morphine, and just like that, he died.  The morphine didn’t kill him; it just relieved his pain enough that he relaxed and let his body do what it needed.  No central line. No compressions. Just peace.

I write this not to assign blame, but to bear witness, to him and all of us. Moral injury is not about failure; it’s about staying true to the truth we hold inside. The truth is this: I can’t keep crossing that line. There is a point at which care turns into harm, where medicine becomes a performance, where the healer becomes the wounded.

I have been to that place and I don’t want to go back.

The Last Allegiance

Why I’m Choosing to Leave The Country I Once Believed In

“I love my country too much to be silent when she is wrong.”
— Edward Abbey

I never thought I’d leave America—not really. I was born here, raised on stories of liberty and justice, of brave women and principled men. I pledged allegiance with my hand over my heart, not because I was told to but because I believed it meant something.

But belief is a fragile thing in the face of betrayal.

I began seriously contemplating leaving the country the day Donald Trump was re-elected.  Something in me cracked. And then came the headlines more outrageous, more cruel, more surreal by the day. A man convicted of crimes, accused of rape, rises once again to power, buoyed by a system that rewards power and punishes truth. I read about the Military and National Guard being deployed to subdue protesters in Los Angeles. Veterans told they may be refused care based on party affiliation. Deportations without due process. The rule of law has twisted until it is no longer recognizable.

And we are told, “Don’t worry, it’s only four years.”  But what will be left of us by then?

I was raised to believe in kindness, in fairness, and in the slow, patient arc of justice. I believed the words carved into the base of the Statue of Liberty meant something: "Give me your tired, your poor…" But now I see those words as a hollow promise, recited in a country where the tired and poor are discarded, silenced, or jailed. In a place where compassion is mocked and cruelty is a strategy.

So no, I can’t pledge allegiance to this version of America.  I won’t.  What I will do is find a way to live a life that still honors those values, but it won’t be here. 

I’ve started preparing for a move to Portugal. It isn’t a rash decision, nor is it an escape. It’s a homecoming of a different kind, to a place where life moves more slowly and people value connection, art, and conversation. I envision a quiet house by the sea, where I can write, create, and discuss resilience and reinvention with women. A place where the values I still cherish—dignity, decency, and democracy- are not seen as laughable relics.

Canada is closer, yes. But I sense they’re tired of us too,  the loud, self-centered neighbor who never quite grows up. Europe calls to something deeper in me. Portugal, in particular, speaks to my longing for stillness and soul.

This isn’t exile. It’s self-rescue. I’ve spent my life as a healthcare provider, a writer, a dancer; all forms of service and devotion. But now, I need to attend to what remains of my integrity. I must walk away from a country I no longer recognize and move toward a place that still honors my values.

It might seem dramatic. But this is the quietest revolution I can offer:
To live kindly.
To age freely.
To create bravely.

This is my last allegiance. Not to a country, but to a future I can still believe in.

If you’re feeling this way too, you’re not alone. I’ll be sharing more about the emotional and practical steps of this transition — sign up to walk beside me.

#SavageGraceJournal #TheLastAllegiance #LeavingAmerica #MidlifeReinvention #PortugalDreams #ExpatLifeOver70 #PoliticalGrief #WomenWhoRoam #CreativeExile #ConsciousDeparture #WritingToHeal #FindingFreedom #KindnessAsRebellion #ArtAsResistance #SecondActStories 

Weathering the Storms We Know

"She stood in the storm, and when the wind did not blow her way, she adjusted her sails."
— Elizabeth Edwards

I’m moving back to Florida in the middle of hurricane season. Most people would think I’m crazy. The Gulf is warm, the winds are unpredictable, and the peak of the season looms just as I plan to reclaim the home I left behind. But I’m not afraid of the storms—not anymore.

I’ve lived through three hurricanes already. I understand the tension that arises as the sky darkens and the silence before the first gust of wind. I know the ritual of filling bathtubs with water, taping windows, and listening to the radio long after the power goes out. I’ve learned how to prepare—but more importantly, I’ve learned how to remain calm. Because some storms can’t be avoided; they can only be weathered.

