Better than a birthday

The one year anniversary of Mothers in Medicine is like a birthday for me, but better. I guess it's like a birthday back in the day when getting a year older was the most awesome thing that could happen to you. Like that day, a month ago, when my daughter woke up and said, "I'm FOUR!" with so much enthusiasm, I thought I could see fireworks and rockets swirling around her head. Turning four was so good.

I think from the idea of wanting to start a group blog of physician-mothers to the actual launch was possibly 2 weeks or less. Things happened quickly. I distinctly remember driving home one night after some event with my husband and having The Idea. That's what we need! A group blog! For mothers! In medicine! After that, it was all momentum.

Starting out, I didn't know the majority of women who joined me to become regular contributors. But, over the past year, in writing together the joys and struggles and challenges and humor that come with this territory, they have become friends.

This year has been amazing. Amazing to see the growth of this blog community which continues to steadily grow. We've had 5 topic days. 18 guest posts. Over 290 posts. Over 120,000 page loads. I'm excited to see what this next year brings.

And probably some of the best moments have been hearing from you, the readers, about what Mothers in Medicine means to you. I encourage you to write in, give feedback, suggestions, submit guest posts, be involved. Because we are all in this together.

In reflecting on this year's posts and what stood out for me, I realized many of them have already been highlighted by my fellow MiM writers. Yet, there was one that wasn't: we received a comment to one of the posts that was so, well, amazing, that we posted it as a guest post proper, even though we never did track down who it was that left the comment.

Guest Post: A comment from a daughter

Thanks for reading (and sharing your stories),
KC

MiM celebrates one year: Fizzy

The end of this month marks Mothers in Medicine's one year anniversary. In honor of this great occasion, I asked our writers to share their favorite post (of their own) from the last year. Throughout the month, I'll be highlighting their picks.

Fizzy wins the prize for most prolific writer on MiM. While being a resident! (Any future resident writers: you have big shoes to fill!) Fizzy has made us laugh on a regular basis with her posts, which have become a staple of this blog. She's a PM&R resident, soon to finish, and mother to a toddler girl.

Fizzy writes:

It was hard to pick a favorite post, since I've written.... holy crap, 44 of them! But it would probably be this one:

http://www.mothersinmedicine.com/2008/08/mothers-dont-let-your-daughters-be.html

Fizzy, your unique writing style and contributions have rounded out MiM --you have woven your voice into the fabric of our community and have made it richer, funnier, and fuller. Thank you for being a part of MiM!

MiM celebrates one year: dr. whoo

The end of this month marks Mothers in Medicine's one year anniversary. In honor of this great occasion, I asked our writers to share their favorite post (of their own) from the last year. Throughout the month, I'll be highlighting their picks.

dr. whoo, an ob/gyn and mother of 2, is a veteran blogger with a popular personal blog with an awesome name. I mean, Ob/Gyn Kenobi, is brilliant, no? We were thrilled when she joined Mothers in Medicine as a regular contributor shortly after we launched.

dr. whoo writes:

Hi KC! Favorite post? Hmmmm, I think I would pick "What My Medical School Accpetance Letter Didn't Say..." I also liked "Boys Club" and "How do you do it all?"


Her choices involve a) her contribution to the Topic Day on "Things we wish we knew in medical school" --apparently a popular source of favorite posts for MiM bloggers; 2) a raw look at working in the trenches of medical culture where there is still a difference in treatment between male and female physicians (Boys Club); 3) continuing struggles to balance work and home life (How do you do it all?).

dr. whoo writes from the heart, with a clear point of view. Her love for the work she does is inspiring. We're rooting for her to be able to strike the work-life balance with a better job on the horizon. Thank you, dr. whoo, for being a part of MiM. We're looking forward to hearing all about your new adventures to come.

Friendship and Female Physicians

I've noticed over the past several years that it hasn't always been easy for me to make friends.

Sometimes I wonder if I'm the reason.  Am I simply un-like-able?

When I was in grade school I constantly found myself blurting out goofy things and wincing afterward.  I'm sure my social awkwardness cost me some friendships at that age.

Then there was high school  Oy.  Recently a friend from high school whom I've always admired told me I could sometimes be intimidating back then.  ME?!  Intimidating?!  But I'm so sweet!  And shy, and awkward! And un-tall!  But I suppose my love of Renaissance history, French poetry, and molecular biology might have struck some people as off-putting...

