Fat Doctor, Versions 1-3

Hello, my name is Sarah Parrott and I am a recovering blogging addict.

In October of 2005, I struggled with emotional adjustment to a health crisis. Because I needed to write to heal, I Googled "online journal", found Blogger and decided my blog's title should be The Fat Doctor, because that's what I am. I chose the username bigmamadoc. My first post was brief, raw and full of anger. I still believe it's the best I ever wrote.

I thought the blog would be just for me, but after a week or so, I realized that taking my blog public would give me more "reason to write." I'm the type of gal who loves an audience. I signed up on medlogs and eventually a few people started to comment on my posts. After I hosted a couple of Grand Rounds, the readership increased. Somewhere along the line I started thinking about my blog as a brand and renamed it "Fat Doctor" and changed my username to that as well. Readers addressed me as FD.

My blog friends became increasingly more important to me. TBTAM, Doctor Anonymous, all sorts of bloggers felt as real to me as the friends I met for movies and dinner. During my hospitalization in San Francisco in April of 2006, Husband printed out the comments on my blog and bring them to me every day. In the heyday of my blog, which was probably Fall of 2006, I was getting about 800 hits a day.

In May of 2007, I was outed at work. Too many personal details...it was bound to happen. My department chair came to my office and said that he was particularly dismayed to read my comments about a recent faculty meeting. He did not ask me to take the blog down, but I did just that. I moved to WordPress and my posts changed tone. Fat Doctor Lite, if you will. It wasn't that much fun anymore.

After changing jobs in July 2007, which probably was a result of the embarrassment I felt about being outed (and the lure of twice my salary), I kept that boring blog going. When I was laid off in 2009 and I needed to find a new job, I took it private, allowing only usernames I trusted to see it. Fat Doctor still exists, and I post there a few times a month, but only a handful (if that) of the 100 or so registered users read it regularly. I believe that blog has started the agonal breathing that signifies impending death.

Meanwhile, it seems a lot of bloggers have outed themselves. What a refreshing concept! I started a new blog as just plain old me. It, too, is extremely boring. I won't discuss work at all. I'm not sure this blog will work out, either, but it feels good not to hide behind an eponym.

Funny, but I don't seem to need blogging anymore. It really served a role when I was worried about dying, but I'm now convinced I'll live forever. Similarly, blogging served a role when I was miserable at my first two jobs post-residency because I could "safely" complain, but that kind of backfired. Now I love my work and want to stay where I am until retirement.


I need a new addiction, perhaps, but I certainly won't choose anything related to exercise. After all, my blogs may come and go, but I'll always be Fat Doctor.

Not Feeling It

It's Christmas Eve, and I'm not feeling it.

The house is decorated, the stockings filled. We baked and decorated sugar cookies. I made hot cocoa as a special bedtime treat. Thanks to the blizzard, there is snow on the ground for the first time in our city since 1962.

We celebrate not just Santa but also the birth of baby Jesus in our house.

But I'm not feeling it. Is it because we are so busy these days? Is it because I can't get my patients out of my brain?

God, I hope I'm able to see "it" in my son's face tomorrow.

An Average FD Weekend

December 5 and 6, 2009


I am an assistant professor in the family medicine/osteopathic manipulative medicine department at a medical school. My job includes teaching on campus and two days of clinic per week. I do not work with residents or do hospital work at this time.

0530: Hit the snooze.

0600: Get up, shower, dress, meet Husband in the great room where he is feeding Daughter breakfast. Have fifteen minutes "share time," a luxury in our marriage.

0730: Pull into parking garage of local hotel which is hosting the winter cme program sponsored by the medical school for whom I work. This is the final day of the program. I am both presenting and moderating today and must stay through the last lecture.

0745: Have a frightening conversation with an elderly family practice doc, retired, who "never believed in mammograms. " Wow.

0755: Cardiologist thought he was to speak at 0800, my speaking time, and he has to get his son to a soccer thing. I trade spots with him because I'll be here all day anyway.

