Before I had a baby, I didn't really believe all that stuff people told me about how the baby constantly cries and wakes you up all night. I thought that was just something they added in movies and TV shows for comic relief. And even if the baby woke up a lot, so what? I had survived med school and internship! This was going to be like a walk in the park.
But then I had a baby and OH MY GOD. I didn't understand how any woman ever had a second one of those things. (It did get better though.)
I was recently discussing this topic with a fellow female resident/mama and we decided that between internship and the first month of your baby's life, that first month is much more exhausting. In fact, that first month is not that unlike internship...
10 ways that intern year is similar to the first month of your baby's life:
1. You are constantly bothered by family members who think they know how to be a better mother/doctor than you.
2. As a new mom, you spend 90% of your time in pajamas. As an intern, you spend 90% of your time in scrubs, the pajamas of doctors.
3. In the beginning of internship, you're woken up pretty much every hour. Then as you get more competent at remembering to do things like, oh, sign your orders, you get woken up less. In the beginning of motherhood, you're woken up pretty much every hour. Then as your baby gets fatter, you get woken up less.
4. Even when you finally get to sleep, you remain in a state of catlike readiness.
5. Weekends, as you've previously known them, cease to exist.
6. You deal with poop a lot.
7. Hygiene falls sadly by the wayside.
8. You're constantly worried that something bad will happen to your patients/baby.
9. 99% of your meals come out of a container that says Kraft or Cup of Noodles on it.
10. For once, you sort of feel like you have a purpose.
Showing posts with label the doctor mother. Show all posts
Showing posts with label the doctor mother. Show all posts
Monday, July 21, 2008
Friday, July 18, 2008
Bees and Birds
“Douche bag!” My tween son hurls at his brother in the car on the way to a picnic.
“What was that?” I counter.
“Douche bag.” He returns sheepishly.
“Do you know what a douche bag is?”
“No, not really.” Will replies.
“Well let me tell you.”
And so continues our snippets of car talk. One would think that talking about sex and sexual matters would come easily for a pediatrician. Conversations about sexual matters and children are a daily occurrence in my practice. Yet a different element exists when I am trying to convey information about sex to my own children.
Trends in our family would suggest that there are some universal truths about sex education. The first is that the topics my children seen to have the most questions about aren’t covered widely in any book I know about. We’ve covered the basics – mostly in the car – about where babies come from and the real words for male and female anatomy. Sometimes it is all I can do to stay on the road. Then there are these other topics like defining a douche bag or masturbation. One time after an Oprah episode my eldest wanted to know what a pedophile was. Okay, where do I begin?
The second universal truth is that I am my sons’ go to girl for information. I am the token female in our family and it is my job to educate them about the female gender. Yeah, right. My job has globalized into ISM specialist or Information about Sexual Matters specialist. As I strive to keep these lines of communication open and honest, I am having epiphanies of understanding for all the parents who struggle with these topics. At one point I had aspirations of writing a coaching guide for mothers of boys to tackle some of these topics. I bought as many books about puberty and boys as I could find on Amazon.com. If I educated myself, I might be able to educate others, right? As the project sits stagnant on my bookshelf, the books have provided practical punctuation for Will’s sexual education and fodder for more conversations to come.
Lastly the universe has decided that we will have these conversations whenever and wherever. Car, movie theater, restaurants. No place is excluded. As a new parent, I assumed that “the talk” would take place in the privacy of our home. When my boys ask questions, they seem out of context because 90% take place out of our house. The silver lining to this truth is that the conversations are usually short – literally snippets – and ongoing. This is a key concept I try to share with families in my practice. The talk really should be an ongoing thread woven into daily life. Break off small pieces to feed your kids on a regular basis. It is less overwhelming that way.
“Sorry about the language, Mom.” Will say at the end of the picnic.
“I’m just try to teach you before someone else does.”
“I know.”
“I don’t want you to be embarrassed by a teacher or someone else’s parent. You need to know the real meaning of the words you use.”
“Thanks, Mom.” Will kisses my cheek. Mission accomplished (for today).
“What was that?” I counter.
“Douche bag.” He returns sheepishly.
“Do you know what a douche bag is?”
“No, not really.” Will replies.
“Well let me tell you.”
And so continues our snippets of car talk. One would think that talking about sex and sexual matters would come easily for a pediatrician. Conversations about sexual matters and children are a daily occurrence in my practice. Yet a different element exists when I am trying to convey information about sex to my own children.
Trends in our family would suggest that there are some universal truths about sex education. The first is that the topics my children seen to have the most questions about aren’t covered widely in any book I know about. We’ve covered the basics – mostly in the car – about where babies come from and the real words for male and female anatomy. Sometimes it is all I can do to stay on the road. Then there are these other topics like defining a douche bag or masturbation. One time after an Oprah episode my eldest wanted to know what a pedophile was. Okay, where do I begin?
The second universal truth is that I am my sons’ go to girl for information. I am the token female in our family and it is my job to educate them about the female gender. Yeah, right. My job has globalized into ISM specialist or Information about Sexual Matters specialist. As I strive to keep these lines of communication open and honest, I am having epiphanies of understanding for all the parents who struggle with these topics. At one point I had aspirations of writing a coaching guide for mothers of boys to tackle some of these topics. I bought as many books about puberty and boys as I could find on Amazon.com. If I educated myself, I might be able to educate others, right? As the project sits stagnant on my bookshelf, the books have provided practical punctuation for Will’s sexual education and fodder for more conversations to come.
