Crunch Time

Sitting in my rocking chair taking a few deep breaths.

We hadn’t shared it on the blog yet but we are expecting Baby #2 any day now. I can tell you that the pandemic is about 8.5 months along because I took the pregnancy test the week we started shutting things down. I had some funny experiences I had forgotten to share - for example, I found out buying a pregnancy test when you’re the small town doctor is a little more difficult than anticipated, and due to a miscommunication between the pharmacist and me, somehow I accidentally bought 6 pregnancy tests.

We have 2 weeks (give or take) until Baby Girl arrives and of course it’s been the worst of the pandemic that the Midwest has seen. I luckily have gotten approval to work remotely doing video visits and phone visits at home alongside my husband who was working from home even prepandemic. However, I still feel every day I remain pregnant is a day we are trying not to bring COVID into our house. We are just ticking down the days. We removed our 3 year old from day care for the next two weeks and convinced my retired parents to watch him at their house out of town, but the members of our already very small family circle are also reporting positive contacts one by one. It feels suffocating. I spend my mornings as a primary care provider cringing at the notifications of positive test results in my elderly and institutionalized patients. I spend meetings hearing about surge planning and watching steadily rising graphs specific to the region where I live. I talk via phone/video to my patients who are either having significantly worsened anxiety - or don’t realize that the term “quarantine” means “don’t leave your house”. I do everything I can to make sure we have minimal in-person interaction in all we do - and then I turn on the TV and the high school football team is still playing their rival team. I scratch my head and I just can’t reconcile the world I live in and the world other people seem to live in. 

I am ready for Baby Girl to get here, but not in the way I was hoping. I wanted to be eagerly awaiting her arrival, not feeling like I have to rush her along so we can barricade ourselves in our house during maternity leave. I wanted to spend time with our 3 year old and enjoy his last moments of being our only child, not ship him off to Grandpa and Grandma’s so I can finish working. We’re doing okay, and we are lucky in so many ways. We’ll continue to take it here one day at a time, and I’ll try to take advantage of this quieter time as much as I can while it lasts.

Kicks

What Exactly Is Coaching?

This being a blog made of women physicians, I thought it would be prudent to write a post about Coaching. If you haven't noticed on the socials, coaching - a fixture in the corporate leadership world for some time - is really taking off in the physician and professional wellness space. There are coaches for every sort of physician wellness niche issue you might be facing: burnout, getting unstuck, work-life balance, negotiations, finances, parenting, weight loss, etc. And with some exceptions, these coaches are predominantly women. During the takeoff of the pandemic, coaching programs around the problems of PPE stress, furloughs, homeschooling, and quarantine were everywhere. 

I used to think coaching was for CEOs or entrepreneurs. High-powered execs who use The Secret and go to Tony Robbins events. Yet now, in our current landscape as women physicians, there's never been a better time to get some coaching.

My experience

When I was in the throes of burnout and self-care failure years ago, I had a coach. He was the spouse of my residency mentor, a person versed in executive problem solving with a thriving business and book on the subject. My sessions with him were so incredibly insightful; he helped me embark on the self-knowledge journey that I started during my sick leave... which ultimately lead me to starting PracticeBalance!

Yes I have a supportive family. I have a great relationship with my husband, and we openly communicate about everything in our lives. I've also seen a therapist during particularly dark times. But until I had a coach, I never realized just how powerful it can be to have an objective person listen to you, whose sole job is to listen without judgement, and help you analyze your thoughts.

It's like, all of a sudden, you gain CLARITY: on directions, on decisions, on values. Yet YOU are the one who solves your own problems... with some gentle help. I've had other coaches since, and I have one now.

The Power of Clarity

Is coaching effective?

Aside from the fact that it's very popular to have a coach right now, it's also effective. A 2019 study in JAMA found that primary care physicians randomized to a 6 month professional coaching program reported lower rates of emotional exhaustion of overall burnout. A 2020 study in the Journal of Occupational Health Psychology of a six-session coaching intervention found the same. And these studies are now extending to medical students and residents.

Coaching can take place in different settings: group, one-on-one, in person or virtual. Sometimes sessions involve themes, lessons, or mini lectures, and other times it is completely client-led. Sessions can last anywhere from 45-90 minutes, and as the coachee, you should expect to be put "on the spot". Coaching is about YOU. And expect to have homework between sessions. Also, the most effective coaching will involve follow-up, as you see demonstrated in the above cited studies. One-off sessions aren't completely useless, but part of the coaching experience is the accountability to take what you've learned/realized and apply it to your life... then report back to your coach.

Coaching vs. other things

How is coaching different from therapy, or even mentoring? Coaching takes a collaborative approach that is often future-focused and/or goal-focused, with the intent of changing behavior or thought patterns. Therapy tends to focus on past traumas and other experiences as root causes of behavior or thought patterns. Whereas coaches ask focused questions to help clients gain better self-awareness so as to institute their own changes, mentors offer advice and more concrete guidance.

What kinds of things can you expect to discuss in a coaching session? That depends on your coach, and why you sought out the coaching in the first place. (Full disclosure: coaching is a service I offer through PracticeBalance.) While I personally love to guide physicians on journeys of self-knowledge and self-care, my approach has been to individualize coaching based on what each client needs: more frequent sessions vs. less frequent sessions, higher structure vs. gently guided conversations. But some exercises I always suggest are mindfulness techniques and self-knowledge assessments; which ones depend on the individual client's interests and lifestyle.

How do you know if a coach is qualified? Unlike the practice of medicine, the field of coaching does not currently have an over-arching, governing body of certification. A "certified" coach is not necessarly better than a non-certified one; it really depends on the coach's experience - both with clients and within themselves. Kind of like a senior resident or a newly-minted attending vs. the senior physician with tremendous academic accolades, recent life experience can trump a pedigree when it comes to the quality of care you receive. In my opinion, in addition to basic listening and questioning skills, a good coach for you is someone who's experienced the pain points you're going through and has successfully moved past them.

Have you ever had a coach - even a traditional coach for athletic performance? What was it like, and what did you learn? Share your thoughts below in the comments.

(A version of this post first appeared on the blog PracticeBalance)

When is it over, mommy?

 I hate this whole thing so so much. I was congratulating myself on the "so far so good" few weeks we had been enjoying. Our kids didn't mind the masks and new school regulations that much, and were mostly excited about being a part of society again. We had settled into a little routine. Life began humming along back to some sort of predictable rhythm. 

Until it unraveled. As kids do, one of my kids caught a little head cold. Congestion, runny nose. No fever, no cough, nothing that in any other version of reality would make anyone blink an eye, much less miss school and go to a doctor for. But, in Corona-land, this little head cold was an all alarms fire. Visits to Urgent Care, begging for a test, Zoom school, quarantine. At one point, my child broke down. "I hate this. When is this going to be over? Why is it still going on? Why can't the world just fix it?" 

Then, (this child has a bit of anxiety) "do I have to stay in my room? Can you hug me? Can I hug the baby? I don't want a test! I hate Zoom School! It's just a cold! What if it happens again? Don't tell anyone- what if someone else gets sick? What if someone dies?..... 

