Planting Bulbs

I love autumn. It's always feels like a time of regeneration and new starts, even more than springtime does. A lot of this probably has to do with school beginning in the fall - we get used to a cycle of starting again each September.

Fall is also a time of planting for me; while many look to the spring to sow seeds and plant annuals, I prefer to put in the bulbs that will become the crocuses, daffodils and tulips that I love to look at in the spring.

It dawned on me as I was planting the bulbs that this is very similar to raising kids. What?

I can prepare the beds and make sure the bulbs are as protected as possible from the environment, including harsh weather and rogue squirrels, but ultimately I have to have the faith that the bulbs will grow where I planted them.

Isn't it the same with our kids? We feed, clothe, nurture them, read to them, snuggle and play with them, and love them. We offer the best environment that we can - but ultimately have to recognize that the final outcome may be out of our control. As someone who is used to directing her environment, this is a tough realization to come to grips with. But, I'll sprinkle a bit of fertilizer and nourish both my bulbs and my boys as best I can. And wait for the outcome.

A

P.S. Have a happy and safe Halloween!

Stains

Pete and I were getting ready for work when he set down the iron, inspected his pants, and said, "Not these ones too! All of my pants have grease stains across the thighs."

"So do mine!" I told him. "Grease stains, mid-thigh."

We puzzled over the consistent appearance and placement of the marks for a few minutes, and then it dawned on us. The range of the stains exactly matched the heights at which our two- and four-year-old plant their little hands when they grab us.

I've been a mother for seven years, and I don't think I've ever gone into work wholly clean in that time. I've had breast milk spit up on my shoulder, crusted rice cereal on my shirt cuffs, teething biscuits cemented to my pant legs, apple juice splash marks on my shoes and now a tideline of grease across my thighs.

Maybe I should go back to wearing a white coat. Do they come in floor-length?

(Cross-posted at www.freshmd.com)

Dr Unicorn

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

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

Mommy Awards

"You did it! CONGRATULATIONS! World's Best Cup of Coffee! Great job everybody! It's great to be here." -Will Ferrell as Buddy the Elf in Elf


One thing's certain: I won't be getting any "World's Best Mom" awards any time soon. "World's Most Embarrassing Mom," maybe - we're getting to that age.

Some people might even wonder - ESPECIALLY if you scour the American Academy of Pediatrics recommendations, or talk to parenting-book authors/readers - how conscientious I could possibly be as a physician when one considers that I have, at various times in the past,

-occasionally co-slept with my kids when they were babies (right in line, I must interject, with, like, 90% of the rest of the world's cultures)
-used Disney's Fantasia and the like as a babysitter when I had to cook dinner
-let my kids jump on backyard trampolines
-let my kids eat raw cookie dough
-skipped back-to-school night
-let them eat apple pie for breakfast (just once - and it was homemade and yummy and we all did it)
-made them memorize their times tables BEFORE explaining multiplication conceptually
-been physically and emotionally unavailable to them due to an excess of call
-let their father take them through a carnival house-of-horrors when they were WAY too little to laugh it off
-been way too permissive about TV-watching and video games/Wii playing
-missed some performances / special days
-failed to nurse at least one of them for the recommended period of time
-used phrases like "Because I said so" and "Don't do that"
-taken them out of school for trips
-required them to stick with certain academic or extracurricular activities against their wishes
-been impatient and snappish when tired or preoccupied
-let them eat a sickening amount of Halloween candy all at once.

Then I think, all those nitpicky little recommendations in the books and guidelines are nice, but they're not gonna make or break our parenting "success." I was sitting around comparing notes on the subject with some colleagues once when I was a resident.

"I watched TV all the time when I was a kid, " said one. "Violent stuff, too - martial arts movies and everything."

"We didn't even own a TV," said another

"We only ate food from local growers."

"We subsisted on chips and soda."

"I read TONS when I was younger."

"I barely read anything before college."

"And look - we all ended up in the same place, with 'M.D.' after our names, being fairly good people, for the most part, right?" someone finally pointed out.

That one conversation enabled me to avoid beating myself up too hard for all my faults and failings. Here's my bottom line: my kids are happy. They are healthy. They are curious. They have a sense of wonder. In general, they are kind. They read lots. They ask lots of questions. They know we expect them to work hard for their learning, to do not just "good enough" work but their best work always, and to accept the fact that they can't have every material thing they want. They have an abundance of what they need, and much more besides.

Most important, when they see our faces greeting theirs, they see us light up at the sight of them. They know they are immeasurably loved. They know we intend to be there for them no matter what.

And despite all those years of medical training, we have family memories to cherish. A brass band concert heard from a picnic blanket one balmy July night. Making s'mores in the wood stove one New Year's Eve. Dressing up as a medieval family with a Power Ranger to trick-or-treat one Halloween. Stolen moments, when I was either post-call or, miracle of miracles, actually off duty. Precious, warm, treasured moments.