0845: I give my lecture on EMR (history, political stuff, choosing and implementation). To my surprise, it went very well and was well-received. Spend rest of the day basking in the glow of good feedback.

1200: Had to cut the financial planner's discussion short as it was clear he was overtime and wouldn't be stopping anytime soon. I don't feel too bad as it was basically a sales pitch. I apologized profusely to him and the audience and he kindly left the room. I'm pretty sure I see his tail tucked between his legs.

1300: Final lecturer finishes and I realize his area of interest is mine, too. We briefly collaborate and agree to start a project together, trade contact info. I realize my self-imposed deadline to identify an area for my academic research by the New Year has been met. I give myself an internal high-five, which may or may not feel like a Kegel exercise.

1340: Fill up gas tank, decide to go to WalMart, closer to my house, rather than Target, closer to the gas station, for my quick errand of getting pantyhose.

1400: Leave WalMart SEETHING that they no longer carry Just My Size. Queen size is the biggest they carry now and for my height that means no heavier than 185. Am I the only obese WalMart shopper? Hmmmph! Go through Taco Bell drive-thru as I'm sure a taco will ease the psychic pain.

1415: Back at Target, telling Sister via iPhone about the WalMart incident. She asks me to pick up panty hose for her, too, while I'm there. She too has her work party tonight.

1500: Now at Catherines all the way across town because Target also doesn't carry Just My Size. Picked out a festive party blouse for my work holiday party tonight. Threw in some cheap costume jewelry for safe measure. Retail therapy. I feel calm and somewhat refreshed.

1530: Deliver Sister's pantyhose to her house. She leans in to take them from me and notes my nasty chin hairs reflecting the sunlight. I produce a pair of tweezers from my purse and she plucks them as I sit in my car in her driveway.

1600: Home. Son is playing Noggin games on the computer. Daughter is grumpy, so I give her a bottle and put her down for a nap. Husband jumps in the shower. We need to leave for the party at 1745 and his mom should be here to watch kids by 1730. My mom, apparently, also will be here at 1730 to pick up library books she checked out for Son. After an all out search, we find only two of the three books.

1630: Update my Facebook status and start this post.

1700: Gettin' purty - makeup, sparkly top, jewelry and perfume. Mom-in-law arrives to watch the kids.

1830: Husband and I arrive at the most expensive and exuberant employee party EVER. The Las Vegas theme was complete with showgirls, elvis impersonators, a great band, aerial artists a la Cirque du Soleil, food, booze and gambling (fake money). Many of my colleagues are in costume. We'd planned to stay 30 minutes then ditch out but stayed for the duration. On the way home, Husband notes that the atmosphere was different than he had ever experienced because it was clear everyone, from the president of the university to the maintenance people and cafeteria workers, was part of the same group. "You all seem to really like each other," he said. I agreed. Best Job Ever.

0000-0530 Sleep!

0530: Wake up and straighten house for cleaning lady. Mom-in-law spent the night and agrees to watch the children, for whom a long church day is exhausting because nap time is missed. Husband makes our turkey sandwiches for breakfast so we can eat in the car on the hour trip to church.

0730-1300: Travel, choir practice, School, worship then travel home.

1300-1600: Skip lunch in favor of a nap. I wake when Daughter is crying on the monitor placed by her crib and note that at some point, Husband has taken Son for their weekly parent-child bowling league.

1600-1730: While Daughter plays, I finish up just a few outstanding EMR reports so I can start with a clean slate in clinic tomorrow. I then check the upcoming week's schedule...clinic, practical exams for the students, serial committee meetings and Husband will be out of town Tuesday through Thursday.


1730-1830: Dinner with the fam. Turkey casserole that Husband made yesterday while I was at the conference. I note that Daughter shares my love for all foods and I feel a pang in my heart. It will important for me to try to model some healthy habits for her, but first I must adopt them.

1830-1900: Bathtime and bedtime for kidlets.

1900: Finish the medical records catch-up and this post.

2100 (anticipated): Fill my weekly medication dispenser then Go. To. Bed.

