I Get To...

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

I Get To:

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

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

Warming up in Wednesday gym class

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

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

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

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

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

What did you "get to" do today?

Mandatory meeting...CHILDCARE PROVIDED

I have posted before about how much I love my job.  I am honored to work with so many amazing people.  Quite recently a revolutionary change has occurred for our late departmental meetings…childcare is provided (as well as dinner).  Such a simple offering means SO much. These special surgeon kid playtimes are now one of the highlights of my daughter’s social calendar!

Below I have posted (with permission) the beautiful and inspiring blog post of our amazing Clerkship Coordinator after the first childcare night. I am so proud of us.  I am so proud of who my daughter (the 6 year old described below) is becoming.  I am proud of this department, of my profession and the future that we are creating for our girls as Mothers in Medicine…

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From the blog of JP -

When I was a kid, about 25 years ago, I overheard my mother repeating a riddle that had been told to her. In short, a young boy and his father were in a car accident. The father died immediately upon impact. The boy was rushed to the hospital. Once in the OR, the surgeon stands over the boy and simply declares, "I cannot operate on this child. He is my son." So the riddle goes, if the father was killed in the accident, how on Earth is this possible? Keep in mind, the riddle is at least 25 years old.

I listened as folks stumbled over themselves with the most absurd answers, "The dad hadn’t really died." "The surgeon was the boy’s step-father!" "The father was not his biological one and the surgeon must have been the boy’s sperm donor." The answers came and went and when the person finally threw their hands up in defeat, the person telling the riddle simply replied, "It was the Mom! The boy's mother was the surgeon!" Gasped responses immediately followed; these gasps were made as if to imply extreme bewilderment that a woman, A MOTHER, could be a surgeon. Nonetheless, the folks on the receiving end of the riddle felt embarrassed for not offering the most overlooked obvious answer even if they could not fathom a female with a scalpel.

Fast forward 25 years, I just spent my evening at work doing arts and crafts with two children of surgeon faculty members so that said parents could engage in an after-hours faculty meeting.  I brought all of my craft items from home so the young girls could make various winter holiday crafts. At one point I noticed one of the girls (6 in age) was making a gingerbread man. I quickly praised her on her great artistry, "Hey! That’s a great gingerbread man!" I pointed out. "That's not a gingerbread man!" she quickly declared. I was caught completely off guard. Y'all. I'm telling you. It was a gingerbread man!  Before I could ask her what it was (since I was so offensively incorrect), she proudly exclaimed, "It’s a gingerbread GIRL!" Immediately, a grin washed over my face. I'd only met this child within the hour. Our time was consumed with learning each other's nicknames, teacher's names and favorite colors. Feminism 101 had yet to make it to our arts and crafts agenda. I wanted to high five her. I wanted to spin around in circles and dance giddily in only the way excited 6 year old girls do. But instead, I nodded, and told her it was the most amazing gingerbread girl I'd ever seen.

Within the next hour, the other little girl (8 in age) casually announced that she was creating a top hat for her snow woman. SNOW WOMAN! Did I hear her correctly? Snow woman!! Yes! And she'd said so, so nonchalantly. It's as if Frosty the Snowman wasn't the first... the only...the standard! “Every snowwoman needs a top hat!” I replied.

If I'd told that 25 year old riddle, now, to both of these young girls, they would have quickly and without hesitation answered that the boy's surgeon was obviously his mother. I am confident of this.

It was in that moment, and for the rest of the evening, I stood proud; proud of the progress women had made in the last 25-30 years. Proud to have been able to witness, in my lifetime, such dramatic change, albeit long overdue and with still so much progress yet to be had. I was proud to be a female working in surgery education. I was proud to work for a team with so many female surgeons. I was proud to work under the leadership of a successful woman, whom not only was a General Surgeon, but also the Program Director of the General Surgery Residency program.  I was proud to work for and with a group of smart and successful women who greatly value their profession and equally, their role as a mother. I was proud that these young girls were exemplifying everything I’d known to be true as a child, but always felt so disconnected with. Perception was no longer reality. The reality had finally become perception! These mothers, these brilliant successful female surgeons, they are paving the way for the next generation of gingerbread girls and snow women to achieve greatness.

