Sports Impairment and My Southern Man-Card

 

This is my column in today’s Herald-Dispatch.  My hometown newspaper in Huntington, WV!

http://www.herald-dispatch.com/opinion/edwin-leap-don-t-worry-you-won-t-lose-your/article_3706dd19-3472-520d-856d-09e3580d3886.html

It’s a terrible confession to make as a Southern male, but here it goes. I don’t care a lick about sports; not leagues, not high school, not college not pro. It feels liberating to say so. I figured I might as well be honest about it, because I’m forever confronting the reality of my sports-impairment in various and sundry ways.
One way my dilemma arises is I’m standing in the check-out line at a store, wearing my WVU t-shirt when another customer asks what I think of the Mountaineer’s chances this year. I usually make some sort of generally non-committal remark about how ‘I sure HOPE they do better this year!’ Which means that at some point in the distant future, if they manage to win a championship, I’ll have to be more careful and say ‘well, if LAST year was any indication this should be a good one!’ I try not to make eye-contact. It’s too uncomfortable.
What I usually want to explain, but never bother, is that I wear the shirt because I grew up and went to school there. And it was awesome and I have wonderful memories (same reason I wear my Marshall shirt). But it’s hard to stop a die-hard sports fan and say, ‘well, the truth is I really didn’t have time for sports because I was studying a great deal, but I’m proud I graduated!’ That makes people go to the next checkout line and shake their heads.
I’ve noticed the same thing at church. I remember finding myself in deacon’s meetings with little to contribute to the discussion at zero dark thirty Sunday morning. As everyone made the rounds of the previous day’s games, it was ‘Ed, Marshall did well yesterday didn’t they!’ ‘Sure did…(I guess).’ I put my head down, ate my biscuits and gravy and (since I live in South Carolina) I just let the orange or garnet wave pass over.


I’m not trying to be a snob, please understand. In my childhood I just wasn’t formally taught anything about athletics. Admittedly, my dad built a basketball court for me in the back yard. All the neighborhood kids and I had a great time there at all hours of the day and evening. But the rules were not exactly formally enforced. It was as much social time as athleticism. I also learned a little about football in the front yard. Specifically, I learned that ‘touch’ can be widely interpreted. I realized that lying on my back gasping for air one day, looking up at the fading blue sky.
I remember once around sixth or seventh grade that I went to the mother of one of my more athletically inclined friends and asked about joining a basketball league. She was kind, in a ‘bless your heart’ sort of way, and said we might be able to cram on the rules but it wasn’t looking good. Age 12 and I was already too old to start. I got the message and moved on without looking back.
Instead I filled my days with walks in the woods, turning over rocks in the creek for crawdads, seining for minnows, riding horses with my grandfather, shooting arrows into bales of straw, carrying my BB gun everywhere, shooting bigger guns whenever the opportunity afforded itself and generally acting like a joyous junior barbarian. Those became my preferred activities, until I discovered martial arts, then girlfriend, in high school.
My wife Jan grew up with brothers playing football. If I don’t understand a game that’s on, I just ask her and she guides me through. Two of my children attend Clemson University, and the other two are also fans, which is great. But they didn’t get it from me. Just recently they were all talking about the season and daughter Elysa said, with surprise, ‘why look at us, talking about sports like a normal family!’
I have great respect for all those devoted to their teams, who can quote stats like chapter and verse of scripture. May your team get all of the touchdowns, field-goals, runs and everything else it needs. But to all those who never got it, who never fell in love with sports, it’s alright. You aren’t alone.
Do your thing. You aren’t less of a Southerner or less of a man. And when the discussion turns to yesterday’s contest, learn to smile, nod and just say this: ‘that was some game!’

On Veteran’s Day ask, ‘what would I die to defend?’

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Veteran’s Day has always meant something to me.  But then, I was born in 1964.  I’m the last of the ‘Baby Boomers.’  I grew up on stories of family members in time of war.  I remember my father, Keith Leap (my name also) leaving for Vietnam when I was four years old, and remember (vaguely) his return.  I recall my uncle’s stories of the Navy, and of a grandfather in the Army in Mississippi and a great-grandfather who served during the Spanish-American War.  There were others, back to the Civil War, the War of 1812 and the Revolution.