I had a great time in college.  I found like-minded people, kindred spirits, people in different spheres who loved a lot of the same activities, subjects, books, etc.  I made some life-long friends in college, as many of us do (and a few good friends in med school and internship as well, though not as many).

I can think of a few things that can make building new friendships and maintaining existing ones hard after college.  Relocation. Marriage.  Parenthood.  Jobs.

And if your job is in medicine as a resident of some kind, you get the added challenge of sleeplessness, no time, no energy, no patience, high stress, contact with suffering on a daily basis, making lonely decisions in what can be an isolating profession, all free time spent sleeping or running errands.  Relationships of all kinds suffer during residency; friendships are no exception.

But I think there's yet an additional layer for female doctors.  I can't quite put my finger on what it's made of, but it's there.  

When people find out you're a doctor - that's if you can even get around to meeting new people in the first place - sometimes their whole vibe toward you can change.  It's almost imperceptible, but there's a turn somewhere.  It's there. A pulling back, maybe, or the inexplicable sudden presence of an invisible veil between you and the person you'd like to befriend who happens not to be a physician.

I'm not sure why that happens, or even if I'm making something out of nothing.  Women-doctors want to hang out and watch chick flicks as much as any group of women friends, or go to cafes to chat, or cook together.  Why the sudden barriers?

I have a friend - a drop-dead gorgeous, brilliant, super-sweet, supportive-beyond-measure, talented, couldn't-be-nicer friend, fellow-mom, and fellow-physician - who meets with a group of women on a regular basis to engage in a much-enjoyed activity.  She told me that for a long time she didn't tell the other members of the group she was a doctor.  She was concerned they might not be as relaxed, or their attitude to her might change, with the knowledge of her profession.  I have another, newer friend - also multi-talented, also a fellow-mom and physician, very nice, with lots of different interests - who has observed a shift in others when she strikes up a conversation but then reveals that she's a doctor. 

I don't think we're all just imagining this.  There's something about us female physicians that seems to make some people hesitate to get too close, which makes making friends even harder in the context of busy, demanding lives juggling work and family.  I tried googling "women doctors" and "friendship" to see if I could learn more, but no one seems to be talking about this much, or I'm not looking in the right places, or no one else thinks there's an issue.

Do male physicians experience anything similar?  Am I just being over-sensitive?  I don't know.  But I do think the whole subject of physicians and friendship in general, and women doctors in particular, is worth exploring.  

Cross-posted at Notes of an Anesthesioboist.

Future Mother in Medicine?

I was reading a story on the Washington Post about a girl graduating high school with 13 years of perfect attendance. She has not missed one day of school in 13 years.

It's easy enough to say that this is a great accomplishment, one to be proud of, but I'd actually say it's a little bit scary that such a young person feels so driven that they did not stay home once since the age of 5. *cough cough* Sound a little familiar to some of you?

I think it's really admirable to have perfect attendance, but not at the expense of being human. This student was mourning the fact that she couldn't go visit colleges because she was unable to miss a day of class. Although I snickered a little bit at these warped priorities, I have to say that I've been guilty of the same line of thinking myself. I recall last year that I dragged myself to work with a really bad stomach bug when any normal person would have stayed home. Instead, I went to the bathroom to vomit between patients. (Yes, I had mints.)

On another occasion, I went to clinic when I had severe laryngitis. I could barely speak a word. I don't know how I thought I was going to interview patients... sign language? As soon as I opened my mouth, my attending said to me, "OH MY GOD, GO HOME." I would have tried to argue with her but I couldn't talk.

Come to think of it, I was kind of the same way in high school.

The end of the article states that this girl is going to be pre-med in college. What a shock, right? She'll fit right in.

Of course, I want my daughter to have a good work ethic, but I don't want her to feel like she's not allowed to be sick, the way I do. A mother always wants her child to inherit her good traits, not her bad traits... I'm not sure where this sense extreme responsibility fits in there.

MiM celebrates one year: FreshMD

The end of this month marks Mothers in Medicine's one year anniversary. In honor of this great occasion, I asked our writers to share their favorite post (of their own) from the last year. Throughout the month, I'll be highlighting their picks.

FreshMD was one of the first women I recruited to join MiM. I came across her personal blog and fell a little bit in love. Since then, we've enjoyed her poignant, articulate, witty, insightful posts here on Mothers in Medicine.

She writes:

"Hmmm, hard to decide. I think this one: http://www.mothersinmedicine.com/2008/11/full-days-work-by-9-am.html

It was fun to review them! I don't remember writing some parts. Some of the details about my son breaking his arm I had no recollection of."

