once I get through May (June, July, August...)

It's Monday morning, hope y'all had a great weekend. I did, but the weekends haven't been a problem, relaxing with Husband, Just Five, and Almost Three, as silly and lovable as they all are. Work-wise, though, I've noticed a trend I've fallen into all too often of late. I find I'll have a lot on my plate, usually professionally (sometimes personally) and so I say to myself calmly, if I can just get through May, then I'll have a lot less to do. I'll just get through all these deadlines that have crept up on me for early, mid, and late May, and then I'll be set. But of course, then June rolls around and I have yet more decisions to make, work to get started on, tasks to complete, things to prepare... They are things I enjoy, usually, but a lot of things nonetheless!

Well, when I had my little fender bender last Monday (no one was hurt, kids not in the car) I had an all to harsh reminder that it was time to slow down, literally and figuratively. Might not have been my fault, after all, in an accident you don't intentionally bump into another car, maybe it bumped into you. Who knows? Then, get this, after the accident and exchanging information and seeing that every one's okay, and taking care of all those necessary details, I got back in my car, drove to my morning meeting, walked in a few minutes late apologizing that I had an unexpected delay, and proceeded to lead the meeting for which I'd set the agenda. Only afterwards did I share what had happened with a trusted colleague, and then with my mom (with whom I cried on the phone) and had already called my ever so supportive ("It could happen to any of us") husband.

So, I've decided to slow down, this month, now, today. You?

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.)

once is enough, apparently

Very recently, my son did what most of us all do eventually. He peed in the potty. In an effort to encourage him to continue with this exciting new development, I gave him a gentle prompt. Before tub this evening, I asked him if he wanted to pee in the potty, and he said "that's okay, I already peed in the potty yesterday."

(match day) - which day was that?

Not sure why but I can hardly separate out in my mind my own match day (in the 1990's) and my husband's a few years later. Earlier today I asked him to remind me about the circumstances surrounding our opening those fateful envelopes. I don't think it's post-traumatic stress-induced amnesia, since we both were happy with each of our matches, despite the hurdles coordinating the geography and job prospects without a true couples match. Perhaps my MIM status has resulted in a loss for specific details; I now more holistically just remember that it ultimately all worked out for the best. Then again, my coffee cup is usually half full.

What's coming back to me now is how silly I felt mentioning "my boyfriend" during interviews leading up to match day, since we'd actually been (living) together for many many years prior to actually getting married. Sometimes I mixed it up by saying "significant other." We did become domestic partners so we could co-habitate in the med school dorms, us and a few thousand gay New Yorkers. In any case, most of the hard part was us figuring it out beforehand, crafting the list, and then once we met our match we planned accordingly. After all, the culture in medicine is to train for 3-4 years, and then make a decision to move or stay. Then you train for several more years and then make a decision to move or stay. And so on. Fortunately for us, the "move or stay" has always involved staying in love.

a gray area

Just read a NY Times article about our presidents going gray. Every now and then I see a stray gray of my own pop up (surprise!). In terms of how I feel, well, you know, it's a gray area. I'm in the early stages of seeing one or two here and there, so I usually feel somewhat amused and am proudly reminded of all my accomplishments. These include first and foremost, being married with children. That is, having met my life partner and our shared attempts at raising two strong and silly kids together. Despite their (all) contributing from time to time to yet another gray hair. I still feel young (except for the occasional hip pains) and think I look fairly young (delusion or reality, I'll never know), so for me I actually welcome the few grays to help on the job, where I am supposed to have the authority to guide patients and families through important decisions about their health and well being. Where I work to educate and advise medical trainees (a few grays among them). Certainly, it's just hair, but it's aging and stress and experience and evolving self-concept as well. No need to pull them out gray by gray, I'll just let them blend in and go with the flow (tucked away in a pony tail, of course).

to a pediatrician, blue is not good

Well he's either cyanotic or it's really that cold out. That's what his preschool teacher, whom I respect and admire, asked me about at drop-off one recent 20 degree day. She didn't explicitly mention cyanosis, just a concerned question about whether it's really that cold out. An innocent, "why are his lips blue?" And his fingers too, upon closer inspection.

Am I stressed? Is this a tet spell?

Why are his lips blue?

Check pulses and the other ABC's (of resuscitation, not of the alphabet)? Stat EKG? Pulse ox? Echo? He's a healthy 2 year old. My healthy 2 year old. Not known to be short of breath while rocking out with his Daddy's guitar, not known to tire easily, might miss a nap but not a heartbeat. What to do? Is he blue?



Well, blue berry.

That's his breakfast. Frozen blueberries in warm oatmeal. Today more on his lips (and fingers) than in his mouth. I've heard they're pretty good for you, too.

