Being The One

As a pediatrician, I got the chance to preview parenthood in more detail than many people likely do. The five-year-old little boy who clutched his mom during bedside rounds my intern year stands out even now: he buried his head in her chest as soon as we entered the room. She whispered, "Does something hurt or are you scared?" He managed to whisper that it was the latter and she held him tight, soothing and reassuring him while she listened to the plan for the day.

I carried that rosy picture along with many others as a boon of future parenthood. The chance to cuddle, to protect, to take complete care of my own little person someday - and, yes, in all honesty, the chance to be so important, to be the one. The one a child immediately turns to, relies on, needs.

Since that encounter, I have had two sons, and it thrills me to know end to be, along with my husband, their person. Nothing compares to the sound of little boy feet running toward the door with the greeting of a wide smile, a "Mama!," and eventually, "Mommy's home!" To the high-pitched voice calling your name in the middle of the night because of a scary dream or a need for water or just some extra cuddles. When in shyness they hide behind me, hugging my legs, my heart bursts with joy and wonder at the chance to be part of this classic, perhaps cliched but no less endearing, image of a child clutching his mother for comfort.

A few months ago, I saw a teenage boy in my office for consultation. I'm training in pediatric hematology/oncology, so trips to my clinic can be nerve-wracking for patients and families. This young man's sheer terror at what he feared were symptoms of cancer (happily, they were not) was visible, audible, nearly palpable. When I sent him to have blood drawn and imaging done, I heard him say to his mother, who had accompanied him, "I need to call [insert girl's name here]."

His reaction startled me. I could appreciate the anxiety, but the realization that, even with his mother beside him, his instinct was to turn to someone different - presumably his girlfriend - took me by surprise. Once I reminded myself that it was, in fact, developmentally appropriate for an adolescent to be developing relationships and establishing independence from his family, I was left with sadness. Someday, far sooner than I hope, my boys will turn to someone else as their person. Someone other than me will be the one.

I sit with that sadness even now. With each milestone, it mixes in with the joy and pride. And as my children grow and I grow, my work continues to provide examples of the realities and possibilities of parenthood. So when I encountered another adolescent who, facing a challenge, had little support and no peers, romantic or platonic, to whom to turn, my apprehension and sorrow began to abate. I want my children to grow and develop, to have healthy relationships and support, even if they must eventually come from someone other than me. 

For the time being, though, I'm fortunate to have my days peppered with eager footsteps, warm hugs, and sticky kisses. And when I dropped my older son off at school yesterday, after we had said our goodbyes, he ran back for one more hug. I savor every single one.

Open or closed? How do you deal with emotions?

My whole life is organized into boxes. (ie, my blog name). I like to compartmentalize, keep work and home life separate, keep public me and private me separate, emotional me and getting-through-the-day me separate. Usually, this works. I can be the happy, relaxed, fun loving mom I want to be to my kids, efficient and professional at work, and contemplative when I'm by myself on a run or on my own. But recently,  I have not been able to figure out who I want to be or who I am when I'm with my husband. The problem, I think, is that I want to be all of me for the one I love and built a life with, but I'm having a hard time putting it all together in a cohesive, not unpredictable, way.

A lot of what we as physicians see daily gives us perspective, and makes us confront our own mortality. It's heavy stuff, if you let yourself think about too much. So I try to leave work at work, keep the danger stories or cool saves to share with my family, and  compartmentalize. With the kids, it is easy. But it is sometimes hard to explain to my partner the intensity of what I do and see daily. I want to share, but sometimes I can't begin to explain or unpack my feelings. I have never been an emotionally open person and keeping things inside and putting on a happy face is how I have been able to overcome a number of difficult periods in my life. It has worked for me before, but now it is creating an emotional void between me and my partner that I don't want to get any deeper. As I write this, I realize more that the problem is that since I can't try to explain, I don't. I simply shut it down. And then, eventually, pandora's box opens and all spills out.

For those of you with non physician partners or partners whose days look very different than yours, how do you balance? Any resources that you have read, or used, to help me feel more comfortable expressing myself and verbalizing my thoughts?