FreshMD, thank you, for writing with us for the past year. We wouldn't be the same without you. (And while we are sad to hear you will no longer be posting at your personal blog, we are glad you will be able to pursue new creative endeavors and thrilled we can still read your words and insight here.)

Dandelion poetry

We brought dinner to the beach last week, and afterwards we walked out to the dock and played along the shore. Leif found a cluster of dandelions gone to seed and hunched over, snapping the hollow milky stems and double fisting his prize.

"I'm going to make a wish!" he said. "I wish for . . . " I could see him searching for something extravagant. "A chocolate cake!" he said expansively.

puff puff spit huff spit puff

"I'm not going to blow anymore. I'm just going to whack the wishes off now," he said, striking the fluff balls against the railing, then plucking them apart manually. "Look - a school of wishes!" He watched them drift off in a hazy clump. "Hey! The wishes are all hugging each other!" And then he spotted some goslings and trotted off down the beach.

How wonderful to wish for chocolate cake. To have to think hard for something to wish for, to have all your needs met, to have no cares or sickness or worries to wish away.

For me, my children and their pure, unspoiled interactions with the world are the most potent antidote to the suffering I witness at work and sometimes carry home with me as a little black cloud over my heart.

MiM celebrates one year: RH+

The end of this month marks Mothers in Medicine's one year anniversary. In honor of this great occasion, I asked our writers to share their favorite post (of their own) from the last year. Throughout the month, I'll be highlighting their picks.

RH+ writes:
In reviewing my posts these are my favorites:
Cry (Guest Post)
Reverse Penis Envy
Oh the Places You'll Go!

We first met RH+, an ob/gyn, when she submitted a guest post last July that knocked our socks off and landed us on Kevin, M.D. We were thrilled to have her join us here.

Since then, she's contributed funny, touching, real stories including the humorous Reverse Penis Envy and the "Things We Wish We Knew in Medical School" Topic Day post, Oh the Places You'll Go.

It's been such a pleasure writing with you this past year, RH+. Looking forward to your stories to come.

Role Reversal

Ever since my husband made the decision to stop working in order to balance our family and home life, things have been ever so much more manageable in our lives. Groceries get bought, laundry gets done, dinner gets cooked, and life is a little easier for all of us. It has been a necessary, though not a permanent, change. As my husband has assumed the "traditional female" role with respect to keeping our house in order, I sometimes find myself falling into the role of a 60s sitcom "traditional male." I come home, grunt a few times, stare at the television or the internet until dinner, hug and snuggle the kids, get them fed and bathed, and become basically a zoned-out zombie until the weekend rolls around. It is only then that I awaken to my real "maternal instinct." It is only then that I can interact with my kids as more of a mommy than a "provider." I know that I haven't changed, but, right now, my role in their lives has. I'm the breadwinner. I'm working for our family, and somehow, it is taking a lot from me. Lately, I find myself more sympathetic to those 60s fathers, bearing the weight of the world on their shoulders, but always ready with a bit of wisdom or a pithy saying. I know my husband respects the hard working (not bon-bon eating) housewives, as well. Still, at the end of the day, I know my mother's heart is still alive and well, especially when Bean holds my face close and memorizes every feature, softly saying "nose," "mouth," "eyes," and "hair." My heart just melts, and I feel so blessed to just be "Mommy."

MiM celebrates one year: Juliaink

The end of this month marks Mothers in Medicine's one year anniversary. In honor of this great occasion, I asked our writers to share their favorite post (of their own) from the last year. Throughout the month, I'll be highlighting their picks.

Juliaink has brought a unique perspective to this blog, both as a psychiatrist in academics, as well as mother to two grown children. She writes eloquently and thoughtfully, and at times, passionately.

Juliaink writes:
I think my favorite is still The Speech I Never Gave though I also like the one I did on mentors/models.


The Speech I Never Gave gave me goosebumps and one I wish was required reading for every female medical student. And her post on mentors was honest and rich.

Thank you, Juliaink, for having the courage to write about what moves you, and to share your opinions on issues seen through your multiples lenses as a mother, physician and concerned citizen. Thank you for your stories.

Seriously, I wanna know...