For better or worse

Are you a better doc because you have kids? As a pediatrician, I am asked this quite often. By students, by patients, by patients' families, by trainees, by colleagues, by neighbors... I try to answer sincerely, but since I resist the notion that one isn't as good at being a pediatrician before having kids, I don't want to fallback on the easy answer that I'm "better" at it now that I have two darlings myself (having experienced breastfeeding, nursemaids elbow, sleep associations, febrile UTI, and the like). In some ways, because I want to rush home promptly if not early from work to be with my kids, and arrive late to work periodically when I practically never did so before I had kids, maybe (for these and other reasons) I'm worse! When asked, what do you say?

The gloves are off

In recent weeks, just about every day my four and a half year old goes through a routine, asking me if I wore gloves at work that day. I think quickly back to my day. Was I sitting at my computer or in meetings or teaching sessions that day, or was I seeing patients? Even with patients, gloves aren't always required; after all it is outpatient pediatrics. Inevitably, though, when I tell my daughter, "Ah yes honey, I did wear some gloves today," she requires a reason. So I tell her I touched a patient's rash. She then informs me, or at least seeks verification that if I were to touch any hypothetical rash she might ever have, I wouldn't need to wear gloves... because I'm her doctor mommy, right? A little assurance that I am a doctor but always her mommy.

after hours

Have you set a "no work at home" rule for yourself? For me, I'm fine with doing a little bit of work after the kids go to bed. I rush home at the close of my workday to spend the most possible quality time with them in those late afternoon/early evening hours, and then I catch up on some work. Could be my office email or other pediatric-related reading, reviewing, and planning, preparing or refining educational sessions, reading applicants' files, submitting trainees evals, and so on. After my kids finally enter REM stage (which, in our family, is somewhat later than the average 2 and 4 year old go to bed). After dinner and books and music and bath and teeth and more books. They are finally asleep. But there is still time for some other activities before morn, what do you do after the kids are finally asleep?

SLEEP: Do you go right to sleep? Are they actually sleeping right beside you?
FOOD: Perhaps you're eating your own dinner. Or is this the time to make their lunches for tomorrow? Or make your own lunch (or your partner's lunch) for tomorrow?
READ: Is it time to curl up with a magazine (The New Yorker? People? Time?), or read the web in its entirety, your academic journals, some fiction?
WRITE: catch up on emails, your blog, your list-making
CONVERSE: have at least one meaningful, or at least uninterrupted, conversation with your spouse/partner.
LAUNDRY: and all those other housekeeping chores, anyone shopping online?
EXERCISE: see next
SEX: in your dreams or in reality

What did I miss, is there anything else? Oh yes, some people probably go out. Is there life after the kids go to sleep (suddenly I feel like I am writing this in Carrie Bradshaw style, do forgive me, MIM pals)?

Not old yet

Still enjoy animal crackers, mac and cheese, grapes.
Still enjoy playing the bongos.
Still enjoy seeing Grandma.
Still enjoy painting.
Still enjoy Clifford, Berenstain Bears, Mo Willems.
Still enjoy They Might Be Giants, Dan Zanes, Laurie Berkner.
Still enjoy wearing mittens.
Still enjoy going to the zoo, zoo, zoo, how about you, you, you?

Don't like too many snaps, buttons, and zippers.
Don't like wearing shoes when riding in the car.
Don't like keeping quiet.
Don't like coats.

Can't help interrupting.
Can't help staying up late.

But the jury's still out on stinky diapers, classical music, carrots, clothes with holes, tub time, hats...

Dr Unicorn

In late September, daughter age four mentioned casually (about 20 times), without pediatric parental coaching, that she wanted to be a doctor for Halloween. Yeah! Not only were there the salient and loving implications of role modeling at play, but also, EASY costume! Perhaps an old adult medium scrub top as a full length dress, my stethoscope around her neck, a reflex hammer in her pocket, an ID tag, a fake chart (no EMR's yet), and we're good to go. But late October (just in time, really) she made a more rational decision, to change her Halloween costume and perhaps future career choice. Why be a doctor when you could be a unicorn? Okay, we can do it. A horn, a mane, a tail, lots of purple and pink fabric paint. And rainbows, an abundance of rainbows. It hadn't occurred to me why she changed her mind, but shall I assume it had something to do with the long hours?

(Fortunately, like RH+'s post, I was able to get time off for Halloween, because you've just gotta go to that pre-school costume parade!)