I grew up looking for dates of service on tombstones, and for flags, ranks and units of the fallen.  I grew up with toy guns, toy soldiers and war movies, in a time when we threw plastic grenades with caps in them, which sometimes actually went off and frankly surprised us.

A great-uncle I never met was a Col. in the US Army in France during WWI, and I always heard that he said he was determined to bring his men home safely.  Another great uncle gave me a bayonet he took from an ammo-dump in Italy during WWII; there appears to be a ding in the side from a bullet. A neighbor survived the Bataan Death March; not surprisingly, he suffered as an alcoholic as long as we knew him.  I once met a gracious gentleman who was a former Wehrmacht soldier, who (after a CT scan when his arms were held above his head) said ‘the last time I held my arms like that one of Patton’s soldiers had a rifle in my back!’

I was immersed in veterans and their stories.  And the ones I knew were ever humble and kind.

Was I taught to idolize war?  Was I taught that bloodshed was the answer?  Was I taught that violence was some sort of higher good, as if we were Lacedaemonian children of Sparta?

I don’t think so.  I think I was taught to idolize sacrifice, courage, and simply fortitude.  I grew up in Appalachia; fortitude was necessary, if only for my ancestors to survive against nature.

I suspect that much that these men did had less to do with bravery than determination; in practical application they can look the same, I suppose.

Many brave men and women follow that tradition of service.  They fight, are wounded and die on many fields.  They live or die by their conviction, by their camaraderie, by their patriotism and belief in something higher.

This is hardly limited to the armed forces.  Many live their convictions, in all sorts of fields of endeavor.  But what I wonder now is this:  who will die for their convictions?

We live in a time when many people, especially those in universities, are emotionally wrecked by the slightest challenge to their beliefs, the faintest intrusion into the coddled safety of their own fragile minds.  College administrators give them coloring books, Play-dough, therapy dogs.  Safe rooms are established where they can cry when things don’t go the way they perceive that they should, when there is no trophy or certificate for all.   I suppose this is included in the price of tuition?

But on Veteran’s Day, I must ask of all Americans, what beliefs will they, will we, go through life willing to die to defend?  We should all ask this. What matters most?  Faith, country, family, these are things men and women historically died for.  Ideology?  To some extent, but I wonder.

Will generations of young people learn the lesson of Veteran’s Day?  Not that they need to serve in the military to be real Americans; not that the only heroes are those in uniform, those in battle.  That is a heresy that would produce a warrior class, and we don’t need that.

The lesson, as I see it, is different.  What will you have the courage to stand up and live for, instead of lying down and weeping?  And what will you have the fortitude to die for, if it comes to that?

On this beautiful Veteran’s Day, contemplate that, whether you are or were or never were in the armed forces.  And find an answer.

The future may call on you to decide.

Driving Country Roads to the ER

These days, I work most of my shifts about 45 minutes from my ‘house on the hill.’ At one of those jobs, the day shift starts at 06:30. Which means I’m rising from my bed at 04:30 in order to get on the road in time. I’ve started waking up at four, spontaneously, as if it were the most natural thing in the world.

I lay out my clothes the night before, so as not to awake my darling wife in her sleep. Sometimes I am able slip out without her knowledge. Others she wakes to kiss me goodbye. Then I go downstairs and put together some lunch, get the backpack and make my way out the door. I know that my wife and children are safe upstairs, as I lock the door behind me.

The door creeks a little, or did until my son Elijah oiled it. (One always wonders why a teenage boy oils a front door…) Occasionally I lock it as I realize I left my keys inside, and poor, tired Jan opens the door for me patiently. On the front porch, by the soft yellow of porch-light or the shock of flashlight, I step over dogs freshly awakened from sleep, who look at me with gentle annoyance. The sharp-eyed cats sleep in more secret places, so are seldom seen in the morning. Other dogs (we have five), sleep on the gravel drive in the summer and seem confused as to how to react when my Tundra rolls towards them, slowly, and I roll down the window. ‘Get up, you silly dog!’ Heads and tails down they amble away.

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Up the long drive and down the road, I am suddenly all but alone on the two lane roads that lead me to Tiny Memorial Hospital. Despite the early hour, I am ‘awake, alert and oriented.’ The sky is dark, and in winter stars shine down when clouds don’t lay low against the earth. I scan the roadside for deer, their eyes reflecting the truck’s headlamps. Opossums sometimes shuffle across, along with squirrels and rabbits. (One day I saw a big, black bear on a hill by the road. He ran away as I stopped for a photo.)
I drive through forests, past sleeping houses and across a dark, still lake where sometimes, the light from a bass-boat shines across the emptiness where someone has fished all night…or started very early. Or a campfire on the shore still burns as their line rests untroubled in the water.