Lastly the universe has decided that we will have these conversations whenever and wherever. Car, movie theater, restaurants. No place is excluded. As a new parent, I assumed that “the talk” would take place in the privacy of our home. When my boys ask questions, they seem out of context because 90% take place out of our house. The silver lining to this truth is that the conversations are usually short – literally snippets – and ongoing. This is a key concept I try to share with families in my practice. The talk really should be an ongoing thread woven into daily life. Break off small pieces to feed your kids on a regular basis. It is less overwhelming that way.
“Sorry about the language, Mom.” Will say at the end of the picnic.
“I’m just try to teach you before someone else does.”
“I know.”
“I don’t want you to be embarrassed by a teacher or someone else’s parent. You need to know the real meaning of the words you use.”
“Thanks, Mom.” Will kisses my cheek. Mission accomplished (for today).
Thursday, July 17, 2008
DoctorMom, revisited
I've been asked about how being a doctor affects the way I'm a parent; in review, I'd have to say there are probably some things I have done differently because of my background: I probably worried less about a runny nose and productive cough when my kids were younger. I'm more annoyed than concerned about the occasional bloody nose that Youngest gets, especially after he's admitted he hasn't been taking his allergy medication. My kids have known anatomical terms for their most private parts since before they could talk, and the "toy" medical kit they used to use contained the stethoscope I received when I was a medical student. And dinner table conversations are as likely to include a discourse on why cocaine can lead to a stroke (even in first time users) as they are to include a review of the school day.
More important, I think, is the question about how being a mom has affected the way I practice medicine. I see a great deal of "carry-over" as I interact with my patients. See the way that lady with Alzheimer's disease grabs my hand and won't let go? In residency we learn about "frontal releasing signs" as an indication of deterioration of the brain; as I speak with families I can describe how this is similar to the grasp that an infant has, because I've experienced that same grasp when my babies were born. Similar to the way I don't shy away from explaining the concept of "you get benefits out of something proportional to the effort you put into it" to my kids, I'm not afraid to tell a patient who has refused to participate in the home program component of physical therapy that I'm not surprised that he hasn't seen any lasting benefits. And (I know that this is not at all politically correct) if one of my patients has shared with me fears or concerns about the future, especially as it relates to the illness I treat her for, I'm not hesitant to give her a hug at the end of the visit any more than I would hesitate to hug one of my children after they've shared their most recent fear or worry.
I'd like to believe that being a doctor has made me a better parent in many way; at the same time, I'd like to believe that being a parent has made me a better doctor.
Have any of you experienced similar experiences with your patients?
Artemis
More important, I think, is the question about how being a mom has affected the way I practice medicine. I see a great deal of "carry-over" as I interact with my patients. See the way that lady with Alzheimer's disease grabs my hand and won't let go? In residency we learn about "frontal releasing signs" as an indication of deterioration of the brain; as I speak with families I can describe how this is similar to the grasp that an infant has, because I've experienced that same grasp when my babies were born. Similar to the way I don't shy away from explaining the concept of "you get benefits out of something proportional to the effort you put into it" to my kids, I'm not afraid to tell a patient who has refused to participate in the home program component of physical therapy that I'm not surprised that he hasn't seen any lasting benefits. And (I know that this is not at all politically correct) if one of my patients has shared with me fears or concerns about the future, especially as it relates to the illness I treat her for, I'm not hesitant to give her a hug at the end of the visit any more than I would hesitate to hug one of my children after they've shared their most recent fear or worry.
I'd like to believe that being a doctor has made me a better parent in many way; at the same time, I'd like to believe that being a parent has made me a better doctor.
Have any of you experienced similar experiences with your patients?
Artemis
Monday, July 14, 2008
Guest Post: The Life of Doctor Mom
ok, so maybe i am crazy. i have never blogged before, but am willing to give it a shot.
i am a pediatrician, mother of 7 children, ages 1 to 18 years and a full time faculty member of an academic university. is that redundant? i really don't have time for this, but feel drawn to speak up on this life of ours. the life of Doctor Mom.
My father told me it would be too hard for me, that I shouldn't sacrifice so much or work so hard. i don't think he meant to be discouraging, he was just scared. still, if my brothers wanted to be the doctor of the family, they would've gotten hi fives and pats on the back too. luckily they are both lawyers, that leaves me, the official black sheep.
my kids are gems, i love every single one of them. my husband and i are like that, we just look at them and smile or sneak a shared giggle behind their backs when they act up, which is frequently enough. they aren't angels, but they are good.
what really breaks my heart is all the patients in my practice. they struggle with so much; poverty, singleness, young parents, joblessness. working in a large urban practice i see more than i'd like of child abuse, mental illness, addictions. i love all these families too, but my husband says i'm not allowed to bring any more children home. he can't take the stress.
i feel the biggest problem we women physicians face is lack of time. if i could only survive on 4 hours of sleep a night, i would be on top of everything. maybe? my bills are stacked sky high in my dining room, my living room is a mess again, the kids watch too much T.V. and we don't eat home cooked meals (unless my husband makes them!) well, i cried when i read the blog from the daughter of an OB/GYN, it made my decision to be a doctor ok too. I also have an 18 year old daughter going off to college, and i'm so proud of her.
p.s. - my baby just crawled on the dining room table to get my attention and kissed my left hand. never forget, doctor moms, what life is really about!
peace, drmamamaria7
i am a pediatrician, mother of 7 children, ages 1 to 18 years and a full time faculty member of an academic university. is that redundant? i really don't have time for this, but feel drawn to speak up on this life of ours. the life of Doctor Mom.