As a doctor, my kids look to me to fix most ailments- scrapes, splinters, even stitched up chins and stapled scalps. But this is something so beyond any of us. The mental health aspect is as-yet not understood, but judging from my little microcosm of family, friends, and acquaintances, the impact on every aspect of mental health will have far reaching consequences. Words like social distancing, quarantine, and the realities of masks, "shadow tag", zoom school, virtual learning, and a pervasive fear of "others" will take years to recover from. My 7 month old baby has had interactions with a total of 2 adults aside from myself and my husband. We are now teaching an entire generation to on one hand love and respect others by keeping them safe, but on the other hand, never to share, not to recognize a smile, and to essentially exclude anyone not welcomed in to a pre-determined "bubble." It's insane. 

As an essential health care worker, I am "lucky" as I get to go to work and my schedule has not been too disrupted. I have a job, we have a home to quarantine in, and we feel safe in our environment. But we are all living on a tightrope, and our sense of "normal" has cracks and tears when examined up close. Sending vibes of peace, love, safety, health, and calmness out into the world. We all need it. 

Guest Post: Frenemies

This isn’t the way I had wanted it to be. When I met and married my husband I had envisioned a relationship with my mother in law that would be better than those of other mothers and daughters in law. We would not become frenemies. My husband would not become the pawn or middle man in our petty disagreements. I would be patient and respectful, and eventually develop a love for the woman that bore and raised the man I loved. Most importantly, I would not become my mother, who I felt harboured a lot of resentment towards my grandmother over things that seemed trivial.

It is clear to me now that how we are and how we come across is as much of a reflection of who we are with as who we are ourselves internally. My best intentions have slowly over the course of the decade chipped away leaving me chronically agitated at the woman who I had hoped to understand and befriend.

 

She has always been a hypochondriac. Something is twitching. Is it a sign of something dangerous? Her face aches with tomatoes. She must be allergic to vitamin C, in fact she is sure of it. She can feel her blood pressure go up, so she will check it every 5 minutes until eventually it does. Her blood pressure is too low, she feels sick. She has this pain, but doesnt want to take tablets. Who knows what the side effects will do to her? We have been there for countless trips to the emergency room via ambulance, only to be sent home soon after as all is fine. I humoured all this, not only because of my commitment to the relationship, but being in the medical profession I was kind of used to dealing with strange and unreasonable people. I had developed a patience with them at work and this transcended easily over to my relationship with my mother in law. So we were doing fairly well, until the children came.

 

With the children came a loss of boundaries. I remember the extreme pain of trying to hobble over into the bedroom with the baby in one hand and breast pump in the other, barely clothed (what was the point?) and the episiotomy and high vaginal tear still very much fresh. My mother and father in law had decided to come by unannounced and were at the front door of our small apartment. Of course they wanted to see the little munchkin. Had he gained any weight? Was I breastfeeding? Were my breasts making enough? It was very important he was breastfed. My husband was breastfed until he was two, my father in law touted proudly. I excused myself, scrambling to hide the formula and baby bottles drying near the sink. Why was he crying now? Had he been changed? Maybe he was hungry. Had I fed him? At this point my mother in law would take it upon herself to soothe the crying baby. My rocking wasn’t good enough. I was failing at mothering already. She had more experience with rocking babies. She would be able to fix it, of course.

 

This only got worse over time. At outings I was instructed to give my son some more chicken, more bread perhaps, the orders from across the table never stopped. He never seemed to have enough food to her satisfaction. She never trusted me to know how much my child should be eating. Of course he didn’t sleep through the night, he was cold and he needed more layers on! (she’d never heard of SIDS). When I went back to work the pity she expressed for my son when he started daycare would make you believe I was sending him to an orphanage to be raised by drug lords. It wasn’t only parenting that my mother in law second guessed me. Here I was managing a delivery suite by day, and then having to convince my mother in law that I have enough medical knowledge to know this rash my son has is not worrying. He does not need to see a doctor as I, his mother and a doctor myself, am not worried. All of this preyed on my insecurities as a new mother. I was a doctor first, and I loved it. My time and attention was divided. This could not work any other way. Would it be enough for my son? It would have to be. Perhaps her words and actions were not as bad as the feelings of incompetence and loss of autonomy they elicited in me.

 

With the second baby came more of the same, but I was better equipped. No she isn’t breastfed, it just didn’t work for us. But I am happy to report she is fed, Sorry, I can’t let you in. I just got out of the shower and am not yet clothed. I will not be opening the front door naked. If you had called before coming I would have told you. They have had enough to eat, thank you. In my assertive and often uncomfortably direct responses to her behavior, I have resigned myself to a relationship with my mother in law that is nothing short of frenemies.

En322  is a OBGYN in London who has been a silent follower of MiM for years. She has two children who are 8 and 2.  

Speaking Up

It’s a strange time to be living in rural America. I suppose it is a strange time to be living anywhere in America, or anywhere in the world for that matter. This is not new territory for my husband or I as we both grew up in small towns and the country side, but we did spend the last few years in metro areas and suburbs before committing to our hopefully forever home here. 

There’s a strange disconnect from what happens in the large metro areas only about an hour away to what is happening here. A large portion of my patients think wearing masks are unnecessary and the whole coronavirus is blown out of portion. I am somewhat removed from the direct horrors of the virus myself, as I am currently working outpatient care in a “clean clinic” which means you have to undergo intense screening to make sure no cough, cold, or loss of smell sneaks through the cracks (which also means I have some frustrated COPD patients I haven’t seen for months). However, an hour away my best friend from medical school is working part time in a COVID clinic seeing 30+ patients a day and part time in the hospital and telling me the stories of the young healthy patients who came down with vicious complications. 

I also have plenty of Facebook contacts from various circles posting fake news and theories about mask dangers from hypoxia - at what point do I step in? At what point do I stand on my medical training and credibility and post that “this is not right” while awaiting the wrath of anyone who dares to post back?

I was raised to not argue from when I was young. I was taught it often doesn’t get you anywhere other than trouble. I have always leaned away from engaging in controversy. I want those around me to feel comfortable in my presence. And I have always been much too cognizant of what others think of me.

However, during my last year of residency I learned a lot about the power of advocacy through social media from some of my favorite mentors and the power of a Tweet- especially a Tweet by a physician. I reactivated my Twitter account when I strongly disagreed with plans to shut down an area hospital that directly served some of the most underserved in the area and probably annoyed my entire handful of followers with my onslaught of Tweets that followed. 

On one hand, I’m not brave enough - or maybe I simply don’t have the energy to fight off Facebook warriors. On the other, I don’t know how much misinformation I can continue to ignore - especially when I happen to have an advanced degree in the field being discussed. 

 So I have to ask - how have you all been handling your social media? Especially friends and family? 

Mindful Parenting and a Toenail Drama

It started back in May. She dropped her stainless steel sippy, and the bottom rim landed right in the middle of her big toenail. For hours, she was beside herself. All we could do was kiss and hug her and say, “Yep… it sucks to drop something on your toe.”

It was the first, but it won’t be the last. A week or two later, there was a good-sized, eggplant-colored bruise right under the nail. Welcome to the Black Toe Club. She didn’t seem to care too much about the discoloration, and we went on with life as normal.

Fast forward to a week ago, when I noticed that the nail was starting to unroof itself. It became so… flappy... that it started to catch on things, which resulted in fits of pain and crying. Being the Doctor Mom that I am, I devised a treatment plan involving an epsom salt bath followed by lidocaine ointment and a sharp pair of scissors. But after the bath, she had a freakout.

She WOULD NOT let me cut it. Would not let me even touch it. We fell into a cycle of hugging and talking and attempting, followed by pullback and more crying.