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It is so early that I drive past gas-stations and convenience stores still dark and locked, the ‘closed’ sign reminding me to keep on moving. The air, even in summer, is cooler and in winter, positively cold. Winter is my favorite, I think, with the heat of the truck turned out, and the chill wind blowing past.

I think as I drive. And I pray. And I listen to the news, a recorded sermon, a pod-cast. Many mornings I turn on an oldies station from the North Carolina mountains; in the loneliness of the drive the music of Sinatra, Johnny Cash and others, make me feel I’ve gone back in time.

I cannot talk on the phone (hands free or otherwise). I pass through places where cell-signals are only a dream, and often even radio reception is poor. Remote areas, mountainous places, lonely and beautiful places defy cell signals and seem to say ‘look around! What else do you need!’ Even at 5 am, I agree.
Eventually I am near, and I find a fast-food joint for the obligatory chicken biscuit and tea, because, well, the South and all. And then I roll into the ER parking lot, lock things up and head to work.
Because this is no urban trauma center, the early morning is sometimes very slow and relaxed. A few patients may be waiting for turnover, but often none. I can sit and think, I can ask about the previous night. I can ease into work. My drive has already prepared me, but it’s nice to have a few minutes peace in the department before the chaos of the day begins. I text Jan. ‘Here safe, love you,’ and she answers. ‘Love you back, have a great day.’
There are those who don’t have to drive long distances. For most of my career it was about 15 minutes to work. And there are those who have long commutes through traffic, and through the waking body of a large city, people and cars just starting to fill its veins and arteries. Sometimes I am jealous. It can be lonely where I am.
But I think I’ll keep it for now. There is a solemnity, a serenity to my mountain and lake commute, with animals heading to bed and people not yet rising, with my own thoughts and prayers to myself.

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And I suppose that if there were a better way to prepare for the madness, badness and sadness of the ER, I don’t know what it is.

A Visit From Balthazar; a guest post by Dr. Rob Lindeman

This is a beautiful post by my friend, Dr. Rob Lindeman, a fellow emergency physician and pediatrician, long-time blogger and now ‘baby-toddler coach.’

Link to his site can be found at the end of this piece, and in my links section.  Please have a look!

I loved working in the Emergency Department on Christmas. I mean I really loved it.

I’m Jewish, and for me Christmas had always meant Chinese food and a movie. This got dull by my teen years. In the days before the internet, there was literally nothing for us Jews to do on Christmas. We sat around and talked to one another. I know: how horrible is that?

Jewish health care professionals, on the other hand, work on Christmas. Virtually everyone who can get the holiday off does take it off, and that leaves the Members of the Tribe, as we sometimes call ourselves, to pick up Christmas shifts.

Now for those who’ve never seen the inside of a hospital on Christmas, I recommend visiting at least once, if only to spread cheer for those who can’t be home. Christmas is just different from every hospital holiday. Everyone is in a good mood, there’s all the Santa hats, the food in the cafeteria is free (or it used to be, anyway), and the hospital is relatively quiet because there are no elective procedures scheduled for the entire week.

Well, that’s not entirely true: the hospital is not completely quiet on Christmas. The Emergency Department is busy. It’s very busy. When I’ve worked Christmas, I’ve usually worked in the ED, and it’s been non-stop for the entire day. One earns his salary picking up the ED on Christmas.

The waiting room is full, triage is hopping, and every room is full. I remember the first Christmas I worked, my head fairly spinning looking at the board full of names, humming “Do They Know It’s Christmas?” tune from the 80’s (let’s just say there have been better Christmas songs.)

There are several reasons why the ED is so crowded on Christmas, not all of them so jolly. There are the cold and flu sufferers, the stomach bugs, the motor vehicle accidents. But one group made me particularly sad: the people who were in the ED because they just didn’t want to be with family. There was nothing wrong with these patients. They were not really sick. They were not injured. They wanted to be somewhere else, anywhere else than at home. That’s one reason for the big crowds.

By nightfall, the census remains high. Now families are falling asleep in the waiting room and in the patient rooms, waiting to be seen.