Over the past week, school systems across my state have administered tests that will determine for some children if they will advance to the next grade. This fourth quarter assessment causes no shortage of angst among the children of my community, and I have seen my fair share of nonspecific headaches and belly aches as a result. It makes me pause and wonder, are we teaching only one side of the anxiety equation? Some anxiety is helpful - it motivates, creates energy for us to act upon a situation. Like all things, though, there is a balance between the constructive state and the paralyzing fear of the unknown. Is there some sort of curiculum that we can use to instruct students about constructive ways to relax? Do you have favorite techiniques you use to guide your children and/or patients through nervousness?

Yes, I watch Idol

For the duration of this American Idol season, Melly was convinced that Danny Gokey was her father. Every time he came on the screen, she announced, "Dada!" Gokey does sort of look like my husband, in that they both have short dark hair, glasses, and are kind of... um, solid.

My husband was convinced that she was simply calling him "Dada" because he was a man, not because he and Gokey are long-lost brothers or anything. To illustrate this, he pointed to Adam Lambert and said, "Who's this?"

Melly hesitated a second before answering: "Mommy!"

Oh man. For the record, I wear way less eye make-up than Adam Lambert.

Admittedly, this entry didn't have a lot to do with being a mother in medicine, but hey, somebody had to post about the Idol finale (yay Kris). I'll also take this opportunity to announce that according to Melly, my job has now been upgraded from "diaper" to "dopter". Not bad, eh?

MiM celebrates one year: Artemis

The end of this month marks Mothers in Medicine's one year anniversary. In honor of this great occasion, I asked our writers to share their favorite post (of their own) from the last year. Throughout the month, I'll be highlighting their picks.

Artemis, a neurologist in a private practice and mother of two teenaged boys, has written with us from the launch. She writes with honesty, insight and wiseness. Her posts make us reflect on our many roles as physician-mothers.

Artemis writes:
I like both the very first post I did (June 6, 2008), and the March 29, 2009 post.


I remember the June 6 post well, called "Moms in Medicine." Her post really solidified for me why we were coming together: to share stories like this, to support one another, and to celebrate being mothers in medicine.

The March 29, post, "No, Mom, Billy does NOT want to stay for dinner" was a humorous anecdote of a dinnertime conversation that could easily occur in any of our homes.

It's been wondeful getting to know Artemis through her posts this past year. Thank you, Artemis. We are lucky to have you writing with us.

MiM celebrates one year: T

The end of this month marks Mothers in Medicine's one year anniversary. In honor of this great occasion, I asked our writers to share their favorite post (of their own) from the last year. Throughout the month, I'll be highlighting their picks.

T is one of the original contributors to MiM and over the year, has contributed honest, witty, real posts about being a pediatrician mother in a 2 physician/researcher family. T writes:

"As I think back to my first MIM post one year ago, get out much, let me report on all the progress my husband and I have made. END of post.

Alas, I'm inclined to say that we've made no progress on the get out much as a twosome front. We still spend our evenings and weekends As A Family. Haven't identified a babysitter. Haven't seen a movie. One or both of us has put them to bed every night of their lives. We did go out on a "date" recently, but it was to an auction/fundraiser at our kids' preschool and they were there in an adjacent room!

Nonetheless, there's been progress of other sorts, indeed. Just Five is learning to swim and to read (now enjoying chapter books read together like Franny K Stein, Nancy Drew, Ramona the Pest, Ralph S Mouse, and others). Almost Three continues to eat all foods and play all instruments. Both know how to be Children in Medicine. They expertly cough into their elbows, wash skinned knees, brush every part of every tooth every night, and answer common questions from parents of patients when Dr Mommy's on call (okay, almost). Oh, and I'm not old yet.

And, though our Couples Time tends to be by day on the phone or at home after the kids finally go to sleep (after hours tends to be late in our family), I'm decidedly still in love with my husband who happens to be a Father in Medicine, or more accurately a Father in Research. And I've participated in (read, laughed, commented, collaborated, posted, cringed) as a first time blogger with a group of fabulous women with varied voices about what makes us who we are, Mothers in Medicine."


T, indeed, is a comforting voice here and we've all felt her reassuring and supportive comments. She makes you feel understood, not judged, and a part of a true collaborative. Thank you, T, for all of your contributions this past year, and hopefully, many more to come. (Also, you should take advantage of Recently Local Grandma VERY SOON.)

Confessions of A Recovering Mother: Warning May Contain Political Content

At this point, with my children living between 300 and 6000 miles away, I find myself recapturing concerns that were submerged in the day to day tasks of mothering. I have always been concerned about politics, and as my children are becoming more independent, I process most political concerns through the lens of "what will this change mean for them?" I am especially concerned about health insurance reform, now that two of the three are no longer eligible for coverage under our family policy.