Her: “I’M SCAAAAAARRRRED!”

Me: “This is the best way to deal with this. Otherwise it’s just going to keep catching on things and eventually rip off, which will be even more painful. Trust me! I’m a doctor! You just took a bath! It’s soft right now! Let me cut it!”

Her: [uncontrollable sobs]

This went on and on, extending past bedtime. And repeated for 3 days. The toenail would catch on something, even bleed. It separated further from the nail bed until it was sticking straight up in the air. I got so frustrated… if you’re a physician, you’re likely familiar with the experience of family members not taking your medical advice. All those past memories welled up, compounded by a screaming, inconsolable child.

One night I threatened to rip it off after she went to sleep. One morning I told her we weren’t going anywhere until it was dealt with. We devised different plans, all foiled by her going into a crying fit… and when one involved her dad helping to hold her down, he looked at me with his peircing eyes and said straight up, “What are you doing?”

[long pause]

Um…. What WAS I doing?

I was trying to control the situation. I was worried for her, anticipating the great pain she might experience if the toenail ripped completely off on its own. So instead of letting things take their course, I tried to solve the problem for her. Like lots of well-meaning parents these days, I was coddling.

I was acting on my own aversion to the appearance of her toe (as a self-confessed Picker, if it were my toe I would have cut that flapping nail off immediately despite any pain pemature action might have caused). The sight of it bothered me more than it bothered her.

I was using logic to appeal to an illogical, 4 year old little human. Although I want to respect her as her own person, she’s not a little adult. Yet I sometimes talk to her like she is.

I was trying to control someone else’s body. Someone’s body that is not mine to control. And I was using threats (again) to try to get what I want.

These are all Respectful Parenting fails.

Before even having kids, we decided that respectful parenting was the kind of parenting we wanted to do. I read books like The Gift of Failure and The Conscious Parent. I listened to Janet Lansbury‘s podcast. But like so many things having to do with mindfulness, theory is different than practice. It’s easy to have a plan, but what matters is how you act in the moment of need. Sadly, this time it took me approaching the use of force to realize how far I had drifted off the path I meant to be on.

Defeated but brought back to reality, I admitted I was wrong. This was wrong. My emotional bank account depleted but not quite in default, I was able to salvage the day by taking responsibility.

She put on flip flops with her little nail sticking straight up, I tried not to look at it, and we went about our day. I dropped her off at the gym childcare center, assuming I would get a call about another episode when she caught her toe on the playground or something.

But do you know what happened? When I picked her up, the nail was gone! She hadn’t even noticed it fall off; it didn’t hurt a bit. After all that, leaving it be was probably the best thing to do anyways.

I’m so lucky to have her (and him); I’m always learning from them. Being a parent has been the greatest lesson in mindfulness.

(A version of this post first appeared on the blog practicebalance.com)

The summers of my childhood

As a kid, my parents rented the same beach house every year for the month of August. We would rent a U haul, and drive down our bikes, boogie boards, surfboards, roller blades, books, toys, clothing and never enough towerls, and set up shop. We were friends with the owner of the local kayak shop and had an open account at the small general store, for things like popsicles, chocolate chip cookie ingredients, and other necessary groceries. It was pure freedom. Pre-cell phones, we hardly saw a screen all summer. Our only rules were to come home for lunch and dinner, and stick together. My brothers and I made friends quickly with the other beach kids, and would bike and swim and play for hours. I'm still a beach kid at heart and can't wait until life can lead me back there again.

We just moved from our East Coast beach town where I finished residency to a big city in the midwest for Fellowship. With the pandemic and the arrival of baby #3, we chose to live in the suburbs, in the heart of a kid friendly, tree lined, park-filled community. Within 1 month my kids have made  a gaggle of friends on the block, biking, meeting up for social-distancing playdates, and doing baking soda-vinegar-food coloring experiments. We have chosen not to participate in organized summer camp for the time being, so their time is unstructured. While the first week was hard, with incessant requests to "watch" or "tablet time," the past few weeks have evolved into what mirrors a summer of my childhood. Sun-kissed, dirty, happy, and (relatively) screen free.

I was pretty nervous to uproot my little family (again) after residency to yet another temporary city for fellowship. But the past month has reassured me that it was an upward move. Career-wise, without a doubt, but for their own needs as well. Change is really scary, but now that we can see the end of the unpacking on the horizon, and we are all in our own beds again, I think it will be a positive change. When I chose to do fellowship and matched, the most common response was "what about your family? Are they coming too?" While I know that many choose to do long distance relationships for training, I am lucky my husband works from home in a flexible position. The question made me wonder about if I was forcing everyone to sacrifice for my own dreams, if I was being selfish in pursuit of my career. Hadn't they endured enough during residency? Were the kids going to be negatively impacted by moving again? Was it wrong? Should I just be grateful I did residency and we all came out in one piece?

But one thing I learned this month, is that I am so incredibly blessed to be part of one resilient, adaptable, and happy crew. My kids will be fine, and have a broader worldview because of their experiences. We are now living in a community that I think will be a better fit than the one we were already comfortable in. Hopefully, everyone will still be happy once midwest winter arrives, but for now, we will enjoy the barefoot freedom of summer.

Anger, selfishness, and some really loud music

It’s the middle of the night and I can’t sleep because the music is too loud and I’m mad at them.

My neighbors are having a party and the music is blaring outdoors. This is the third time this month. The first was a small gathering on Memorial Day and I was shocked as the cars pulled up and guests spilled out, carrying foil pans of food. My husband and I had looked at each other, wondering if we hadn’t gotten the memo that the pandemic was suddenly over. The last was two weeks ago, seemed like a child’s birthday party (the huge “8” balloon and unicorn bouncy house gave it away), and now, tonight, they’re eating and dancing and laughing on the front lawn like all is well in the world. Don’t they know that even though it’s Saturday, I have to go to work tomorrow? Don’t they know that I  have an autistic preschooler who can awaken at the drop of a hat (or a ray of sunlight) and that his lack of sleep can ruin his entire day? Don’t they freaking know that we are in the middle of a freaking pandemic?

I’m so mad at them.

How can they be so selfish?

Let’s get real: it’s not really about the music. Yes, it’s true, I’d rather not spend my night playing a game of chicken with a subwoofer. But really, it’s about COVID. How can they be so nonchalant when in our country alone, over 100,000 people have died from COVID, most without family by their side? When MIS-C is emerging as an enigmatic and frightening disease? Call me a pessimist (or a pediatrician), but I see every kid on that lawn as a potential MIS-C patient. (I also wonder, as a pediatrician, why the children are still awake at this hour.) In pediatrics, we don’t typically care for patients with diseases brought on by poor choices such as lifelong smoking. But now I may be caring for children who are stricken with COVID or MIS-C because their parents wanted to party. I wonder if there’s anything more selfish than that.

If I’m being even more honest, I realize that I’m angry, but not exclusively at them. When I come home from the hospital, I have a decontamination ritual: I head straight for the shower, stow my work shoes and work bag out of the way, wipe down my glasses and cell phone, and wash my hands until they’re raw. The only indoor places I have been since March are the hospital and my house. So why do colleagues of mine stop at the grocery store in their dirty scrubs, on the way home from work? My children are distance-learning and distance-socializing, and my autistic preschooler is regressing without his essential services. So why have friends of mine been allowing their kids to have in-person playdates all along, half-heartedly doling out the ol’ mental health excuse, topped off with a shrug emoji? My own baby brother, a twenty something single in the city, has decided that after weeks of social distancing, he’s done. He’s jumping back in to socialization head-first and doesn’t care what anybody has to say about it. How can they be so selfish?

