Hi,
I just came across your blog and really enjoyed reading the posts (while I put off another question set as I procrastinate studying for Step 3).
I’m an Internal Medicine intern, and I have a 10 month old baby boy. I had a mentor prior to medical school - my boss (a psychiatrist) while I was a research assistant for her had two kids in the beginning of her research career. She told me several times “being pregnant during your 4th year of medical school would be ideal.” My husband and I are a little older than the average medical student and wanted kids sooner rather than later, and thus our son was born right before match day.
This year, as I’m sure most people can relate, has been tough, being a new mom and a new doctor. My program is a rigorous academic center where few women have children and as one attending said in my first month on the wards back in July “oh you have a baby? Wow… good luck.” And chuckled. And she was a woman.
Now, I’m so tired. So so tired. I just finished up three months of call (one of which was q3 in the ICU) and capped it off with two weeks of night float duties. And now I’m on a short clinic rotation but spending my precious three day weekend studying for step 3. I can’t seem to catch my breath.
I’m pleased to say that through all this, I still find moments where I love my job (strangely enough in the ICU, never thought I would actually WANT to be there) and my son is thriving. My marriage, however, is taking a hit. I just don’t know how to stay connected to him. He is not in medicine and seems less and less interested in the cool stories about patients that I have. We still definitely bond over our baby and he is doing an amazing job with him while I’m at work. I know intern year is hard on every couple, but if there are any other stories out there about marriage survival when you have a child and a resident, I would love to hear them. I need a little boost to help me through the rest of the year (because every R2 and R3 keeps telling me “don’t worry, it gets better next year…” – and I’m really counting on that).
Again, thanks for all the great posts on this blog. I will keep reading (when I have time!).
-NiqueKee
Tuesday, January 19, 2010
Sunday, January 17, 2010
Breastmilk vs. Formula: the epic battle
Breastmilk vs. formula is one of those topics that is highly controversial on the internet. When my daughter was of breastfeeding age, I was scared to even broach the topic on this blog. However, she's almost three now, which is an age where I would probably be given a lot of funny looks for breastfeeding, so I feel safe talking about it without being accused of child abuse.
I think most women would agree that breastfeeding is better than formula. However, there's a culture of women (very vocal on the internet) that will yell at any mother who does not breastfeed. You must at least try to breastfeed. Any woman who doesn't breastfeed is selfish. Formula is full of chemicals and is harmful to your baby.
But for a physician mother, especially one still in training, it can be hard to provide exclusive breastmilk for a baby. I know women who are great mothers who just couldn't swing it with their schedule. Giving your baby formula is not child abuse. Saying that is an insult to babies who actually ARE neglected or abused, of which there sadly are many.
My story:
I struggled with breastfeeding initially. I wanted to do it very much, but it was not one of those things that came instantly and easily to me. I had a very hungry, jaundiced baby who wanted to suckle nonstop, which was becoming more and more painful. With a rising bilirubin level, I consented for my daughter to have a couple of ounces formula in the hospital, which she sucked down in about five seconds. I felt guilty about this, because people told me that if she was given formula, she'd get nipple confusion and it would hurt my supply.
When I brought her home, I was determined to feed her only breastmilk straight from the source. She had a voracious appetite (she was at the 50th percentile for height/weight at birth, but was at 95th percentile by two months and stayed there) and I didn't get much pumping done, so we had no supply tucked away early on, which meant that I had to be up for every single feeding. I was stubborn and wanted to do it all myself. But when I was hospitalized with 103F fever at two weeks postpartum, my husband and I decided that he would give her one bottle of formula per night so that I could have the luxury of four straight hours of uninterrupted sleep.
I told this to a friend of mine who had been giving me advice about breastfeeding, and she belittled me for allowing my daughter to have a bottle of formula per night for the sake of my sleep. I was being selfish. Once again, I felt guilty.
When I went back to work, I was attached at the hip to my pump. I would hook it up while I returned pages on my cell phone, praying nothing would come up that couldn't be put off for fifteen minutes. When I came home from work and saw a bottle of breastmilk on the counter that was half empty, I'd be furious about the wasted two ounces of milk. We did have a can of formula in the cupboard, but I was proud of the fact that we rarely used it.
At six months, I moved on to a much more demanding rotation where I was the only resident looking after twenty patients. I put away my pump and just nursed in the morning and at night (until one year, when my daughter self-weaned).
When I look back on all the stress I had worrying about my daughter getting a few ounces of formula, I feel angry at myself. I was a loving mother. I cared about my baby and took very good care of her. It was stressful enough to manage residency and a baby without feeling like an ogre because my daughter was getting a few ounces of formula. Whenever a working mother tells me she gave up nursing because it was too hard, I immediately give her my sympathy. I would never say anything judgmental, because I'm sure she gets enough of that, most of all from herself.
If I have another baby, I don't know if I will do anything differently. I loved nursing and I think I stopped at the right time. But I definitely will keep a can of formula in the cupboard and not allow myself to feel guilty if I need to use it.
I think most women would agree that breastfeeding is better than formula. However, there's a culture of women (very vocal on the internet) that will yell at any mother who does not breastfeed. You must at least try to breastfeed. Any woman who doesn't breastfeed is selfish. Formula is full of chemicals and is harmful to your baby.
But for a physician mother, especially one still in training, it can be hard to provide exclusive breastmilk for a baby. I know women who are great mothers who just couldn't swing it with their schedule. Giving your baby formula is not child abuse. Saying that is an insult to babies who actually ARE neglected or abused, of which there sadly are many.
My story:
I struggled with breastfeeding initially. I wanted to do it very much, but it was not one of those things that came instantly and easily to me. I had a very hungry, jaundiced baby who wanted to suckle nonstop, which was becoming more and more painful. With a rising bilirubin level, I consented for my daughter to have a couple of ounces formula in the hospital, which she sucked down in about five seconds. I felt guilty about this, because people told me that if she was given formula, she'd get nipple confusion and it would hurt my supply.