This isn’t just about hurricanes. It’s about the storms we experience in life—the ones that come uninvited and rearrange everything. The ones that strip away what we thought we needed and reveal what truly matters. The storms that test our foundations and remind us who we are when the lights go out.

I’ve known heartbreak—the kind that doesn’t always stem from romance but from misplaced trust, lost dreams, or the realization that the version of life you worked so hard to build doesn’t love you back. I’ve experienced the ache of a dissolving marriage and, later, the slow grief of watching identities fall away—partner, provider, even dancer—each one asking me to let go of something I thought defined me.

I’ve experienced burnout. The kind that creeps in even when you're competent, even when you're praised. Especially when you’re praised. I’ve shouldered the weight of other people’s pain for decades in medicine—triaging lives while slowly losing parts of my own. I’ve sat in rooms lit by fluorescent lights, listening to monitors beep, and wondered if I’d ever hear my own heartbeat again.

And I know reinvention. The brave, terrifying decision to start over—at an age when most people are settling down. Reinvention sounds noble until you're knee-deep in boxes, unsure of where you belong or what comes next. I moved to Virginia, hoping for a fresh start, a meaningful job, a place that would feel like “after.” But what I found was a system that didn’t welcome me, a role that drained me, and a loneliness that echoed louder than I expected.

Sometimes the best-laid plans don’t just fall short—they fall flat. And when they do, it’s tempting to blame yourself and feel foolish for hoping. However, what I’ve learned is that failed plans aren’t signs of weakness—they’re the friction that reveals what we truly need. Virginia was never a mistake. It was a mirror. And it showed me what I refuse to live without: dignity, belonging, vitality, and peace.

So now, as I prepare to return home, I’m not expecting calm seas. I’m just ready to meet the waves differently. Some part of me knows: I’ve already faced the worst of it. If another storm comes, I won’t crumble. I’ll light a candle, make tea, and hold space for the wind to pass through.

We can’t control the storm. But we can decide who we will be inside of it.  And this time, I choose grace. I choose steadiness. I choose to come home.

Scalpels, Ceasefires, and the Shape of Peace: What Women in Healthcare Can Teach the World About Diplomacy

“There is no force more powerful than a woman who has held both a life and a death in her hands — and still chooses to speak for peace.”

I have stood at more bedsides than borderlines, but I know what conflict looks like. I have seen it in the gaze of a patient fighting for breath, in the quiet chaos of a failing heart, in the wrenching silence of a family asked to let go. I have not worn a soldier's uniform, but I have carried the fatigue of a frontliner — one who fights daily battles in hospital corridors rather than war zones.

And somewhere along the way, I came to believe that those of us who live at the intersection of healing and humanity may have something profound to offer the world’s conversations on peace.

The ICU as a Microcosm of Diplomacy

While pursuing a master’s degree in International Diplomacy and Conflict Resolution, I was stunned by the parallels between global conflict and hospital systems. Power, history, resource imbalances, and human vulnerability govern both. And both, I learned, can be transformed — not by domination, but by dialogue.

What truly shocked me, however, was what happened when women entered the diplomatic field.

According to studies from the United Nations and Georgetown Institute for Women, Peace and Security, treaties are more likely to be signed and upheld when women participate in peace processes, and post-conflict societies show greater economic resilience and stability. Women bring different policies and paradigms — emphasizing inclusion, empathy, and long-term reconciliation.

I realized then: that’s what we do in healthcare, too.

Healthcare as a Model for Human-Centered Negotiation

In medicine — especially in critical care — we don’t get to pick our “sides.” We walk in and care for whoever is there: young, old, rich, poor, broken, angry, hopeful. We build trust with families in crisis. We translate the language of suffering into possibility. We navigate disagreement with tact and humility. And when the moment calls for it, we offer radical presence — the kind that changes outcomes, even when it cannot change prognosis.