Guest post: On becoming a physician mom

While on a walk around a lake on a beautiful day with my newborn baby in the stroller, my dog, my husband, and my parents, we ran into one of my parents’ acquaintances. She congratulated me on my recent residency match, asked me where I matched to, and took a look at my baby in the stroller and congratulated me on that too. She then proceeded to tell me that through my dad, she had been hearing about my journey to and through medical school and that she too has a daughter who is in her first year of medical school at the same school I was about to graduate from. I quickly thought back to how grueling and demoralizing, at times, my first year of medical school was and I hinted at that to this woman and wished her daughter luck. She then looked at me and said something like “well it looks like it can all be done---you look great and not at all stressed!” I could feel a lump form in my throat, but of course that did not show to her. I’m not portraying my life accurately I thought.

Many people look at all of these doctor moms and think: wow they can do it all. Even as a medical student, I am frequently told by people how impressed they are with me-- that I was able to go to medical school as a “non-traditional, older, career-changer” student and have a baby during my fourth year (“perfectly timed” such that I had my baby two weeks after ending my last fourth year rotation giving me four months to stay at home before starting residency). And I suppose it is a lot to be proud of. I wish I, too, looked at it that way more often. But there is a struggle beneath the surface. To get to this point in my life, I have become a detailed oriented perfectionist and I am often driven by fear and anxiety that things won’t work out exactly how I have planned them.

The skills and traits that got me to my “perfectly planned situation” of having a baby fourth year after my Step 2s were taken and months before residency began were not helping me in motherhood. In fact, these skills and traits seem to harmful in motherhood. Crafting detailed daily schedules of when to study, what to study, what assignments to complete on rotations, and research deadlines to meet have felt necessary to me. Life schedules, when to get married (a few months before Step 1), when to conceive a baby (a couple of months before Step 2 so I was past first trimester on test day), and have the baby (a couple weeks after end of rotations) seemed to be the only way I could work things out.

As a new mother, I so badly want to make stringent schedules, check things off, and see that my hard work each day pays off. But it just doesn’t work that way here. My 10 week old baby is a wonderful baby but schedules, yeah right. Some things just don’t get done some days. And hardest of all for me, even on a day where he takes well-timed and restful naps, and I am so proud of that, he still has trouble falling asleep at night-- and that is so hard for me--seeing that all the hard work I put into the day trying to get him to do all the “things he should be doing” didn’t even pay off in terms of a timely and successful bedtime.

I am trying to teach myself how to be more flexible and go with the flow, how to not be so hard on myself, how to realize that everything really truly will be okay and that everything need not be perfect. And I luckily have so much support to achieve those things. For one, my husband is incredibly helpful, encourages me, and is much calmer and relaxed than I. And even more importantly, my child gives me the greatest smile in the morning when I first see him and sing his favorite song, regardless of how many times he awoke during the night. That is so rewarding and reinforcing that everything will be okay. However on a daily basis, I must remind myself that everything need not go as planned, I am doing an incredible job being a mom to my baby boy, I am trying my best and that is all I can do. I still have a lot of growing to do, in fact I am still meticulously keeping track of all his feeds and naps today. But I will be a physician mom. I am scared but I can do it if I let go of total control, adapt and show gratitude for all that I have.

Future PM&R Resident
Mother of 1 baby boy

Adventures in Pumping II: The rotating resident

Here is my past few months in pumping chronicled by rotation. As the weeks went by, I turned from a shy awkward pumper to a frank “I’ll do it wherever just get me a plug in” resident.

Ortho: show up to clinic struggling with clinic bag in one hand and pump in the other. Young ortho PA that I am scheduled with has kids, gets it, and finds me a private office for the day.

Cardiology: lots of older male physicians, and scheduled with a new one every half day. Rather than explain the pumping every single half day, I pump on the way to and from work and simply say I need to leave half an hour early to make my q4h schedule. I don’t say why, they shrug and say sure. I tell the younger female cardiologists I need to pump and they “remember those days” and are full of support.

Hospice: in a car with my wheelie backpack going to multiple hospice sites. At one point, I am stuck far from my pump as I misjudged how long the trip would take me and as my mentor for the day is sharing a deeply emotional story as we are ending or day together, all I can think is “gottapumpgottapunpgottapump”. Also had a mentor that went to NP school in the pre-double electric breast pump days and not-so-fondly remembers hand expressing during breaks. I’m so glad we’ve come far from that.