When I brought her home, I was determined to feed her only breastmilk straight from the source. She had a voracious appetite (she was at the 50th percentile for height/weight at birth, but was at 95th percentile by two months and stayed there) and I didn't get much pumping done, so we had no supply tucked away early on, which meant that I had to be up for every single feeding. I was stubborn and wanted to do it all myself. But when I was hospitalized with 103F fever at two weeks postpartum, my husband and I decided that he would give her one bottle of formula per night so that I could have the luxury of four straight hours of uninterrupted sleep.
I told this to a friend of mine who had been giving me advice about breastfeeding, and she belittled me for allowing my daughter to have a bottle of formula per night for the sake of my sleep. I was being selfish. Once again, I felt guilty.
When I went back to work, I was attached at the hip to my pump. I would hook it up while I returned pages on my cell phone, praying nothing would come up that couldn't be put off for fifteen minutes. When I came home from work and saw a bottle of breastmilk on the counter that was half empty, I'd be furious about the wasted two ounces of milk. We did have a can of formula in the cupboard, but I was proud of the fact that we rarely used it.
At six months, I moved on to a much more demanding rotation where I was the only resident looking after twenty patients. I put away my pump and just nursed in the morning and at night (until one year, when my daughter self-weaned).
When I look back on all the stress I had worrying about my daughter getting a few ounces of formula, I feel angry at myself. I was a loving mother. I cared about my baby and took very good care of her. It was stressful enough to manage residency and a baby without feeling like an ogre because my daughter was getting a few ounces of formula. Whenever a working mother tells me she gave up nursing because it was too hard, I immediately give her my sympathy. I would never say anything judgmental, because I'm sure she gets enough of that, most of all from herself.
If I have another baby, I don't know if I will do anything differently. I loved nursing and I think I stopped at the right time. But I definitely will keep a can of formula in the cupboard and not allow myself to feel guilty if I need to use it.
The Fourth Law of Mommodynamics
For years now, I have lived by the laws of Mommodynamics:
1. Energy is finite.
2. Clutter, like entropy, tends towards an infinite maximum.
3. Matter is neither created nor distroyed, it is merely misplaced.
Now, to my amazement, I recognize a fourth law has been operating all along, behind the other three: the law of conservation of clutter. This law requires that every time I find a lost object, an object of equal importance will go missing. This weekend it was my watch, which turned up under some papers on a countertop, and my cell phone, which instantly disappeared from my coat pocket. I have noticed the same sly switching going on with my faculty id and my drivers licence, my ward key and my office key, my metropass and my credit card--whenever I have one of these ready to hand, the other one slips off into the shadows for a giggle and a rest. After a frantic search which rivalled the rummaging of a cocaine addict in search of a fix, I just found the missing cell phone, under a potholder in the kitchen. I can hardly rejoice--lord knows what has just gone missing in its place!
1. Energy is finite.
2. Clutter, like entropy, tends towards an infinite maximum.
3. Matter is neither created nor distroyed, it is merely misplaced.
Now, to my amazement, I recognize a fourth law has been operating all along, behind the other three: the law of conservation of clutter. This law requires that every time I find a lost object, an object of equal importance will go missing. This weekend it was my watch, which turned up under some papers on a countertop, and my cell phone, which instantly disappeared from my coat pocket. I have noticed the same sly switching going on with my faculty id and my drivers licence, my ward key and my office key, my metropass and my credit card--whenever I have one of these ready to hand, the other one slips off into the shadows for a giggle and a rest. After a frantic search which rivalled the rummaging of a cocaine addict in search of a fix, I just found the missing cell phone, under a potholder in the kitchen. I can hardly rejoice--lord knows what has just gone missing in its place!
Wednesday, January 13, 2010
Guest Post: Mentors
My mentors have been very important to me.
My first mentor was a Pediatric Metabolism specialist at the New England Medical Center in Boston. I met her shortly after I fell in love with Pediatrics, in my third year of Medical School. I was impressed with how she remained involved with her patients as she continued to manage their metabolic conditions into adulthood. These were patients she had diagnosed as young infants!
My second mentor was the program director at my Pediatric Residency program. In fact, I had ranked this program first because of my experience working with her in Pediatric Infectious Disease in my fourth year elective. When I became pregnant with my first son, she told me to take off as much time as I needed because I would learn more about child development by being a mother, than at any other time in my career!
My third mentor was my continuity clinic preceptor at the private Pediatric practice near my residency, twelve years ago...I joined this practice after finishing my residency and am still there today. My mentor, however, despite her clinical excellence and devotion to her career, left the practice of medicine five years ago after having her son due to the challenges of trying to balance her career with the needs of her family. Her husband is a surgeon.
One of the senior physicians at my practice continues to fill the role of mentor to me. When I have questions about psychiatric or developmental issues (this is his area of expertise), he has so much to offer me.
Recently, I have been able to act as a mentor to others through precepting and lecturing. And I have had the opportunity to give talks to school nurses from several school districts about food allergies in school, one of my interests.
As I think back, I realize I had mentors in my life well before my medical school career. There was my favorite English teacher in ninth grade, my undergraduate thesis advisor, and many other teachers throughout the years!
My father, a theoretical Statistician and University professor, was my first and most important mentor. He had so much faith in me, was always interested in what I had to say, and always knew I could achieve whatever I wanted to. This support from him made all the difference to me.
When my father died a year ago, I received many thoughtful notes from people I had known for many years. The most poignant letter, though, came from the first PhD student my father had mentored. He spoke of my father's love of teaching and how he had inspired and supported him in his own development. I was amazed to read this, I had not seen this side of my father. However, I realized only then that my father had supported my intellectual growth in this way as well.
-Pedimom, mother to 2 (ages 9 and 11)
My first mentor was a Pediatric Metabolism specialist at the New England Medical Center in Boston. I met her shortly after I fell in love with Pediatrics, in my third year of Medical School. I was impressed with how she remained involved with her patients as she continued to manage their metabolic conditions into adulthood. These were patients she had diagnosed as young infants!