I am uncomfortably aware that my interests as physician, mother and citizen are diverging. As a physician, I want beneficiaries to be able to see me at reasonable rates with minimum hassle for both of us. Out of network coverage, health savings accounts, and any other mechanism that subverts managed care seems the most desirable when I am sitting behind my office desk.

As a mother, on the other hand, I am devastated that the last remaining not- for- profit HMO in my state is being dropped by the employer who provides our insurance. Growing up, my asthmatic daughter never had an attack before 6:30 in the evening. Only by the grace of Kaiser did she avoid emergency rooms and hospital stays. The idea that we (and she) no longer have an evening urgent care clinic to go to gives me shivers. She has had several ER visits since moving away and has no regular doctor. No one but me now reminds her to have check ups and refill her prescriptions, as the HMO used to do.

Then there is citizen me, who believes that national, single payor health insurance is the only way to correct the disparities that deny care to so many—including my middle daughter who is likely to be uninsured when she returns from abroad and has not yet found a job. As a doctor, I am wary of having the same type of people who man the kiosks at the DMV involved in managing health insurance, but as a mother I would welcome it, if it meant this child would not be uninsured, however briefly that is likely to be.

Like everyone else on this blog, I wish that politics did not divide and distress us. But some day in the not too distant future, I expect to have to vote on what it is I really want to see in health care reform. To the extent that my identity extends beyond myself to my children and my community, I frankly have no idea what it will mean to have the courage of my convictions. It would certainly help if I actually knew what those convictions were.

Baby names

Warning! Your name or the name of someone you love may be disparaged in this post. Read at your own risk.

It boiled down to two possible names for my daughter: Claudia or Ariana.

Pete wasn't keen on Claudia. "Would you name your son Claude?" he asked.

"No!"

"Then why would you name your daughter Claudia?" he asked practically.

Because I love the name. It's beautiful, it's solid, it's got years behind it, it's not overused. And yet, something didn't quite sit right about it. Finally, when I looked up the meaning, it all came crashing together: Claudia means lame. Of course - from the Latin claudus, from the same root as claudication. I was mortified that this hadn't been immediately obvious to me.

As a physician I'm more finely attuned to the medical implications of names than most, and I don't expect others to associate Claudia with vascular disease. But the name had been spoiled for me. Ariana it was.

Having narrowly averted my own baby naming fiasco, I am sympathetic to parents who inadvertently grant their newborns medically inadvisable baby names. By which I mean, I may inwardly gasp but I keep my mouth shut.

I met a little girl recently named Nevis. Maybe to her parents the name conjures up the beauty of a Caribbean island, but to me, well, she was a living, breathing mole.

Then I came across a variant spelling of Kyle, a name which until then I had considered benign. Chyle is a milky fluid consisting of lymph and emulsified fats, formed in the small intestine during digestion - not a preschooler.

Tanner reminds me of the stages of puberty, Addison warrants an endocrine referral, Lance is asking to be incised and drained, and Brady needs an ECG. 

I can medically bastardize most names, but that doesn't mean the general public can. So I don't recommend that parents fret over the medical implications of their name choice. Unless they're planning for a medical career for their child.

Because Melena isn't going to get past round one of the medical school selections process.

How I met your nanny

Most working moms stress about what they're going to do with their babies when they first go back to work after maternity leave. I was no exception. I had just made this beautiful, perfect baby and now I was horrified at the idea that I was going to leave her for even one second. But of course, I couldn't quit and let all those 30 hour calls be for nothing.

Initially, we were thinking about day care. A well established day care seemed somehow less frightening than letting a stranger into our house. However, most day cares in our very expensive area had a two year waiting list.... so basically, you had to get on the waiting list before you even were pregnant. And the prices were scary. The alternative was a "family home", where a registered person took a handful of babies in their home. They tended to charge less, have more openings, and fewer children.

I brought Melly to visit a family home in our area. I liked it immediately. It was very small: only two women and six children. But I still can picture the image of my helpless little 2 month old girl screaming on the floor of that day care. She was so young and I wanted her to have more individual attention. I couldn't leave her here. Not yet.

So I decided not to cheap out and I hired an agency to find us a nanny. I figured this way we'd get the absolute best quality nannies. The agency would check out the nannies, verify their credentials, and find us the nanny of our dreams. In exchange, we'd pay them $250 plus 10% of the nanny's salary for the first year.... pricey but worth it to get our "dream nanny". One agency guaranteed to find me someone in the four weeks before I went to work, so I hired them on the spot.

