When Being Broken Means Becoming Better

Jul 6, 2021 by

17 years ago on July 1, 2004, I put on my first long white coat, clipped a bulky black pager to its left front pocket and snapped a picture of myself standing before a full-length mirror.  

It was my first official day as a doctor.  

I started intern year of residency at Westchester Medical Center equipped with two black pens, three pocket-size “quick reference guides” and giant grey PalmPilot to look up every medication I was now legally allowed to prescribe. I had a naïve belief that four years of undergrad and four years of medical school had properly prepared me for this day, the day I would start changing the world, one patient at a time.  

I was so wrong.  

The next three years gutted me of everything I thought I knew, and then proceeded to shatter my very sense of self into a million worthless pieces.  

The days were long, the night shifts were longer, and whoever thought the 80-hour work week was doable had clearly never done one, much less three consecutive years of them.  

It seemed as if every day was a loss, and only seldom was there a win. The harder I worked, the more I failed.   

There was a limit to how many times I could say “I am sorry, there was nothing more we could do,” before I began to ask myself “is this really the place I am supposed to be?”  

I had lost hope in hope.  

But then slowly (so very slowly) residency stopped breaking me, and it was then I began building this doctor that I have become.   

And so what have I become? To start, I am a doctor who works tirelessly, I am a doctor who acquires wisdom, and perhaps, most important of all, I am a doctor who is (once again) filled with hope for every patient- regardless of circumstances, regardless of diagnosis and regardless of their often times terminal condition.  

And in the 14 years since completing residency I of course have been shattered again and again. Those first 6 months of 2020 alone left me in terrified pieces as I continued to care for patients- my most pervasive thought being “if I die now, my daughter Heather will never remember my face.”    

But now, instead of rebuilding the parts of me which were destroyed, I hand those fragments over to my patients and say “here, this is me, this is the part of me that cares for you. Carry it and know that in this, you are not alone.”  

I don’t know everything, and I know I never will, but I know that I am a very good doctor. 

To all of those who have entrusted themselves to my care… thank you, it has truly been an honor.  

And today, July 1, 2021, I can say with all confidence that I do change our world every single day, one patient at a time.  

Sarah Mildred Gamble, DO, is a Board-Certified Internal Medicine physician. In 2010 she founded Greenwich Pure Medical, LLC, a concierge medical practice in Greenwich, Connecticut. For the past 7 years, she has been consistently recognized as a Castle Connolly Top Doctor in the New York Metro Area and as a Top Doctor In Concierge Medicine Across America. Her clinical interests and expertise focus on personalized primary medical and primary preventative care. She enjoys gardening (for which she has little skill), gluten-free baking (frequently lacking in taste) and trying to keep up with her 4-year-old daughter (which has proven to be quite difficult at the age of 45). Her website is www.GreenwichPureMedical.com and she can be followed on Instagram @greenwichpuremedical  

Thank You,  

Sarah Mildred Gamble, DO 
Board Certified Internal Medicine Physician 

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“front line”

Apr 26, 2020 by

I lay in bed on this beautiful Sunday morning telling myself I should be outside with my daughter.

I have so little time with her as it is.

I can hear her laughing as daddy builds the new water table I bought last week.

But Heather doesn’t understand that I give gifts to show my love.

All she sees is daddy putting it together and daddy playing with her in it. 

I can’t get out of bed.

I’m tired from mourning the life I once knew. 

The life of a doctor before COVID-19. 

Neighbors walk by, friends send texts, the media states over and over “thank you doctor, thank you for being on the front line.” 

But I now know there is a vast difference between the “front line” and the “front front line.” My “front line” is quite simply this…sit day after day alone in my office and FaceTime my patients- desperately trying to manage issues that only one month ago required extensive face-to-face visits.

I FaceTime my patients and watch them cough and sweat and shake and cry and struggle while begging me “can’t you do anything to help?”

I cannot. And then twice, perhaps three times a day, I dress myself in head to toe hazmat gear to care for patients whose clinical condition can no longer be managed over the phone.

Those times, I am so very afraid. How do I still “put patients first” when their very presence riddles me with fear?

The chaos is unmanageable.

My “front-front line” is quite simply this…I wait. I wait for a few more of my colleagues to fall sick and Jesus God, how can this even be real- to die.