Night float: Sitting in my call room calling specialists with the little “whirr whirr” in the background. Eye the pagers carefully, just daring them to go off with a Code Blue while I am plugged in.

In between, check Facebook. That Willow pump that keeps haunting my news feed with ads looks wayyyy too good to be true. But cheering on the days to an better breast pump.

Psych: checking into an attending’s office for a half day. He has a no show, so I casually mention I need to pump sometime in the next two hours. Ten minute tour through the offices ensues, ending with me pumping in his private office and him waiting outside in his own lobby.

Clinic: having much more in depth conversations with my patients about pumping, supplementing, etc. Run downstairs every 3-4 hours past all the patients in the lobby past  to the pump room, stopping to briefly complain to the care coordinator about how pumping sucks literally and figuratively as we both have babies within a few weeks of each other. She made it a year with her first so we are cheering each other on.

Conference: presenting a poster at a conference at a large office building. Find the pump room of dreams including sink, long counter, multiuser pump, fridge, large comfy chair. Immediately send an email to my office manager outlining this in case we ever have extra money lying around when we design our next clinic. The pump room is in use when I need it in the afternoon, so I am directed to a Breastfeeding Pod (called a Mamava) that looks like one of those party photo booths. Crawled inside, feeling slightly seasick but very private and secluded in my little cocoon.

OB: I pick up an OB shift for a resident out sick. I sit in the pump room in peace wishing I could figure out how my Spectra parts could attach to the multi user hospital Medea  pump. I get to work with the nurses who helped deliver Baby, show them pictures, and they let me eat from their potluck spread.

I mainly wanted to write this all down so I can remember both the ridiculousness and support when we’re finally ready to shelve the pump. Hopefully someday I can say “I remember when I had to haul my pump around with lots of parts from place to place in a huuuuuuge bag! You have it so much easier now!” Until then, pump and I will continue to hit the road.

Kicks

I Get To...

I had just survived one of those hyper-scheduled "days off." Early morning short work assignment at the fertility clinic, my daughter’s first gymnastics class, squeeze in a quick workout for me (as long as she agrees to stay in the gym daycare), back home for a fast lunch, then out for a mid-afternoon doctor’s appointment with babe in tow because I couldn't work out childcare. It was the kind of day that used to get me very frazzled, but I’ve been working on my organizational techniques lately, which has really been helping. I won’t lie, though, it’s hectic making that many logistical moves in a day with a two-year-old. It can be as busy or busier than a day in the OR! As the sun was going down, I pulled out my journal to reflect on all the day's events. Instead of the typical narrative you often hear from moms like us, “It was so busy today, I had to… (insert long list here)”, I decided to turn it around. I wrote at the top of the page, “I get to…”

I Get To:

• Wake up at 5 AM to provide anesthesia for two women at the same fertility clinic where I was a patient, giving them hope and reassurance that they too will someday be an IVF success story

• Take my daughter to a Mommy & Me gymnastics class on a weekday when I don't have to be in the OR

Warming up in Wednesday gym class

• Do a workout for myself, since after suffering for months with both a back and a shoulder injury, things are slowly resolving and I'm able to perform some of my favorite exercises such as the overhead press and barbell deadlift again

• Spend more time with my lovely daughter by bringing her to my doctor's appointment (she surprisingly behaved perfectly)

• Argue with my husband about what wording to use in a text to a landscaper, who we are fortunate enough to afford to pay for landscaping services, as opposed to arguing with my husband about something less frivolous (such as where our next meal will come from or how we're going to pay bills, etc.)

• Clean up potty training messes x 3 ("Oops, mama! There be poo poo on the seat/floor/etc."), including a wipe down of the whole bathroom each time, and then bathe my beautiful baby by candlelight before laying her down in her bed, where we read books and sing songs and have a cuddle-fest

• Have a few minutes of silence to myself after everyone in the house is asleep, where I prepare healthy foods for lunches the next day, and then reflect like this on my "crazy" day

What did you "get to" do today?