If it didn't compromise my identity, I would expose this horrible agency and how they turned out to be a lying bunch of scumbags. It took them over a week to send us one single candidate and she was the opposite of what we told them we wanted... for starters, she wasn't even able to work the hours we needed. I later heard an awful story about this particular agency: they instructed a nanny candidate to accept a job that she didn't want, then told her to cancel at the last minute (leaving the mother stranded), in order not to lose the client. We also read some news stories about nanny agencies who didn't check out their candidates as closely as they promised, such as one that sent over a nanny who was wanted for MURDER in another country. Scary. We lost our $250 deposit on this agency but at least we didn't end up hiring The Babysitter Bandit.

Meanwhile, my maternity leave was dwindling down and I was getting desperate...

With precious little time left, desperate times called for desperate measures: I advertised on Craig's list. I know you probably think Craig's list is just a way for murderous med students to meet their victims, but as it turns out, you can also get a nanny on Craig's list.

Several potential nannies didn't show up to their interviews and one even showed up on the wrong day (not a good sign). One was an older, very experienced and no-nonsense Mary Poppins type that my husband immediately liked, but I was wary, mostly because she wore too much perfume. Then I met Gloria. She showed up on time (score!) and the second I laid eyes on her, I immediately knew she was our new nanny. I just had a FEELING about her--this was the woman I had been picturing when I first started the nanny search. She seemed so loving, asked to hold Melly, and wasn't demanding like the more experienced nanny.

Unfortunately, my husband was stuck on Mary Poppins, so I had to convince him to give Gloria a chance. She also didn't have any actual nanny experience, but hey, the woman had three kids. We did a background check and called her (non-nanny) references, then did a practice day with her, in which she totally won us both over.

Two years later, I think Gloria was the best thing that ever happened to us. She was an amazing nanny, who took care of Melly like she was her own. I never had to worry about my daughter's safety when I was at work. One of the reasons we have been reluctant to move was that we didn't want to lose Gloria!

In the last year, we have mostly transitioned Melly to that family home we rejected when she was two months old. She's older now and we want her to have more social interaction with her "baby fwends" as she calls them. But I will always be grateful to Gloria for helping to raise Melly during that precious first year.

And that, kids, is the story of how I met your nanny.

(P.S. Happy mothers day!)

MiM celebrates one year: Anesthesioboist

The end of this month marks Mothers in Medicine's one year anniversary. In honor of this great occasion, I asked our writers to share their favorite post (of their own) from the last year. Throughout the month, I'll be highlighting their picks.

Anesthesioboist joined Mothers in Medicine last fall. Since then, we've been graced with her phenomenal writing - a true aesthetic purist (hope I'm not putting too much pressure on her with that).

She writes:

I think my two favorites would have to be "Code Indigo" and "Mom's Apple Pie."

T., thank you for making us routinely swoon from the beauty of your words and insight.

Mother's Day

My oldest gifted me my mother's day gift a couple of days early. You can have one, too: http://news.cnnbcvideo.com/index2.html?p=jbj. We have a running joke about Mother of the Year awards and my credentials (or lack thereof) at my house. This was a perfect present from my IT-savvy son. At the beginning of the school year, each child in his middle school took possesion of a Macbook for the year. Technology in the hands of my children is an amazing thing....the websites, the comfort level of navigating the WWW, the animation and movies Will has made this year blow my mind.

Happy Mother's Day to all!

MWAS

The intersection of science and motherhood

Upon learning that we were approaching our first anniversary at Mothers in Medicine, I sat down to reflect upon what I have learned. I am, relatively speaking, a newbie to blogging and to this site in particular. I think I have only posted 7 or 8 things. Most of the other bloggers have a lot more to show for themselves, and Fizzy blows me out of the water. Anyway, what I discovered is that the parallels between motherhood and doctoring are many. It has been fun to notice them, share them, and ruminate on them. But what about the parallels between motherhood and science? Are there any? To quote a one-time VP candidate, YOU BETCHA. Here are just a few of my favorites.

The following scientific definitions come with a nod to Wikipedia.

Heisenberg uncertainty principle, as originally proposed:
"In quantum physics, the Heisenberg uncertainty principle states that certain pairs of physical properties, like position and momentum, cannot both be known to arbitrary precision. That is, the more precisely one property is known, the less precisely the other can be known. This is not a statement about the limitations of a researcher's ability to measure particular quantities of a system, but rather about the nature of the system itself."