Time Flies

It's the end of 2009 and this is just my fourth post of the year. Thanks to KC for allowing some flexibility this year. New baby, then a layoff and subsequent job search...I got too busy to post here regularly. But now I'm back.

Last year at this time, we were in the midst of adopting our daughter. One year later, it seems she's always been here. Time flies. I note some of my mothers-in-medicine colleagues have new babies in their homes. I would encourage them to take plenty photos to document how time flies.

Here, for example, is a demonstration of what a change just one year can make...

Just to update you in all areas of the Fat Doctor Life, I thought I should just list some general subjects.

• My weight: Highest ever. One foot in the grave. Not yet hopeless, but not sure what I need, want or can do right now. Praying for guidance.
• My career: Happiest job ever. Teaching, clinic work, may get back to some hospital work soon.
• My family: Son growing into a funny, smart kid. Daughter just had her first birthday and is starting to toddle. Husband is busy with work, the church and taking care of me. He remains my favorite person ever.

So the holidays are back now and the FD family has a full schedule of work parties, church programs and family get togethers. I'm busy but not complaining. This is the kind of busy that makes the world go round, the kind of busy that makes time...well...fly.

It's good to be back.

Flexibility is Key: Change is OK

The take home message from the following, for those who don't have time to read the whole post: Don't be afraid to change childcare when your child's needs change...or if your care provider pisses you off. We've been flexible, and that has served our children well.

When Son was born, I was a resident and husband traveled most of the weeks of the year. I needed flexible child care, but we couldn't afford a live-in. We chose Lourdes, a wonderful grandmotherly woman from Ecuador who lived just a few blocks from the hospital. She had watched my niece and we were comfortable with her.

She spoke Spanish in her home and spent 99% of her day holding our baby. Whenever I picked him up, he was clean because she and gave him baths several times a week. When Daughter came along, I couldn't believe how much I had to bathe her. I didn't bathe Son more than a dozen times in his first two years of life.

I could call her at 6pm and tell her I had a patient in labor and wasn't sure when I'd be able to pick Son up and she'd say, "Mamacita, let me keep him overnight...please?" We never did that, because we are lucky to have so many friends and family members who would pick him up in our absence.

When he was two, we clearly saw that Lourdes was more a "baby" person than a kid person. We wanted a bit more structure. We switched him to a highly recommended preschool near the hospital. The owner, a Russian immigrant, ran a very, very tight ship. Son spent a lot (a lot!) of time in "time out" but seemed happy overall.

I, however, needed to grit my teeth and practice deep breathing when the teacher would critique my parenting in front of him, other children, other parents. I tolerated it because it was better to keep him in one place than to move him again. She saw every one of his age-appropriate rule infarctions as evidence that I, a "woman doctor" (which she said as though she was spitting the words) did not spend enough time with him.

Finally, after he had been there about 18 months, I asked her for a note of support for our adoption home study. She told me in front of Son that she couldn't recommend we bring another child into our family to neglect it like we had Son. That was it. We gave our notice and moved Son to my new hospital's award-winning child care center.

Having Son, and then Daughter, at the hospital was a dream come true. I occasionally wandered over to the center after lunch to say hello to them then went back to complete my rounds. Alas, the job ended (and for that I thank God on a daily basis!) and I couldn't leave them there.

We moved Son to a new preschool. He actually attended the first day it was open. It is run by a PhD in early childhood education who hires only teachers with baccalaureates in some related field - music, teaching, psychology. It is across the hall from an autism training center, and part of each day the regular kids and the autistic kids get together for activities. The new school is very small and currently there is a 3:1 child to teacher ratio any given day. When Son goes to kindergarten next year, he will benefit from the intensely individualized curriculum at this school.

Daughter, on the other hand, is too young for Son's school, though she'll start there when she is 2-1/2. Until then, she is happy in the home of a neighbor who runs a licensed child care. Daughter is one of five little girls under the age of 4. Our care providers (the neighbor and her sister) love her as though she is their own. There are plenty of toys and the environment is safe. We feel good that when we drop her off, she reaches out for these women, and when we pick her up, she reaches out for us.