This is how we lift each other up. We create an environment in which we welcome one another's children so that we and they grow enlightened, encouraged, educated, inspired and excited by possibilities. We embrace the difficult balance. My God, the balance is difficult. We dispose of the box that which we were placed in and we become assertive in our ideas of becoming both brilliant and successful professionals as well as invested mothers. And it doesn't just begin and end with women, my friends. We must embrace our professional fathers as well! We are only as good as our counterparts. Our strengths are magnified when we surround ourselves with other strong, confident and supportive human beings.

I am grateful to be able to contribute to their (our) mission.

Childcare Options for Doctor-Moms

Genmedmom here.

Childcare is such a huge issue for working parents. It can be so expensive, and it is so important. With me in outpatient primary care and my husband traveling for his work pretty frequently, we needed to figure it out.

Thankfully, we have my mom who lives close by and provides the bulk of childcare for our little ones. We have also used daycare, as well as nanny services, both to give her a break and to provide socialization for our kids.

Family help is the best, but it can't always work, for many reasons. Daycare has the advantage of providing key socialization, as well as building relationships with other working parents, a bonus that I didn't realize would be until it was. However, if we didn't have my mom to pick up our kids at the end of the day, we'd be pretty miserable. It probably wouldn't work at all.

I found nannies to be the most difficult. It was almost a part-time job to find a decent nanny, even with Care.com. And, they weren't always decent. Plus, that option can be very expensive, prohibitively so. Upwards of twenty dollars an hour in the Boston area, for a nanny with experience.

Other docs have written about au pairs, and that options sounds wonderful, but one has to have a place for the person to sleep, and we just never had that. It's a small house, barely enough room for us and the two kids. Au pair, sadly, was never a possibility for us.

What childcare options have worked best for others?

[Watching our friends get] Married... with [our] Children

Let's bring the boys to the wedding, we said.

It will be fun, we said.

We were so cocky. Bean had been to several weddings and loved to dance, we reasoned. And Teeny, though young, was just so chill that it wouldn't be a big deal. An outdoor, afternoon wedding of a laid-back couple with tons of family medicine and pediatrics residents in attendance. It would be like a weekend away without needing to pay for a baby-sitter. What could be more perfect?

We rented a house through Airbnb so that we would have plenty of space and the boys would have their own rooms. We beat traffic on the way there and spent the next morning exploring the cute town. We stumbled upon a farmers' market and ate ice cream for lunch. The boys even went down for a pre-wedding nap.

On the way to the wedding, we talked about how we would need to be very quiet. (We had no illusions that we would actually sit down for the ceremony, but planned to watch from a safe distance.) As we rounded the side of the beautiful inn where the festivities were being held, the bride was just starting to walk down the grassy aisle to the strumming of a guitar. Bean pointed to the musician and began shouting, "Man playing 'tar!!!!!"

We retreated. A staff member inside kindly pointed out a large picture window overlooking the lawn where we could watch without disrupting things.

At that point Teeny let us know that he was hungry, so I settled into an armchair in the corner to nurse him. My husband headed to the window with Bean, but there was a problem: the parlor of the inn was filled with so many nice things and Bean needed to investigate all of them. There was a large birdcage containing actual birds and a stone fireplace and so many trays of seashells and trinkets and shiny objects. In other words, it was a room we had no business entering.

"We really need to rethink whether we bring the boys to weddings," my husband noted a few minutes later in a tone that struck me as irritable, though he adamantly denies having felt annoyed. I sighed and internally (or maybe externally) rolled my eyes. We were in another state and the celebration that we had traveled here to attend had just begun. There could be no second thoughts.

