Dr. Karen Winkfield
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On Thoughtfulness and Grief

5/29/2019

3 Comments

 
My best friend died a year ago today. It was 12:24am.
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We were on a family vacation in Charleston SC having a great time.
Jeff had been ill the week prior but insisted on traveling to honor my aunt Mary who had passed several years earlier but the family was gathering to memorialize her. He really wanted to be there for my cousin, his friend, Chris. Jeff was always thoughtful that way.
In retrospect, I believe he knew he would pass that weekend and wanted to do it while we were traveling. I think it was his intention to not die at the hospital where I worked. He realized that would have been too great a burden for me to bear – to enter that space day in and day out, reminded of his last hours on earth. Jeff was always thoughtful that way.
He also had a master plan to get my daughter and I together, with him, alone, for one last hurrah. Ashley and I were still dealing with some mother/daughter tensions, some unfinished and unspoken business. But when he was with us, all of that was forgotten. We just loved being together – all 3 of us. Our little family. He wanted to make sure Ash and I mended. Jeff was always thoughtful that way.
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My grief comes in waves as I consider how thoughtful, and caring, and loving he was. Wishing I could have given him as much in his final hours. He struggled in pain the last weeks of his life but was still so concerned about me and Ash that he fought with all his might to stay present. I wish I had been thoughtful enough to just tell him to rest. That it was ok. That he could transition and no longer be in pain. But I was not that thoughtful.
Then I realized he has not left me completely. I feel his spirit and it moves me. He sends me funny JibJabs® on the holidays, some of which I have shared with friends and family.
And without fail, when I get down, or castigate myself for not doing more for him, he sends me a butterfly – a reminder of how beautiful and freeing transitions can be, and it makes me smile. Jeff was always thoughtful that way.
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Rest in Peace, My Love. Your butterfly....

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The Empty Seat Beside Me

2/6/2019

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​Jeff would have turned 59 today. It’s not a particularly interesting number and not typically considered a milestone. But for him, it would have been major. One more year to notch on his belt, but also potentially another year of suffering.
 
Two weeks ago, I took my first vacation since Jeff passed away in May. Decided to leave the country. Traveled to Costa Rica prompted by a friend who had lost her husband 4 years ago last week. It was a bit weird; I wasn’t quite sure how to feel. There was guilt, loneliness, sadness, joy… relief!! An entire gimmish of emotions. So many folks asked “Are you traveling alone?”
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During this trip, ​I had time to reflect on how meaningful my relationship with Jeff was and still is to me. Gave thought to how I wanted to honor him with both my life’s work and my life’s play. He always wanted me to have fun!! However, I hadn’t given much thought to the fact that his birthday was approaching!  What was I going to do??
 
My plan was to arrive home Tuesday to allow a day of recovery prior to my busy clinic on Thursday. Unfortunately I ended up spending Wednesday reviewing references for a book chapter. Completely exhausted on Thursday evening, I decided to celebrate Jeff’s birthday by heading to the Superbowl to support our team -- GoPats! The drive there was intense and laborious; traffic at most major cities on the way down to ATL from Winston Salem. The vendors would not sell me a single ticket – they needed to sell 2 or more to keep seats together. But finally someone said they were interested in a single and we paired.

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 As I took my club level seat in the Mercedes Benz Stadium, I had tears of joy streaming down as I thought about how much he would have enjoyed the experience. I wore Jeff’s Hightower shirt over my Brady shirt to make me feel as though he were there with me. I waited for my ticket partner to come to thank him for buying the other seat, allowing me to attend.  He never showed. It was my sign that Jeff was truly right there with me.
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Happy Birthday, JD!!

3 Comments

Finding New Holiday Traditions

12/26/2018

2 Comments

 
PictureAshley and Karen; Christmas 2018.
Yesterday was the first Christmas in 16 years that we spent without, Jeff. When my husband passed away this summer, I hadn't anticipated how challenging the holidays would be. My daughter, Ashley, and I decided to travel to avoid spending the week in NC. We hoped a trip away from the familiar would reduce the pain of missing Jeff. However, sitting here looking out of my hotel window, not certain what our plan for the day will be, there is so much that reminds me of him. In fact, this is exactly what the 3 of us always did!! Our family Christmas tradition was to wing it!