The New York Times published an article about how social distancing represents a giant marshmallow test and we are failing miserably. I’m not talking about families steeped in poverty, making painful decisions to go to work so they can literally put food on the table, or about cancer patients weighing the risks and benefits to go in for their chemo sessions. I’m talking about people who are more or less financially comfortable just deciding that they have had enough. Why do people think that just because they’re bored, or lonely, that the pandemic is over? How can they be so selfish that they’re willing to expose not just themselves, but countless other people?

Here’s what I want to say to them, my neighbors, and everyone else who is flippant about the pandemic: This is hard. Disease is hard, the economic reality is hard, loneliness is hard. But please. If you just do your part, we will be closer to going back to normal. Yes, the country is opening up a bit. In my state, at least, you can go to a restaurant and sit outdoors, buy a car, or have a small outdoor religious gathering. You want to start relaxing the rules even further? I’m not going to stop you. But please, don’t have a party like the one you’re having, an indoor-outdoor affair where the fifty of you are dancing together and the handful of you that are wearing masks have them hanging down at your chins. I see white-haired people at your party, and that one man in a wheelchair. Please, I beg you, just consider if it’s really worth the risk.

And please, for the love of God, turn off the music and put your kids to bed.

Birthday

It's my son Jack's fifteenth birthday today! A quinceanera, if he was a Mesoamerican female, which he is decidedly not - he's a tall, handsome dude, but still. It's a big deal. I was reliving his birth in the shower this morning - premature membrane breakage on the early morning treadmill walk, the long stay in the hospital with that terrible medicine that stops labor - mag. I could not read or watch TV it wrecks your concentration and blurs your vision. I did get a pedicure, that was nice. Labor and delivery were easy, when it finally was time, after the surfactant. His physicality today flies in the face of his tiny birth weight. Miracles are real.

I wanted to name him Jack, but my husband at the time thought that was a nickname, so we named him John and call him Jack, after my maternal grandfather. I think it's funny that his name is John Schneider, considering I was in love with Bo Duke as a preteen. One of my first crushes. I remember listening to his cassette tape over and over one summer at the beach on the top bunk in our rental house. It wasn't really that good, but I was infatuated. I may have told you all this before, but if history repeats itself (pandemic! protests!) then so can I.

Yesterday I learned that our head transcriptionist - a magician really - her name is Tina, is having her tenth grandchild today. Which is crazy, because she could pass for someone my age. I excitedly popped out of my office and asked if they had a name. "Yes, it's a boy, he's going to be a junior. Darius. I'm calling him D.J."

Tina's husband also works at Baptist. He always smiles real big when he sees me in the hallway and greets me - he calls me doc. It's impossible not to smile back. About five years ago, I learned there was a Martin Luther King celebration at Baptist in the afternoon of that holiday. I wandered in. It was a little disheartening to see how few white people were in the room, so I vowed to attend annually if I was at work that day. Tina was there. A white reverend was the headliner, which was also disheartening, but that has been remedied in years since. I was so surprised when Tina's husband got up to sing - he has an incredible voice. She later told me that her son was one of the one's playing a musical instrument, I forget which one. But I remember him. His sheer height and bulk and pleasing visage make it impossible to forget him.  Don't tell Tina I said that, it's kind of embarrassing. But he's really cute.

I started call this week, for the first time since April, and Monday was super frozen heavy - I had eight before nine. I was bragging to one of my partners that they were all easy and karma hit me in the head when I had a really hard one at the end of the day. I was also trying to sign out my cases and my keyboard stopped working. The bluetooth light came on when I toggled the switch on the back so I thought it couldn't be the battery and kept waiting for it to connect. When it didn't I banged my hands on the keyboard in frustration.

I walked out in the transcription area when I was called for another frozen. Tina was there with one of the other transcriptionists, she had been working on a computer problem with her for over an hour. Which made me reluctant to bother her but I needed help. If this frozen was as hard as the other one, I was going to have a meltdown. After the frozen, of course. I interrupted, apologized, and explained my problem. I asked her how could she be so calm dealing with this issue for over an hour when I was banging on my keyboard after only ten minutes. She smiled and promised to look at it while I went to the gross room.

Luckily, the frozen was pretty easy. Then I got back and my keyboard was fixed. She told me it was the batteries. Of course.

Tonight after work my ex's wife is making Jack's favorite meal at her house - fried chicken and macaroni and cheese. When I asked her what I could bring she said only wine, what a relief. I wrapped some presents last night and I can't wait to go over there and give him a big birthday hug - I have to look up to him now it's the weirdest sensation on the planet. I'm so excited. Hope you have a fantastic Wednesday too. Much love, E

*cross posted at my blog, www.gizabethshyder.blogspot.com

Ascension Day

So I went to the Dr. Lounge for lunch. Their pizza is sooo good. I just discovered it last week. Already had sausage, sausage and veggie, and veggie. Their veggies are fresh and amazing. My brother Michael told me it was because all of the restaurants are so slow coming out of shutdown that mass servers, like hospital cafeterias, are getting the best produce around.

Today was cheese. I sat down next to Ali, an excellent and very friendly GI interventionalist. He told me about a girl he once worked with from India who was a strict vegetarian. She told him thank goodness for pepperoni pizza, it was what she lived on. He kind of did a double take, wondered if he should inform her of her error, and decided to tell her that pepperoni WAS meat. She thought it was sliced peppers or something? I wondered whether she was sad about all the meat she had eaten and he told me she was more sad about not getting to eat pepperoni pizza anymore.

We were on one end of a table full of hospitalists. One was telling a story about a husband and wife across the hall from each other who had COVID - he was taking care of them. The wife went home earlier, the husband had not yet been discharged. He walked in one morning and the husband was dressed up in a tie and jacket and was in the middle of a Zoom meeting for work. He didn't have time to talk to the doctor during the meeting. Needless to say, he was discharged that day.

Then my other good friend Eric, also a hospitalist - he and his kids live in the house that Mike and I lived in on North Spruce street years ago - told another story. He was taking care of a woman 90 years old who slipped in the tub when her 60 year old daughter giving her a bath left the room for a minute. He ended up getting into good relationship with the daughter, who was preparing for her upcoming wedding at the Capitol Hotel and enjoyed describing her wedding dress. He asked who she was marrying - she said, "Well, you know him." Eric wondered how. "He's Squidward." Turns out the voice actor who is Squidward graduated from Central High School and has made tons of money throughout his lifetime doing lots of voice acting. How cool is that? Eric pulled out his phone and showed me a picture of the wedding, you of course know the theme - the cake had a pineapple on the top and a video he showed me played the SpongeBob SquarePants theme song. Everyone was dressed formal and nice. I even caught a glimpse of the famous groom.

Ascension day is celebrated the 40th day after Easter Sunday, so it varies from year to year. It commemorates Jesus Christ's ascension into heaven according to Christian belief. Most people aren't aware of this day, I've found - I polled quite a few. The Bible says that Jesus promised the disciples that they would soon receive the Holy Spirit, and asked them to remain in Jerusalem until the Spirit had come. I just copied that from Google.