As soon as Teeny had finished nursing, my husband pounced. "My turn to hold him!" he exclaimed, which was code for it's your turn to chase the toddler. But Bean was in great spirits, happily occupied by tracing the contours of the stone fireplace with the car key that my husband had handed him to play with. I relaxed a bit and began to really take in the gorgeous setting. On the other side of the fireplace, I noticed a basket filled with books and a plush stuffed lobster. As Bean began to edge too close to the hurricane jars lining the hearth, I lifted him up, intending to plop him down by the [unbreakable] lobster. While in the air, he started to protest: "Hold key! Hold key! Hold key!"

Which is what he says when he wants to hold something that he is not holding.

I looked down at his empty hands. "Key? Where's the key, Bean?" I asked in an urgent whisper, not wanting my husband to hear. "Bean, what did you do with the key?"

"Hold key!!" he wailed, and I left his side, hurricane jars be damned, to retrace my steps, scouring the floor.

"What does he mean, 'hold key'?" my husband asked, because of course he was right there and had heard and now realized the predicament.

"Don't worry, I'm sure it's here - " CRASH!!!!!! 

I spun around, expecting to find my family covered in shards of glass. My husband, with Teeny in his arms, had sprung to action trying to find the key, but in doing so had knocked over an end table. An end table that had held a glass dish of beautiful, fragile seashells.

Of course that was the moment that the inn's manager entered the room.

"I'm so sorry! We're so sorry!" my husband yelled, frantically gathering shells in one hand while cradling Teeny in his other arm. 

"Hold key! Hold key!" Bean continued to wail.

"Just let us know how much we owe," my husband huffed, still scrambling to scoop bits up off the floor. "And also, we're missing a car key."

Outside, the ceremony came to a close. The bridal party and guests began to make their way back up the lawn toward the inn. Having already crawled along the floor to peer under the couch, I stood up and spied the key nestled behind a throw pillow. Somehow the glass and shells and whatever else were picked up off the floor. My husband and I gathered our things and, each taking a child, stepped out onto the back porch where guests were now mingling over cocktails. In the kind of frustrated yet silent agreement that comes from more than a decade and a half as a couple, we parted ways, each joining a separate section of the throng.  

By the time dinner started, Teeny was napping contentedly on my shoulder and Bean had begun to make his presence known on the dance floor. We had caught up with old friends and made new introductions around the table. And for the rest of the night, our family was happy and smiling.

I had thought that some time would need to pass before we could speak of - and certainly before we could laugh about - the scene at the inn. But as he pulled our car out of the parking lot at the end of the night (well, the end of the night for a family with small children), my husband grinned. "Well that will make quite a story."

Since that time, I have referred to it as "The Wedding Where We Almost Got Divorced," though he swears it was never that serious and he was never that annoyed. And as for bringing the boys to weddings? We haven't done it again. 

At least not yet.

The DC public school lottery struggle is real!

I will paraphrase my mommy friend C when she said “we literally have spent hundreds of hours on this”.

We moved back to DC June 2015 and since then have spent hours and hours touring and talking about schools. My husband O and I are both products of public education - we know it has many challenges and limitations but we are both committed to having our son Zo in a public school that all children have access to. We were extremely blessed in North Carolina to find our outstanding Spanish-immersion daycare. We never ever ever worried about him while he was there. We hope things will work out with public school, but thankfully being a doctor-mom, private school is a viable option.

WHAT WE ARE WORKING WITH:

Flash forward to public school in DC and we have had issues with lack of supervision in the bathroom for the preschoolers, lack of vision, organization, and communication from the administration, teachers who rely too heavily on strict discipline and quiet, homework for preschoolers, and the disorganized and understaffed aftercare that we promptly pulled him out of. What we have loved about Zo’s school - that he really likes it, the Principal Mr. L (he is truly wonderful, so committed to the students and parents), meeting wonderful families and making new friends, the beautiful playground, being a Parent-Teacher Organization parent (I feel like I’m becoming my mom every time I attend a meeting), and the overwhelming majority of his teachers.