My father told me it would be too hard for me, that I shouldn't sacrifice so much or work so hard. i don't think he meant to be discouraging, he was just scared. still, if my brothers wanted to be the doctor of the family, they would've gotten hi fives and pats on the back too. luckily they are both lawyers, that leaves me, the official black sheep.
my kids are gems, i love every single one of them. my husband and i are like that, we just look at them and smile or sneak a shared giggle behind their backs when they act up, which is frequently enough. they aren't angels, but they are good.
what really breaks my heart is all the patients in my practice. they struggle with so much; poverty, singleness, young parents, joblessness. working in a large urban practice i see more than i'd like of child abuse, mental illness, addictions. i love all these families too, but my husband says i'm not allowed to bring any more children home. he can't take the stress.
i feel the biggest problem we women physicians face is lack of time. if i could only survive on 4 hours of sleep a night, i would be on top of everything. maybe? my bills are stacked sky high in my dining room, my living room is a mess again, the kids watch too much T.V. and we don't eat home cooked meals (unless my husband makes them!) well, i cried when i read the blog from the daughter of an OB/GYN, it made my decision to be a doctor ok too. I also have an 18 year old daughter going off to college, and i'm so proud of her.
p.s. - my baby just crawled on the dining room table to get my attention and kissed my left hand. never forget, doctor moms, what life is really about!
peace, drmamamaria7
Thursday, July 10, 2008
Tuesday Hunger
In the morning, I’m a hungry mother. My eyes take in her profile, her impossibly long eyelashes, the outline of her lips. Drinking in every detail of this face that is more beautiful to me than my childless brain could dream. I get ready for work, taking intermittent breaks to focus on her. This face that I will only get to see this morning.
Even if it means I’ll be running late, I want to walk her to school. JP tries to help me get on my way, offering to walk her, but I won’t have it. This is my time. This morning is my walk.
We walk (and jog and skip) to school and as much as my mind is on the time and having to go off to work soon, I push it aside to be present in this moment. We might stop to admire an overhead plane. Watch the birds swooping from tree to tree. And at the door, our kiss and hug means more than it usually does. I linger. I squeeze a little tighter. The pause bringing her cheek into my lips – a deliberate moment filled with my hopes that her day is a good one.
Too quickly, our good-bye is over and she is already running to see her friends. I watch the back of her and quietly accept my retreat.
During the day I am a manic doctor/teacher/mentor. Rolling along at a mad clip: too many things to do, so many competing thoughts. Throwing on these various hats as I sequentially cross the different thresholds. First a teacher/doctor, then an administrator/mentor, then an employee, then a clinic physician. There’s not much spare time to think about how her day’s going. But when I see a toddler in the waiting room or children playing outside as I drive to campus, hoping to steal some moments before class to finish my assigned reading, the missing floods me.
I arrive on campus to find myself in a sea of the very young. The undergraduates look like children to me, my pregnant body belying my age and clearly separating me from them. Conspicuous. We’re in different worlds. I can’t even remember that age of self-indulgence, yet together we wade in the school waters of a campus Starbucks, caffeine-fixes and studying. My watch says it’s time for her to be picked up by JP. I wonder what she’s done today, the artwork left on top of the cubby, whether she’s coming home in different clothes than she left in. I think about calling.
In class, I’m a hungry student. I hang off the words deliberately spoken by my trim, brilliant professor. It’s a small doctoral-level seminar but she doesn’t often meet my eyes, which might bother me in a different place, a different time, yet, it doesn’t now. For the wisdom and perspective she’s delivering is feeding my mind. I’m wholly engaged and captivated by the material. Soaring expansiveness fills me as I am lost in thoughts of identity and adult development. It’s a quiet excitement filled with stored potential. Potential that bears the snapping promise of fireworks to light the nighttime skies.
On the drive home, in the settling of my mind rhythms, again I think to my family and the absence of me. I need loud music in the background. I need green lights. I need to be home, in the embrace of my husband and my home. I need to see my daughter in the light of the next morning. Breathlessly, I await her.
Hungry again, I wait.
Even if it means I’ll be running late, I want to walk her to school. JP tries to help me get on my way, offering to walk her, but I won’t have it. This is my time. This morning is my walk.
We walk (and jog and skip) to school and as much as my mind is on the time and having to go off to work soon, I push it aside to be present in this moment. We might stop to admire an overhead plane. Watch the birds swooping from tree to tree. And at the door, our kiss and hug means more than it usually does. I linger. I squeeze a little tighter. The pause bringing her cheek into my lips – a deliberate moment filled with my hopes that her day is a good one.
Too quickly, our good-bye is over and she is already running to see her friends. I watch the back of her and quietly accept my retreat.
During the day I am a manic doctor/teacher/mentor. Rolling along at a mad clip: too many things to do, so many competing thoughts. Throwing on these various hats as I sequentially cross the different thresholds. First a teacher/doctor, then an administrator/mentor, then an employee, then a clinic physician. There’s not much spare time to think about how her day’s going. But when I see a toddler in the waiting room or children playing outside as I drive to campus, hoping to steal some moments before class to finish my assigned reading, the missing floods me.
I arrive on campus to find myself in a sea of the very young. The undergraduates look like children to me, my pregnant body belying my age and clearly separating me from them. Conspicuous. We’re in different worlds. I can’t even remember that age of self-indulgence, yet together we wade in the school waters of a campus Starbucks, caffeine-fixes and studying. My watch says it’s time for her to be picked up by JP. I wonder what she’s done today, the artwork left on top of the cubby, whether she’s coming home in different clothes than she left in. I think about calling.
In class, I’m a hungry student. I hang off the words deliberately spoken by my trim, brilliant professor. It’s a small doctoral-level seminar but she doesn’t often meet my eyes, which might bother me in a different place, a different time, yet, it doesn’t now. For the wisdom and perspective she’s delivering is feeding my mind. I’m wholly engaged and captivated by the material. Soaring expansiveness fills me as I am lost in thoughts of identity and adult development. It’s a quiet excitement filled with stored potential. Potential that bears the snapping promise of fireworks to light the nighttime skies.