So when the kids run to the door exclaiming "Mommy!" and throw their arms around me in big bear hugs every time I arrive home from work, or come home after a long night of call, I take heart. I may not be the world's best mom, or the world's best doc, for that matter, but I've had more than my share of the world's best moments.

EXERCISE AT 4AM??

Okay, I think I finally figured it out. Last year I remember talking to a colleague who told me he exercised at 4 in the morning before work. I looked at him like he was crazy. Turns out he wasn't so crazy after all. I discovered if it's something you love to do (dressage horseback riding) AND you don't want to take time away from the kids and the husband, it's a PERFECT time to do it. Not only that but you get there quicker since there's no traffic - and no one is there so you get the whole place to yourself!! It has completely eliminated the guilt I felt when I rode post call because I was either missing picking the kids up from school, or missing eating lunch with my hubbie. Not only that, the post call days weren't even that predictable and progress with riding was haphazard. This way it's 4 days a week guaranteed (Thursday is staff conference at 6:20). PLUS there's the extra added benefit that I come to work completely happy and relaxed, so no matter how bad the day goes I just remember my ride in the morning and I automatically get that meditative wash of "yah, but I got to RIDE this morning!"

Seriously, I wanna know...

Did you change your name after you got married? Do you use one surname professionally and one name socially? Do you hypehenate? How about your children's last names?

"But aren't you a doctor?"

It's funny how in medicine, you fall into your own little niche. In medical school, you start out "learning it all." Eventually, you find yourself gravitating toward a certain area of medicine. Once you decide what it is that you want to do "for the rest of your life," the rest of the schooling tends to fade into the background in favor of learning the intricacies of your chosen field over the broad generalities of medicine. Of course you still have to know enough to pass the tests, and often you can cram that information into your brain for the whole of 24 hours, only to happily empty it out once the exam has concluded. You become a doctor, and you forget more than you have ever learned, but you still hold the title of doctor of medicine.

In residency, you become even more specialized. No more prostate exams or interpretation of peak spirometry tests for me! Of course, that doesn't keep people from asking you medical questions to which they think you should know the answer. Why do I hear rushing in my ears when I lay down? (I'm no ENT, but, um, probably just your blood circulating?) Could you tell me what this rash is? (I'm no dermatologist, but I'll bet if you put hydrocortisone cream on it, it will go away!) I'll never forget the day that Mr. Whoo and I were witnesses to a pretty bad car accident my intern year, and as we pulled over, I panicked "What am I going to do, check their *cervix*?" (Everyone was ok, thankfully, and neither my meager first aid/BLS skills nor my advanced cervical checking skills were needed.)

In the same vein, I still find myself overwhelmed with uncertainty when it comes to medical knowledge about my children. In fact, I am certain that my kids have been to the pediatrician more in their young lives than most kids are in all of childhood. I can't help it. It is the best example of a little knowledge being extremely detrimental. A high fever? What if it isn't just a virus? What if they have MRSA that I brought home from the hospital? Bean isn't wanting to bear weight on his leg after a fall? What if it is a bone sarcoma?? This week I had Bean to the pediatrician for a freaking cold. Even though my pediatrician is too kind to say it, I'm sure she is thinking, "Um, hello? Aren't you a doctor, too?" Are my diagnostic skills so shoddy that I cannot distinguish between a common cold and pneumonia? I guess, when it comes to my children, they are. Ever since I became a mother, I am better able to understand why physicians should not even attempt to treat their own family members. Not only are we too emotionally involved with the outcome of their care, those very same emotions cloud what little medical prowess we may have. Do you find your medical education a help or a hindrance when caring for your family?

The Best Nest

We have a lot of estrogen in our office…. And I don’t just mean the Premarin samples. We have 4 physicians (3 who are moms and one that’s “trying”) two nurse practioners (both moms, one that’s pregnant) and about 16 employee’s (all women). We’re OB/GYN’s so the only men in the office are the patient’s husbands. The atmosphere is pretty relaxed and the conversations at the lunch table can get pretty strange (The Tampon had been in for HOW many weeks?). Is it just our office where people yell down the hall “Who’s hoarding the Gynezole because I really have a bad yeast infection!!!”? Hmmm. I was afraid of that.

I’ve been here over three years now, so the newness has worn off, still I feel really blessed to have found such a good fit. Sure, we have our moments but for the most part we get along. We genuinely respect each other personally and professionally. I know I can count on my partners if I have a bad hemorrhage in the middle of the night and need a second set of hands in the OR. More importantly, I can also count on them if I need some one to talk too.