MOVING FORWARD:

In early April we find out the results of this year’s lottery. For those who don’t know about DC public schools - there are public schools and separate public charter schools. Some participate in the common lottery and others have separate application processes. All super confusing and overwhelming unless you live in an awesome neighborhood with in-bound preference which we don’t. We based our rankings on a private session with Educational Consultant EV Downey (I still shake my head writing this cuz’ who thought you’d need to pay someone to figure out where to send your kindergartener but I quickly realized there were way too many schools I didn’t know about and I am all about tapping into my resources so we went ahead and paid her and it was well worth it), hours and hours spent touring schools in our preferred neighborhoods, countless conversations with each other, friends, and school administrators. There are so many different schools. So many different neighborhoods (drop off process and location is of prime importance in DC), school buildings with very diverse architecture, philosophies, discipline plans, and aftercare programs. So many different “vibes”.

A few of my favorites (in alphabetic order):

- Capital City, a well-established charter school with the most perfect natural outdoor space and great reputation. Too far out of our preferred neighborhoods, but if I could it would have been in my top three

- DC Bilingual, a well-established Spanish-immersion charter school. In a really nice building, but they might have to find a new site next year. Ranked low for us as not knowing where the school building will be was a deal-breaker for us.

- Mundo Verde, a Spanish-immersion charter school focused on environmental justice and study of world cultures. We love their vision.

- Two Rivers, we preferred the Young Campus as its closer to our preferred neighborhoods and O really liked the Principal

- Tyler, a public school with a Spanish-immersion and arts program that O loved

- Van Ness, newly renovated and reopened public school in Navy Yard (prettiest public school I’ve ever seen though in need of a new playground; which I hear is in the works)

Going to the Doctor

Recently, I took Blur2 to the doctor. He’d been having a diaper rash for weeks. Initially, it started out like any other rash and my usual treatment (40% zinc oxide) worked. But weeks later, it was worsening and my treatment wasn’t working like it should if it was a typical diaper rash. So we went to our doctor.

I love my/our doctor (and the whole office) but I hate going for these minor ailments. As an ED doc, I knew what the next step was likely an antifungal cream; as a Mom, I didn’t want to be treating my own kid. Some of my colleagues and doctor friends would have just called in their own prescription. I feel dumb sitting there, telling the story, just really wanting reassurance. I do have a small supply of medications and laceration repair supplies at home for minor things; we don’t go for every URI/fever/etc but when things aren’t going how I expect, we go to the doctor. When Blur2 went through ear infection after ear infection, I kept hauling him into the doctor, to get them all documented because I was afraid he was going to need tubes - he ultimately did.

We have a separate Pediatric Emergency Department that is staffed by Peds EM and plain EM doctors. I do about 20% of my shifts there and most of them on the overnight shifts. I remind myself of my feelings that I have sitting in my own pediatrician’s office and teach my residents that the parents are often just looking for reassurance - that this fever is a virus, that this GI bug will pass, that this rash is not a serious rash, that the simple closed head injury does not need a CT scan - and guidance as to what to look out for next that would mean something serious.

I got my reassurance and prescription for an antifungal cream. And I feel better and so does Blur2.

When do you take your kid to the doctor? What’s your threshold? What do you take from your personal healthcare experience and add to your practice?

See you in a month, Itty!

A couple of weeks ago, my husband, N, and I found out that we both started our intern year in the MICU.  We soon realized that this meant that we would almost never be able to pick our daughter up or drop her off at daycare. Considering it would be her first month ever in daycare, we were stressed!  Nanny interviews commenced, and we tried to ignore the impending financial doom that our first month with a paycheck would bring (due to the high cost of nannies). 