My second mentor was the program director at my Pediatric Residency program. In fact, I had ranked this program first because of my experience working with her in Pediatric Infectious Disease in my fourth year elective. When I became pregnant with my first son, she told me to take off as much time as I needed because I would learn more about child development by being a mother, than at any other time in my career!
My third mentor was my continuity clinic preceptor at the private Pediatric practice near my residency, twelve years ago...I joined this practice after finishing my residency and am still there today. My mentor, however, despite her clinical excellence and devotion to her career, left the practice of medicine five years ago after having her son due to the challenges of trying to balance her career with the needs of her family. Her husband is a surgeon.
One of the senior physicians at my practice continues to fill the role of mentor to me. When I have questions about psychiatric or developmental issues (this is his area of expertise), he has so much to offer me.
Recently, I have been able to act as a mentor to others through precepting and lecturing. And I have had the opportunity to give talks to school nurses from several school districts about food allergies in school, one of my interests.
As I think back, I realize I had mentors in my life well before my medical school career. There was my favorite English teacher in ninth grade, my undergraduate thesis advisor, and many other teachers throughout the years!
My father, a theoretical Statistician and University professor, was my first and most important mentor. He had so much faith in me, was always interested in what I had to say, and always knew I could achieve whatever I wanted to. This support from him made all the difference to me.
When my father died a year ago, I received many thoughtful notes from people I had known for many years. The most poignant letter, though, came from the first PhD student my father had mentored. He spoke of my father's love of teaching and how he had inspired and supported him in his own development. I was amazed to read this, I had not seen this side of my father. However, I realized only then that my father had supported my intellectual growth in this way as well.
-Pedimom, mother to 2 (ages 9 and 11)
Sunday, January 10, 2010
Saturday - Girl's Day
My four year old John and his dad left early for a car show, mummy movie at the Imax theater, and the Pharaoh exhibit at the Arts Center downtown. So I had a full day with Sicily.
First we showered and got ready. She came out in jeans, a long eggplant purple velvet hippie bohemian skirt, and an I Love Penguins t-shirt. Although she looked fabulous I chided her, in spite of myself.
"Sicily, we are going to a musical. You love to get dressed up, and you don't get the chance to do it very often. Shine for me, please."
She came back out in a beautiful lime green corduroy dress, white tights, and a low ponytail.
"Mom, will you please do my hair for me? Dry it, and fix it?"
I'm not the best with hair, but my sister gave me an elegant flower-shaped rhinestone pin for Christmas a couple of years ago that I love to wear in my ponytails to fancy events. So I offered it to Sicily, and she was enamored. We got all dolled up, and headed to lunch at Wendy's, her choice.
They were featuring Mad Libs, so over chicken nuggets, french fries, and a Southwest salad, I taught her the meaning of adjectives, verbs, and nouns. She peppered the Mad Libs liberally with nonsense words from Roald Dahl books I have read her over the last year, and the final product, which we read in the car in order to save the Wendy's patrons from lots of potty humor, was hilarious.
I got directions on my iPhone, and we headed over to the Baptist Church after filling the car with gas. We were the only Caucasian couple in the large audience of the predominantly African-American church, and I wondered, feeling a little like I was sticking out like a sore thumb, if this is what my partner felt like at work sometimes. Private practice is not nearly the melting pot of academics, especially in the South. I knew that we might be the only Caucasian people in the crowd, and worried, unnecessarily, over my six year old daughter Sicily's response. Earlier, while we were getting ready, she asked,
"Mom, is the church going to be only Spanish? Like the time (her nanny) Nina took us to her church?"
"No Sicily, but it is a church attended by mostly black people. We may be the only light-skinned people there."
She looked up at me and smiled. "No mom, you will be the only light-skinned person there! Not me. My skin is brown." She tans easily. I smiled, agreed with her, and loved that she has absolutely no qualms or hang-ups over skin color. I was silently projecting and worrying that she might make an observation aloud in the church that would offend someone. I resolved to quit my internal nonsense.
God the musical was incredible. It was The Black Nativity, by Langston Hughes. I read earlier in the week that it originally opened on Broadway in 1961 to rave reviews, even though two of the lead actors quit, because they were worried about the audience response during such a racially unstable time in our country. African chants, beautiful dance, choir music, amazing blues, silly rap, and gospel. During the intermission, my partner stopped by to say hello, and wondered if I was enjoying it. I nodded enthusiastically.
I asked her, "Did you see this for the first time when you went to St. Louis in mid-December?"
She smiled. "Yes."
"And you and your husband brought the entire St. Louis Black Repertory here, to your church, to share it with your church family? That was so quick! It is only the beginning of January."
She smiled again, a humble smile, but a pleased one. I wondered at the magic and power of possibility. Just imagine something, put a little work into it, and you can make it happen. She showed me that, on Saturday. After she went back to her seat, I got a tap on my shoulder.
"Gizabeth, is that you?"
My chairman's personal assistant from residency was sitting behind me, next to the former head of histology. I shrieked with recognition and hugged her excitedly. We caught up on old times, and I thanked my old histology boss for making me go to the doctor when I cut myself on a gallbladder the first month of residency. She towed the party line, while I was trying to hide my cut and staunch the flow of blood, in order to "be tough." I ended up needing many stitches. She smiled at my recollections. "At least you didn't dump formalin on it, like (so-and-so)!" We all wished each other a Happy New Year.
Sicily and I headed to Starbucks, again her choice, after the event. I had promised her, when she got a little bored and tired during the musical. She's only six - it's hard to blame her. I remember getting bored at Phantom of the Opera in New York when I was young. At least she didn't start stripping like she did when I took her to see Annie when she was four (she gets hot when she's tired). I asked her, over coffee and cinnamon cake, what her favorite part of the musical was.
"When they were doing like this. In the microphone. Ssshhhh."
"When did they do that? I don't remember."
"At the end, mom. What was your favorite part?"
I had so many, it was hard to think of one. I repaired my eyeliner, on the way into the coffee shop, because I teared up at least three times during the performance. The music, dance, and stories were incredibly moving.