We hired a new office manager recently, who came to us from a cardiology group. The first time one of us cancelled office to go to our child’s preschool play she looked at us like we we’re crazy. She has quickly learned that our families take top priority and that is our office culture. Our walls are plastered with pictures of the babies that we’ve delivered as well as pictures of our own families. We often gush on and on with stories of our children. Because we can. My patients who I haven’t seen in awhile will always ask about my son and what he’s up to now. I ‘m a doctor. A good doctor. But being a mom is a huge part of who I am as well.

Recent good question, “How do all those women get along?”
Answer: “fine most of the time”
Truth: Two medical assistants once got into a screaming match in the hallway over salad dressing (don’t ask).

Recent stupid question, “ Four ‘lady’ doctors in the same office…. Hmmmm… do you all cycle at the same time?”
Answer: “What the *&$#%^??????”
Truth: No.

So, as I prepared for Halloween next week, I realized that it was a Friday (our busiest day). I asked the receptionist to block any openings in my schedule. “Honey, we already blocked the afternoon, to get everybody home in time to take the kids trick or treating.”

Wow. I really do have the best nest.

Me Too

I went to the hospital at 4 p.m. yesterday. Instead of getting home at my usual 2 a.m. and climbing into bed next to sleeping Son, I flew through the door at 7 a.m.. Son and Husband were busily zipping up their coats, ready to hit the road for school and work.

Home about 30 seconds, I saw that something was missing.

I picked Son up and plunked him on the kitchen counter and stuck the patch to his eye.

"Kiss," Son said. I reached up to the cabinet for the daily-after-eye-patch Hershey's reward and put it in his hand.

"No, kiss," he said, puckering his lips.

Duh. Soft, wet, four-year-old lips on mine.

"I really missed you today," he said.

"Me too," I said, swinging him to the floor and patting his bottom as he ran out the door to his father's waiting car.

Me too.

Generation M--what would Abraham Lincoln say?

So I was driving to work the other day, listening to NPR while checking voice mail on my handheld cell phone and eating a banana with a glass of OJ balanced on my thigh (and driving, remember) when I heard a story about Generation M. The M in this case was for multitasking. The story was about teenagers who do online research for their homework while listening to music on their iPods, surfing around on Facebook, and instant messaging up in the corner of the screen with a couple of friends. I pictured the kids in this story like those computer-game-addicted adolescents I see everywhere these days and thought to myself: "I am not going to let my kids do that." And then I looked down, noticed the steering wheel, the banana, the OJ, the cell phone, the radio, and the patient chart I was about to open on the passenger seat so that I could return a phone call from a referring physician during my drive...oh no, I am ONE OF THEM! My fruit and juice and cell phone are the low-tech, old-fashioned version of Generation M, Generation M for the not-quite-middle-aged.

I have to say that I love multitasking. On the one hand, I resent being so busy that I have to do 4 things at once to have any chance of getting a solid night's sleep. Kind of. The truth is, though, that I love that feeling of productivity, knocking 5 items off my To Do List simultaneously during my commute, getting a day's worth of errands done in one big sweeping geographic circle with no backtracking and no dead time. I might even be addicted to it. I suspect that many physicians share this perverse enjoyment of multitasking, and if it wasn't in their blood when they started med school, it certainly has been beaten into them by the time they finish their internship. Add to that parenting as a physician (or maybe parenting period), and it's easy to see how multitasking gets reinforced in all of us. We multitask, we get rewarded, we multitask more, we get rewarded more.

So, I'm not the only one addicted to multitasking and thinking about it. NPR apparently can't get enough of it, either. They have had 3 stories about it in the month of October. And they are alarming. One segment reported that multitasking on a cell phone while driving reduced reaction time and driver attention to a degree similar to driving while intoxicated. Another talked about the results of functional brain imaging showing that we really don't multitask even if we think we do. We just switch quickly from one task or thought to another and back. But, in so doing, we really cause a kind of "brown out" in our brains. The electricity doesn't go out entirely, but it dims noticeably, enough to be an irritation to those in the environment. In one experiment, a highly accomplished professional musician was noted to make several mistakes while playing familiar pieces of music if asked to perform simple mathematical calculations in his head simultaneously. There were several other experiments, all with similar results.