We are, after all, the real constants in the lives of our children. We will never leave them, and we feel confident that they understand that. With my new job and husband's now-reduced travel schedule, we are usually home together with the children by 5:30. Will they remember the changes in their care providers? I doubt it. Will they remember that we were always there for them? I certainly hope so.

Karen

Before residency, I doubted I would find a mentor in medicine. Who but me could have varying interests, put her family in front of her career and still be wildly successful? Surely, I thought in my typically narcissistic way, I am one of a kind.

But then I met Karen.

Karen became residency director shortly after I joined the program. She is a busy woman, and I think we all figured she would put our needs last on her agenda, but Karen proved to me that time is relative.

She has three little kids, all well-adjusted and involved in their own sports and activities. Her husband has an equally high profile career and they don't have a nanny. But somehow, she was able to meet with us whenever we needed her. She counseled, mothered and taught us until we became doctors.

After residency, Karen and I became colleagues when I joined faculty. I watched her handle departmental dramas and marveled at how she quietly but swiftly worked her projects through the bureaucracy. She spent time with her patients and they were devoted to her. She lectured, published and kept up with relevant research. She had plenty of non-medical interests and activities and kept up with non-medical friends. And she never apologized for being a devoted and attentive mom.

When I decided academia wasn't for me, Karen blessed my departure. We don't talk much anymore, but I know her office door is always open should I need to talk, cry or laugh.

Learning Lessons and Lessons Learned

Son, born eight weeks early, spent the first four weeks of his life in the NICU. When he came home, I had to consider his prematurity when looking at his motor development. Some things that happened late, like sitting, standing and crawling, were OK when adjusted for his prematurity. Other milestones were relatively early when adjusted, but some were just plain off the chart delayed (eating solids, for example).

Daughter, on the other hand, is a healthy full-term infant and she is waking up.

Now two days shy of six weeks, she smiles. Usually this happens in her sleep and it is fleeting at best. Occasionally, I catch her smiling when looking at someone or something, but when I call someone over to see it, the smile disappears. She doesn't have a responsive smile yet, but it is so beautiful when it accidentally happens. You may call it gas, but her "gas face" is decidedly unhappy.

She can push her head up when on her tummy and when she is on her back she rolls almost onto her side.

If she could, she'd be held 24/7. She balks at the swing and bouncy chair, but after she cries a bit she seems to realize, "Hey, I like this!" Mama loves the swing and bouncy chair so she can get things accomplished around the house check e-mail and blog.

This morning, at Son's ophthalmology appointment, she picked up on my tension as Son wasn't 100% cooperative with the exam. I picked my screaming daughter up from her carseat and held her against my chest as I willed myself to relax. I felt us both melt into each other and, as we both grew calm, so did Son.

The doctor told us his exotropia is gone and his astigmatism is improved. She said we can reduce the patching to 3 days per week. I realized I was upset not that Son wasn't a perfectly behaved preschooler, but that he might have a vision deficit.

I still have numerous mothering lessons to learn, and this baby of mine is going to help me along the way. I wish I'd had the maturity to realize when Son was teaching me his own lessons. In hindsight, there were many.

Med school, schmool. I'm getting the best education in human development from mommyhood experience.

*cross-posted at Fat Doctor.

Boys and Girls

So we have a girl now. And they are different than boys. With Son, I'd just lift up the penis and wipe up any poop on it.

With Daughter, poop gets mashed in between the labia, and I'm entirely freaked out using the wipes on such a sensitive area. And what if I inadvertently shove some fecal matter into her urethra? The state may not allow me to complete this adoption if I were to cause UTIs.

Husband laughs because I've had all this fancy training and I can't change a diaper.

To tell the truth, I've never been much into newborns, but this kid is special. She's mine.

We are having a stellar holiday season thus far. I hope your families are enjoying this season, too.

Voice

I used to have a lovely voice. I thought so, at least.

