There Is A Real Human Behind Every Mask-Searching For Peace

By Brian De Francesca

18 years ago today, my mother died. If that was the end of her journey – I do not know.   I was not with her. I was on my way to Stockholm where Casper was due to arrive on the scene; that had its own challenges and learning experiences – a story for another time.  I know that I was a good son, but still feel I could have been better.

My mother died, I will die, my children will one day die.   Until of course, we find a cure for death, which will eventually happen. Brian and momI am not sure that is a good thing – but it will not be my decision to make. But for now, our physical time here is very temporary and fleeting.  Each moment, more valuable than the one before – because there are fewer remaining.  As tribute to my mother, today will be special

I started with breakfast with my good friend and a wonderful human.   I will cut my daily dosage of medications in half, as part of a tapering target of being totally free of them by October 30th.   For those of you who don’t know, I have been on a cocktail of anti-anxiety medications for almost two years, since my world blew up.   I have been on maximum dosages of: 20mg of Cipralex (escitalopram), 50mg of Anafranil (clomipramine), 100mg of Seroquel (Quetiapin) and 2mg per day of Xanex.   This has allowed me to function in society, but has limited me to being somewhat of an emotionless Zombie – but without these, I would have been disabled by panic and anxiety.   So, medications at times are the proper weapon – taking them is not a sign of weakness – they are a tool to serve a purpose.   I know that I am strong enough now, to finally toss away this temporary chemical crutch, which I know will make my mother happy.

I am starting to feel that most people live and then die, having never known true peace; I feel this way, because I am learning that my path to peace requires true forgiveness of everyone; surrender to the universe (which is hard to explain in this short space) and complete transparency – which is a step or two beyond being just “honest.”  I am just at the beginning of the journey.   I have learned that so many of the people around you, have some sort of horror they keep caged inside.   This may be the cause of one person being an asshole; and another being so shy – most of the time, we never get to see inside.  My mom is a star now; occasionally she visits us as a butterfly – she is proud of me, I know this.   When I was very young and attending Catholic church, there was always a section in the mass, where you were to turn to the people around you and say, “May peace be with you.”   We all robotically went through the motions and parroted the words.butterfly

Now, all these years later; I can say, this and truly know what I mean:

May peace be with you.
Written by, Brian de, @B_defrancesca

“The Meaning of Brian De Francesca’s life-his purpose for being -is to use digitalization and connectivity to help as many people as possible before he dies”


How Strange A Thing Is Life?

By Alya Ahmad, Pediatric Hospitalist

“How strange a thing is life…”

It starts out so simple, just food , sleep, and comfort for the bodily routines. It is the baby regarding the warmth of the mother’s voice, face, and the breast. 

then comes the first turn, the roll over, the baby steps, and so then comes the watchful eye of the mother. She fears the fall, the break, the pain.

as time flows, so does the worry. the child speaks, first asks, then demands, then expects. The mother does it all and then the child runs, spells, and befriends.

The baby becomes the child; the child becomes the teenager.

Very soon, the child has no memory of all those tender kisses, the smell of sweet milk, the hugs, and reassurance. The teenager shuts the door, speaks little, and goes on with what they hold important. The mother upholds, waits, and wonders.

How strange life is? As the man walks out the door, waves goodbye, and moves on. All those days that have melted away, the chalk on the ground, the bicycle lays rusted in the garage, the books on the shelf have aged and grown with the child, soon to be stored away. Memories of movie nights, junk food, cereal boxes, appointments, parent teacher conferences, game days, the audience at graduation, the accolades, and the pictures on icloud streaming away.

How strange life is? As I sit here, waiting, wondering, hoping, watching, thinking, writing, feeling, storing. All the things you spent a life time building and now having to discard, give away, and handover. Forget, forget, forget. 

How strange life is? It stops for no one, it tics away without fail. it lives beyond you. 