"When the kids were performing. And singing. They were hesitant, and cute. It was funny. And when the men were kvetching over their jobs as shepherds. Singing the blues about hating their jobs, and losing their wives because they weren't making enough money to support their family. It was so funny, in a bittersweet way. And I loved when they were reigning in the people who were hunched over, acting like sheep, trying to wander off the stage."
"Let's just play rock/paper/scissors now, mom."
I went to the bathroom at the coffee shop, and told Sicily she could just sit in her seat instead of come with me, if she wanted to. I still get nervous about doing this, even though she is pretty grown up. As I walked out a minute later, I couldn't find her. My heart stopped. I caught the eye of another woman, and she glanced down behind a chair to show me where my child was hiding. Relief flooded me. I played along with Sicily's game, and pretended to search the whole store for her.
"Mom! I'm right here."
"My God Sicily! I've been looking for you everywhere! Where on Earth did you go?"
She laughed. "Magic, mom. I disappeared. Were you worried?"
Of course I was. But we were having so much fun, I didn't want to ruin the day by getting mad at her. I would discuss hiding in restaurants while I was in the bathroom later. "Not in the least. Glad you magically returned to your seat. How about we go home and check on John?"
"OK, mom. But let's go slow. I want this moment with you, without John, to last forever."
I missed John. And wanted to catch up with him and his day. But I understood, and we drove around the block a couple of extra times, singing at the top of our lungs, before we went home.
Just an Observation
So the week before Christmas I got to attend my son's first holiday program at school. My husband and I watched with video camera in hand, as he and the other kindergartens sang along to to familiar Christmas carols. I waved to several other parents I knew across the gym and had caught up with a few collegues as well (The majority of the doctors at my hospital send their kids to the same private school). As the first-graders took the stage, I noticed the chief of surgery's son was singing a solo. He was adorable and did an amazing job. Surgeon's trophy wife was there taking video, but surgeon was noticeably absent. As the program came to end and we all gathered for cookies and cocoa (yum!) I looked around and noticed that despite overall an equal number of moms and dads, where physician parents were involved, it was only moms. Probably 6 female physicians/moms were there and no physician dads (though probably 10 of their kids were represented).
Just an observation.
Just an observation.
Sunday, January 3, 2010
Why I Thought I Would Post My Holiday Letter, Then Decided Not To
I consider myself a connoisseur holiday letters, which I have sent and received pretty consistently since I first had children. Since my friends and I are roughly of an age, most of our children have left, or almost left, home. This year, I am struck that my letter and the ones my friends send still focus on the doings of our kids, with some people adding a bit of travelogue or home repair updates. It makes me wonder if having children means that ever after, we live and see the world through others’ eyes, sometimes at the cost of closing our own. I know holiday letters are not an intimate genre, particularly not the mass produced kind, but it seems that I and my mother-friends reflexively place ourselves in the background and move the kids to the foreground of our lives and our relationships. This posture of stooping over our kids becomes so engrained, it is hard to straighten up and reclaim interest in our thoughts and feelings after the kids have grown.
Being in medicine complicates things a bit. My non-medical friends would be baffled if I wrote about how amazed I am about the way that we are finally understanding the illnesses I treat at a genetic level, or how I believe I have experienced an inner paradigm shift in my understanding of psychiatric disorders since I discovered evolutionary biology. But other professional friends are equally reticent about their inner lives—they may report promotions or job changes, but not how they have been evolving and changing themselves.
In the end, I can’t decide whether the loss of interest in one’s self, or perhaps just the expectation that no one else would be interested, is a natural part of growing older, an artifact of being mother, the result of being in a fairly esoteric profession, or simply my own view of things. In the end, being a mother/doctor seems to have greatly expanded my sense of who I am, but with some loss of the value I once placed on reflecting about my experience and sharing it with others.
Of course, nowadays I can blog about it, and leave the kidalogue for my holiday reports.
Being in medicine complicates things a bit. My non-medical friends would be baffled if I wrote about how amazed I am about the way that we are finally understanding the illnesses I treat at a genetic level, or how I believe I have experienced an inner paradigm shift in my understanding of psychiatric disorders since I discovered evolutionary biology. But other professional friends are equally reticent about their inner lives—they may report promotions or job changes, but not how they have been evolving and changing themselves.
In the end, I can’t decide whether the loss of interest in one’s self, or perhaps just the expectation that no one else would be interested, is a natural part of growing older, an artifact of being mother, the result of being in a fairly esoteric profession, or simply my own view of things. In the end, being a mother/doctor seems to have greatly expanded my sense of who I am, but with some loss of the value I once placed on reflecting about my experience and sharing it with others.
Of course, nowadays I can blog about it, and leave the kidalogue for my holiday reports.
Friday, January 1, 2010
Things kids love to do with their Mothers...
As we make resolutions for the new year, I'm sure we will all be thinking about how we can be better parent, spend quality time with our kids and nurture healthy relationships in the family. I came across this wonderful article http://tinyurl.com/ybf43go with a list of the top ten things students around the world said they remembered and loved most about their mothers. It was reassuring to see that despite my craving to make ambitious plans for the year, it's the simple things they love. I thought I would share...
1. Come into my bedroom at night, tuck me in and sing me a song. Also tell me stories about when you were little.
2. Give me hugs and kisses
and sit and talk with me privately.
3. Spend quality time just with me, not with my brothers and sisters around.
4. Give me nutritious food so I can grow up healthy.
5. At dinner talk about what we could do together on the weekend.
6. At night talk to me about about anything; love, school, family etc.
7. Let me play outside a lot.
8. Cuddle under a blanket and watch our favorite TV show together.
9. Discipline me. It makes me feel like you care.
10. Leave special messages in my desk or lunch bag.
1. Come into my bedroom at night, tuck me in and sing me a song. Also tell me stories about when you were little.
2. Give me hugs and kisses
and sit and talk with me privately.