Once I began paying attention, I realized that it was true; I really wasn't keeping all the balls in the air, as I thought. I was remembering to gather up the overdue library books and a shirt to return to the mall as I dashed out the door to my physical therapy appointment, which is on the same road as the library and the mall, but I was leaving the house without my car keys, then my wallet, then the library books, then the receipt, rushing back to the front door over and over. I was dealing breakfast dishes onto the table like cards in Vegas and unloading the dishwasher and throwing the laundry into the dryer and packing up my breast pump and absentmindedly putting a halt to the sibling bickering at the table, but I wasn't really listening to the kids or even noticing anything around me. I was missing a golden 10 minutes of making a real connection with my kids in the morning, hearing them say something goofy or precocious that would bring me joy repeatedly over the course of a long workday, or (God forbid!) eating breakfast while not in a vehicle. I had come up with creative questions for patients whose answers would provide multiple essential bits of history and also serve as ice-breakers or social chit-chat, but I wasn't really engaged in the process. I was missing the body language and the pauses. I was always one step ahead, trying to pick up a few minutes here or there because I was so overcommitted. I was being a mechanic, diagnosing and fixing a problem, instead of a doctor.

So, what's the message here, and where is Abe Lincoln going to come into the picture since this post is nearing its end? I haven't stopped multitasking. Sometimes I have to do it. Sometimes we all do. But I have stopped multitasking without thinking about it, and I've realized that we really don't have to do it all of the time to get by. In order to stop multitasking 24/7, I have also had to stop saying yes to everything and everyone, including myself. I just acknowledged that I couldn't do it all anymore--it's too much with 3 kids and 2 physicians in our family of 5--took a deep breath and felt relieved. And so, as Abe said: You can please all of the people some of the time, and you can please some of the people all of the time, but you can't please all of the people all of the time. Amen!

MiM Mailbag

Occasionally, we receive emails from readers looking for advice. With our readers' permission, we thought we'd share some of these here with the larger community for your collective wisdom and thoughts.


Hi ladies!

I'm a fourth year medical student and planning on going into Family Medicine. Thankfully, I think that this is a pretty family-friendly specialty, but right now I'm trying to figure out how children might be worked in for me over the next few years. This past June, I had a miscarriage at 9 wks (had that baby not miscarried, I would be around 6.5 months right now, and would have been due in Jan.) I thought that this would be the perfect set-up, go into residency with a 6 month old. Obviously, (wo)men make plans and the gods laugh. But now, I am having this feeling of being dead-set on getting pregnant, and not having anything man-made (ie residency) interfere with my husband and I being able to have a child (hopefully) within the next year. That means that I would possibly be having a baby during intern year. So mostly, I have a few questions:

Am I crazy in thinking that intern year and newborn are doable?

Should I just take a year off if I get pregnant within the next few months?

I'm getting ready to start interviews, like, soon....should I bring up these issues at the interviews?

Any advice is appreciated, honestly.


Thanks,
A medical student

Future babies

I know a lot of the women contributing to this blog have concluded their babymaking years, but I still am hoping for one more. Just one. Sometime in the not so near future. But not so far either, since my aching back has just reminded me that I'm getting on in years.

Considering I've still yet to finish residency and then will possibly do a fellowship and likely my first real job will not be a permanent one, I worry a lot about having to make a job switch while pregnant. Is there anything more unpleasant than having to tell your new employer that you're X weeks pregnant and will be taking Y weeks of maternity leave in the near future? Surprise! Bet you didn't notice that during the interview, did you? Of course not, or else you never would have hired me!

(A sad truth: my pregnant friends had to dress very creatively during their residency interviews.)

I already had the pleasure of being three months pregnant going into residency, so I'm not looking forward to explaining another baby bulge to a new employer someday. I'm hoping I have the luxury of being at a job for at least a year before the stork pays my uterus another visit (that's how it happens, right??). Long enough for people to maybe get to like me before they grow to resent me.

Or maybe I'll find a job where the people I work with will actually be happy for me and not just congratulating me through gritted teeth. A magical job in Happyland in a gumdrop hospital on Lollipop Lane.

Of course, with the economy being the way it is, maybe I'll luck out and be unemployed for the next 5-6 years.