On the drive home, in the settling of my mind rhythms, again I think to my family and the absence of me. I need loud music in the background. I need green lights. I need to be home, in the embrace of my husband and my home. I need to see my daughter in the light of the next morning. Breathlessly, I await her.
Hungry again, I wait.
Wednesday, July 2, 2008
I want to be a homer...
My daughter is 3 years old and in preschool. The class is split into those who go home after lunch "homers" and those that take a nap after lunch, "nappers". She started there when she was 2 and has always been a 'napper'.
We just came back from vacation, I was tucking her in bed and wanted to remind her that tomorrow was a school day. She says to me " Mommy, I don't mind going to school but what I really want is to be a 'homer'. " My heart sank. I try my best to make her wishes come true. I take days off when there's a field trip. I rush home when she says 'come early'. I dawdle in the mornings when she's feeling lazy...but being a homer...there's no way I can pick her up at 1pm...(I have clinic every afternoon). My mind flirts with ideas of switching - maybe I could work fewer days, maybe I should just work mornings and go completely part-time!
I might even consider any of the above options if it would be the end of the guilt. The reality is there will likely always be requests that I can't fulfill...the answer I think lies in my ability to get through the moment, listen to a pep talk from my spouse and hopefully see the big picture in the morning.
...for now, my 3 year old with remain a napper. Maybe I'll take an afternoon off next week and surprise her.
We just came back from vacation, I was tucking her in bed and wanted to remind her that tomorrow was a school day. She says to me " Mommy, I don't mind going to school but what I really want is to be a 'homer'. " My heart sank. I try my best to make her wishes come true. I take days off when there's a field trip. I rush home when she says 'come early'. I dawdle in the mornings when she's feeling lazy...but being a homer...there's no way I can pick her up at 1pm...(I have clinic every afternoon). My mind flirts with ideas of switching - maybe I could work fewer days, maybe I should just work mornings and go completely part-time!
I might even consider any of the above options if it would be the end of the guilt. The reality is there will likely always be requests that I can't fulfill...the answer I think lies in my ability to get through the moment, listen to a pep talk from my spouse and hopefully see the big picture in the morning.
...for now, my 3 year old with remain a napper. Maybe I'll take an afternoon off next week and surprise her.
Sunday, June 29, 2008
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?
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?
Thursday, June 26, 2008
The baby behind the badge
Male resident: "Is there, like, a law that every woman has to have a photo of her baby on the back of her ID badge?"
Me: "Well, we can't put it on the front of the badge, can we??"
So yes, I am one of the many, many physician/mamas who sports a photo of my baby on the back of my ID badge. It covers up the instructions on what to do in case of fire.
I don't want to confess how much time and effort I spent picking out the perfect photo of her to display on the back of my badge. More time than I spend reading New England Journal, that's for sure.
My badge has a tendency to flip around, so that instead of displaying my own photo, name, and job description, I'm walking around the hospital with a photo of a baby on my chest. I'm pretty much the epitome of professionalism.
And of course, I'm always praying that the patient will notice the photo and comment on it, so I have an excuse to talk about her for a minute. A comment that would be great would be something along the lines of: "Your baby girl is beautiful." Unfortunately, comments I've heard include:
"Aw, how old is your son?" (Girls are allowed to wear green, you know.)
"Isn't that ID photo of you a little outdated?" (Ha ha.)
"Wow, you have a kid too? You must be exhausted." (Yep.)
What it all comes down to though is that I love having the photo of her on my ID so that if I'm ever feeling down during the day, I can look at it and feel a little bit better. That or the huge photo album of her that I keep in my white coat pocket at all times.
Me: "Well, we can't put it on the front of the badge, can we??"
So yes, I am one of the many, many physician/mamas who sports a photo of my baby on the back of my ID badge. It covers up the instructions on what to do in case of fire.
I don't want to confess how much time and effort I spent picking out the perfect photo of her to display on the back of my badge. More time than I spend reading New England Journal, that's for sure.
My badge has a tendency to flip around, so that instead of displaying my own photo, name, and job description, I'm walking around the hospital with a photo of a baby on my chest. I'm pretty much the epitome of professionalism.
And of course, I'm always praying that the patient will notice the photo and comment on it, so I have an excuse to talk about her for a minute. A comment that would be great would be something along the lines of: "Your baby girl is beautiful." Unfortunately, comments I've heard include:
"Aw, how old is your son?" (Girls are allowed to wear green, you know.)
"Isn't that ID photo of you a little outdated?" (Ha ha.)
"Wow, you have a kid too? You must be exhausted." (Yep.)
What it all comes down to though is that I love having the photo of her on my ID so that if I'm ever feeling down during the day, I can look at it and feel a little bit better. That or the huge photo album of her that I keep in my white coat pocket at all times.
Tuesday, June 17, 2008
Mims with older kids
My three daughters are now just in and out of college. Somewhat to my chagrin, not one of the three has any interest in science or in medicine. I am the child, niece, cousin and sister of physicians, and I wonder what this means. I have certainly loved having a profession, and I don't think my children have suffered from any lack of my involvement in their lives. (If anything, they have benefitted from me not helicoptering over their choices and experiences.) Yet when it comes to choosing a career, they look to their father and their peers. All are aspiring to change the world in some fashion, but medicine no longer seems to promise that, as it did when I was going into the field. Remarkable lack of interest in medicine in the children of female physicians was noted by Diane Shrier in her research on mother daughter physician pairs. I wonder if the children of male physicians, or the male children of female physicians, are any different.
Monday, June 9, 2008
Mommy of the Year
Husband is out of town. The person who said she would be on call to pick Son up if I had to work late forgot and made other plans. So after calling half the world and not finding anyone at home or on mobile phones, I decided to pick him up from daycare and bring him back to the hospital. After all, I had only two patients left to see, and both were "easy."