3. Spend quality time just with me, not with my brothers and sisters around.
4. Give me nutritious food so I can grow up healthy.
5. At dinner talk about what we could do together on the weekend.
6. At night talk to me about about anything; love, school, family etc.
7. Let me play outside a lot.
8. Cuddle under a blanket and watch our favorite TV show together.
9. Discipline me. It makes me feel like you care.
10. Leave special messages in my desk or lunch bag.
Wednesday, December 30, 2009
MiM Mailbag: Calling other/former resident moms
Recent comment to New Years Resolution:
I would like to resolve to have one day of residency when I didn't wonder if I should quit and stay home with my son. And, once I've had that one day, I'd like to move on to more days than not...Any more experienced and wisers have advice for how to accomplish this?
How did others do it? Was/Is this a constant struggle? Any regrets? Does it get better?
I would like to resolve to have one day of residency when I didn't wonder if I should quit and stay home with my son. And, once I've had that one day, I'd like to move on to more days than not...Any more experienced and wisers have advice for how to accomplish this?
How did others do it? Was/Is this a constant struggle? Any regrets? Does it get better?
Sunday, December 27, 2009
New Years Resolution
I've decided my New Years Resolution this year is to spend less time online. I feel like I spend much of my day at work on the computer and I feel like I spend too much of my night on the computer. I have this crazy compulsion to check my email. It needs to stop. Now.
(And yes, I know there's irony in making such an announcement online.)
I've made one other serious New Years Resolution and that was to eat more vegetables. I totally kept that one, so I'm hoping to do as well with this one. I'm storing my laptop in the bookcase and not opening it till my daughter falls asleep for the night.
What's your New Years Resolution?
(And yes, I know there's irony in making such an announcement online.)
I've made one other serious New Years Resolution and that was to eat more vegetables. I totally kept that one, so I'm hoping to do as well with this one. I'm storing my laptop in the bookcase and not opening it till my daughter falls asleep for the night.
What's your New Years Resolution?
Thursday, December 24, 2009
Not Feeling It
It's Christmas Eve, and I'm not feeling it.
The house is decorated, the stockings filled. We baked and decorated sugar cookies. I made hot cocoa as a special bedtime treat. Thanks to the blizzard, there is snow on the ground for the first time in our city since 1962.
We celebrate not just Santa but also the birth of baby Jesus in our house.
But I'm not feeling it. Is it because we are so busy these days? Is it because I can't get my patients out of my brain?
God, I hope I'm able to see "it" in my son's face tomorrow.
The house is decorated, the stockings filled. We baked and decorated sugar cookies. I made hot cocoa as a special bedtime treat. Thanks to the blizzard, there is snow on the ground for the first time in our city since 1962.
We celebrate not just Santa but also the birth of baby Jesus in our house.
But I'm not feeling it. Is it because we are so busy these days? Is it because I can't get my patients out of my brain?
God, I hope I'm able to see "it" in my son's face tomorrow.
Wednesday, December 23, 2009
Christmas Miracle
About three months ago, I got an e-mail from my lawyer friend.
"My wife and I have been trying to have a baby for a long time. We are encouraged by our friend's recent success with adoption, and have decided to go this route. We need letters of recommendation from friends, for the adoption lawyer. Would you please write one for us?"
I was awed and felt honored to do so. I didn't know the details of their fertility struggle, but it made sense. They had been married for a few years, and were lagging behind on the baby train. I took my task seriously, and wrote from my heart. When I completed the letter, and sent it to my friend for approval, ready to edit and re-write if necessary, he made me laugh out loud in his reply. "Um, these people you described sound amazing. When can I meet them?"
About a month later, I got an e-mail with a blog link. Their adoption blog. Advertising themselves, as prospective parents, and asking everyone they knew to post it on Facebook, forward it to everyone in their contacts. Apparently that is how it is done, these days. I was busy that day, but a few days later, I obliged.
My husband got a text from him last night. "We are in the NICU. Giz's father is listed as the attending. We have a baby."
My dad has been a neonatologist in the hospital I now do pathology for, for over 25 years. I remember visiting the NICU various times growing up. Having a dad as a neonatologist is a lot to live up to. I remember being in gas stations in rural Southern towns, filling out checks to pay for college essentials like gas and caffeine. We have a very rare Norweigan last name, listed on the check. "Is your dad Dr. so-and-so?" the clerk asked. I answered, "Yes. That's my dad." "He saved my little boy. I think of him every day. He is like the sun, to me. The one that hung the moon." This sentiment repeated itself, throughout my life, in restaurants and other various public venues. In medical school, when my attendings learned my maiden name. Living with my dad was like living with a celebrity. A very aloof, private one, that reserves emotion and judgment and does not seek attention. It just came, with the nature of his business. He is very good at what he does.
My dad was over for sushi last night, when my husband received the text. "I think I remember the baby I admitted last night. The one your friend is adopting. Tell him I work again on Christmas Eve, and I will be happy to talk to him."
I worked today, and couldn't contain my desire to visit and participate in their joy. I called my dad at 9:30 and asked, embarrassingly, what floor the NICU was on. I visit the SICU, MICU, CCU, the floor, radiology, and the lab, but don't have the occasion to see the NICU. "It's on the second floor. Down the long hallway off of the physician elevators. Use my physician code to get in the door."
I did, and felt apprehensive and intrusive. I went up to the desk clerk, and announced myself. "I am Dr. so-and-so's daughter. I have friends with a baby here, and they asked me to visit." She smartly replied, "Let me just check with them, and then I'll guide you to the room."
As I walked into the darkened cubicle, my lawyer friend was holding his new baby girl. His face was shiny with tears. My heart was skittering all over my chest. "Hi, Gizabeth. This is Lorelei. She's my daughter. She is coming home on Christmas Day." He told me his story. They got a call from their lawyer at noon the day before. The mom had just learned she was pregnant a few days before, and was not prepared to be a mother. Her friend, the father, was in full agreement. The mother read through dossiers of prospective parents, and chose my friends.