Notes from the Parents' Axuiliary

I am a psychiatrist married to an academic. In our family, “Take Your Daughter to Work Day” ranked somewhere between Groundhog Day and National Oatmeal week as a celebration. It was nearly impossible to bring our three daughters into our worlds when they were young. Instead, we tried to enter theirs. Their dad coached them, we devoted Saturdays to swim meets. We never missed a concert or a play, even when a daughter had a non-speaking part as an inanimate object, or had only built the set. I, for my sins, had three painful years as a Girl Scout leader (anything, anything to avoid being the Cookie Mom). I learned to make wax dolls for dioramas, where to buy poster board at midnight, and which thrift store racks have the best fairy princess costumes (sleepwear, hands down). Still, the girls grew away from us, with their own friends, their own media, their own intellectual and academic accomplishments. Their growth left a hole in my world, and I missed my dwindling role in theirs (except for the Girl Scout leader part).
Now the dynamics have changed. Yesterday for me was “Take Your Mother to Work Day.” I volunteered in the campaign office where my daughter is an organizer. She put me through the training program with focus and poise. When I brought back my tallies, she patiently corrected my work, with generous dollops of humor and tact. To my surprise, I found that I am a Jill-come-lately to the mothers’ auxiliary of this campaign. Many other volunteers had brought parents to work with them. It wasn’t cute, like having kids in your cubicle, but it was a statement of loyalty and closeness that warmed my heart.
I guess I should not be surprised to follow rather than lead. My husband dragged me from the world of WhiteOut and erasable bond into the computer age, but it was the children who introduced me to Hogwarts, the internet (from which they still must still untangle me from time to time), and, eventually, to the worlds of opera, competitive ballroom dancing, and now voter organization. Lately, I have even tried to develop some enthusiasm for math and computer science. My daughter has been kind about it.
At one time, my sphere as a parent seemed narrow—medicine was my window into the world outside. A doctor’s experience is both wider and more circumscribed than many. We are involved with people that most others in our social class never see. They are always on our turf, however, and we too often meet them with their clothes off and with the richness of their experience cloaked in a veil of illness.
As the girls grow past college, the time they seemed farthest away, I am entering a wonderful phase of parenthood. My adult children bring back the broad horizons I once had, offering me opportunities to visit and live in worlds beyond my office and the hospital. To see them working, to engage in conversations in which they are the experts, and I the novice—these things bring intense satisfaction that mothers of young children can only dream about. Dream on, sisters, the day will come.
And did I mention that my daughter does a great job at her job?

Helloween

Husband is leaving tomorrow for his annual boy’s weekend at the beach - Helloween. For the next five days (I thought weekends were two days long?) he’ll let his hair down – what’s left of it – with a group of longtime friends at a house with no heat or A/C. He says it’s perfect for this group of guys. For the past six weeks, this weekend has been his constant topic of conversation. It’s his de-stressor – time to drink cheap beer, play football, inflict bodily harm by paintball, not shave, commune with his fellow man and blow off steam. In more recent outings, they’ve become sort of domestic and actually cook – deep-fried turkey and chili. Our household is not lacking testosterone – I have two sons, a male golden retriever, male cockatiel, and three male African frogs – but the adult male camaraderie and freedom from family responsibilities provides him with a vitamin-like boost.

Once upon a time I dreaded his weekend plus away. My children were young, and with one less parent to supervise them on the weekend, mayhem would always ensue. Single parenting brings out my latent attention deficit disorder as two children, pets, and household compete for my undivided focus. One year my youngest decided to take a bath in my stand-up shower by blocking the drain. He sat happily in the bottom playing with boats and legos in one inch of water. I ran downstairs to grab his towel out of the dryer and noticed that the ceiling fan in the family room had suddenly become an upside down sprinkler – spraying water over the entire room as it trickled down the arm of the fan. I dove for the switch so as not to electrocute us all, and ran upstairs to investigate. The shower was overflowing – tsunami style – onto the floor above the family room as youngest continued to splash and enjoy himself.

Somehow, events that happen while husband is away never happen while he is home. In late July, husband went to visit his best friend in Indiana. During his four day leave of absence, the golden retriever (child #3) decided to do laps in the new pool in the backyard. The fur from the hairy beast clogged the filter as I tried to vacuum the bumper crop of hickory nuts squirrels were lobbing into the water. Upon his return, Husband’s pool expertise solved the mystery of why it took three hours of minimal suction to clean the nuts off the bottom of the pool.

Water seems to be a constant theme to husband’s weekends away – whether it is both children having an unintended water gun fight in 50 degree weather or leaking roof from torrential rains. Experience has improved my outlook on Helloween. I know that Husband will return recharged (hung-over). Most small crises are survivable, and the boys and I can do things that we wouldn’t ordinarily do with dad home – like have a sleepover on the sleeper sofa in front of the fire place. The boys get undiluted mom time, and I look forward to the adventures we have together.

I also look forward to my own me-time. That’s the deal. Husband gets his weekend and I get mine. So in a couple of weeks I’m taking off for a writing conference in Massachusetts –deep immersion into words, character, plot, and all things bookish. In the past, I’ve done beach weekends with the girls, a polymer clay retreat with my mom, bead shows and a solo writing conference to see favorite author, Sue Monk Kidd. These weekends are sanity-savers, a time to pursue who I am besides mom, spouse and physician (not necessarily in that order), so I understand Husband’s enthusiasm for his Helloween crew. So while my crock-pot is my domestic secret weapon, personal retreats – solo or with friends are my trick and treat for self preservation.

My kids hate me (and I'm sure it's because I work)

pI'm convinced that there are parents out there whose kids do not talk to them the way my kids talk to me. My son has, of late, been lashing out (usually when he gets in trouble for something), and he will tell me that I am "mean" and he "hates me." It does wear you down after you hear that too much.