Heisenberg uncertainty principle, with children:
In parenting, the Heisenberg uncertainty principles states that pairs of siblings, like "Munch" and "Iggy", cannot both be known to arbitary precision. That is, if I can actually see my 3 year old daughter and reassure myself that she is not coloring on (as in directly on) our kitchen table, I cannot also be simultaneously upstairs to observe my 5 year old son using my two mostly full leftover tubes of Lansinoh to glue ALL of his Lincoln Logs to his closet door (true story). This is not a statement about my limitations as a mother, but rather about the nature of parenting itself. Well, that's reassuring. I love physics.

The Law of Conservation of Energy, as originally proposed:
"The law of conservation of energy states that the total amount of energy in an isolated system remains constant. A consequence of this law is that energy cannot be created or destroyed.
Another consequence of this law is that perpetual motion machines can only work perpetually if they deliver no energy to their surroundings. If such machines produce more energy than is put into them, they must lose mass and thus eventually disappear over perpetual time, and are therefore impossible."

The Law of Conservation of Energy, with children:
With children, the law of conservation of energy states that the total amount of energy in an isolated system, such as when we do not have grandparents visiting for a long weekend, remains constant. A consequence of this law is that my husband allowing me to sleep in on Saturday morning leaves him doubly trashed and incapable of functioning for the remainder of the day, even though I am peppy and grateful and ready to have a big family day. Another consequence of this law is that perpetual motion machines (aka mothers) can only work perpetually if they deliver no energy to their surroundings, which means that I basically have to quit going to work, going to the gym, going anywhere at all actually, in order to keep my head above water with these kids. Apparently, they haven't gotten to this part in preschool science yet. If mothers produce more energy than is put into them, they will cease to exist. Take heed, children and husbands...and note that Mothers' Day is just around the corner, and they don't call it the "Rejuvenating Spa Day" for nothing. It could save a life.

Second Law of Thermodynamics, as originally proposed:
"The second law of thermodynamics states that the total entropy of any system cannot decrease except insofar as it flows outward across the boundary of the system. By implication, the entropy of the whole universe, assumed to be an isolated system, cannot decrease. In fact the entropy of the universe is always increasing. We know this because we can identify processes that produce entropy from scratch, and the second law tells us that these increases cannot be undone elsewhere."

Second Law of Thermodynamics, with children:
With children, the second law of thermodynamics states that the extreme disorder and chaos of your minivan (substitute favorite location: kids' bedroom, playroom, etc) cannot decrease except insofar as you have a successful yard sale, consignment store transaction, or Salvation Army pickup. Note that if you move the clutter from the playroom to the attic or unfinished room in your basement, the entropy of your system remains constant. By implication, the clutter associated with childrearing in the whole universe cannot decrease and indeed is always increasing. We know this because we can identify processes that produce entropy from scratch (baby showers with swings, jumperoos, infant carseats and bases, activity gyms, pack n plays, and diaper pails before you even have anyone to use them). And the second law tells us that once you have this stuff, you will end up holding on to it for an inordinate number of years even once you are absolutely, positively, (almost) definitely done having kids. And when you do get rid of it once and for all--usually because your childless younger sibling, to whom you have ranted that you are "so done" having kids after a particularly frustrating day, tells you she is pregnant and wants your stuff--the empty space vacated in your home and cars will be promptly filled with Matchbox cars, Polly pockets limbs, Legos, and jigsaw puzzle pieces.

And finally, I was a literature major in college, so I am not aware of the corresponding law in physics for this one, but I know it must be there somewhere (science majors, speak up): Children expand to occupy the number of adults present. This refers to the phenomenon that I am currently living as a temporarily single parent while my husband is deployed for 5 months. It takes me half the day to get a shower on the weekend when I am here alone with them. When the grandparents or aunts and uncles come to visit, it takes all of us half the day to get a shower. Even if there are 4 adults present, everyone is occupied. Someone is changing a diaper. Someone is helping to build a pizza shooting robot out of Legos. Someone is cleaning up the food thrown all over the kitchen floor by the 16 month old during lunch. Someone is attempting to catch the muddy child and wrestle her into the tub before she leaps onto the yellow sofa. If this has never been reported as a phenomenon before and you take a notion to scoop me by submitting it to Popular Science, please consider naming it Tempeh's Law.