I sat in the dark room for 45 minutes. My friend the adoptive mom showed up eventually, from her mad dash registering at Target ("I think I probably registered for too many things twice, I couldn't concentrate!") and took the baby in her arms. She is a schoolteacher for inner city children, and worried about the fact that her kids are unprepared for her maternity leave through mid-February. But she was thrilled, and knows the kids will wait for her. She babysits my kids, occasionally, and they love her to death. She has the right combination of artistic creativity, compassion, and boundaries that will make her a wonderful mom. And her new baby girl looks a lot like her. The daughter is biracial, a mixture between Caucasian and African-American parentage. She has the olive skin and dark, wavy hair of her adoptive Caucasian mom. She is ravishing. They were all glowing.
I walked back down to my office and tried to focus on my livers, lymph nodes, SPEP's, IFE's, and peripheral smears. I kept thinking of them all day. Of their wonderful Christmas miracle. Beats the hell out of all the lights and the presents under the tree. I am so happy for them.
Tuesday, December 22, 2009
Private vs. Public School
My oldest daughter is 5 years old and her birthday is in December so she missed the cut-off to go to kindergarten this year. At first, I was disappointed that she would be 'left behind' for the year, but I soon realized this meant an extra year to be with her and one more year for her to be a kid.
Meanwhile, one of my goals this year was to understand the education system. I grew up in Canada where almost everyone I knew went to public schools. The school system from elementary, to junior high to high school, even including the universities in Canada are all about the same quality. There isn't the same diversity in quality of schools as there is in the US. Since moving here, I have heard all about 'magnet schools', the 'gifted track', and schools with 'bad test scores'. Until recently, I found all of these terms quite intimidating and insisted that I would blindly send my kids to public schools because I didn't want to complicate life. Trying to keep life simple is an over-arching goal I am striving for. Sometimes in contradiction, I have also been trying to make educated decisions, particularly those that affect my children.
Well...in the name of getting 'educated' about the school system, I now find myself drowning in the debate of whether to send my kids to public or private school. I have researched dozens of schools online, called at least a dozen and visited a handful of schools in the area. This search has taken hours of my time and at the end of it all, I have a host of new emotions - irritated, excited, frustrated, inspired, and very, very confused.
Here are some of the highlights of my search:
- Some schools you can triage over the phone. I called one school, which is a Montessori school, and explained that I was looking for a school for my 5 year old. The lady who answered spent the next few minutes explaining why my child was now past the ability to learn in Montessori style and why all other preschools were inadequate. Montessori was the better way to learn she said but it was too late for my daughter....thanks.
- My husband and I went to one of the elite private schools in the area and spent one hour on what I thought was a tour and what turned out to be an interview. We were amazed by the grounds and the facility but not so inspired by the way the lady was sizing us up the whole time. This was early on in the process, I didn't realize that they were vetting us as well and I knew we really blew it when my husband asked after the schools finances - she answered "I'll have the development team get back to you on that...." as she rolled her eyes. Knowing that it would cost us at least 1 Million dollars if we sent all 3 of our kids to her school, I thought this was a very reasonable question...but clearly she wasn't impressed.
Here's what we've decided. While the public school system in our area is generally speaking one of the best in the country, our particular school has one of the lowest scores in the county so we won't be sending our children there. If we move in the next few years (which we might) then we will gladly reconsider as there are many advantages to the public school system.
In the meantime, I will try to send my daughter to a private school. I say 'try' because unfortunately she needs to take an IQ test. Unfortunately, because these tests are not good at predicting future cognitive ability - they only test a child's current skills which means that 70% of future gifted children would be missed when tested at the age of 5...(this fact is courtesy of Nurture Shock - a book I HIGHLY recommend).
So if she passes the IQ test, behaves well on her trial 'day at the school' and the administrators like our application, then she will go to a private school that is affordable (more than Catholic, less than the elite), on the smaller side in numbers and not a Montessori :).
We would like to send her there for at least kindergarten, maybe Grade 1 and then we'll have to see...I'm not convinced that long-term private school is the right path - there are social, financial and academic implications that I still need to think through.
Would love to hear any other thoughts on this debate that I'm sure many have considered.
Meanwhile, one of my goals this year was to understand the education system. I grew up in Canada where almost everyone I knew went to public schools. The school system from elementary, to junior high to high school, even including the universities in Canada are all about the same quality. There isn't the same diversity in quality of schools as there is in the US. Since moving here, I have heard all about 'magnet schools', the 'gifted track', and schools with 'bad test scores'. Until recently, I found all of these terms quite intimidating and insisted that I would blindly send my kids to public schools because I didn't want to complicate life. Trying to keep life simple is an over-arching goal I am striving for. Sometimes in contradiction, I have also been trying to make educated decisions, particularly those that affect my children.
Well...in the name of getting 'educated' about the school system, I now find myself drowning in the debate of whether to send my kids to public or private school. I have researched dozens of schools online, called at least a dozen and visited a handful of schools in the area. This search has taken hours of my time and at the end of it all, I have a host of new emotions - irritated, excited, frustrated, inspired, and very, very confused.
Here are some of the highlights of my search:
- Some schools you can triage over the phone. I called one school, which is a Montessori school, and explained that I was looking for a school for my 5 year old. The lady who answered spent the next few minutes explaining why my child was now past the ability to learn in Montessori style and why all other preschools were inadequate. Montessori was the better way to learn she said but it was too late for my daughter....thanks.
- My husband and I went to one of the elite private schools in the area and spent one hour on what I thought was a tour and what turned out to be an interview. We were amazed by the grounds and the facility but not so inspired by the way the lady was sizing us up the whole time. This was early on in the process, I didn't realize that they were vetting us as well and I knew we really blew it when my husband asked after the schools finances - she answered "I'll have the development team get back to you on that...." as she rolled her eyes. Knowing that it would cost us at least 1 Million dollars if we sent all 3 of our kids to her school, I thought this was a very reasonable question...but clearly she wasn't impressed.
Here's what we've decided. While the public school system in our area is generally speaking one of the best in the country, our particular school has one of the lowest scores in the county so we won't be sending our children there. If we move in the next few years (which we might) then we will gladly reconsider as there are many advantages to the public school system.