When I was a child, my parents did not celebrate Christmas so I had no family traditions associated with the holidays. In medical school, a colleague was kind enough to invite me to her parents’ house in Brookline, MA to spend the holiday. Despite their efforts to make me feel welcomed and a part of the festivities, there was no personal context, so I felt like a complete intruder.
PictureOur 1st Christmas @ Jeff's house - 2002
Similarly, Jeff didn’t speak much of Christmas with his family; things changed after his grandmother died. I suppose there is always one person who holds the family and its traditions together. When Jeff and I married, it was like we were two blank canvases – and we were left to create our holiday traditions together.
 
So in true renegade fashion, we had no real holiday tradition. One year we would travel, the next we would serve dinner to the homeless, and many were spent with great friends and extended family. But perhaps the most memorable Christmas holidays were those where we just hung around the house in our pajamas, sipping whatever yummy beverage we designed as we gazed into the fireplace all aglow. Sometimes keeping it simple is the best way to create lasting memories.

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Christmas in the Bahamas 2005
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Christmas in Boston w/best friends 2009
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Serving Christmas dinner to the homeless at the Salvation Army with Abundant Life Church, Cambridge MA 2015
Hoping that whatever your seasonal traditions are, you have a joyful and merry celebration with the ones you love.
 
                                Happy Holidays!!

~ Dr. Karen

2 Comments

Waiting for the Fog to Lift

11/30/2018

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Looking around, I wonder how folks can just keep moving forward when my life has come to a dead stop. Still reeling from the loss, I try to move about my days as if nothing has changed, but everything has. My fragile mind cannot keep up with the pace I am used to – there is no more hustle in my bustle, no more pep in my step. The air has been let out of my sails.
 
Yesterday, November 29, 2018, marked 6 months since my husband – my best friend – left this earth. 
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The fogginess in my mind was heavier than usual. Awake by 5:30am, getting work done, my second alarm went off at 7am. But I couldn’t recall why I had set it. I checked the clinic schedule and saw that my first patient didn’t arrive until 9:30am so I kept working. Then the text came – “The first set of scores are underway”.  It had completely slipped my mind that I was to be at the lab at 8am. The rest of the day was no better as I dragged myself from one task to the next.
 
Sorrow, fear, longing, regret, guilt – oh the guilt! Emotions swirl. Bolstered by the cheery jingle of the Christmas music that has infiltrated the airwaves.
 
Caregiving is difficult. Grief is devastating.
 
I have been told it gets better with time. Hoping that time comes soon.
​

~Dr. Karen

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Remembering an Amazing Clinician, Teacher, Administrator and Role Model

10/5/2018

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 ​One of my heroes passed away early this morning. Dr. Brenda Armstrong was Dean of Admission at the Duke University School of Medicine where my medical career began. I recall the day I came to Duke for my interview. As a poor, single parent, not able to afford airfare or a decent place to stay, I drove through the night and slept a few hours at a rather seedy hotel that was near the school. My stomach was rumbling from nerves as I pulled onto the campus. Dr. Armstrong was short of stature but had a very large presence; and I immediately admired this powerful woman who later became an amazing role model for me.
It wasn’t clear to me then, but my class in 1997 was the first she had been completely in charge of admitting to the school. She had worked with Dr. Lois Pounds, former Dean, the year prior. But mine was the fortunate class to have Dr. Armstrong’s hand placed fully on its selection. We were diverse in socioeconomic, academic, and racial/ethnic background. It was wonderful – nine percent (9%) of the class was from backgrounds traditionally underrepresented in medicine (URM). The following year, the number skyrocketed to 22%!! And not a single thing changed with respect to the credentials of the incoming class – just what they looked like. It should have come as no surprise that the woman who was among the first to integrate Duke’s undergraduate campus and who later became the second black woman in the US to become a board-certified pediatric cardiologist, would be a stalwart supporter of workforce diversity and made it her life’s mission to bring talented people of all backgrounds to an institution that had previously not been very diverse.
 
Dr. Armstrong’s success recruiting talented URMs to the medical school came because she was willing to invest time and look where others might not. She would not just sit and wait for applicants, particularly since she knew the schools history and understood that some, especially students of color, might not apply because they didn’t think they would be accepted. She went out and brought in talent that others might have overlooked. I personally was grateful that despite being a single parent, she saw value in having me join a class of stellar students. The expectations of me were the same as they were for every other student and perhaps higher. You see, Dr. Armstrong herself was as single parent in addition to being a pediatric cardiologist and Dean of Admission for a top tier medical school, while she gave back to the community, coaching for the Striders track team. She never let me allow my situation to define what I could become. And for that I am eternally grateful.
 