These are not soft skills. They are diplomatic competencies.

They are the very tools that could reshape how we broker peace, rebuild post-conflict societies, and create agreements that don’t just stop violence but heal it.

The Feminine Edge

For too long, the word “diplomacy” has conjured images of dark suits, tight lips, and geopolitical chessboards. But what if diplomacy also looked like a nurse holding a patient's hand during withdrawal? Or a physician assistant gently guiding a family through the grief of a DNR conversation? What if the ability to listen deeply, build rapport, and nurture outcomes over egos was precisely the missing ingredient in traditional negotiation models?

Women in healthcare carry these capacities as part of their daily rounds. We don't ask for power to dominate — we ask for it to restore balance. We don’t seek victory — we seek viability.

And in a world tearing at its seams, that kind of leadership may be our greatest untapped peace strategy.

Where Do We Begin?

We start by recognizing that diplomacy doesn't always require a title. Sometimes, it begins in a patient room, in a hospital hallway, in a difficult conversation handled with grace. Healthcare workers—especially women—are already practicing the art of peace, one interaction at a time.

Now, we need to elevate those voices, bring the wisdom of healers into policy, reimagine diplomacy as not just political but deeply personal, and remind the world that peace isn’t forged by force—it’s created by care.

Let the ones who have witnessed the fragility of life be the ones who help preserve it.
Let the women who have kept hearts beating be the ones who guide broken nations back to rhythm.

Savage Grace…Sacred Ground

“There is a light that shines beyond all things on earth, beyond us all… that is the light that shines in your heart.”
—Chandogya Upanishad

I didn’t plan to watch Eat, Pray, Love again. It found me late at night, after a long and exhausting day filled with self-doubt and self-pity. A day when I found myself longing for what was instead of looking forward to what could be. 

Perhaps the Universe conspired with my tiredness to bring me something I didn’t realize I needed. But there she was—Elizabeth, the protagonist—standing at the edge of her old life, trembling and brave, saying: "If you can leave the comfort and safety of everything you have known… your home, your family, your place of safety… and be willing to face your personal crazies, then there just may be something waiting for you on the other side of that journey."

Something in me exhaled because that’s exactly what I’ve done and am still doing.

I left a carefully constructed but slowly dying version of myself. I left the safety of who I had been—the dutiful daughter, the steady provider, the relentless caregiver, the dancer. I left the illusion of certainty and walked straight into the wild, unpredictable terrain of becoming. I am still walking, still unlearning, and still waking up.

In this long journey of midlife reclamation, I realize now that Savage Grace is my Eat, Pray, Love. Though Elizabeth and I may be walking on different continents, we are walking parallel paths. Both of us are seeking something sacred, something lost, something real.

I wasn’t necessarily looking for God. For me, the spiritual journey didn’t resemble prayer beads and pasta (although I envy her trips to Italy and Bali). My journey involved bearing witness in hospital rooms and dancing out my grief across ballroom floors. It involved holding strangers' hands as they took their last breath. It entailed painting what words couldn’t convey. It was about staying until I reached a breaking point. And then, finally, it was about leaving.

I used to think God was something separate—something out there, a voice in the sky or a force judging my worth from a distance. But now, something quieter and deeper has settled in. God lives in me as me, all of the good, bad and ugly of me.

It feels strange to say, and yet, entirely right. I see it now in the simple holiness of each breath, in the act of choosing joy after sorrow, and in the quiet courage to begin again at seventy-one. I think of that old story where God speaks to Moses from the burning bush, declaring, “I AM.” Not past tense. Not a future promise. Just… now. Presence. Being. God as being.

Maybe that’s what I’m reclaiming: not a religion, not a system of belief, but my own sacred flame. My right to name the divine as something intimate, something that knows my voice, something that sounds like my truth, finally spoken. Something moving me towards my final chapter. The last chapter where all the pieces of this crazy, chaotic, nomadic life come together in purpose.