First we went to the cafeteria, where I let him pick out his own dinner, which we put in a to-go container. Next we stopped at the gift shop and bought a coloring book and crayons. We then went to the telemetry unit, where Son was an angel. He sat at a desk eating and coloring while I saw a patient.
Next, and this is where I question my sanity, I decided he was so good on the telemetry unit that I could take him up to the mental health unit. One patient. One easy patient. And nothing ever happens there.
After asking the charge nurse if it was OK, I parked him at a desk in the nursing station and got him all settled in with his crayons. I kissed his cheek and told him I'd be right back.
And then it happened in a flash.
A wild man, twenty-something, ran out down the hall screaming, "I'll kill you all!" Nurses surrounded him but he was very, very strong. Security guards appeared out of nowhere and tackled him.
Needless to say, Son didn't need to see that. I was nuts to think he'd be OK up there. So I got him outside and we sat at a picnic table and waited for PaniniFreak to come get him. And then I went back for my one easy patient. Funny, that patient wasn't so easy, after all.
At home, I asked Son if he had been scared by that man yelling. He seemed to not know what I was talking about.
Mommy of the year I'm not.
Unfit for Duty
The pediatrician diagnosed Squirtlet (age 7 months) with an ear infection today. ‘Yup, left ear looks really red. That probably hurts.’ She’s been sick for 5 days. I keep telling my husband that it’s just a cold, a virus, and will get better. After all, look at all of the goop draining from her nose. Last night she screamed for half an hour, despite motrin, tylenol, and the panacea for all things, nursing. This delightful episode triggered the inevitable call to the pediatrician’s office, where Sue, the efficient RN who triages sick appointments, got right to the point. ‘Does she have a fever? Is she pulling at her ears?’ We were deemed worthy of a visit, although I got the sense that Sue could make this diagnosis over the phone.
In the interest of full disclosure, I work in an emergency department. I diagnose otitis media several times daily. In kids. With confidence. Yet, I find myself curiously unable to make clinical judgements for my own children. Is that ear really red? Did he just scratch his face, or is it impetigo? (answer: impetigo).
I feel like I need to find the ‘right’ time to take the kids to the pediatrician – that day when the cold turns into the ear infection, or the fever has gone on just one day too long. Yet, I become a victim of my own anchoring bias: if I waited too long last time and the ear infection got really bad, then THIS time I show up on the pediatrician’s doorstep for a temperature of 100.1 and an isolated sneeze. She reassures me in her best Doctor-to-Mommy voice that my wee one will be just fine, while I apologize profusely for wasting her time. On the way home I resolve, yet again, to exercise my clinical judgement the next time around. This sets me up neatly for another episode like today’s.
Tonight I am combing the internet for the perfect pediatric first aid kit to keep at home in case of a Real Emergency. I hold out hope that, when something serious happens, I will know what to do.
In the interest of full disclosure, I work in an emergency department. I diagnose otitis media several times daily. In kids. With confidence. Yet, I find myself curiously unable to make clinical judgements for my own children. Is that ear really red? Did he just scratch his face, or is it impetigo? (answer: impetigo).
I feel like I need to find the ‘right’ time to take the kids to the pediatrician – that day when the cold turns into the ear infection, or the fever has gone on just one day too long. Yet, I become a victim of my own anchoring bias: if I waited too long last time and the ear infection got really bad, then THIS time I show up on the pediatrician’s doorstep for a temperature of 100.1 and an isolated sneeze. She reassures me in her best Doctor-to-Mommy voice that my wee one will be just fine, while I apologize profusely for wasting her time. On the way home I resolve, yet again, to exercise my clinical judgement the next time around. This sets me up neatly for another episode like today’s.
Tonight I am combing the internet for the perfect pediatric first aid kit to keep at home in case of a Real Emergency. I hold out hope that, when something serious happens, I will know what to do.
Saturday, June 7, 2008
You didn't tell me you're a doctor!
Our painter, a fifty-something fellow, has done many jobs for us over the years. He works hard, grunting and thumping and wheeling the roller around whatever room he's working on. I commented once on the superb quality of his work. He responded kindly, "I'm sure there's something you're good at, too."
Months later, touching up our living room, he caught sight of my medical degree tucked in a corner of a bookcase. "You're a doctor!" he said accusingly when I saw him next. He felt deceived because I hadn't volunteered that information.
This has happened to me on many occasions, where someone who has known me only as a mother discovers that I am a physician. A neighbour is seated in the clinic waiting room and is shocked to see me with a stethoscope around my neck. A mother at the playground asks why I'm carrying a pager, and is taken aback when I explain that I'm on call for the clinic. The response is usually dismay, and I know it's because they are madly working to mentally recategorize me. They're disconcerted because they realize they've been using the wrong set of assumptions.
The response to both occupations bothers me. I resent being patronized as a mother, and I feel embarrassed when I'm congratulated for being a physician.
While doling out hot dogs and orange drink to my kids at the school barbeque recently, I remarked that the energy and enthusiasm of students made teaching look attractive. A teacher grasped my arm and replied earnestly, "And I'm sure you could do it, one day!"
What was I supposed to say? I just nodded and thanked her.
Months later, touching up our living room, he caught sight of my medical degree tucked in a corner of a bookcase. "You're a doctor!" he said accusingly when I saw him next. He felt deceived because I hadn't volunteered that information.
This has happened to me on many occasions, where someone who has known me only as a mother discovers that I am a physician. A neighbour is seated in the clinic waiting room and is shocked to see me with a stethoscope around my neck. A mother at the playground asks why I'm carrying a pager, and is taken aback when I explain that I'm on call for the clinic. The response is usually dismay, and I know it's because they are madly working to mentally recategorize me. They're disconcerted because they realize they've been using the wrong set of assumptions.