In the meantime, I will try to send my daughter to a private school. I say 'try' because unfortunately she needs to take an IQ test. Unfortunately, because these tests are not good at predicting future cognitive ability - they only test a child's current skills which means that 70% of future gifted children would be missed when tested at the age of 5...(this fact is courtesy of Nurture Shock - a book I HIGHLY recommend).
So if she passes the IQ test, behaves well on her trial 'day at the school' and the administrators like our application, then she will go to a private school that is affordable (more than Catholic, less than the elite), on the smaller side in numbers and not a Montessori :).
We would like to send her there for at least kindergarten, maybe Grade 1 and then we'll have to see...I'm not convinced that long-term private school is the right path - there are social, financial and academic implications that I still need to think through.
Would love to hear any other thoughts on this debate that I'm sure many have considered.
Saturday, December 19, 2009
Guest Post: Leave it at the Door
I’m talking of course about all of the personal “stuff” we carry around. Those of us who work in direct patient care are not allowed to have personal stress. Right? The expectation is that when we walk into work, the stressors of our personal lives are, well, left at the door so to speak. It makes sense. In order to perform well in stressful situations, we have to be able to focus, on the moment, on what is presented in front of us. OK. I can accept that. In fact, I 100% agree. I have always been irritated by those who come into work and bemoan their personal lives, and or use it as an excuse for doing a sub -par job. PLEASE! Just leave it at the door. In a perfect world it works. But we don’t live in a perfect world. For the first few years after I had my son, I was sorely irritated by the idea that everyone else (patients) could behave poorly due to the stress of their everyday lives, (which may or may not have been anywhere as stressful as mine), but alas, I could not. I was still expected to be there, at work, focused, unfeeling of the storm that may have been taking place in my own life. I’m not typically one to roll around in the mud. I don’t like to wallow. I don’t appreciate over sharing of personal lives from the people I work with. It makes me…uncomfortable. But I am human, and from time to time, I am knocked off center by various events in my life.
Here’s a crazy secret… we all have our own lives. But… NO. We do not have the luxury of feeling, or even acknowledging it, unless we are on our own time. As a mother it is hard to disconnect. This expectation used to make me angry.
I remember one night in particular, my husband was deployed once AGAIN. I was doing the single parent thing AGAIN. My life at home was a little, ok a LOT more stressful than usual. That night, I had a patient who was deaf, and so was her spouse, I was struggling via multiple phone calls, to get an interpreter to come in and help us communicate, as I was writing everything to her for us to communicate. It was taking too long. What if there was an emergency? How would I tell her information quickly? Exactly what I didn’t want to happen, happened. (it’s Murphy’s law I guess) It was traumatic. The baby started having terrible, decels of fetal heart tones, and I could barely communicate to my very frightened patient, why I was flopping her from side to side and giving her Oxygen. I called the patient’s physician, he said he was coming in, he told me to administer terbutaline to stop contractions. I was performing all emergent response measures to improve heart tones and had another nurse come in to write out what we were doing and why we were doing it. I was stressed. My work cell phone rang, a call transferred to me by the receptionist, I figured it was my patient’s doctor but it turned out to be my children’s night time sitter calling from my house. I was irritated to have a call transferred to me at this time. I needed to Focus. On. The. Moment. “Big boy and Baby boy are both vomiting….Everywhere. I stripped all of their sheets and put Big boy in your bed, and then he vomited again. In your bed.” “Oh, fantastic” (sarcasm) “Baby boy is settling down, but he has a 102.2 fever, and Big boy feels feverish too, but I haven’t taken his temp yet” (Big boy has a history of febrile seizures) “I’m afraid to give them Tylenol and make them vomit again.”
Times like that, are HARD to leave at the door. Our jobs are all consuming. When we are “on duty”, There is no half way. I quickly gave my sitter some instructions for cool baths. Told her to try Tylenol anyway, and told her to put a bucket next to Big Boy, and hung up. I finished the night and came home to 2 pathetic, sick children and a sitter who was worn out from her all nighter with them. My guilt over the course of the night ate at me all night long. But they were fine. My patient ended up being fine too. And the baby did well, after we got her out by caesarean section. We all survived.
Now, I am experiencing another deployment, which means more balls to juggle in the air, on my own, again. The juggling never gets any easier, but over time, “leaving it at the door” has become easier. Knowing my children are well taken care of in my absence makes it possible. In some ways, I even welcome it now. As a mother, I often feel guilty over this. But I can’t help it. “Leaving it at the door” has become an escape. I am grateful to have something else to immerse myself in and forget about the rest of that swirling storm at home. If even for a few hours. I am happy to be there, focusing on the moment, and on what is presented in front of me.
MomRN2Doc1Day
Here’s a crazy secret… we all have our own lives. But… NO. We do not have the luxury of feeling, or even acknowledging it, unless we are on our own time. As a mother it is hard to disconnect. This expectation used to make me angry.
I remember one night in particular, my husband was deployed once AGAIN. I was doing the single parent thing AGAIN. My life at home was a little, ok a LOT more stressful than usual. That night, I had a patient who was deaf, and so was her spouse, I was struggling via multiple phone calls, to get an interpreter to come in and help us communicate, as I was writing everything to her for us to communicate. It was taking too long. What if there was an emergency? How would I tell her information quickly? Exactly what I didn’t want to happen, happened. (it’s Murphy’s law I guess) It was traumatic. The baby started having terrible, decels of fetal heart tones, and I could barely communicate to my very frightened patient, why I was flopping her from side to side and giving her Oxygen. I called the patient’s physician, he said he was coming in, he told me to administer terbutaline to stop contractions. I was performing all emergent response measures to improve heart tones and had another nurse come in to write out what we were doing and why we were doing it. I was stressed. My work cell phone rang, a call transferred to me by the receptionist, I figured it was my patient’s doctor but it turned out to be my children’s night time sitter calling from my house. I was irritated to have a call transferred to me at this time. I needed to Focus. On. The. Moment. “Big boy and Baby boy are both vomiting….Everywhere. I stripped all of their sheets and put Big boy in your bed, and then he vomited again. In your bed.” “Oh, fantastic” (sarcasm) “Baby boy is settling down, but he has a 102.2 fever, and Big boy feels feverish too, but I haven’t taken his temp yet” (Big boy has a history of febrile seizures) “I’m afraid to give them Tylenol and make them vomit again.”