Savage Grace is not merely a title—it’s a spiritual map, a testimony, a survival song. It’s my I AM.

The Time We Have Left

This morning, I found myself dreaming.

Not the kind of dream that fades when the alarm sounds, but the kind that rises slowly with the sun and lingers in the heart like a hymn.

I saw a life that feels just within reach: mornings that begin with coffee and journaling, wrapped in a blanket by the fire—or under the soft hush of a garden morning in spring. A hike to a quiet vista where the trees listen without judgment and the sky makes room for prayer. Dogs bounding ahead on the trail. Cats curled into sunlight back at the house.

After breakfast, I’d write—another book, a blog, a course. With Liam, of course, at my side like he always is. In the afternoons, I’d wander to a small barn studio to paint or play with resin, letting color speak where words fall short. There’d be retreats—maybe on the property, maybe across the country. I’d travel to speak, to teach, to tell stories that remind others they are not alone.

I want to touch hearts. I want to leave something behind that matters.

But alongside this vision comes a quieter, more vulnerable question:
Do I have enough time?

I am 71. And though I’m healthy and strong, I know the truth of an aging body. I wonder how many more years I’ll have to hike without pain, to dance without hesitation, to write without rushing. I look to women like Jane Fonda and Cher—still active, still powerful—and I think, yes, maybe. But they have teams and resources I don’t.

And still… I dream.

Because here’s what I know deep in my bones:
It is not too late.

The dreams we carry into the second half of life are not remnants of lost time. They are the distilled wisdom of our lived experience. They are what remains after everything false has burned away. These dreams are not foolish—they are sacred.

I didn’t have this dream at 30. I wasn’t ready.
I have it now.
Now, when I understand what matters.
Now, when I’ve loved and lost and risen again.
Now, when I’m strong enough to be soft and brave enough to begin again.

If you’re reading this and feeling the same ache—the longing to become who you were always meant to be—I want you to know something:
You don’t need decades to live meaningfully. You need alignment. You need willingness. You need to begin.

Let your next chapter be the one you write with your whole heart.

Let the fear of not having enough time push you toward what matters, not away from it.

Let yourself dream out loud.

Let yourself start.

What dream is whispering to you now that didn’t—or couldn’t—emerge until this season of life?
Write it down. Say it aloud. Share it with someone who will hold it gently. And then… take the first step.

When the Fire Becomes Light

For most of my life, I wore survival like a second skin.
I knew how to hustle through grief, how to hold everyone else’s pain, how to build a life out of sheer grit and self-forgetting.
I knew how to carry the weight of others — children, patients, partners, stories that were never mine to begin with.
But I didn’t know how to carry myself.

And then, somewhere around the edges of midlife, I began to burn out — not just in my work, but in my bones.

It didn’t happen all at once.
It was a slow undoing —
a quiet forgetting of who I’d been before the world demanded so much.

That unraveling, painful and necessary, is what led me here.
To Savage Grace.

My memoir is not a tidy tale of triumph.
It’s a reckoning.
With trauma.
With silence.
With the lies I told myself to keep going.
And more than anything, with the longing I buried beneath competence and care.

I wrote Savage Grace not just to look back,
but to speak directly to the woman — maybe you —
who has spent decades showing up for everyone else
and now finds herself wondering:
Who will show up for me?

What I’ve learned is this:
there comes a moment, often after midlife, when the masks begin to slip.
The old roles stop fitting.
The titles — mother, nurse, partner, provider — no longer tell the full story.
And the voice we once silenced begins to stir, whispering:
There’s more.

Not more to do.
More to become.

Savage Grace is about that becoming.
It’s about remembering the girl inside who once danced, or dreamed, or dared to speak.
It’s about healing not just from what happened to us,
but from the way we learned to disappear inside of it.

In these pages, you’ll find stories — raw, poetic, sometimes hard to tell.
But they are true.
And my hope is that in reading them, you will remember your own truth.
Not the polished version.
The holy, unfiltered one.