Despite some snafus, we are doing relatively well with testing - I'll save some entertainment in that arena for another day. Numbers are still good at Baptist. As of yesterday (5/20/20 - I just love those days where the day matches the year - it's thrilling to write) we had 16 inpatient positives, and 2 patients on the vent. I'm sure the Arkansas data is easy to find somewhere so I won't repeat those numbers. I'm headed to my favorite place on Earth, Eureka Springs, for the long holiday weekend with my husband. New place - a cabin on Beaver Lake. I can't wait. I think I'll have a bonfire. With lots of accompanying food and drinks, of course. Happy Thursday. Much love, E

*Cross posted at my blog - www.gizabethshyder.blogspot.com

Licking the Spoon All by Myself

Salmonella aside, there is nothing better than licking the spoon after making a chocolate cake. Or scraping the buttery sugary creamy deliciousness left from a batch of chocolate chip cookies. The sweetness is made that much greater when it's quiet. When I know that everyone in my little family is tucked in, safe, healthy, sleeping, peaceful. 

This whole stay-at-home ordeal really through our family for a loop. My ever so short, but so needed, 8 week maternity leave was punctuated by quarantine, Zoom school, limited groceries, and the fear that the post partum anxiety and depression I battled the last 2 pregnancies would return. The support of family around and the bliss of the newborn smell that enveloped me the first 4 blurry-yet-grateful weeks suddenly evaporated. We were thrown into the scary, ever changing, fast moving, unrecognizable vortex with the rest of the world. Now, 2 months in, we are finally finding our footing. 

As an Emergency Medicine resident, I knew that the end of maternity leave would mean entering into the heart wrenching, confusing, and very real work on what others call "the front lines." I feared for the health of my newborn, and cheered the 60 and 90 day milestones that meant his immune system was a little more ready to face the world. I feared for my patients, listening to podcast updates during 2 AM nursing sessions. I devised don/doff plans that include stripping down to my underwear in the parking lot to change before going into my car. I grappled with the guilt of not separating myself from my husband and kids, and grappled with the fear of what I could bring into our house of otherwise strict social distancing. It's still going on, and I'm still grappling. 

But one thing that quarantine has taught me is to let go. Let go of the messy house ( except the kitchen. I held on to that). Let go of completing every homework assignment, or attending every Zoom class. Let go of pajamas until 12, or 2 pm. We have been baking, learning TikTok dances, lots of arts and crafts, and bike riding. I got roller blades for an early mothers day present. I'm nursing more successfully than I did with my first 2. 

I miss the decompression quiet time after shifts, where I used to process the pain, suffering, illness, and rapid fire chaos that ricochets around my head for hours. Now, I stay up later, sleep deprivation notwithstanding, and sneak in yoga and baking sessions at night, after a dream feed, once everyone is asleep. And I always, always, lick the spoon. 

Covid-19 has Ushered in a New Era of Fashion More Suited to Ladies on the Go

I'll admit I was crushed when, the day before I was due to get my every 6-8 week highlight job, they closed the hair salons. How long would it be, I wondered, before I could get my touch up? I bought an at home bridge dye kit from my beloved hair stylist and still haven't taken the time to learn how to use it. I watched my beautifully manicured toes slowly deteriorate. Now all that's left is a couple of spots on my big toes - the rest are au naturel with my distinctly bad hurried nail clip job. I had stopped drying my hair a couple of months earlier and was reminded of how much time this saves me and my curls come out when I am not violently taming them with my Dyson hair dryer. I thought of Linda Hamilton. Not from the first Terminator, the one I saw in the theater with my Dad when it came out but the new, aged, experienced version of Linda - the one where she is in her 60's and her roots are grey and she is beset with substance abuse issues from her traumatic past but is still a righteous badass.

Would that version of me give a crap if my toes looked like they do? If my brown roots are nearing two inches, rendering my dirty blond hair much dirtier? Hell no. All those random bruises and cuts I get from bumping into things - I'm a klutz - suddenly took on a new, cooler significance. I imagined them being battle scars from fighting the evil empire over all this Covid testing - keeping the false Gods with their promise of accuracy hiding their lies and desires to make money off of this pandemic at bay. I started to show them off, be less insecure about having them. Abandoned the desire to get those roots touched up with my at home kit. Also the desire to do my own pedicure - that can wait, shouldn't be too much longer now.

I scheduled a hair appointment today for June 11 - first available that works for both myself and Deidre. I cannot wait to see her - our relationship spans about 17 years and we have become almost like armchair therapists to each other over the years. In the meantime, I'm going to embrace those roots - even Deidre texted me that roots are actually in now. I'm not going to worry about that strange piece of white that is on the cherry red polish left on my left big toe. I have wondered what it is (White out? Caulk? - None of those make sense really) and tried to pick it off to no avail. It no longer seems important, thank goodness. I see a future full of scrubs and roots and not perfect pedi's looking actually much cooler than someone who is perfectly coiffed (although it is fun to dress up sometimes and I will continue to do so if it works for me). Back to 90's grunge, with a lot more experience and know how.

Happy Monday! It's been a while. As I teach my kids, sometimes you have to put on your own oxygen mask first in order to be your best self to others. And if that best self can look shabby on the outside, it doesn't matter, because she shines on the inside. Much love, E

*cross posted at my own blog, Methodical Madness

The bright side of staying home

COVID has induced major disruptions to my life - both personally and professionally - but trying to see the bright side. As I hold positions at two institutions, one administrative and one clinical, I am both in the work-at-home camp and the radioactive-don't-touch-anything-when-I-come-home-from-hospital one, afraid to hug my kids (and, oh, I'm a hugger), although I sneak in a low kiss to the middle of the back from time to time when I'm 14 days out from possible exposure because I would wither from the lack of affection giving.

I see how Facebook, scary as it is, can understand my innermost desires and thoughts these days as I'm pitched ads for 1) scrubs; 2) pony-o hair accessories; 3) premium lounge wear; 4) at home hair coloring kits; 5) hair growth serums (gee thanks, what are you trying to tell me?); 6) weighted blankets - I totally impulse purchased that one; 7) fashionable fabric masks. Also, why have I NOT been wearing scrubs all of these years post residency? Why? Why have I worn nice clothes to the hospital ever? It seems like an anachronism now. All those germs.

So, the bright side of #stayhome:

1) More family togetherness outside. Not going with just plain family togetherness (maybe too much of that) but it's the outside part that's been a difference. Since we are trapped at home all day many days (although husband still must go to work), and kids no longer have their intense sports practices, we've been going out to exercise as a family daily. Taking walks, some of us run together, playing soccer or baseball at the field. We used to do this before but now it's daily. Now that I've played soccer for the first time in my life on a women's adult team (different post!), I can actually pass the ball (kind of) to everyone else! Kind of! In that general direction! This outside togetherness has been source of family joy. (Except for the time I took a walk with the kids and we were on a sidewalk next to a busy street, and I kept scaring the bejesus out of them, yelling at them to stay away from the road and walk in single file so if a car came veering off the street, they wouldn't be killed. I don't think they want to walk with Mama on that street anymore.)

2) We're closer to our neighbors. Similar to the above, we are seeing our neighbors outside more too and our desperateness for human interaction makes the heart grow fonder for visible people, even if >6 feet away. On my daughter's 15th birthday the other day, I messaged a number of neighbors to see if their families could come outside to surprise her with birthday wishes at a specified time. Everyone was "in." We got our daughter out onto the front porch swing and family by family came by and wished her a happy birthday. Daughter marveled at how many people knew it was her birthday and did not realize it was coordinated. One family came by on a walk and then serenaded her by singing Happy Birthday in Spanish. Another dad had his toddler daughter on his shoulders and she had a karaoke microphone, singing a series of songs for her. Another family came by with a huge poster and stopped on our lawn to sing her Happy Birthday. Daughter finally caught on that maybe this was a conspiracy --and was touched. And embarrassed. But mainly touched.