Times like that, are HARD to leave at the door. Our jobs are all consuming. When we are “on duty”, There is no half way. I quickly gave my sitter some instructions for cool baths. Told her to try Tylenol anyway, and told her to put a bucket next to Big Boy, and hung up. I finished the night and came home to 2 pathetic, sick children and a sitter who was worn out from her all nighter with them. My guilt over the course of the night ate at me all night long. But they were fine. My patient ended up being fine too. And the baby did well, after we got her out by caesarean section. We all survived.
Now, I am experiencing another deployment, which means more balls to juggle in the air, on my own, again. The juggling never gets any easier, but over time, “leaving it at the door” has become easier. Knowing my children are well taken care of in my absence makes it possible. In some ways, I even welcome it now. As a mother, I often feel guilty over this. But I can’t help it. “Leaving it at the door” has become an escape. I am grateful to have something else to immerse myself in and forget about the rest of that swirling storm at home. If even for a few hours. I am happy to be there, focusing on the moment, and on what is presented in front of me.
MomRN2Doc1Day
Tuesday, December 15, 2009
Lunch privileges
When I was an intern in the medical ICU, I didn't get along very well with my senior resident. There was a name I used to call her and... well, I'm too polite to say it on this blog, but it started with the letter B and rhymed with "switch."
On my first call in the ICU, my senior resident who I will call Cruella (yes, I've been watching too many Disney movies) sent me to see a patient in the ER. I saw the patient, she came down to see the patient with me, and eventually he was stabilized. It was after 1PM and at that point, Cruella said to me, "Why don't you go get lunch?"
I was quite relieved because the cafeteria was closing soon and I needed to get some food for dinner too, considering I was likely not going to have time to make another trip down there. I got a sandwich (and one for dinner), ate it in maybe five minutes (chewing a total of six times), then went back to the ICU where Cruella promptly paged me.
"Where were you?" she demanded to know.
"I was eating lunch," I stammered.
"I told you to get lunch!" Cruella said angrily. "I didn't say you should eat it!"
I swear to god, she said that.
Cruella's switchiness aside, I feel like lunch is something I've had to fight for ever since starting my clinical years and it's gotten less and less acceptable to me. On my first day of residency, I nearly fainted because I skipped lunch. I attracted quite a crowd and I ended up having to confess to my attending that I was two months pregnant because otherwise she'd think I was a wuss who fainted from removing a G-tube. I also remember there was one day when I was six months pregnant and rounds were lasting forever, well past lunch time... I told my attending I needed to eat because I was feeling faint. She said, "You really think you're going to faint? Okay, let's just round on one more floor of patients, then you can eat." I swear to god, she said that. (And she was actually pretty nice otherwise.)
Moreover, I've noticed it seems commonplace for clinics to be scheduled to go straight through lunch. When I did clinics with surgeons especially, there was never ever a lunch break planned into the day. Surgeons eat maybe one meal every two days, which they eat standing up. I've theorized they must have some sort of bear-like fat storage system to allow them to go for long periods without eating.
Recently, my morning clinics have been running past 1:30 and I feel too embarrassed to complain. I honestly feel like there must be something wrong with me because by 1PM, I am actually really hungry. In fact, I'd rather eat at noon. Am I really the only one? Am I weak for needing to eat lunch? Should people who need to eat lunch avoid medicine entirely?
I don't want to have a gigantic lunch followed by a siesta. All I want is like ten minutes built into the middle of my day when I can sit down and eat some food, preferably with a drink, and not have to apologize for it.
On my first call in the ICU, my senior resident who I will call Cruella (yes, I've been watching too many Disney movies) sent me to see a patient in the ER. I saw the patient, she came down to see the patient with me, and eventually he was stabilized. It was after 1PM and at that point, Cruella said to me, "Why don't you go get lunch?"
I was quite relieved because the cafeteria was closing soon and I needed to get some food for dinner too, considering I was likely not going to have time to make another trip down there. I got a sandwich (and one for dinner), ate it in maybe five minutes (chewing a total of six times), then went back to the ICU where Cruella promptly paged me.
"Where were you?" she demanded to know.
"I was eating lunch," I stammered.
"I told you to get lunch!" Cruella said angrily. "I didn't say you should eat it!"
I swear to god, she said that.
Cruella's switchiness aside, I feel like lunch is something I've had to fight for ever since starting my clinical years and it's gotten less and less acceptable to me. On my first day of residency, I nearly fainted because I skipped lunch. I attracted quite a crowd and I ended up having to confess to my attending that I was two months pregnant because otherwise she'd think I was a wuss who fainted from removing a G-tube. I also remember there was one day when I was six months pregnant and rounds were lasting forever, well past lunch time... I told my attending I needed to eat because I was feeling faint. She said, "You really think you're going to faint? Okay, let's just round on one more floor of patients, then you can eat." I swear to god, she said that. (And she was actually pretty nice otherwise.)
Moreover, I've noticed it seems commonplace for clinics to be scheduled to go straight through lunch. When I did clinics with surgeons especially, there was never ever a lunch break planned into the day. Surgeons eat maybe one meal every two days, which they eat standing up. I've theorized they must have some sort of bear-like fat storage system to allow them to go for long periods without eating.
Recently, my morning clinics have been running past 1:30 and I feel too embarrassed to complain. I honestly feel like there must be something wrong with me because by 1PM, I am actually really hungry. In fact, I'd rather eat at noon. Am I really the only one? Am I weak for needing to eat lunch? Should people who need to eat lunch avoid medicine entirely?
I don't want to have a gigantic lunch followed by a siesta. All I want is like ten minutes built into the middle of my day when I can sit down and eat some food, preferably with a drink, and not have to apologize for it.
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