The response to both occupations bothers me. I resent being patronized as a mother, and I feel embarrassed when I'm congratulated for being a physician.
While doling out hot dogs and orange drink to my kids at the school barbeque recently, I remarked that the energy and enthusiasm of students made teaching look attractive. A teacher grasped my arm and replied earnestly, "And I'm sure you could do it, one day!"
What was I supposed to say? I just nodded and thanked her.
Cross-posted at www.freshmd.com.
Friday, June 6, 2008
Warped
To say that pediatrics has altered my outlook on life is the understatement of the last general election. Take my children, for example. Most of my parenting decisions come from 1) gut response 2) experience from pediatric residency 3) pediatric practice or distant #4) indoctrination from my own parental units.
For several years William and Harry have requested some type of reptile coming to reside at our house. I have a difficult time calling a reptile a pet since they are neither cute nor cuddly.
Gut response says “Hell, No. No slithering critters with tails who can escape from minimally-lidded glass aquariums.”
The joint Pediatric camp says “Are you crazy? Turtles, lizards, geckos, etc. carry salmonella and shigella and can give you bloody diarrhea just to start.” Flashback to PICU patient seizing with generalized shigella infection.
Finally the Parental/Growing up experience has no comment because I grew up in a house full of girls who had nothing to do with reptiles.
The issue of “heelies” has also come up with the two boys in my life.
“They’re fun.” Says Harry
“We won’t get hurt.” Says William
“What about the classmate with the two broken elbows from last week?” The Pediatric Camp volleys.
“We’ll wear pads.” H and W say simultaneously.
“Yeah, right.” We’ve already paid a small fortune or at least a couple of house payments to our friend the orthopedist. Let’s not add our friend the ED doc to the family payroll. Another flashback to PICU patient with head injury seizing in the unit – maybe I just have Pediatric Post-Traumatic Stress Disorder.
And then there are the video games which are heavily regulated by the Homeland Parental Unit (HPU). E rated and the occasional T rated games only. Every now and then the HPU catches Harry sneaking next door to play M rated games with the neighbors. Gut response wants to know how long it will be before William or Harry go postal and wind up on E! television as a True Hollywood Story about serial killers. The Pediatric camp wants to know how much weight they’ll gain from playing 2 hours a day instead of being outside. The Growing up response again has no comment because I’m a girl and too old to have dealt with this issue in my own childhood.
Ok, I’ll admit it. My career has warped me into an overly neurotic, lizard-hating, heelie-avoiding, E-rated un-fun (but safe)parent that I am today.
For several years William and Harry have requested some type of reptile coming to reside at our house. I have a difficult time calling a reptile a pet since they are neither cute nor cuddly.
Gut response says “Hell, No. No slithering critters with tails who can escape from minimally-lidded glass aquariums.”
The joint Pediatric camp says “Are you crazy? Turtles, lizards, geckos, etc. carry salmonella and shigella and can give you bloody diarrhea just to start.” Flashback to PICU patient seizing with generalized shigella infection.
Finally the Parental/Growing up experience has no comment because I grew up in a house full of girls who had nothing to do with reptiles.
The issue of “heelies” has also come up with the two boys in my life.
“They’re fun.” Says Harry
“We won’t get hurt.” Says William
“What about the classmate with the two broken elbows from last week?” The Pediatric Camp volleys.
“We’ll wear pads.” H and W say simultaneously.
“Yeah, right.” We’ve already paid a small fortune or at least a couple of house payments to our friend the orthopedist. Let’s not add our friend the ED doc to the family payroll. Another flashback to PICU patient with head injury seizing in the unit – maybe I just have Pediatric Post-Traumatic Stress Disorder.
And then there are the video games which are heavily regulated by the Homeland Parental Unit (HPU). E rated and the occasional T rated games only. Every now and then the HPU catches Harry sneaking next door to play M rated games with the neighbors. Gut response wants to know how long it will be before William or Harry go postal and wind up on E! television as a True Hollywood Story about serial killers. The Pediatric camp wants to know how much weight they’ll gain from playing 2 hours a day instead of being outside. The Growing up response again has no comment because I’m a girl and too old to have dealt with this issue in my own childhood.
Ok, I’ll admit it. My career has warped me into an overly neurotic, lizard-hating, heelie-avoiding, E-rated un-fun (but safe)parent that I am today.
Thursday, June 5, 2008
Pretty in pink
Whenever we go to Toys R Us, my husband and I always gaze wistfully at the toys for older kids. We can't wait until Melly is old enough that we can buy her some awesome toys for us to play with. There's only so much fun we can have with a rattle.
On our latest trip there, I was practically slobbering over a toy doctor's kit. And it wasn't just a doctor's kit... it was a doctor's kit for GIRLS! Now you ask, what made this kit specifically for girls? Why, it was PINK, of course. There was a little pink stethoscope, a little pink BP cuff, a little pink syringe, a little pink otoscope, and a little pink thermometer. Unfortunately, it was for ages 3 and up. (Although the "and up" probably didn't go all the way up to 30 years old.)
Me: "And look! It comes with a little pink doctor's bag!!!"
Husband: "Do you want to buy this for Melly or for you?"
Me: "Ooh, there's a pink penlight too! Do you think it actually shines light?"
Husband: "You know, you have real versions of all this doctor's equipment."
Me: "Yes, but mine isn't pink."
Also, I'm missing my otoscope. Tell me, how hilarious would it be if I were examining a patient's ear and I pulled out that little pink otoscope? Answer: very.