Last week was bad. My head was spinning after trying to compensate for short staffing at work. Then not only my son, but my 3-year-old daughter starts in on me. She throws a fit, gets in trouble, and has to go to her room without stories that night. I go in to talk to her. Through her tears, she tells me point blank that she 1) doesn't love me and 2) wishes I would die (!). I told her "you don't mean that." Of course, she says "yes I do!!"

I told her I wasn't going to let her be mean to me, and I retired to my bedroom, where I promptly burst into tears. I told my husband "ss-ss-ssophie s-s-said she...she wanted me to DIE..." Friday night is not a good night for anything emotionally taxing to happen to me.

As I said, I know there must be kids who don't say these kind of things to their parents. Which makes me think, "what am I doing wrong?" Bingo-I am a full-time career woman! Of course my kids hate me, how could they not? Maybe I shouldn't work, then my kids would be awesome to me and really appreciate me all the time.

As soon as that thought crossed my mind, I realized how ludicrous it sounded. My kids will hate me (at times) no matter what. I'm not naive enough to think that spending more time with them will make them hate me any less; I may just be around for them to express that to me more often! Pathology may be a thankless job at times, but being a mom is in a thankless league of its own!!

I told a friend Saturday that what surprised me most about being a mom was not the work involved, but how ugly the ugly times could get. And I had to screw up my courage to write this post, because it is really hard to admit how awful your own kids can be sometimes. Those of you who read this will belong to one of two camps: those who have, either by virtue of their much younger or infinitely better behaved children, are aghast at the events above; or those who read this, laugh, and say "oh yeah, sister, been there! In fact, that's the tip of the darn iceberg!!"

Weaning guilt

My 9 month old is on a nursing strike. He refuses to nurse even before bed these days, unhappily wriggling out of my arms, trying to use those floppy abdominal muscles to snap into an upright position like a fish flopping on the boat's deck.

It is killing me. Nightly.

What kills me more is what happens when I dutifully trudge back downstairs to the kitchen to fix him a bottle of expressed milk and give him the bottle.

Party time.

He grabs the bottle with both hands, shoves it in his mouth, and proceeds to twist and fondle the bottle like he has just been reunited with his best friend. He slaps it with one hand. Giddily moves it from side to side. He drains it, then.

I should be happy, right? He is providing a prime opportunity for me to finally wean him, just as I planned months ago. Six months was my goal. Nine months was my reach. I'm under doctor's orders to stop at 9 months (osteopenia, long story). He is a champ at eating solids and is very close to walking. But, even though the time appears to have come, I still don't feel ready.

Last night, I searched "nursing strikes" to reassure myself that this new rejection was due to him actively teething (hello bite bruises up and down my arms) and yes, the articles reassured me that nursing strikes happen for all kinds of reasons. (My bruises suggest teething, or perhaps my involuntary screaming when he bit me last week was poorly received.) They also emphasized the transient nature of these strikes and to push through.

In my internet searching, I also came across many sites that basically pounded The Guilt into me for even contemplating weaning before 12 months. About how no child would self-wean before 12 months, possibly not before 18 months. They talked about earlier weaning would only be for Mom's benefit (read: you are a selfish hog) and could result in less secure children. They said that mothers often misinterpret a nursing strike or normal developmental changes in the child to mean that they are becoming disinterested in nursing (read: you are ignorant and should not be allowed to procreate).

Poison in my eyes!

I thought of my 3-year old who I started weaning at 9 months during a very similar nursing strike. I remember feeling similarly sad and rejected, solemnly repeating the words, "It's the end of an era," to my husband and anyone else who would listen. Was I wrong then too?

Here, I was, thinking that I was almost deserving of a medal for working full-time, pumping 3 times a day to keep up, and downing Mother's Milk Tea every single day (I'm not a tea person, and definitely not a nasty tea person) to feed my son exclusively with breastmilk for 9 months. And then I read this article which makes extended nursing sound so beautiful and bonding that I'm left feeling inadequate.

I think it might be time. But, no one makes this easy.

First day of school

Tomorrow is my 2 year-old's first day of school. We're all excited, fortunately this includes her. As I was watching her today, she looked so little to be going to school. I wondered if I will look back on this phase of life and feel content that we started her in school so young (which is largely because of my interest in working) or if I will regret this decision and wish to have spent more time with her while she was young. Hindsight is 20/20 and I have terrible foresight so I really struggle with this.

My father-in-law once told me (regarding parenting) to remember that we know better than them. (he said this as I was struggling to force antibiotics down)...but I often recall this phrase. I know that my 2yr old will enjoy and benefit from the socialization and learning she will get at school. And most days I'm sure that even if I was home I would want her to go to school for her sake...but then I'm not entirely sure I'm being objective.