3) Greater oversight of kids' development. Stay with me here. School is a blessing. Teachers are a blessing (and saints too). But, I didn't really know what they were learning exactly and didn't know other ways they were developing to the degree that I do now. We spent many hours apart each day and a lot of it was a black box, except for those rare "parent lunch duties" where I completely appreciated that School is a blessing and Teachers are a blessing. For this window of time (that I hope is not so prolonged...), it's kind of nice to know what they are learning, how they are approaching the concepts, their questions, their curiosity. Don't get me wrong: I have lots of frustration too about this homeschooling situation, could certainly fill a few other posts, but there are some a few a rare number of good things too.

4) Familiarity with the diversity of toilet paper options. I blinked during the beginning of the pandemic and toilet paper was no longer present anywhere. I had to resort to buying various toilet paper varieties from Home Depot that I had never seen before, including business-grade rolls that do not fit on the toilet paper holder and individually wrapped rolls like you see in hotels, just with lower paper grade. Using these alternatives has made me feel unusually resourceful and like I'm roughing it a little - you know, making me humble and all. Like I'm in a developing country or camping or something. But I'm doing it! And it's not that bad.  I also purchased in desperation these paper towels that you pull from the middle of the roll and are massively wide. It's been kind of fun to use these rolls, even when they get to the end when they no longer stand up due to floppiness and must lie dejectedly on their side while we keep pulling out the middle. I'll miss these guys once normal supplies are revived. Luckily, I have many of them still to work through.

5) Outdoor living space revival. As it was becoming clear that we would be staying home for awhile, I finally took steps to make our porch and backyard deck more livable. It's been a dream of mine to have a porch swing and we just pulled the trigger and did it. Now I love our swing! Plus we got chaise lounges for the back. Hanging out at home has become much more pleasant.

I'm sure there's more - less traffic, comfy pants, gas savings? Now I'm reaching.

What are yours?

WHEW

Happy Friday (mine anyway). I made it. We all made it. I'm off the next 5 days, but will be coming in to get updates from Amy and to finish of some cases. Attack that admin pile. Dust.

I asked Tina to put in a work order for Don - I'd seen him in the hall this morning while I was running to a needle in CT 4. It's the last to do decorate wise except to find a sweeping large piece of art to put in front of me in the left. That will be fun to look for. So anyway, Don, a handyman with much raw and emotional intelligence, we've known each other for six years and he did projects in my other office. He was worrying about his younger wife needing surgery - luckily not anything dire or life threatening just aging necessitates that things sag and droop. Especially on women who carry a lot of babies - they get uterine prolapse sooner. Don suggested something I hadn't thought to do - put the diplomas in chronological order of my time as an SP Fellow, AP/CP resident tenures, Chief Resident cert. and finally a fellow in cytopath. A square of four rectangles. A small sum of my past, my climb to get here.

At the end of the day I went downstairs to get more snacks and drinks from the Dr. Lounge - I'm sharing a bit with the admin assistants we made a little basket in the main area so they don't have to bug me to get a treat. Hopefully the camera that is installed to watch the doctors (I saw the Eye) and curb bad behavior will think, WOW. That girl is working out so much she can eat anything she wants and needs more to sustain her these days.There weren't enough barbecue chips left (homemade in a bowl with tongs) so I looked over at the hot food that was currently being broken down for the 3:00 lockdown. Chicken Fried Chicken. I hadn't eaten that since I was still dating my husband. I got some honey mustard sauce and put it in a styrofoam container (sorry, I'll reuse the next one). Forgetting utensils and being too hungry to wait, I ate it joyfully with my hands while releasing cases. Taking care to prevent the keyboard from getting grease on it.

Writing this blog is like an after dinner cigarette, like the ones I so brazenly enjoyed in front of everyone when I was in college and dating my first husband. We were both young and foolish then. When I started medical school I cut way back on that, and tried not to use it unless I really needed it. I try not to fault the close ones in my life their oral fixation blankets anymore either. My husband chews gum all day but oh god his breath always smells so good. I used to chew a lot of gum but after my jaw broke that didn't feel the same anymore. So now I'm addicted to altoids. And I just got some new Coconut Lime Velamints that are like a Pina Colada on a hot summer's day. That doesn't sound so good with the Cherry Coke Zero, so I'll wait until I'm done with that.

See, we are all perfect, and not so perfect in different areas of our lives so we need to cut each other all a little slack. Give ourselves grace, a pat on the back for a job well done, in parenting and in our work and our creative pursuit. Signing off with much love, E

*cross posted at my blog, www.gizabethshyder.blogspot.com. I need to relearn linking. Just did.

Coming Out of the Dark

Happy Monday - it's my Thursday I'm so excited. And I'm about done with this day.

Weekend was kind of crazy but talking to my husband and Alyssa helped me get through it. And I'm glad because I've got to support another friend this afternoon and evening.

So last Friday we were working  on some alternate means of testing. We didn't know we were getting 42 test kits and the clinicians will want to get back to doing surgeries ASAP. So we ran a couple of courier routes to a lab in Joplin and a lab in Memphis - American Esoteric Laboratories (What a great name!). Now we are no longer using Viracor - we are using AEL. We can get more than one courier up there to decrease the turn around time, and like that we are bringing the work more locally.

Friday at lunch I was commiserating about something going on with me all day - hot flashes. I asked a group of women "Do you think it could be menopause?" One micro tech said it sounded like what she experienced, another said that if you go to a male OB they will offer an antidepressant. "Oh that's freaking rich! I cannot believe it, but I can. Not that there is anything wrong with antidepressants, but to give a blanket offer, ugh." I wondered if prostate docs offered antidepressants with their prostate checks. Probably not.

The other day I went to a bathroom down by the cafeteria - hadn't been there  in a while. It is a four staller. Went to the handicapped bathroom stall. This place was usually so full it was weird having it to myself. Mid stream the lights went out. It was terrifying, to be caught in the dark with my pants down. I calmed myself down quickly - these were probably on motion detectors and I could get out of my predicament if I just moved, so I did, and I was right. Little did I know it was a premonition, but we are coming out of the woods now.

Jack won an award today! He is so happy. The 8th graders take these state-wide exams - I remember C got number one on Spanish. I was so confused - "Number one at your school hon?" "No mom, the state." "Wow." Now Jack has won the mythology award, and he didn't even have to study. I told him, "That's how it is with your passion. You could be an academic and study mythology and teach." But mom, cooking is my other passion, and I still might want to be a doctor I'm not sure." "Well you could talk to Uncle Mike and Aunt Effie. And there is this cool series on Netflix that S and I watched a little while back about the chefs with Michelin Stars, and about their journeys that would be good for you to watch. What a great mash up - cooking and mythology. I'm outta here. Much love, E

*Double posted at my blog www.gizabethshyder@gmail.com

What's Going on With You in the Pandemic

I've been blogging for about 2 weeks now. You can follow that at my blog - www. gizabethshyder.blogspot.com.

I'll continue to blog here. More tomorrow.