Guns and The City


arms-background-bang-1076813By Alya Ahmad MD, FAAP, Pediatric Hospitalist

It was a slow night in the pediatric emergency room, a little after 2 am on April 8, 2000. A 15 years old African American male walked in to the pediatric emergency room with a chief complaint of a sore throat. Working the night shift was always tough for me, as a pediatric resident my body clock struggled between the constant switches from nights to days and vice versa. I was already fatigued that night and wanted a quiet night. I got only the opposite.

I pulled chart for the, 15 year old boy from the bin. Flipping through the paper clip board, I was I have to admit, a little angry at having to see this kids at 2 am for a sore throat at that. The nurse took the teenager to the back. He walked with a swagger, quiet, and expressionless. As he was being triaged, I wondered what he was doing here alone without a parent. He appeared to be the typical disinterested, pubertal, well-built athletic boy, wearing extra loose baggy jeans, and a long basketball shirt visible under his oversized hoodie. He seemed a little tense but without much distress. Lying “restfully” on the patient bed as though he came to the ER to sleep. I eyed him and then went to the back room doctor’s area to get my stethoscope and a rapid strep throat swab.

Within a few minutes, I heard the nurse call for a code. He was the only patient in the back, so I knew it must be this kid who suddenly arrested. Odd.

Alarms rang; monitors beeping; crash cart was wheeled in; and a sudden emergence of staff came rushing in from all corners of the ER. He was in full cardiac arrest. While intubating him and staring down his airway, all I could think was what the heck just happened here? It was only after he was stabilized and CT scanned from head to abdomen, did we discover the reason why he walked into the ER.

We cut through his hoodie. He was covered in blood. He had been shot, and wore the hoodie to avoid suspicion. In his stomach the bullet laid placidly with a small entry wound from his upper deltoid area. While the bullet had penetrated through his chest without significant damage, it was his esophagus, perforated, that was worrisome.


Next, He had to be transferred to trauma center in the medical center for further stabilization some 15 miles away. As the only resident of the shift I was assumed to take him via ambulance to the medical center. I held my breath, knowing this. My fear of him coding again or bleeding out, was palpable up my chest.

It was only while in the back of the ambulance that I actually saw his whole face, his still youthful features and cherubic face, his large yet graceful hands, and his thickly styled dark hair. In the gurney, he lay unaware of the ambulance swaying, jerking, and sirens blasting. He was helplessly wrapped up in tubing and lines. While staring at him and feeling for his pulse to compare to the monitor I held his hand. It hit me. He must be somebody’s child, a son to someone. I prayed silently in my head for mercy. While also praying, we make it to the regional trauma center, the gunshot capital of the city.

After an eternal 17 minutes later, we were in ER landing area. We wheeled him into the trauma unit. The paramedics quickly regurgitated his details to the accepting hospital’s ER staff, and I handed over his medical details to the next resident. He was swiftly swept up to the operating room and disappeared engulfed by the trauma team and nurses.

I never heard about him again and to this day don’t know if he survived. Years later, I still think about him, and all the other gunshot wound death and survivors who may have passed through our hospital and or our system. As pediatrician we are told to talk to families about gun safety and storage. I do what is recommended, and go through the checklist of gun safety in the home.

Yet, violence persists. Sixteen years later, I continue to take care of kids with intentional or accidental shootings. Teenagers, who have survived gunshots, failed suicide attempts, gang warfare, or accidental miss-firings, continue to stream through the inpatient units. Families now burdened to take care of this special needs patients, permanently disfigured physically and or emotionally from their wounds. A gun injures nineteen children each day in the USA. Among injury related death’s, firearms rank second AFTER car accidents.

Yet, gun injuries and deaths are only getting increasing. Killers are walking with “bombs”. Guns now with AK-fire-power that is more irreparable and destructive.

Physicians are told to first do no harm, and that is the mantra we carry near and dear to our hearts. Guns should do no harm? That is an oxymoron.

By Alya Ahmad MD, FAAP

Pediatric Hospitalist