On our latest trip there, I was practically slobbering over a toy doctor's kit. And it wasn't just a doctor's kit... it was a doctor's kit for GIRLS! Now you ask, what made this kit specifically for girls? Why, it was PINK, of course. There was a little pink stethoscope, a little pink BP cuff, a little pink syringe, a little pink otoscope, and a little pink thermometer. Unfortunately, it was for ages 3 and up. (Although the "and up" probably didn't go all the way up to 30 years old.)
Me: "And look! It comes with a little pink doctor's bag!!!"
Husband: "Do you want to buy this for Melly or for you?"
Me: "Ooh, there's a pink penlight too! Do you think it actually shines light?"
Husband: "You know, you have real versions of all this doctor's equipment."
Me: "Yes, but mine isn't pink."
Also, I'm missing my otoscope. Tell me, how hilarious would it be if I were examining a patient's ear and I pulled out that little pink otoscope? Answer: very.
Wednesday, June 4, 2008
The doctor's doctor
I kind of feel like a failure when I bring Melly to the doctor. Because, you know, I'm a doctor. (Sort of. That's what it says on my badge.) So naturally I should be able to diagnose any medical problem that comes up. Then prescribe amoxicillin to treat it.
My current excuse for my poor pediatric diagnostic skills is a lack of proper equipment. I don't have the tiny stethoscope like my pediatrician's. (And I'm fairly sure the stethoscope I use for work is colonized with MRSA and every other bug I've come across in the six years I've owned it... it's pretty much a petri dish. Melly tried to lick it once and I almost had a heart attack.) Also, I left my otoscope at my mother's house and there's absolutely no possible way I can get it, short of some sort of experimental matter transportation device (a la The Fly).
Yeah, if only I had my otoscope, it would be NO PROBLEM to stick that thing in her tiny ear to visualize her eardrum while she's flailing about wildly. Because I was just so good at it as a med student.
The sad truth of the matter is that I'm lucky if I can even get a temperature for her. That ear thermometer we bought is very suspect. I took her temperature on it once and got 102.4, then took it two seconds later and got 97.5, so what am I supposed to do... average the numbers?
Part of the problem is probably that I have too much knowledge for my own good, but not enough knowledge to do anything useful. Like when she's drooling a lot, instead of assuming that she's teething, I think to myself, "Oh my god, is this epiglottitis?? Will this require intubation???" And slowly I lose my mind.
I recall in med school that my worst exam grade was in my pediatrics rotation. Damn, if only I had studied harder... I could have saved myself so many $20 copays.
My current excuse for my poor pediatric diagnostic skills is a lack of proper equipment. I don't have the tiny stethoscope like my pediatrician's. (And I'm fairly sure the stethoscope I use for work is colonized with MRSA and every other bug I've come across in the six years I've owned it... it's pretty much a petri dish. Melly tried to lick it once and I almost had a heart attack.) Also, I left my otoscope at my mother's house and there's absolutely no possible way I can get it, short of some sort of experimental matter transportation device (a la The Fly).
Yeah, if only I had my otoscope, it would be NO PROBLEM to stick that thing in her tiny ear to visualize her eardrum while she's flailing about wildly. Because I was just so good at it as a med student.
The sad truth of the matter is that I'm lucky if I can even get a temperature for her. That ear thermometer we bought is very suspect. I took her temperature on it once and got 102.4, then took it two seconds later and got 97.5, so what am I supposed to do... average the numbers?
Part of the problem is probably that I have too much knowledge for my own good, but not enough knowledge to do anything useful. Like when she's drooling a lot, instead of assuming that she's teething, I think to myself, "Oh my god, is this epiglottitis?? Will this require intubation???" And slowly I lose my mind.
I recall in med school that my worst exam grade was in my pediatrics rotation. Damn, if only I had studied harder... I could have saved myself so many $20 copays.
Tuesday, June 3, 2008
Following in my footsteps....
...by compulsion. For the record, the pictured garb were provided by my father. He is a doctor himself, and had to have the grandkids participate in his medical clinic-sponsored float during our home town's fall festival parade.So literally, I was parading my kids around in these.
Although I don't have expectations that my kids will become doctors, it would be nice to think that, should they opt to go that direction, I inspired them that way. Of course, my husband is a physician too, so it would technically be difficult to tell who was the primary influence.
Okay, I'll admit something. I not only kept my last name upon marriage, but tried to persuade my husband to adopt mine. This was not a battle that I won, nor did I really expect to. I just thought it was worth the argument.
Sometimes, though, I think about what the difference would have been if things had gone that way (indulge me for a minute in some unladylike egotism). My kids would bear my name, and if they became doctors, they would be the next (third) generation of doctors in my immediate family with my surname. If people called me and asked for Dr. ______, I might have to ask clarification for which Dr. ____ (and yes, I realize this would also have been the case had I taken my husband's last name, so don't bother pointing that out, that is not the point).
Mothers are not so different than fathers, after all. Sometimes we just kind of want our kids to follow in our footsteps.
It's a shame though. I guess the world will have to do without two more "Dr. Singh"s.
Perspective
I'm a highly trained physician, but I can't put drops in my kid's eyes. He fights, and I'm afraid prying open his eyes will hurt the recent sutures.
I seriously believe every physician should have children before telling mothers how to give medicines. I used to prescribe 10-day courses of antibiotics all the time. Now that I realize how difficult that is, I would never do it to anybody else.
Just sayin'.
Friday, May 30, 2008
Taking my kids to work
Ok, obviously with a 3 year old girl and 4 year old boy, I do not take my kids to work for the entire day. However, when granted the opportunity for a brief run-in, I will snatch it up, whether it means 30 minutes in the morning for breakfast in the cafeteria or an hour over lunch. I can't help it--I love having my kids in my hospital workplace!