I peer into a dark patient room. A young mother and her 2-year old son are laying on the exam table, both fast asleep. The boy is audibly wheezing. The board says “asthma” next to his name.

I knock gently and clear my throat. Mom springs up and hurriedly sweeps away the hair that has stuck to her face. She smiles embarrassedly introduces herself.

“And who’s this?” I ask, nodding toward the precious little blonde boy still asleep on the table.

“His name is Balthazar,” she replies, “he’s one of the Three Kings.”

I get it immediately. I’m not extremely well-versed in New Testament Scripture but I know the story from the Gospel of Matthew about the three wise men (or “magi” or “kings”, depending on the rendering) who visit the baby Jesus in the manger, bearing gifts.

And I feel an immediate sense of warmth toward this child and this mother. Here it was, Christmas Day, and Balthazar had come to “visit” me, a Jewish man.

This Balthazar was not particularly distressed with his asthma attack. He was sleeping, after all, and that was a good sign. A couple of nebs and a dose of prednisolone and he was on his way, improved. I had no “gifts” for him. A prescription. That was all.

Like many such stories, this one can have meaning if you want it to, or it can mean nothing at all. I’m still not sure what this episode means in my life. But it feels meaningful. I often think about Balthazar’s visit to the ED that Christmas. And I’m grateful.

http://www.essentiallyhealthychild.com

Summer Wants You Dead! My column in today’s Greenville News.

http://www.greenvilleonline.com/story/opinion/contributors/2015/08/08/ed-leap-careful-summer-wants-dead/31298333/

Enough of the tedium of politics and culture! Let’s focus on the real enemy. Which in the South is clearly Summer. I was working in a Southern ER recently, in a location which is beautiful, full of Northerners, and which shall remain unnamed. We’ll call it ‘Vacation Memorial Hospital.’ Lying before me was a charming lady of some 80 years, who had fainted.

‘What happened?’ I asked.

‘Well, my husband and I decided to ride bikes to lunch. It’s such a pretty day and all. And after about three miles I just felt funny and when I sat on a bench I passed out.’

(Relevant fact for the reader: The heat index was 115 that day.)

‘Oh my! It’s very hot outside. Where are you from?’

‘We’re here from Chicago.’

‘Do you ride bikes at home?’

Laughing, says ‘Oh no, only when we’re here!’

So, living in a city which feels nearly Arctic most of the year, my patient comes to South Town and rides a bike three miles in heat that makes the hardiest Southerner cling to the AC unit with something akin to worship. But this was certainly not the only misguided person I saw who did something similar. There were variations of course: ‘I drank a 12 pack and went to the beach for a few hours.’ Or, ‘I paddle-boarded for 8 hours against the tide, starting at noon.’ You get the picture.

Please excuse my bluntness and paranoia, but the fact that non-Southerns don’t realize about our summers is this: nature wants to kill you. Heat and humidity are its favorite weapons, and dehydration and heat stroke it’s favored techniques. (It’s the opposite of life in the far North, where nature wants to terminate you by turning you into a solid block of ice.)

However, as I realized long ago, it’s more than the heat. Summer in the South has many weapons at its disposal. For instance, it has water. More specifically, water and alcohol, the combination of which makes a fine cocktail but a very poor form of recreation. Summer doesn’t mind drowning the unwary.

Summer also employs creatures. I spend a large part of my summer finding, and destroying, the dozens of wasp nests that inhabit our property in the summer, and which make every expedition outside an exercise in looking for ‘booby traps.’ (I’m not vindictive; one of my sons is dangerously allergic.) There’s a nest on every door frame, in every shed, in the ground over which we mow, under the diving board, in the old can in the woods. Ditto for spider webs; a giant black widow was living happily under my wife’s lawn chair last week.

And I’d be remiss if I didn’t mention venomous snakes. Copperheads have been particularly busy over the last couple of summers, causing painful bites and no doubt receiving financial kickbacks from the makers of $2000 per vial antivenin. Apparently, they have also been communicating with the shark population on the Carolina coast to start some form of horrible insurrection worthy of a B movie.