Although she has transitioned, her legacy as a champion for workforce diversity, both at the Duke University School of Medicine and around the country, will not be diminished. 

~Dr. Karen

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A NYC Meeting Leads to a Trip Down Memory Lane

3/11/2018

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This weekend I traveled to NYC for the NCI’s Associate Director/Program Leader Workshop; trying to learn a bit more about my new role as Associate Director for Cancer Health Equity. I arrived a day early to participate in the Population Health Assessment in Cancer Center Catchment Areas meeting held at the  Albert Einstein College of Medicine in the Bronx. My flight left Piedmont Airport in Greensboro at 6:15am and arrived at LaGuardia (LGA) 7:43am - according to the timestamp on the text I sent my husband letting him know the flight had landed. Just 7 miles away, the cab ride to the Einstein took about 24 minutes. Despite growing up in NY, I never realized how close LGA was to the Bronx. Stepping foot onto campus made me think of one of my “besties” whose very first job out of residency was at Einstein. She has since moved on.

​There were a few familiar faces in attendance and I was thrilled to make new acquaintances. The meeting was intense and filled with tons of great info. It wasn’t until the meeting ended and I was on the shuttle to the hotel that I realized how exhausted I was. That 11 mile bus ride from the Bronx into Manhattan at 6pm seemed to take forever.


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We arrived at the Roosevelt hotel and I disembarked from the bus - a bit disoriented from fatigue. It was 7pm and I hadn’t eaten since the boxed lunch they served at noon, but still needed to check in. I dropped my bags in the room and did a quick search for Chinese. Followed my GPS, but realized after 2 blocks of walking that I was headed in the wrong direction. I completely forgot how screwed up the GPS gets around tall buildings. But that was the best thing that could have ever happened…. I found myself standing in front of the gate to a building that held so much significance for me.
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You see, science/medicine is not my first career. For those of us who are first generation college grads, our paths may not be so straightforward. Even if given a map to follow, we sometimes find that the  career “GPS” seems to be a bit screwed up. I did not take a straight path to medicine. The twists and turns in my story may cause some say that my non-traditional course was a rocky one. I choose to look at my experiences as providing a rich background – a perfect foundation upon which to build a career in medicine and social justice.

​I couldn't help but take this photo of the gate to Tower45 located at 120 W. 45th Street, NY, NY.

​It was here that my journey began… Let me tell you the story.

    ~Dr. Karen

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When a Loved One is Sick

5/8/2017

7 Comments

 
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So, I'm back in the ED with my husband, Jeffrey. Never sure whether to post or not -- he is here so often. Admission after admission; occasionally someone will check in on us, but typically not. Family and "friends" not around. Very few call him to say "hello" or find a time to visit, despite us moving to NC so he could be closer.  Been part of the reason for lack of posts.
We've just been handling the episodic hospitalizations quietly on our own. It's interesting to see our Cousin Dan share his amazing story of caregiving in the setting of Alzheimer's. So much of what he says I can identify with -- chronic illness is a messy, horrible thing. Especially when you know things will only get worse. The worry, stress, concern, anger, disappointment... is this what I signed up for???

The entire gamut of emotions on top of the fatigue can be daunting. And even harder when your best friend - the person you'd like to rely on for comfort/strength - is the one who is sick. 

Just remember to take care of yourself.
Just remember to take care of yourself.
Just remembers....

Perhaps if I say it enough... #FeelingSomeKindaWay
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Can we afford NOT to keep the Affordable Care Act?

1/25/2017

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 ​In my first blog of 2017, I recounted the story of finding my husband unresponsive on the floor the day after Christmas. When he finally came to, he reluctantly agreed to let me get a wheelchair from the hotel lobby.

After settling him into the car, I asked, “which hospital do you want to go to?”


What seemed like a very straightforward question at the time was, upon later reflection, one that demonstrated a major issue related to healthcare access.

1. Insurance – While insurance provides folks a degree of coverage it also can impose restrictions that limit options related to where people can seek care. Some are forced into networks with limited access to specialists or with doctors that are culturally insensitive.