This memoir isn’t a map,
but it is a mirror.

It’s for the woman on the edge of reinvention.
The healer who forgot she was human.
The artist buried under the weight of duty.
The survivor who is ready to become more than her scars.

If you are standing at the threshold of your second half —
not sure whether to leap or retreat —
know this:
you are not alone.
Your voice still lives in you,
your fire is not gone,
and grace — even the savage kind —
is waiting for you to rise.

Welcome.

From ICU to Inner Peace: What a Lifetime in Medicine Taught Me About Grace

I used to believe grace was something reserved for Sunday mornings — something quiet, polite, draped in stained glass and whispered prayers.
But I found it in far stranger places:
in sterile hallways under fluorescent lights,
in the chaos of code blues and the stillness of holding a stranger’s hand as they took their last breath.

I found grace in the ICU.

But not at first.

At first, I found adrenaline.
And exhaustion.
And the strange exhilaration of being needed — constantly, relentlessly.
For decades, I lived inside the machinery of medicine, where every shift was a test of endurance, every chart a record of someone else’s suffering.
And somewhere along the way, I lost touch with the quiet hum of my own life.

Like so many of us in healthcare, I became very good at disappearing.
I disappeared into scrubs, into shiftwork, into showing up for everyone but myself.
I knew how to triage trauma, but not my own.
I could comfort a dying man’s family, but not speak the grief building in my own bones.
I could restart a heart — but I didn’t notice mine was slowly closing.

The truth is: medicine taught me a thousand things about the body.
But it took burnout to teach me anything about the soul.

There came a point, sometime after COVID, sometime after the weight of one too many losses,
when the part of me that had kept going finally said,
“Enough.”

It wasn’t dramatic.
No collapse, no great scene.
Just a quiet, internal knowing that I couldn’t live like this anymore —
hypervigilant, hollowed-out, haunted by the perfectionism that used to keep me afloat.

And that’s when I began to search, not for a new career, but for something deeper.

I didn’t know it at the time, but I was searching for inner peace.
Not a bubble bath.
Not a day off.
A real reckoning — the kind that invites you to look at everything you thought made you valuable,
and ask:
Who am I without the role? Without the badge? Without the stethoscope?

The answer, it turns out, is both terrifying and liberating.

This blog — and my podcast — is not about leaving medicine.
It’s about finding yourself inside it, or after it, or somewhere between what you gave and what you still want to become.

It’s about transformation and about grace —
not as politeness,
but as power.
The kind that whispers, “You’re allowed to choose yourself now.”

To anyone who’s ever lived in the chaos of caregiving and wondered if there’s life beyond medicine…
there is.

And it’s waiting for you —
in stillness, in beauty,
in the sacred act of becoming more than what the world once asked of you.

The Geography of Escape

I didn’t move to Virginia.
I ran.
I ran from the heavy breath of a broken system that once called itself healing
and now only seemed to profit from suffering.
I ran from fluorescent-lit hallways and whispered hypocrisies in white coats.
But more than that—
I ran from him.

There was a man.
And there was dance.

And there was the quiet unraveling of a woman
who no longer knew how to say no to either.
Not when the music started.
Not when he looked at her like she was a secret worth keeping.

I told myself it was a job change.
A sign-on bonus.
A fresh start.

But it was exile.
I exiled myself from a love that had grown sick in its silence,
and from a city where my boundaries had grown too soft,
where my desire to feel alive outweighed my discipline to heal.

Yes, there was work I could’ve done in Florida.
Easier work.
Closer to the sea and the sun.
But I couldn’t stay and resist the pull of the past.
So I left.
With boxes packed in a rented truck,
a poodle in the passenger seat,
and heartbreak wrapped in denial.

Now I live in a small apartment
where the walls echo with absence
and the floor beneath me creaks like an old memory.
I miss my house,
the one I painted with hope.
I miss who I was when I thought love might save me.
But most of all,
I miss the illusion that leaving would be enough.

Because it never is.