I've learned a lot from my close Dr. friends in LR about how different specialties are handling this crisis. I want to know more.

Please revive this blog and talk to me. This is a dear space to me. All you beautiful ladies must need an outlet, as I do, in these crazy times.

If you need to reach me, I'm at my personal e-mail - gizabethshyder@gmail.com. It's only accessible to me.

Wax eloquent. Much love. E

Quarantine Questions with a 4 Year Old

(Blubbering) "But WHY can't I go play with Sarah??"

The extent of our current outdoor adventures

How's everyone doing in the era of COVID and shelter-in-place? I, for one, am having a difficult time parenting my 4 year old daughter. Overall, I can't complain; we're happy together as a family, and we're all healthy. Despite changes in work volume, we're secure. Finding ways to balance our time with her needs, as well as physical exercise for all, is going alright. But explaining complex concepts to a 4 year old has been... challenging.

Being that she's 4, her world is pretty small. We've talked about the virus. Why our travel plans for the end of my sabbatical from academic anesthesia have been cancelled. Why Nana and Papa can't come visit this spring. Why we can't go to our gym or her gymnastic classes. Why only Mommy or Daddy goes to the store when we need things. But even a month into staying at home, she doesn't quite get why she can't play with other kids.

It's been easy with friends she's made through her preschool classes, since they're just not nearby. But little friends in our neighborhood are another story. We're in a condo complex, and for the most part, people are doing their best to remain active but socially distant. Dog walkers shift to the other sidewalk when passing. People wave hello, some wearing masks and some not. And as with any neighborhood, there are a few odd ducks. With kids.

Of the similar-aged children in the complex, I've seen the spectrum of parenting styles... made fully obvious now that everyone's home all the time. There's the child who's outside all the time, garage door open and toys strewn about the driveway. She's scootering up and down the roads, calling out for other children. She's wearing her pajamas and eating candy, all day. Mom is young and single, but three other men seem to be living in the home as well. Cigarette smoke wafts from the windows. On the flip side, there's the child who parts the drawn blinds and peers out the window longingly as we take our multiple daily walks. Her parents keep the house dark and quiet. Despite our previous evening chats and child exchanges, I haven't seen any of them outside for weeks - only glimpses of their silhouettes at the dining table when passing by.

My child desperately wants to play with both of these kids. The one is unavailable for even a distant hello. The other is too available. And the "family" is too tricky... When she asks why she can't see the one friend, or why I won't let her play with the other, I have a hard time coming up with what to say.

We definitely believe in authoritative vs. authoritarian parenting. I never want to say "because I said so" as a response to "why". At the same time, I want her to understand that we prescribe the boundaries. So I guess what I'm wondering is, how do I talk about these decidedly complex issues? Mamas of older kids, what have you done? What would you do differently if you could go back?

Guest post: Maternal Awakenings

I always wanted to be a perfect mother and was naïve enough to think she existed. There was so much that I did not know when I became a mother at age thirty-four, so many things to learn as I went along. My husband and I decided to have children soon after our marriage in August 1983. David was born in October 1984, Anne in June 1987, and Laura in February 1991. During the first seven of my mothering years, we lived in a small two-story house in a quiet, mixed Houston neighborhood in the Montrose area along with other yuppie families, several gay couples, and nearby apartments which housed middle-income Hispanic families. A modest, shady park with a playground was located nearby. My husband and I were busy with work those first years, but also dealt with many unexpected childhood issues. There were breastfeeding challenges and night terrors, toilet training, early discipline and temper tantrums to manage. Later there came embarrassing, immature and impulsive behaviors in kindergarten and grade school. We tried our best to sort through all our children’s needs and issues.

We did not ask our parents what they thought; after all, we were smart, educated doctors. I did not plan to pattern my mothering after my own mother. I wanted to be involved with my children’s lives, to protect, and encourage them. I was extremely lucky to have married another pediatrician. He was always calm when things went awry but did not seem as hungry for knowledge as me. I consumed stacks of books written by experts on child behavior and child development. (Thank goodness there was no internet back then, or I would be addicted.) I needed to know if all the things I observed with my children were normal. Surprisingly, there were several childhood conditions that I had neither encountered nor learned about in my own pediatric training.

Understanding why young mothers, including me, knew so little about breastfeeding was simple. The generation before us had not breastfed, as a rule, hence they were unable to inform us of the correct ways to go about it and could not support us through our breastfeeding problems. They fed formula to their infants, so it was natural, when anything went wrong, for them to say, “Why you don’t just feed him/her some formula?” My mother had a theory that David would sleep through the night at six weeks of age once she fed him a large bottle of formula. One evening, after we returned home from a date night, she had been babysitting and happily announced “He took a full bottle.” David woke up three hours later, around 2am, as usual. Sadly, he busted her theory; moreover, he didn’t sleep through the night for three more weeks. My mother did not know that sleeping through the night is a brain-thing and not a hunger-thing. A few days later, I asked my husband to hint that my mother refrain from giving me any breastfeeding advice. I remember thinking about returning to work when my newborn son was six or eight weeks old. I distinctly remember being bored. I loved caring for him, holding, rocking, and nursing him, but there was no challenge, no thought process there. About six weeks after her daughter was born, my older daughter mentioned to me that she wanted to return to her work as a nurse in the Pediatric ICU. She wondered if that was a bad thing. I tried to reassure her as I recollected how lots of working moms would rather work than stay home full-time with babies. Maybe it’s an activity thing. Maybe it’s maternal style. Some women clearly crave satisfaction and success. Your personality type may play a role: Extroverted thinkers (as opposed to introverted feelers) tend not to stay-at-home. Some of us are just not meant to be stay-at-home mothers.

I never entered the field of medicine to work part-time. The training had been too long and arduous. Besides, I loved being a doctor. Medicine gave me a huge sense of contentment and competence. My mother had worked full-time as an elementary school librarian. In addition, she was away from home quite often doing church-related volunteer work. Back in the 1950’s, when I was growing up, mothers did not hover over their children. They certainly did not go to all their school and sporting events; at least mine didn’t. As a result, I learned independence from an early age.

Likewise, our parents had disciplined us in different ways than we planned to discipline our own children. Parents were more authoritative in the 1950s and 1960s. The other neighborhood mothers would contact your mother if you acted up in their yard or home. My parents were very strict disciplinarians. “Because I said so” was heard often, and Daddy’s rules were set without discussion. Mother went along but left the punishments to my father. My husband’s father had acted similarly in his family—he used physical punishment. Phillip and I discussed discipline, and we planned to be more lenient parents. From the outset, we both cared more about our children’s self-esteem than setting limits or strict discipline.

I recognize now that there is no such thing as a “supermom” even though we were told that she existed in the 1980’s and 1990’s. Working mothers were expected to do it all. Even TV commercials told us to “bring home the bacon and fry it up in a pan.” In fact, most of us young working mothers voluntarily chose to “do it all.” What they did not tell us was that both work and mothering were daunting, and each in different ways. They did not tell us that our children would need things from us at the most inopportune times, usually the same time that work did. I spent the first ten years of my own motherhood experience learning that there is no such thing as a “supermom.” I came to understand that I was a typical working mother—constantly trying to balance full-time work and motherhood. Sometimes things were manageable, but plenty of times everything felt totally off balance and out of whack.