I guess for now, I'll enjoy the moment, her excitement to go to school and hope that when I pick her up tomorrow she has a smile on her face because it will surely make it harder if she's not happy.

First degree burns

I've probably burned myself while cooking more in the last year than I have in my entire life.

And they're all kind of stupid burns. Like when I explain what happened, I'm actually embarrassed. Not that there's any smart way to burn yourself. But some stories are dumber than others, like when I burned myself while trying to move a boiling pot with my bare hand. SMRT.

(My father actually has the stupidest burn story I've ever heard from a real person: he burned his chest while trying to iron the shirt that he was wearing. He's a doctor too.)

I've theorized that the reason I keep burning myself is that I'm cooking under very pressured conditions. Admittedly, I don't have some British guy yelling curses at me, but I've got a two year old who alternates between standing at the gate to the kitchen and screaming or toddling over to my bookcase and throwing books all over the floor. So I'm feeling a bit rushed to finish up dinner before our house is ripped to shreds.

Plus I'm just a wee bit tired from working all day so I'm not at peak performance.

Just because I'm a doctor, my husband thinks I know the best way to treat a burn. I don't. Last time, I tried everything that The Great Internet had to offer before the pain eventually faded away on its own. I seriously had toothpaste smeared on my hand at one point.

I get very frustrated by these burns because they keep me from doing what I need to do. I can't take care of the baby (change her diaper, give her a bath), I can't concentrate on studying, I can't wash the dishes or clean up. I can't be Supermomdoc anymore. I usually end up in tears over these burns, even the really tiny ones. It makes me realize how little breathing room I have in my life. Sometimes I worry I'm just two or three burns away from the edge.

My Grass Has Always Been Green

How do you keep going with a juggling act after losing one hand? I am a doctor married to a doctor. I am fortunate to possess the holy grail of mothers in medicine: a part-time job that is (mostly) really part-time. Somehow though, much like getting a raise and then finding yourself saving no more money than you used to a few months down the road, I have the same issue with time. The extra TWO FULL WEEKDAYS OFF per week I reveled in two years ago have somehow become the new norm, and we are again wishing for more hours in the day, more days in the week. Somehow my daydream that the busy work of our three small kids--the doctor’s appointments, grocery shopping, haircuts, laundry, trips to return library books, etc--would be accomplished in those two days with hours of quality time to spare, leaving evenings and weekends for nonstop family fun, was popped in a matter of months. We are in no better shape than we were before. We feel like we are just barely keeping our heads above water again.

So, picture the scene. It’s Wednesday, my late day in clinic. I get home at 7:15pm. Bedtime is officially at 7:30pm. The kitchen looks like a still shot from Storm Stories. No one is in the tub yet. A quick survey of the kids’ bedrooms alone foretells at least an hour of “pre-cleaning” for our once-a-week housekeeper visit. I breastfeed “Fig,” our 7 month old, on my lap while attempting to eat a petrified bagel that I actually toasted YESTERDAY morning and never managed to get out of the toaster because at least, it’s ready to eat, lunging simultaneously for 4 year old “Munch” who is begging to be tickled over and over in the next seat, all while nodding and listening to precocious not-yet-3 “Iggy” describing random events of her day in what has to be the world’s longest run-on sentence ever, except this one. Everyone eventually gets washed, combed, toothbrushed, pajamed, read to, and tucked in. The house is returned to some semblance of order. Finally, after 2 ½ hours of the parental version of running uphill on a treadmill backwards, it’s 9:45pm and we collapse in bed to say hello to each other for the first time. Then my hubby drops the bomb. “The Comfort is leaving on Sunday.” The Comfort is the Navy’s hospital ship. I am too tired to wonder why this would be the first thing out of his mouth when we haven’t seen each other all day. “Oh really?” I say. “This Sunday,” he adds hesitantly. “Wow, where are they going?” “Georgia…ex-Soviet Georgia.” “That’s really short notice,” I note with vague disinterest. At this point, he obviously can’t take my dementia of exhaustion another minute and says, “I’m on it.” “WHAT?!?!?!”

And, in that moment, the juggler lost her left hand in mid-act. Suddenly I had 72 hours to figure out how to swing being both the “drop-off” and the “pick-up” parent, who was going to get my son to his weekly PT appointments which were right in the middle of my late afternoon clinic, how I could even register our kids for the preschool they have been so excited to restart which required being in line outside the school by 5:30 am the day after he was leaving, what I would do if we had a childcare crisis since I had just used up every iota of my vacation and sick leave and then some from taking 4 months of maternity leave, and on and on. My mind raced. The list grew. The punctuation vanished.