On Facebook, many friends I meet again from my high school and college days ask if I'm still singing.

Well, yes.

"What's gonna work? TEAMWORK!" (I loves me some Wonder Pets).

And let's not forget the Mail Song from Blue's Clues.

But here's the kicker. Son doesn't appreciate my musical stylings. He actually shushes me when I sing along. I'm crushed.

I thought myself brilliant once. But I'd take the role of mama over broadway star any day.

Years from Now

Dear Fat Medical Student,

You worry too much. It's gotten you this far, but enough is enough.

Years from now, it won't matter if you get a 92% instead of a 100% on an exam. You won't care if a resident thinks you are lazy for wanting to leave just two hours late. You won't even remember your step one score, but you'll remember the hangover from the celebration upon passing the test. Years from now, your patients will love you because you care. They won't care if you don't know all of the answers as long as you know how to find them.

You'll be a family doctor, a combination of all of your "favorites"...internal medicine, pediatrics, obstetrics/gynecology and psychiatry. You'll know a little about a lot of problems but not a whole lot about any of them. You will be comfortable referring to specialists. People will tell you their deepest secrets and will care about your opinion. Don't let them down.

Years from now, a lot of your "hero" teachers will seem emotionally immature to you once they are your colleagues. You'll watch them be cruel to ancillary staff, students, their families and, heartbreakingly, some patients. You'll feel superior to them in all ways other than raw knowledge. Don't put them on a pedestal until you are sure they deserve it.

Don't be so desperate to find a mate now. You will marry your best friend and have happy children. You'll see.

Years from now, you'll be sorry you quit walking the dogs when you got a fenced yard. You'll regret those drug-rep bagels, too. Stop when you are 15 pounds overweight and you'll never be 140 pounds overweight.

You will hurt many patients...not with malice but with honest mistakes, misjudgments and quirky fate. Decide now how you will handle it so it doesn't kill you. You'll cry about these circumstances because you are a good person, but don't let the bad outcomes make you jumpy.

Years from now, you won't care about money because you'll have some. Save for retirement and live below your means. Your loan payments will be a small part of your overall salary because you borrowed wisely.

Years from now, you'll find yourself wanting to snap at people in "ordinary" life. Practice now how to manage fatigue so you don't become an ass. Medical students will turn to you for a kind word or emotional support and you should give it. Always.

You'll be glad you spent time with your nieces and nephews even when finding time was difficult because the children make your life whole. Invest love in them and it shall be returned when you are back in diapers.

Years from now, you'll be a generally happy person. Of course, you'll wonder what might have been in you hadn't chosen medicine. You'll consider chucking it all and going to cosmetology school. Don't let your mind go there. On the day when you decide you are in the wrong career, a patient will tell you that they credit you for helping change his or her life. It will feel good.

Enjoy the success...it's what you wanted.

XOXO,

Future Fat Doctor

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.

Regular Mom

Son is asleep on the couch next to me...couldn't make it through the presidential candidate debate. I know I should move him to bed, but I love the warmth of his feet pressed against my leg.

Last night, he woke up with growing pains. My mom is staying over to help me while Husband is frolicking in Europe attending an important business meeting. She slept next to him in his bed and tried to help him. His screaming "Mama! Mama!" woke me.

I gave him some ibuprofen, then put him in my bed and tried my best to comfort him. I rubbed his legs and sang songs. Twenty minutes later, he was asleep.

I had growing pains, and I know that's what Son was experiencing, but the doctor in me went wild thinking of more unlikely, and scary, causes of leg pain. Osteosarcoma. Rheumatoid arthritis. Leukemia.

I realized, after an hour of stewing, that I would have those fears even if I weren't a physician. It's a maternal impulse to fear the worst. I'm just a regular mom.

Big Fat Time Savers!