The truth is,
your pain comes with you.
It rides in the backseat.
It sleeps on the floor beside the bed.
It waits for the quiet
and whispers when the lights go out.

But here’s what I’ve found in the aftermath:

You can’t bury your ghosts in a new zip code.
You can’t buy freedom with a bonus check.
And you can’t heal by pretending the wound doesn’t exist.

What you can do—
is begin again.

In the stillness that follows the storm,
when the noise of the world fades and you are left
only with your breath and your choices,
transformation begins.

Not with fireworks.
Not with fanfare.
But with a whisper that says:
“This isn’t working. Something has to change.”

And so I sit now,
not in victory,
but in surrender.
In the rawness of knowing that rock bottom
is often the sacred ground
where reinvention plants its roots.

I still mourn the loss of him—
of us—
of the woman I was when I believed
that dancing might be enough to carry me home.
But grief, too, has its place in the wild.

And maybe that’s the grace of it all.
Not that I escaped.
But that I survived the running.
That I am still here.
And still—becoming.

I Still Hear His Silence

It was 2009, and I was working for a neurosurgeon, covering clinic as his PA. It had been a long, grueling day—one of those stacked afternoons where you're just trying to keep your head above water. We had just finished when the call came in from the ER: STAT consult. Cervical trauma. Young male. Diving accident.

The details would unfold quickly and painfully.

A 21-year-old boy—because at that age, they're still boys in so many ways—had dove headfirst into unknown water and struck something hidden beneath the surface. The impact severed his spinal cord high in the neck. He was now a ventilator-dependent quadriplegic. No sensation. No movement. No future, at least not in the way most of us define one.

His history was complicated. Raised by his grandmother. His parents were alive but estranged, completely absent from his life. A few arrests as a teen. A turbulent path. But recently, he had been trying to pull himself together. Trying to make something of the wreckage.

And then—this.

When the neurosurgeon reached his grandmother, she said flatly, “He's 21. He can make his own decisions. I won’t be coming.” His parents were unreachable.

He was alone. In every sense of the word.

And in that loneliness, he made a choice.

He told the surgeon he didn’t want any intervention. He didn’t want to live as a shell of his former self, attached to machines, no chance of recovery. He said the world would be better off without him. That his life hadn’t amounted to anything good.

And so... he died.  Alone.

No one held his hand. No one whispered words of comfort. No one stroked his hair or said, “You matter.” He simply... left.

I found out the next day, and my heart ruptured.

I wept in the breakroom. I wept at the thought of my own son, who was the same age. I wept because I couldn't shake the image of this boy—barely a man—slipping away without a witness.

There was a Carly Simon song playing on the radio around that time. It haunted me then, and it still does now. The first verse echoes him in ways that language alone cannot:

“Oh my boy, what have you done? 
Did you go out surfing on a frozen sea? 
Did you scare the livin' daylights out of me? 
Did you go too far to drive away the demons? 
Did you go too far to know what love really means?” (From Hold on to Your Heart, Carly Simon)

I’ve carried his story like a stone in my chest all these years. Not because I failed him. Not because anyone did anything “wrong.”  But because something sacred in his death was missing, and I still don’t know what to do with that absence.

There was no hand to hold. No voice to say “you mattered.” No one to sit beside him in the moment when his soul left his body and maybe that’s why this story doesn’t have a takeaway.

Maybe it’s not a lesson, but a lament.

A reminder that for all our knowledge, all our procedures, all our rounds and consults and clinical notes—we are still just human beings trying to catch each other as we fall.

I don’t know what that boy needed in his final moments.  But I know what I needed: for someone who loved him to have been there.   Someone to say, “You don’t have to leave this world unseen.”

I still see him.  I still hear his silence.

And maybe that is the only truth I can offer here:

That some stories don’t resolve.  Some stories just live in us, shaping how we hold the next patient, the next sorrow, the next soul who wonders if they matter.  This one taught me to stay close, even when there’s nothing left to fix.

Especially then.