There is just no way on earth that one person can be in two places at once. Maybe if you are Hermione Granger in the Prisoner of Azkaban of the Harry Potter series, but not if you are me. My favorite, yet horrible, early memory of this lesson was David’s first Mother’s Day tea held at the church preschool. He was three years old, and I was held up leaving the hospital because one of my babies took a turn for the worse. That baby needed attention. Ultimately, she needed intubation (a tube inserted into her airway), and because of my work ethic, I felt that I could not leave the situation to someone else. I paged my husband and begged him to attend the tea for me while I stayed to oversee the care and stabilization of that baby. I have the cutest picture of my husband receiving David’s hand-made Mother’s Day artwork in my stead. The art was a small, purple, left handprint inked onto cloth and Phillip is sitting in a little chair at a low, round table next to David, both drinking milk and eating a cookie. David was contented; he didn’t notice that my husband was the only father there. On the other hand, I felt miserable for days.

So, I learned early on that working mothers carry guilt. My friends all had it too. And as we compared notes on child rearing, we began to understand just how much of a trade-off working full-time actually was. I was fortunate enough to afford a stay-at-home nanny and housekeeper. We never employed a live-in helper, but lots of my doctor friends did. Without a nanny and housekeeper, I would not have been successful in practicing medicine. (The same caveat goes for my husband. When I was absent, he did everything for our children.) Mable, my elder first nanny, fussed at me when I came home around 6pm several evenings in a row. She scolded me with, “He needs you more than this.” She was probably correct, but I was busy building my academic career then. An older neonatologist, a good friend and mentor, had told me that she and her physician husband had struggled like “ships passing in the night” raising their three girls. She described one of them heading home in response to something going wrong or a sick child. And then the other one would drive home later to relieve the first one, followed by the first one returning to work. My husband and I did a pretty good rendition of “ships passing in the night” ourselves those first years.

I remember vividly one morning that David was sick with some childhood virus or ear infection. He was around two years old and had awakened with a high fever. After treating his fever and dressing for work, I called the pediatrician’s on-call service to set up an appointment. When I observed my husband straightening his tie, putting on his white coat, and heading out the front door, I said, “Wait a minute, where are you going?” He said, “I’m going to work.” I asked him “What about David, what about me?” He said, “You’ll take care of it. You always do.” He turned and walked out the door, seemingly without a care. He apparently had no guilt; he was not worried. He fully expected me to take care of everything, like I always did. This instance was my first recognition of my inability to ask for help from my husband when needed. I would continue to struggle with this and many new issues as a working mother.


Susan is a retired neonatologist, living in Austin,TX. After thirty-six years of full-time practice (fourteen in academic, and twenty-two in private practice) she is actively remembering essential moments from her medicine and mothering career, and she hopes to publish a memoir.

Should I be enjoying my bubble?

As a daughter and granddaughter of high risk loved ones, this pandemic hits close.
As a mom of elementary school kids, the homeschooling vortex hits even closer.
As a mom of a 5 week old, the unknown is just very scary.
But,
As an Emergency Medicine resident, the COVID-19 pandemic hits really hard too. Maybe even the hardest.

But yet, I'm not there. I'm not in the trenches. I'm not wearing a bandana because there are no more masks. I'm not donning and doffing. Sure, I listen to the podcasts, attend the ZOOM meetings and conferences, but with audio and video off, in pajamas, while also nursing and now virtual homeschooling, in the comfort of my home.

Friends and family reached out with different sentiments that range from " you are so lucky you are still on maternity leave" to " do you feel bad that you are missing out?" I don't know how to answer, other than "please just do your part and stay home."

I'm not sure how I feel right now. Not sure how I want to feel, honestly.  I know I want to protect my nuclear family, stay safe, and keep everyone- from husband to big kids to infant- safe and exposure free. But I'm conflicted about my residency family, my colleagues on the front line. I know I need my time to rest, recover, and take care of myself and my own family right now, but my heart is torn. I'm also scared to go back.

As a physician, we dedicate our lives to helping others, hopefully saving some lives and making a difference. Throughout our training, we sacrifice time with our families, missing out on events, celebrations, quality time. Our priorities are constantly challenged; being a mother makes those challenges at times more acute.

So many thanks, and prayers of strength to all of you out there, fighting this on the daily. Please stay safe. Please know you are appreciated.

Coronavirus and being a mother

I have a confession to make.

I don't know how stressed out to be about COVID19. I'm a chief resident, so my job is to make contingency plans and sit in on big, hospital-wide policy meetings, and field questions from residents via phone all day long, but I don't know how stressed out to be about this.

In medicine: One of my doctor friends' husband works for the CDC, and she is constantly sharing tidbits with me, such as "we should cancel noon conference, or ideally space people 6' apart from each other as social distancing. And no one should eat the food." States are cancelling international work-related travel, then international personal travel (goodbye, husband + my planned trip to Portugal to go cycling while my mother watched the kids for a few days...), and now, domestic professional travel is cancelled, while domestic personal travel is recommended to be cancelled/postponed as well.

In the world, there are two perspectives:

1) Buy more bleach. "But I already have 3 jugs of bleach at home!" Nonsense, they say - the best treatment for infection hysteria is more bleach, and $50 bottles of hand sanitizer, and flats of 16 cans of black beans from Costco. This weekend at the grocery store, they were running low on tomatoes, beans, broth... and lines were out the door.

Have you ever tried to prevent two toddlers from putting their fingers in their mouths? "Wash your hands" they say, "sing happy birthday twice," they say. I say "TAKE THAT USED GUM FROM THE PLAYGROUND SLIDE OUT OF YOUR MOUTH RIGHT NOW." My daughter licked her fingers and smiled at me the whole. way. home.

I felt like I was weighing every choice this weekend when home with the toddlers. Go to the library? The children's museum? Church? Everywhere felt like a hotbed of infection, where I'm not only risking their lives (note: COVID19 is thought to be particularly less-severe in children) but risking become a vector for those around me, and almost as importantly, risking a 2 week quarantine from my job.

2) Just go anyway. At church yesterday, I asked a bunch of mothers whether they considered not coming to church. Everyone I asked said no, and I was surprised. "Really?" I asked them, not believing, "I almost made us all stay home... even as we walked out the door." (Not to mention, I emailed the pastor mid-week and asked if we could change our communion practice to minimize multiple unwashed hands touching the same loaf of bread and risking becoming "that church where everyone got Coronavirus.").

I'm trying to balance fear and risk, anxiety and trust in the world of parenting, where all choices affect them, too. Not just if they get sick, but if I get sick, but if their school is closed, but if my job changes such that the hospital can't run. And what do we do, if there are no residents to come in, and the patients balloon? No one is talking about what it's like to work in these hospitals in China, South Korea, Italy, where patients are in lines out the doors, in courtyards getting IV fluids from bags hung up in trees.

In so many parts of parenting, you weigh risks and benefits, you try to choose trust and hope over being stressed out and anxious. You pull the used gum out of their hands, the rocks out of their mouth, and prevent them from petting a strange dog and then licking their hands (toddlers = so much licking). But when it feels like the world wants you to be anxious, when the meetings all day long fuel the anxiety, then what?

It was beautiful out tonight, sunny and gold, the last flecks of yellow hitting me through the office window over the building tops as my husband put the kids to bed (#win). And I felt this sense of hope, of possibility. Of belief that sometimes you do the thing, before you believe the thing. So maybe just going to the park, just reading them a story, just telling them how much we love them - maybe that's doing the thing, before believing the hope that we will all be okay.