However, perhaps the most insidious technique of summer is the use of the lawn. The lawn compels us to expose ourselves to the intense sun, to stinging insects and to power equipment. Now, I’m pretty careful about blades turned by engines. But if I ever have a heart attack, odds are it will happen while I’m trying to start the 2-cycle engine of a weed-eater, already partly destroyed by ethanol-containing gasoline. Furthermore, it’s not only a danger to my earthly body. The anger and profanity that boil up while working with the weed-eater, or reprobate mower, are surely enough to make a Baptist into a backslider.

I know, this sounds crazy, but I’m ready for Autumn. And especially for that first freeze when stinging and biting things take a break, when the lawn grows more slowly and when a bike ride needn’t be accompanied by a 9-11 call.

I have a theory about why Southerners make up such a large proportion of our Armed Forces. It’s because of summer. As Southern children we learn that nature, for all it’s wonders, has it in for us. And we spend our time fighting and enduring temperatures, creatures, Kudzu, Poison Ivy and every other nefarious thing thrown our way. We learn caution, appropriate distrust and how to fight dirty. These are lessons that our visitors would do well to understand. Because like it or not, Summer wants you dead.

Now go and enjoy your bike ride!

 

A chart should tell a story. (My EM News column for March.)

 A Chart Should Tell a Story. 

My EM News column for March.

 

http://journals.lww.com/em-news/Fulltext/2015/03000/Life_in_Emergistan__Tell_Me_a_Story.6.aspx

 

 

I suppose it is obvious that I am a fan of stories. I like to hear them, read them, watch them, collect them and tell them. I believe I am participating in stories every day of my life. The story of my family is a beautiful epic. The stories I hear at work can break my heart. One of my favorite stories starts like this, as told to me by an adult man in his forties: ‘The thing is, me and my mama live with her boyfriend. And the other night, her boyfriend had a cardiac arrest! And when he had the cardiac arrest, he rolled out of bed, and crushed the Pomeranian.’ I can tell it better in person.

Obviously, story is truly essential to medicine. The history we obtain from patients is a story, a narrative of the development of whatever affliction they are facing. The medical record we generate is a larger version of the story, which includes past conflicts and resolutions, various antagonists and protagonists, symbolism, sub-text, conclusion and all the rest.

The problem is that in medicine, we have murdered the story. But it isn’t a complicated mystery. The murder occurred because the modern medical record is designed to gather demographics, monitor (and modify) our behaviors and generate bills. Therefore, it must be easily interpreted by people, or computer programs, that look for clicks and checks rather than descriptions. After all, it takes time and training to learn to read and appreciate a well-crafted story. But not so long to do a word-search.

I suspect that it is also a generational issue, as younger physicians have grown up with communication shared in short bursts, whether on television, in music, while texting or using various forms of social media. So I suppose that I understand how we have evolved, or perhaps devolved, in our medical communications.

In all fairness one can ‘reassemble’ the story from click boxes and drop-down menus. It just takes effort. It certainly requires more time than it would take to read a story. It’s rather archeological in nature, in fact. One must look at the nurse’s notes and the time-stamps, the triage vital signs and the things ordered, the timing with which they were ordered and interpreted, the consultations, the disposition, the prescriptions, the out-patient tests. All of it, when properly put together, can give an approximation of the who, what, when, why, how and where of the encounter.

But what we often do not have, particularly in times of crisis when the patient suddenly returns, is the luxury to put the pieces together again. Nor do the consultants and primary care doctors and specialists who see our patients later and who very much want to understand what transpired. And yet, as I travel around, and as I look back on various charts to discern what happened on previous visits, I see check boxes, labs, findings, diagnoses (often vague) but no description. The ‘Medical Decision Making,’ or ‘Emergency Department Course,’ are empty fields. In years past, we were told that these were critical parts of the chart that showed the complexity of our thought processes. I suppose EMR has changed that, on some level. But I’m think we’re worse for it. Looking at those particular blank spaces is like listening to crickets in a field. Or staring into an empty room. The absence of words doesn’t help anyone; least of all the patient.

So let me take this moment to encourage everyone to leave a note, even a wee, little note, describing what transpired in that patient encounter. Fine, if it’s strep throat, if it’s an ankle sprain, I get it. I can figure that out. But for anything with the slightest complexity, anything requiring several labs, or studies or consultants, please tell me a story!