Commute time is not more fun than time with the kids

Like the dog year to people year conversion factor (what is it 7 to 1? I'm no vet...), there is something funky about the commute time to kid time equation. Even though I can listen to my favorite radio hosts who catch me up on local, regional, and world events, even though I can unwind after a rough day seeing pregnant teens who didn't know they're pregnant, and even though I can make cell phone calls (hands free) to friends I don't get to see that often anymore, I will unequivocally say that time spent commuting is not more fun than time spent with my kids. A simple fact. The commute is a time-sink. And commuting in traffic is negative time. At least if I were in the car with my kids for the bulk of those travel minutes, then it wouldn't be too bad, as we talk, listen to music (on my rockin' cassette player), discuss what we see on the side of the road, and make stops at farmer's markets (always a winner) and gas stations (fun because Mommy washes both rear passengers' windshields a few times) . But commuting without either rear passenger is painful indeed. I recently obtained a navigational GPS that I thought would help me Get Places Sooner, but I find it actually gives me more choices that I can now fret about... will it be faster or slower to turn onto this side road, and why does it say "no outlet?"



One good option which serves to add precious moments to the standard 24 hour day, when I can swing it, is to skip out of work early on administrative days or light clinical afternoons, avoid traffic altogether, and surprise my children with an early pick up. And, on a typical trafficky commute, what makes up for those negative minutes are the positively huge smiles, cheers, and hugs when we all meet up again at the end of the day. And I don't dare let thoughts of tomorrow morning's commute intrude on our fun-filled evening.

watching from the sidelines

First swim lessons this weekend for Just Four. As a former lifeguard, current mother and pediatrician, one would think that I could have taught her some swimming basics. But despite our best intentions and her inquisitive nature, my daughter has a hard time learning from her parents. She knows Dr Mommy is the best at putting on band-aids. And that daddy can rock out on the guitar. However, our teacher-centered little girl who is frequently found to be instructing her stuffed animals in all of life's lessons, appears to learn best from Other People. We struggled with which class to choose, one in which we parents could wade in the water too versus one in which we were banished to the sidelines (instructor to parents "Step away from the pool"). Choosing the latter proved to be a wise move, as she made us proud, nervously saying Goodbye and then completing her first lesson, bubbles, floating, gliding with an occasional wave to Dr Mommy, who, behind a glass wall was watching her daughter learn and grow on her own. Needing me but not needing me. Oh, yes, and my needing her.

Laborious thoughts Parts 1 and 2

Laborious thoughts and sequence of events Part 1:

1) Am I having contractions? It feels like bad menstrual cramps. I don't remember learning that in med school.

2) I'm on call for the gen peds practice right now and in labor.

3) Are these contractions 3 or 6 minutes apart? Perhaps we should go to the hospital now. But first, why don't you set up the pack and play, Honey. OH that's another one .

4) Why am I being escorted to the room where I am told "all the doctors and lawyers" deliver? I am ready for a suite on Kauaii, but alas it is in sunny (hot/humid) Local Hospital room (with a good NICU, which is what every pediatrician wants but wants not to see). Fortunately we find no need for a NICU, no malpractice, no lawsuits.

5) The epidural hasn't helped at all... more anesthetic.

6) Oh (too much). Now I can't feel my legs. Then a quick nap.

7) Wow, having Husband count to 10 while I push actually matters/helps.

8) There she is!

9) Let the breastfeeding begin. (Room in and post "no formula" signs)

10) Life changes as we know it (for the better)...




Laborious thoughts and sequence of events Part 2:

1) What will we do with Precious First, while we're having Second? Grandparents take shifts awaiting the big day.

2) I need two doses of Amp for GBS so no waiting around at home this time.

3) Why is there no air conditioning in this hospital?

4) Wondering why my systolic is down to 75. Glad the senior attending decides to stay.

5) I hope Precious First is enjoying her time with Grandma, french fries and all, and is ready for her whole world to change (for the better, we hope).

6) Were those practice pushes or the real thing?

7) There he is! 9 pounds!

8) Let the breastfeeding begin. (Room in and post "no formula" signs)

9) Get me out of this room so I can see Precious First and introduce her to Second, NOW.


10) Life changes as we know it again (for the better)...

When I retire perhaps I'll be a daycare provider

I took a vacation day from pediatric practice a few weeks ago to accompany Just Four (and 15 classmates) on a trip to the National Zoo. My daughter and I (and 15 classmates) walked that whole zoo up and down. Fun but tiring, and I still crazily fantasize that someday when I retire from general pediatrics I'll be a day care provider. Assuming I receive the proper training, of course.

But for some time until I retire, I'll be a pediatrician and have children in day care, so I will struggle with various options when it comes to hiding or sharing a vast array of pediatric (and other) medical knowledge. Do I let them know that teething isn't the cause of the 102 fever? That one doesn't actually get a cold from being in the cold. That diarrhea is usually contagious but eczema is not.

Do I show them my technique for reducing a nursemaid's elbow? Perhaps it's best to just do it myself--on my own child yes (twice) but on a classmate? I'll presumably gain some cred in the process, as an unintended but welcome side effect. That cred can go a long way when I assure them that my child who was sent home yesterday vomiting raisins is actually fine today and able to stay and play.