1. Buy pre-cooked food at the grocery store deli. More expensive, but your time is worth it.
2. Lay out clothes for self and kid before going to bed. Good theory, and when I do it I'm really happy.
3. Tape a "don't forget" note to the door before bed, i.e. "don't forget bagels for a..m. meeting."
4. Hire a housekeeper to come in once a week to do floors, dusting, etc. Even if she or he is lousy, it's probably better than you could do some weeks.
5. Take Detrol-LA. Save time on those pesky potty breaks.
6. Keep your emergency pickup kid people on call. If I know I have a late meeting on Wednesday and Husband is out of town, I call around on Tuesday for someone to be on call just in case. Put these numbers on your speed dial.
7. Take your lunch or at least get it to go...sneak into the nurse's breakroom with a stack of charts and eat while charting.
8. When people offer to help you, take them up on it.
9. Brush your teeth in the shower while conditioning your hair.
10. Marry the right mate...a co-parent, co-shopper, partner in all things domestic.
    

Normal Incompetence

This blog is useful. Yes indeedy. Because all of you, I'm sure, will understand the emotion behind this post.

I can run a code. I could, if forced to, put in a chest tube, intubate, throw in a central line. I've delivered over 100 babies and I've taken care of countless numbers of people in the ICU. I can and do coordinate the care of patients when they are circling the drain. I can and do make life and death decisions every single day.

But put me in the room with my 4-year-old and I'm weak. He throws a tantrum (or eight) and I break. I yell. I threaten. I have no control over him, and no control over myself. I've never hurt him, but that's because I put myself in time out when things get really bad.

Yes, I occasionally lock myself in the bathroom to get away from my son.

Today, while sitting on the toilet in my locked bathroom, I thought, "What am I doing bringing another child into our family?"

_______________________________

After I typed the above, my phone rang. It was my adoption coordinator. I think perhaps God dialed the phone for her. I told her about my day and my feeling of utter incompetence. And then I wept on the phone with this woman who has the power to make our adoption happen or not.

She said I'm normal. She said she's glad to hear that I'm scared and feeling overwhelmed. The adoptive parents who have it all together, she said, terrify her. Like the mother I want to be, she soothed me with her kind words and lifted my spirits.

I'm normal. Incompetent, but normal.

So I went to peek in on Son, who is asleep in my bed. Angelic. I lay next to him and he snuggled in, his hot breath brushing against my neck.

And as I type the second half of this post, I'm starting to feel better.

Normal, if you will.

Backfired

Years ago, I heard my sister tell her then 2-year-old son that she was 'so excited' to go to work. I questioned her motive behind that statement, as I knew she would rather spend time with him.

"I don't want him to think I would ever leave him to do something I don't like," she said. "If he believes I love going to the hospital, it won't hurt him as much when I walk out the door."

Now that I, too, am a mother, I see the logic in her little white lie.

A few days ago, Son was quite upset when I left him at preschool to go across the street to my own hospital. I stooped down so I was at his level and explained to him that going to work was fun for mommy, that sometimes I need to have fun like he needs to have fun.

Today, we are staying home. I told Son our plan to meet our friends (a nurse I work with and her son, who is in Son's preschool class) for a picnic in the park. I suggested it would be fun for us both.

"No, Mama," he said sternly. "You go to work to have fun," he explained. "The park is not fun for you."

Sigh.

I guess I need to rethink that line.

FMLA Guilt

A birth mom chose us. We don't know the baby's gender. It was so easy, really fell into place with minimal effort (but a lot of stress) on our parts.

How to plan our FMLA has been a nightmare. If she goes early, the following will have to be adjusted.

She is due 12/3, but it is a planned section, so we think she'll probably be scheduled at 38 or 39-ish weeks and her state is half the country away from ours. If we are lucky, they'll deliver her 11/24, the Monday before Thanksgiving. I'm off from 11/24 through Wed 12/3 and then start a week of nights on 12/4. We have to stay in the state of the birth for 7-14 days for legal shenanigans before we could bring the baby home. I could, if need be, fly back a.m. of 12/4 if we still aren't allowed to leave the state and leave Husband there with the kids (pleural...neato!).