So that once there are too few to serve, the hospital powers that be will telephone and say “Dr. Gamble, we need your help on the “front-front line.”

I am heartsick at what is happening to my friends, to my patients and to my colleagues.

Such irreplaceable loss.

I am paralyzed.I am powerless. I am afraid.I don’t want to die.

I don’t want my daughter to grow up not even remembering who I was. Or maybe she would only have memories of a mother who wouldn’t hug her until she had showered “the virus” away.

If I am lucky perhaps she will remember how we would lay in bed at night to read a few short stories and sing Disney songs until one of us fell asleep…If I die now, she will never remember my face.

And yet (and yet), in the ugly and intubated face of my COVID-19 fear- I will help, I will not give up and I will never, ever walk away. My little girl’s laughter drifts through my bedroom window, saying “Mommy come play with us.”

That little voice is so much more important than my COVID-19 fear.

So I kick off the covers and place both feet on the floor.

Before standing I muster the courage to reach over and check my phone. There are no missed calls from the hospital and no desperate emails stating “it’s time.”


I am a doctor who is nothing more than human in the time of COVID-19.“

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Sep 12, 2016 by

Are we texting our way to back pain?   As we spend more and more time hunched over our 1-devices we’ve become a nation afflicted with what is now being called, ‘Text neck.”  Slouching can be a prequel to long-term back, shoulder and neck pain,

Seems our mothers were right when they told us to stand up straight! Not only does good posture help you avoid these pain problems, it can also help improve your digestion, reduce stress and, even give you a shot of confidence.

From health.com, here’s a very do-able and sensible approach to become better aligned.  Try and implement as many of these moves as you can on a daily basis.

sitting_at_computer_cartoonWeek 1:

Good posture may feel awkward at first if you’ve trained your body to slump, explains Rami Said, a physical therapist at Columbia University Medical Center. Take a few moments every day to learn how correct posutre feels.

Stand taller: Evenly distribute your weight between both legs, with your feet parallel under hips and shoulder blades pressing down and back. Engage your glutes and core so your pelvis is stable beneath your ribs but not tucked under.

Sit smarter: Keep your earlobes above shoulders and shoulders above hips; allow a slight curve in the lumbar spine. Your feet should be flat on the floor and lower back against the chair (add a rolled-up towel if your back doesn’t touch).

Sleep straighter: Try to fall asleep on your side or back to help your spine stay more neutral.


Week 2: Tweak your routine

“Everyday habits make maintaining good posture much trickier,” says Jill Miller, founder of Yoga Tune Up. Do this instead:

Bag it better: Heavy purse? Change the shoulder you’re carrying it on every 10 minutes.

Ditch text neck: Keep your shoulders back and head lifted when checking your phone by holding it closer to eye level.

Stay down-to-earth: If stilettos put strain on your lower back, wear them for two-hour periods and take sitting breaks.

Week 3: Build strength

Do each of these moves daily to improve your muscle memory and overall alignment.

Shoulder stack: Every 30 minutes, bring your shoulder blades down, then back. Hold for two to three seconds. Repeat five times.

Pillow pose: Lie facedown on the floor and place a firm pillow under your abdomen. Take slow, deep breaths into the pillow for a few minutes.

Proper squat: Stand tall, feet slightly wider than hip-width, then lower into a squat. Extend your arms overhead, palms turned slightly backward to engage your upper back. Do as many 30- to 60-second squats as you can. Do not allow your spine to round or bend.


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Got Milk?

Aug 12, 2013 by

Here are some fun facts and good substitutions for cow’s milk:

Cow’s milk is designed to grow a baby calf into a 1500 lb. cow.  Stop drinking it or you will become a 1500 lb. person!

Soy milk is the most popular non-dairy milk; comes in lots of different flavors (original, vanilla, chocolate).  For baking, use unsweetened plain soy milk, but if you are making desserts use regular plain.

When trying to figure out which brand to buy, buy the one with the least amount of ingredients (make sure it is not a GMO—genetically modified soybean).

Soy creamer is a good substitute for half and half in your coffee.

Oat milk bakes very well, tastes great on cereals, and cooks perfectly.

Nut milks, which include almond and hazelnut, are much thinner than oat and soy and do not bake well, but are good chilled with cereal or in tea.

Rice milk does not have a lot of protein and has a lot of sugar but is low in calories.

Hemp milk is good because it has high omega 3 content.

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