Truthfully, things never go as I anticipate. I always have this vision of my daughter showcasing her adorable made-up songs and my son making hilarious (though appropriate) jokes, thus bringing all my anecdotes and imitations into a stark and incontrovertible reality for my co-workers. In actuality, my kids have, over the course of several visits, managed to: 1) sit in a corner and pout, 2) scream at each other about who gets to push the wagon, 3) scream at me for not letting them eat a donut they dropped on the MRSA-ridden hospital floor, 4) pull my shirt down so that my bra is fully visible to a half-dozen people, and 5) inform my boss that he (my son) didn't want to be at this "stupid (retirement) party" (okay, maybe that last one was an avoidable error on my part, but they had food there).
Am I crazy? Why do I let myself in for this recurrent exercise in mortification? One thing I underestimated was the fun of seeing the hospital through my kids' eyes. My son's "favorite place" is the...cafeteria. Think about it - donuts, soft serve ice cream, juice, cookies, french fries. How cool is that to a 4 year old?! It's like working at a Luby's. They also think my microscope is one of the neatest things on this earth, and I have essentially no one else in my life who agrees with me on that.
Also, I have this irrepressible desire to merge my work life and family life. I want the people I work with to know my kids, and my kids to know them. I guess the folks at work are getting to know them in a certain way, which at the very least, should garner me sympathy for going home to a veritable nuthouse (or on the flipside, garner criticism for being a mom of two out-of-control hellions). But I don't care. Sooner or later they'll see the whole package, and until they do, they will just have to settle for my imitation of my daughter singing Rihanna:
My umbwelluh - elluh - elluh - eh - eh - eenee my umbwelluh!!
Truthfully, things never go as I anticipate. I always have this vision of my daughter showcasing her adorable made-up songs and my son making hilarious (though appropriate) jokes, thus bringing all my anecdotes and imitations into a stark and incontrovertible reality for my co-workers. In actuality, my kids have, over the course of several visits, managed to: 1) sit in a corner and pout, 2) scream at each other about who gets to push the wagon, 3) scream at me for not letting them eat a donut they dropped on the MRSA-ridden hospital floor, 4) pull my shirt down so that my bra is fully visible to a half-dozen people, and 5) inform my boss that he (my son) didn't want to be at this "stupid (retirement) party" (okay, maybe that last one was an avoidable error on my part, but they had food there).
Am I crazy? Why do I let myself in for this recurrent exercise in mortification? One thing I underestimated was the fun of seeing the hospital through my kids' eyes. My son's "favorite place" is the...cafeteria. Think about it - donuts, soft serve ice cream, juice, cookies, french fries. How cool is that to a 4 year old?! It's like working at a Luby's. They also think my microscope is one of the neatest things on this earth, and I have essentially no one else in my life who agrees with me on that.
Also, I have this irrepressible desire to merge my work life and family life. I want the people I work with to know my kids, and my kids to know them. I guess the folks at work are getting to know them in a certain way, which at the very least, should garner me sympathy for going home to a veritable nuthouse (or on the flipside, garner criticism for being a mom of two out-of-control hellions). But I don't care. Sooner or later they'll see the whole package, and until they do, they will just have to settle for my imitation of my daughter singing Rihanna:
My umbwelluh - elluh - elluh - eh - eh - eenee my umbwelluh!!
Thursday, May 29, 2008
Proud Moment
About half an hour ago, I was at a neighborhood pizza restaurant with Sister, her two kids and their two friends. Sister asked me to keep an eye on her kids while she used the restroom.
I was in the process of sternly asking one of them to climb down from the skeeball machine when Son tugged on my sleeve. I shook him off and kept my focus on the skeeball climber. He tugged again. "Stop it, Son," I said, giving him the shake off again. Finally I turned to him, ready to sternly lecture him, as well.
Son stood at my side, a horrified look on his semi-cyanotic face, trying to speak, trying to breathe. Choking. Niece had asked me if Son could have a starlight mint. I said yes. He then tried to get my help and I brushed him off.
Before I could even form the thought to do the Heimlich, he coughed the piece of candy up. It went shooting across the room. Then he vomited, all over his neglectful mother.
"I'm sick. I need to go to the doctor," he cried.
But I am a doctor. And your mommy. And not very good at either right now.
"No you don't, sweetie," I said, cuddling him, "that was scary, wasn't it?"
He's fine now. Incident forgotten. But I'm still shaking.
Tuesday, May 27, 2008
Small Things
Tonight, I have to prepare a lecture for a group of healthcare professionals. I've known about this for nine months, yet I've put it off until the night before. Exactly 22 hours from now, I will be embarrassing myself with my unpreparedness. But I'm not thinking about isn't my professional reputation right now.
I'm thinking about Son, who is upstairs in his bedroom for the first time in two weeks. He's been sleeping with us lately. We don't know why. Tonight we decided to try him back in his room. We told each other he'd last five minutes, and we were OK with that. But five minutes passed a long time ago.
He's intermittently singing, though I can't understand the words. Every now and then I hear a knock on the door. "Mama," he calls, "where are you?" I ignore him, though it is so tempting to call back to him. He knows how to open the door, so if he really wants to come down, he will.
These small things are the challenges in my life. I know how to treat a pneumonia, how to run a code, how to track down the most elusive data using our complicated electronic medical record and how to work my patient onto the closed radiology schedule.
But how do I make my son feel safe in his own bedroom? It's a small thing, really, but aren't those the ones that perplex us? I wish being a mother were as "easy" as being a doctor.
By the way, it's now been 30 minutes. The singing and knocking have slowed down. I'm fighting the urge to open his door and look, but I know better.
After almost four years, I've learned a thing or two about being a mama, too.
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