We think Husband, whose job is in accreditation, will work from home in December, something he is able to do in around the holidays. I will go ahead and work through my current schedule, which is set through January 4th, then take eight weeks of FMLA.

Why, as an adoptive mother, do I feel guilt for taking FMLA? If they were to cut this baby out of my own uterus, I wouln't think it extraordinary to stay with the baby for awhile. I haven't gotten a lot of flack for it at work, but the discomfort I feel is totally self-inflicted.

As Mothers in Medicine, sometimes we have to be better, stronger, faster than our colleagues to avoid being judged. And sometimes, we do it for ourselves, as in, "Look at me. I'm still a good doctor even though I have a new baby."

Meanwhile, please pray this goes through. The birth mom is mature and intelligent and already has three children, but we know this could go wrong anytime, even after the baby has been born.

Isn't it amazing that we could be so attached to a person we've not met, who hasn't even been born, who isn't our blood relative?

Love is amazing.

Control Freak and the Uncontrollable Birth

Son on his birthday...already beautiful (if you squint)

At the end of my second trimester, I was a senior resident and transitioned into the chief resident role. Our program had 30 residents, and I took the job seriously. I prided myself on never calling in sick. As I oriented the new first years, I gave them the same advice my chief gave to me on day one: If you are not an inpatient in the hospital, you are not sick.

At 31 and 3 days, I had a headache and was short of breath. I was in clinic, so I took my blood pressure at about 8:30 and it was high. Really high. As a doctor, I knew I should talk to my own doc, who also happened to be my residency director and was down the hall in her own clinic, but I had patients to see.

If you are not an inpatient in the hospital, you are not sick. I pushed through, knowing I could rest during the didactic session planned for all of the afternoon.

During the didactic session, I became more and more dyspneic, even while sitting still. Panic, I thought, and I willed myself to calm down. I wondered if I would make it to the second week of October for my due date. It's because I'm fat, I thought, cursing myself for intentionally getting pregnant at 280 pounds.

After the lectures, at about 4 p.m., I found my residency director and told her about my symptoms and my a.m. blood pressure. She got out a cuff, sat me down and took it herself. It was the same as in the morning, 220/110.

She put me in a wheelchair and sent me directly to L&D for admission, where I insisted on writing my own admission orders. Stupid, but I'm a control freak and writing orders was something I could control.

The BP had improved somewhat by the time I got to L&D. My doc consulted the perinatologist, who examined me and ordered a biophysical profile. The score was OK, so he recommended a 24h urine, a renal consult (I'd been seeing them as an outpatient), steroids and aggressive BP control. No mag yet, he said.

August 7, 2004, day three of my hospitalization. The BPP was not good, and a followup doppler ultrasound showed that the blood that should go toward the fetus was actually reversing flow. The perinatologist recommended c-section right away. I asked if an induced vaginal birth would be OK. He actually laughed.

This is not what I had planned! I'd planned an epidural and a beautiful vaginal, family-centered birth experience in October.

My favorite OB senior resident did the surgery, and my favorite family med intern (who happened to be on her gyn month) assisted. My husband must have wanted to die, but he sat calmly at my side, stroking my face, telling me he loved me.

When they briefly showed him to me on his way to the isolette, he seemed bigger than I'd expected. I heard his cry and immediately gave a prayer of thanks. Two hours later, I got to hold him in the NICU. He was 3 pounds 7 ounces and doing well on a CPAP.

Back in my room, I developed four beat clonus and got to experience mag sulfate for 24 hours. Yeah. That sucked, but now as much as not being able to see my kid.

Husband stayed with the baby and visited me every now and then to give me updates and share the digital camera with me so I could see my boy. Mom and my mother-in-law, both RNs, provided personal bedside nursing.

Another senior resident came and physically removed my beeper from the room. "Don't worry about us," she said. "We'll be fine." And they were...turns out they didn't need me at all. Go figure. And here I thought I was the center of the universe.

I went home on day three, then went with Husband to the NICU every day, 7 a.m. to 9 p.m., to care for our new son. He was a "feeder-grower" and never required intubation, antibiotics or other special care. Sister went nightly at 9 p.m. to rock him and feed him until midnight. On day 28, he came home.