So, just in case you have decided against becoming a radiation oncologist and now wonder why physics was required for med school, it was because those med school admission committees knew it was only a matter of time before you would want to pass on your genes. And when you did, with Physics 101 under your belt, you'd be ready. Or at least you couldn't say you hadn't been warned...I mean, consented.

MiM celebrates one year: MWAS

The end of this month marks Mothers in Medicine's one year anniversary. In honor of this great occasion, I asked our writers to share their favorite post (of their own) from the last year. Throughout the month, I'll be highlighting their picks.

MWAS has been writing here from the beginning, sharing her stories of being a pediatrician in a private practice and being a mother of two tween boys. She writes:

When I went back and scanned my posts - the standouts were different than I expected - my writing has definitely changed over the year - which I love. I have a hard time just picking one favorite - Favorite things, 5 ways I know I'm not my mother at Christmas, & Bees and Birds are my selections.

MWAS also created the signature Seriously, I wanna know... posts where she throws out a pressing question on her mind to all of our readers. The one on keeping last name/changing name/hyphenating and the one on fiction recommendations got almost 30 comments each.

Thank you, MWAS, for a wonderful year, and hopefully, more to come.

Membership

When I arrived at my office this morning, I had a walk-in patient waiting for me. In the winter months, it’s not unusual for a parent to try to “jump the line” and want to be seen first thing, and I try my best to accommodate parent and patient. I had promised to do a medicine re-check for my nurse’s child after I made morning hospital rounds today so that we could get her child to school, and my nurse back to work. My partner saw the walk-in who had stalked Lori, my scheduler, at the back door forty-five minutes prior to my arrival, while I saw my scheduled re-check.

Sometimes parents believe that medicine is a club – one that you can join if you have the right political affiliations or money or a very important job. Membership in this club gets them exclusive bonuses –kind of like frequent flyer miles or box tops – bonuses that include a physician’s home phone number or pager and the right to call them any time of day or night. Occasionally a parent will ask for my direct number- sometimes with a smile or a giggle as they promise not to call me at 2 AM for a diaper rash or spit-up. Acceptance into this club also allows members to talk about their child’s sex education in Starbucks, or ask for antibiotics (just in case) whenever they are leaving the country for Turks and Caicos for the next two weeks.

Being truthful with myself, I accept that I am part of a club of sorts. When my triage service calls about a family friend who bit his tongue and needed advice about whether to go to the ER or not, I call the family because they‘re friends, and they would show the same concern for my children. I’ve also referred my brother-in-law with appendicitis to Dr. Ileum because he’s a friend and I know he’ll take good care of my relative. I’ve also met a fellow partner and her child in the middle of the night when she suspected her daughter had new onset Type 1 diabetes. (She was right!) My family and close friends (I can count the number of families on one hand) are default members, and they know there are rules about membership.

The notion of an exclusive membership or concierge medicine doesn’t sit well with me. As humanly possible, I try to treat my patients as well and equally as I would treat my own family or friends regardless of socioeconomic status. There are boundaries, though, and limit pushers that make me put my foot down. I won’t write prescriptions on the fly for administrator or staff’s children anymore when I’m trying to make hospital rounds. It’s not fair to my patients to get distracted like that. I cannot prevent a patient with lice showing up on Sunday morning on my front porch, but I won’t let them expose my kids. My phone has caller ID, and we screen the calls heavily, so when I’m not on call, I’m focused on my family, and my personal time. It’s all part of a balancing act that I’ve had to learn bit by bit.

Ship 'em off!

When I made a post last week about fellowship, I was surprised by one commenter who suggested the idea of living apart for a year while I did a fellowship. Either my daughter could come out with me and I could manage as a single parent (eep!) or she could stay with my husband and I could just visit on odd holidays.

Now I've lived apart from my husband for periods of time and it was not fun, but it was doable. But living apart from my child is a totally different ballgame.

I know the commenter meant no offense in this statement, and the truth is, women do this. I know of a few female residents who have sent their babies to live in their home country with the grandparents while they furthered their careers. I don't judge these women but it's not something I would ever remotely consider.

In my daughter's entire life, I have only been away from her for one single night. (Not easy to manage as a resident!) My husband has only been away from her for a handful of nights. For either of us, it is painful to even contemplate a year spent apart. I can do a fellowship in ten years from now if I want, but AGE TWO is only going to happen once. I'd never forgive myself if I missed out on it.... or if I put my husband in a position where he was forced to either give up his job or miss out on it.

For me, feminism does not necessarily equate with always getting my way in terms of career.