2. ​Copays – The thought of a copay never crossed my mind, despite the fact that if we went out of network, we would pay 20% of the hospital bill out-of-pocket. $100,000 hospital bill = $20,000 out-of-pocket costs. Deductibles, co-pays and co-insurance can be expensive and prevent some from going to the doctor even when sick. Medicare only covers 80% meaning the savings of older adults who cannot afford supplemental insurance may be at risk. This is called being ​underinsured.
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What happens to those who are uninsured??
They may not even feel empowered to seek medical attention! The  Affordable Care Act (ACA) is not perfect, but it is a first step towards providing all US citizens with basic coverage. There are many parts that need repair including prohibitive copays levied by insurers, but allowing citizens to go without coverage leads to cost-shifting and burdens the healthcare system, ultimately leading to higher costs. Click here to contact your legislator and petition them to save the ACA. 
​
~One Drop of knowledge

Dr. Karen

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The Day After Christmas

1/10/2017

1 Comment

 
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Welcome to 2017!! Hoping you and yours came through the prior year with minimal scars and bruising and ready to make 2017 a happy and healthy one.

On New Year's Day, I elected to post the image above on the DrKarenWinkfield  Facebook page (please Like & follow) and thought it would be helpful to share why.


On Dec. 26, 2016, I awoke to a loud thud.  I was a bit disoriented since for Christmas, I surprised my husband with a weekend trip to Durham, NC to visit friends we hadn’t seen in years and needed to remember where we were. The room was dark, but I realized the bed next to me was empty. Usually Jeff is the first to respond to loud noises but when I called his name, there was no response. As my eyes adjusted to the dark, I saw my husband slumped on the floor in a small space between the bed and the corner of the side table.

He was unresponsive.

After several attempts, he finally roused but was dazed and a bit confused. Immediately we knew something was wrong with his heart!

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I rushed him to the hospital.

​Our experience with the healthcare system was stressful and anxiety-provoking. Gratefully, Jeff recovered and went home. However, the experience left an indelible impression upon me about the challenges patients face when participating in our healthcare system.
 
I am a physician and my husband is very invested in his health, yet we still struggled to navigate and feel heard. Over the next few weeks, I’d like to explore some of the barriers we faced and see if we can come to some solutions together. Are you with me?

~One Drop of Knowledge

Dr. Karen

1 Comment

Slavery, Medical Experiments, & Black Health

2/28/2016

0 Comments

 
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The movie "​12 Years a Slave" aired on BET Network tonight. I have always made a conscious effort to stay away from movies that depict the brutality of slavery. To think that human beings could treat other humans with such cruelty makes my heart pain. Despite the accolades and award-winning casts, I never saw the movie Amistad or watched the mini-series Roots. 12 Years was no different – I just couldn’t bring myself to open myself to the emotions that might surface.
 
My first opportunity to watch 12 Years was in 2014 on a flight to Botswana. I decided not to watch, fearing how I might react, especially being confined on a plane for 14 hours. Would I cry uncontrollably or scream from the top of my lungs?!? I was afraid of feeling alone and vulnerable on that long international flight.
 
As a flipped channels tonight, something forced me to stop at BET and to watch 12 Years. Over the past two weeks I have spent focused attention on modern day medical atrocities performed against blacks. . Eugenics, J. Marion Sims, radiation experiments, and Tuskegee – experimentation by the US government that ended a few years after I was born!

A few days ago, I gave a lecture about health inequities and shared how the institution of slavery and modern day experimentation on blacks have dehumanized an entire people and continue to contribute to the poor health condition of blacks in the US. Almost everyone in that mostly white audience heard, understood, and repudiated these injustices. But I saw and felt disbelief from at least one person – someone I looked up to and respected. It angered and saddened me. 
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How could such an intelligent person turn a blind eye to the past? To discount the impact that so many centuries of abuse have had on an entire race of people?
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Perhaps I thought my inability to watch realistic portrayals of slavery was in some way ME turning a blind eye, condoning the past, refusing to acknowledge the horrors my ancestors endured. So tonight, it was time to watch.
 
I screamed. I cried. And I am now more convinced than ever that I must continue exposing the past and advocating for the health and future of blacks in this country. May we never forget.
 
                         ~One drop of knowledge can ripple through an entire community

Dr. Karen

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