It needn’t involve a ‘dark and stormy night.’ But it should have enough information to help the next person reading it. ‘This 14-year-old girl has had two weeks of intermittent cough, fever and shortness of breath. She has a negative chest x-ray but was noted to have scattered wheezes. She was feeling much better after an Albuterol treatment and her parents agree to arrange follow up with her doctor next week.’ It’s not ‘For Whom the Bell Tolls,’ but it’s a nice, simple summary that helps everyone else to have a sense of what happened. And it did so in three, count ’em three (3) sentences!

Chest pain? Summarize it and describe the plan. Trauma? Tell me why they were safe to go home. Headache? Explain, however briefly, why it wasn’t necessary to do more work-up. Heck, make it a game! A kind of ‘micro non-fiction.’ (Micro fiction can be a story as short as six words.) Diligence at this craft makes us more effective, more succinct communicators. And in the press of modern medicine, that can only be a good thing.

When my children were little, bedtime was always accompanied by this question: can you read a story? I’m just asking a similar thing of my colleagues. Before you put the chart to bed, write me a story.

And if it involves a Pomeranian, so much the better.

Looking to Syndicate My Work

Dear Friends and Readers,

While I am a full-time emergency physician, I am also a columnist. I have been writing op-ed columns twice each month for the Greenville News for nearly 20 years. In addition, I have been writing monthly columns (titled Life in Emergistan) for Emergency Medicine News, owned by Wolters-Kluwer publishing,, for 15 years. I also write a monthly health column for the SC Baptist Courier, as well as publishing many blog posts each month. Many of my medical columns and posts find their way to the popular website KevinMD.

It is my goal to become a syndicated columnist, and I believe I can best start by being self-syndicated. Therefore, if you have a publication in need of content (medical, health, faith, family, Southern or humor), please consider letting me write for you. I promise it will be cost-effective and that the content will be engaging. If you know of any editors of local papers, small or large, who might be interested, please put in a good word and put me in touch!

Here’s a list of links to some of my collected works. Any help is greatly appreciated.

http://www.kevinmd.com/blog/?s=Ed+Leap

http://journals.lww.com/em-news/Pages/collectiondetails.aspx?TopicalCollectionId=6

http://www.greenvilleonline.com/search/Ed%20Leap/

http://baptistcourier.com/?s=Edwin+leap

Sincerely,

Edwin Leap

Life in Emergistan

Dear readers:  If you would like to order an e-book edition of Life in Emergistan, my latest compilation, please go to this web address:

http://www.nursingcenter.com/lnc/journalarticle?Article_ID=1713150

If you’re kickin’ it old school and would like a print copy, please e-mail Ms. Lisa Hoffman, editor of Emergency Medicine News, with your name, address and phone number, and a copy will be shipped to you:

emn@lww.com

Thanks for your faithful readership!

Edwin

The infant is packed away

http://whimsygal.com/wp-content/uploads/2013/01/Packing-Christmas-Ornaments-Away-5.jpg

 

January 2nd, the infant is packed away

On one corner counter, the year-round creche,

ceramic, where Jesus lies adored by silent figures,

December to December.

 

The rest of Christmas relegated to boxes,

crates, cartons, all on basement shelves,

out of our daily way.

 

There is no trace of tinsel, tree, ornament,

gift-box, sparkling light, angel or, even, kind Nicholas,

to draw us backward.

 

No hymns, oratories, carols or lessons speak of Silent Nights,

Refiner’s Fires, mangers, Bethlehem, Kings, infants or Wassail;

none assail our suddenly secular ears now.

 

The New Year looms as fresh as the house is clear of the old,

and we are sated with food and things and rest;

now we, oddly, must search for the infant again.

 

Perhaps it is not too great a hope that the child

has not been stored away too well, wrapped too tightly,

for us to know him for the next 12 months.

 

But then, we have always wrapped him up; swaddling clothes,

thorns, shrouds, lies, denial, hatred…storage crates.

Ever and again he emerges to seek us.

 

Edwin Leap 2015

Dear aspiring writers…if I can do it, so can you

For those of you who are regular readers (or those who should be), here’s a list of collections of my posts and columns I was able to put together today. I did so because an old friend asked for them, but I think there’s a larger lesson here for other writers.
If you are a writer, struggling writer or aspiring writer, please note:  I do not have an English degree and I do not have a Journalism degree (started one but moved to Zoology pretty quickly).  My advice, dear writer, is this:
Write, write, write, submit, submit, submit.  Be persistent, practice, find your voice and find your niche.
If I can do it, so can you.
Edwin