And in preparation for my retirement position, I'll take note of all that I can learn from the day care providers. How do they get my children to nap, everyday, let alone getting 12 toddlers to do so, at the same time, under one roof? When I asked, they laughed it off. And when I asked again --it wasn't a rhetorical question-- they explained, "Oh we just tell them it's nap time and turn down the lights and read a quiet story." Ah, that's how they do it. I'll think I'll try that at home.

Someday I'll "retire" and become a day care provider so I can continue the teaching and learning cycle. I'll greet the parents in the morning and late afternoon with information about their precious children. I'll read books to my class, tell them stories, and hear their tales. I'll feed them healthy food. There will be no potato chips in my day care. They learn not to bite each other. I'll teach 16 preschoolers to skip and 12 toddlers to jump. They'll all know how to dance. I'll be tired, but I'll nap too. When I retire.

best time for them to have the minor febrile illness...

A question, purely hypothetical of course, on the topic of weekend versus weekday illness. If your child in daycare has to have one or the other, which would you prefer? And I use the word "hypothetical" in a rather euphemistic way for the very actual sense in which this may be happening to my little family right now. Assuming you work Monday through Friday (though I'm sure many of us have schedules that deviate from this traditional schema)... Would you rather that your children have a minor (+/- febrile) illness on a Friday afternoon so that you get to tend to them throughout the weekend, bringing them back to full toddler health as only a mother (perhaps a mother in medicine, indeed) can do by Monday morning? Late on a Friday so that you don't have to miss work, don't have to rearrange child care, don't have to draw upon your colleagues, your relatives, your neighbors, your spouse... Late on a Friday so that your little ones don't continue to infect peers in preschool. Late on a Friday may ruin weekend plans, but is it preferable to ruining weekday (read: WORK) plans?

Or, would you rather that your children begin their minor illness on a Monday and then you get a forced opportunity to stay home for a day (probably more like two or three), put work aside, and mother them back to a usual state of afebrile rambunctiousness? Is it even possible to put work aside? As I think one of my co-MIM-bloggers described that we are in a profession where the world seems to collapse if we need to take a day (or even a few hours) away from our clinical duties at short notice. So, given that your child's minor illness will fall either on a clinical or non-clinical time, which do you prefer?

And, another question altogether, whether you are a mother in medicine or not, do you dose the ibuprofen and send them off to childcare anyway?

Mommy Daddy Mommy Daddy

Although their first early utterances often sound more like "Da Da Da Da" rather than "Mommy, Can I Have More Breastmilk And By The Way, Thank You For Everything," when you share your children with a father who is as dedicated as my husband, you don't mind that the kids initially and still sometimes call you Daddy, or the more formal "Mommy Daddy Mommy Daddy" even when they are Just Four and Nearly Two. After all, upon looking through our wedding album on recent nights, Just Four decided that she will either marry her brother or her father. Perhaps reasonable, given her vantage point, but not legal. Here are just a few loving witticisms, courtesy of my kids, in tribute to the dads out there:

"I'm going to love you every day, and I'm not even going to skip a day"

"I had a dream that I loved you"

"I love you.... table"

"Happy Mother's Day Daddy"


As a post-script, allow me (a mother in medicine) a brief shout out to my own father (neither a mother nor in medicine, except he was the latter, I guess, as a patient succumbing to cancer over 15 years ago). When I casually mentioned to my daughter that the Berenstain bears book we were reading was one that "my parents" read to me when I was little, she asked, "Who was the Daddy?" For the first time a clear reference to my father, her should-have-been grandfather. And I told her, "He was a wonderful man who read me books and taught me to swim." I miss father's day.

get out much?

It's Saturday night and my husband and I have just returned from a very rare night out without our children Nearly Two and Just Four. So rare that it just may have been a first. Not that he and I don't go out, it's just that we do it As A Family. So, the four of us go out to lunch and the library and the park and the ice cream shop and the occasional museum. On weekdays we do go to work As Adults , but it is no Couples Time. This may come after the kids go to sleep, unless, of course, they are still awake.

All of our time when we are not actually at work is Family Time. We do not have a babysitter at the ready. Somewhat embarrassed to say how long it has been since I've seen a movie on the big screen. We put our children to sleep late, and we like to say it is simply in accordance with their natural circadian rhythms, but more accurately we've groomed them to fall asleep late enough so Working Parents can get in some quantity (quality?) play time at the close of day. Is it just us, or is this a modern day dual career family phenomenon? Actually, no one other than me or my husband has put our children to sleep in 4+ years, except for the one night when I was In Labor.

Even tonight, we rushed home from our Night Out to put Nearly Two and Just Four to bed , late as it was. Once home awash in hugs and cheers, we were surprised to find that they had a great time without us, feasting on fries with Recently Local Grandma. And we had a pretty good time being A Couple, as well. Maybe we'll go out on a date again, in another 4 years...