His birth, while scary at the time, is the best thing that ever happened to us. Next week he'll be 4. He's still beautiful... and now bright, funny and well-adjusted. There is not a day of his life that I would trade for anything.

My Insanity

This post is a direct response to RH+'s post last week about her sanity. I commented that I'm jealous, but I think this sentiment deserves its own post.

I am jealous, jealous, jealous. Green with envy. Coveting my neighbor's stay-at-home-dad of a husband.

When we were engaged, Husband told me he would stay home when the children came. Then Son came, and Husband backed out of the deal, claiming his ego couldn't handle it. I, and everyone who knows Husband, agrees he would be the best stay-at-home dad ever (no intended disrespect to Mr. RH+). He loves to cook, he loves to engage Son with learning experiences, he loves to plan little outings with him, he prides himself on countering my general messiness with some order in the home.

When we discuss this, and we often do, he tells me that since Son is enrolled in preschool, he doesn't see the use of staying home. Au contraire, mon fraire. Here are my arguments:

1. You do all the shopping anyway.
   
2. You keep the house running anyway.
   
3. You are Son's primary parent.
4. We hope to soon add a second child.
   
5. Even though Son goes to school, the chaos of his before and after school life when you travel is bad for him.
   
6. We can easily adapt to having one salary.
7. You will keep the church, which is your true vocation.
   
8. How about stay-at-home doctoral candidate? Does that sound better for your ego?
9. I can't go on like this.
10. I'm slowly going insane.
    

So, while it seems all about me (like everything else in my life), don't you agree he'd be happier being a stay-at-home dad/husband?

I'm fairly sure he doesn't read this blog. But just in case, could y'all leave some encouragement for him in the comment section? Pretty please?

Yep, I'm selfish. I know, I know.

Married White Female Seeking Wife

Burning the candle at both ends is dangerous...eventually you get burned. I slathered Silvadene all over my ego and am feeling somewhat better.

Intellectually, I realize that I'm trying to do too much - mother, wife, blogger, beader, friend, teacher, physician. I can't do any of it well.

Something had to go. I gave up my scheduled lectures to the medical students. Yes, I'll miss it, but it's one "extra" that I could easily shave off the to-do list. I'll still have first and second years working with me now and then, so it'll keep me connected to the university.

Meanwhile, the house is a disaster. When I get home, I'm too tired to tackle the piles of stuff everywhere.

My colleague said it best: I need a wife. Do you think Husband would mind?

Mommy of the Year

Husband is out of town. The person who said she would be on call to pick Son up if I had to work late forgot and made other plans. So after calling half the world and not finding anyone at home or on mobile phones, I decided to pick him up from daycare and bring him back to the hospital. After all, I had only two patients left to see, and both were "easy."

First we went to the cafeteria, where I let him pick out his own dinner, which we put in a to-go container. Next we stopped at the gift shop and bought a coloring book and crayons. We then went to the telemetry unit, where Son was an angel. He sat at a desk eating and coloring while I saw a patient.

Next, and this is where I question my sanity, I decided he was so good on the telemetry unit that I could take him up to the mental health unit. One patient. One easy patient. And nothing ever happens there.

After asking the charge nurse if it was OK, I parked him at a desk in the nursing station and got him all settled in with his crayons. I kissed his cheek and told him I'd be right back.

And then it happened in a flash.

A wild man, twenty-something, ran out down the hall screaming, "I'll kill you all!" Nurses surrounded him but he was very, very strong. Security guards appeared out of nowhere and tackled him.

Needless to say, Son didn't need to see that. I was nuts to think he'd be OK up there. So I got him outside and we sat at a picnic table and waited for PaniniFreak to come get him. And then I went back for my one easy patient. Funny, that patient wasn't so easy, after all.

At home, I asked Son if he had been scared by that man yelling. He seemed to not know what I was talking about.

Mommy of the year I'm not.