Ok, I told myself, you can do this. You have done this before. He had been deployed for 19 weeks while I was pregnant with our third child, just gotten back only 10 months prior in fact. We already knew he would be deployed again in April 2009. But for those, we had time to prepare ourselves and the kids, time to make arrangements, time to exhale and come to terms with it. This time, it came out of nowhere. Well, it wasn’t entirely out of nowhere. There was a moment, I think, during my commute two days prior when I heard on NPR that Russia had just bombed Georgia, a fleeting moment when I thought to myself: “Uh-oh”. But I put it out of my head, reasoning that we couldn’t be in Iraq AND Afghanistan AND Georgia. Our military was stretched too thin as it was. And there was an election in a matter of months. No, nothing to worry about.

The next week after that Wednesday night bombshell went by in a blur as I attempted to cancel and reschedule our lives, make contingency plans, prepare the kids emotionally when I wasn’t even prepared myself. The miraculous news that the entire US deployment to Georgia would be canceled came several days later, not from the US Navy, but rather from a Baltimore Sun reporter and new personal hero named David Wood. That is a saga in and of itself for those who are interested: http://weblogs.baltimoresun.com/news/militarywatch/2008/08/post_45.html. But this is one long preamble for the real topic of this blog.

The next woman I saw in clinic was a new patient, 34 years old, a mother of 4 kids ranging in age from 1-7, widely metastatic breast cancer, a recent move from out of state for her husband’s high-travel job, no immediate family on either side, and no friends to speak of yet for 800 miles in any direction. She reported in a perfectly matter-of-fact way when I asked about her meds that she takes an extra dose or two of Oxycodone to control her bony pain enough to be able to make the kids dinner and do their baths. I was paralyzed by awe, by shame, and by the perfect storm of awe and shame: humility. As I sat wringing my hands over my husband’s unexpected, uncertain, and slightly risky deployment of probably a few months—maybe six at most—here sat this woman in constant pain, facing her own certain mortality, juggling despite having lost both arms, knowing that if she even blinked or faltered ever so briefly, it was over. Permanently. And her husband. What would he do? When she was gone, he would be on his own until the last baby was grown. And he worked full-time. Traveled several days a week. Seventeen years. It was an eternity. It was incomprehensible to me. How would he ever manage? How did he even lift his head off the pillow every morning? Here sat this young couple in front of me, and I was supposed to be the wise one? The doctor? And, in that moment, I became a medical student again. Suddenly I was the same young woman who years ago stared wide-eyed as patients gave their spouses a last kiss before being wheeled in for their liver transplants, wondering if they would make it, wondering how they managed to smile, wondering how they could be so strong, wondering whether I could ever be so strong, hearing that disquieting voice that told me I knew the answer and it was no.

It’s been over 6 weeks since this all happened, but I am think I am permanently that medical student again, if a bit more wrinkled these days. I realize now that every patient I see is living some variation of this story. She is trying to get her chemo and get home after dropping off her son at preschool and before her daughter gets off the bus and hoping her nausea medicines will work well enough that evening for her to cook dinner without the smells making her sick. She is terminally ill and desperately wants more time at home but cannot quit her full-time job because, without it, she will lose her health benefits and therefore, the treatment that may give her another month or two with her children. These people are all juggling more than I could ever comprehend and with so much more at stake.

I finally got it. After so many years focusing on whether the grass was greener on the other side, I finally realized that my grass has always been green. I just never sat still before long enough to notice.

The Mothers in Medicine Challenge: Giving back to public schools

Getting into medical school is competitive. We're hoping that competitive streak in you will help us in our goal to raise money for a great cause: our public schools. Many public schools, particularly those in poorer school districts, can't afford the materials they need.

Have you heard of DonorsChoose.org? It was started by a former teacher as an experiment and now is an alternative funding source for teachers nationwide. Teachers upload projects they want sponsored such as Biology Lab basic equipment for a Mississippi high school where students have never had an exposure to a real laboratory ($818). Donors can contribute as little as $5. DonorsChoose purchases the supplies and ships it to the classrooms, along with a disposible camera. Donors receive thank you notes from the children, as well as photos.

According to Fortune magazine, "Donorschoose.org has raised $24 million to get support to 1.4 million students in 50 states. Nearly 60,000 projects have been funded."

Now, to the competition.

Starting October 1st, bloggers around the country will be competing to see who can generate the most donations to DonorsChoose classroom projects. Last year, blog readers donated $420,000 toward books, art supplies, technology, and other resources, reaching 75,000 students in low-income communities.

Mothers in Medicine in joining in and we're hoping that we can show the internet who wears the pants. Please visit our giving page and see what projects we've selected to raise funds for. You can also get to our giving page via that nifty widget in our sidebar. After donating, you can leave a message for the students you are helping. Since the giving account is under Mothers in Medicine, leave your name, if you wish, in your message and where you are from.

Give if you can!