Soon thereafter, my mother-in-law suggested that we take our daughter, Itty, back home to spend the month with grandparents, aunts, and uncles.  Just for reference, we moved 15 hours away from “home, home” a month ago, and we have no family nearby.  Initially, I was resistant to the idea, as I couldn’t imagine a month without my Itty, but we eventually decided that it was probably the best idea for everyone.  Itty would get to see her extended family, who previously provided all childcare for her, and N and I would have a month to focus on our new roles at physicians.

She’s been gone for 4 days now.  While I was very sad during the first couple of days, I’m now realizing what a great idea it was.  Grandparents are happy, Itty is happy (at least for now, she doesn’t miss us too much), and we do not have to worry about her at all during a stressful day at the hospital.  I had forgotten what it was like to not have to think about picking her up, feeding her dinner, giving her a bath, getting her ready for bed, and putting her in bed.  Not to mention the middle of the night awakenings that still seem to happen although she is almost two years old.  Once you have a child, it is difficult to remember life without one.  

Part of me almost feels badly that I’m enjoying this “me” time so much.  I miss her tremendously but also feel that a significant burden has been lifted, at least temporarily.  Has anyone ever done anything similar?  This is probably the only time that we will ever send Itty away for a whole month, so does anyone have any childcare tips if we are ever in a similar situation again?  We were so worried about having multiple new caregivers in such a short period of time, especially with the limited amount of time that she would be able to see us anyway.  I can’t tell you how many times I’ve asked myself, “How are we going to do this?  What did we get ourselves into?  Why did we move so far from our families?”.  However, I’m confident we’ll figure it out, little by little, with a lot of help from others (hint, hint!).

On another note, I was a physician today :)  Crazy!

Hurtling toward the next phase

I have searched but I cannot find the flying trapeze story I read a few years ago that explains my life, so I’ll paraphrase and add to it here:

I swing back and forth preparing for my next take off. I have prepared, but I know that this leap is longer and more challenging than ever before. In spite of a long line of successful jumps, there have been some near-misses, some full on misses, some blood, scrapes and even some still healing deeper wounds. This time I jump, my husband is watching and waiting readying himself for his jump into dissertation land and as we prepare Zo waits by ready to take off with us.

Well MiM friends, it’s official, I have accepted a position as a Pediatrician in my dream clinic. I’ll be back in DC working at an academic center-affiliated community clinic. I did my community pediatrics rotation there as a medical student and so many of my respected supervisors and medical school friends are still there.

Interviews were a whirlwind. I met so many nice people, got lost countless times, learned even more about what I need, want, and will compromise on.  

And now onto school finding. Every day I have a mini-freak out when I think about Little Zo starting pre-k. Our cherubic toddler has been replaced by an almost 4 year old hilariously funny and extremely sweet rib-protruding knock-kneed ball of energy. And then I freak out more about making pick up and drop off work and I pray so intensely that we find the right environment for him and that we will find balance so I can rock my boards and O can finish his dissertation expeditiously. I wish I could transplant his daycare to DC.

And house hunting on a single income in a very tight housing market is not my favorite thing to do but I guess house hunting without the beloved Property Brothers will always be lackluster. We have several leads on promising houses and are heading up next weekend prepared to make an offer. Can’t wait to have our first home secured and then on to do-it-yourself projects for years to come.

This jump seems epic. Push-pull-push-pull, forward backward forward backward, take off.

I'm too old for vacation care!

It's arrived.  The 12.5 year old boy child who already thinks he's 22 and in charge of his own life. Occasional glimpses of my sweet, tender, gentle boy peek out between the lashes of the billy goat gruff.  Sigh, always knew it was coming, still a shock when it's here!

 My problem, however, is not BGG, for I know it too will pass.  It's actually vacation care.  Entering high school next year, vacation care no longer exists!  The problem is, not only does he have a 9 year old sister, who will still require vacation care, but I actually think he's too young to be spending vacation days at home alone.  All that unsupervised internet at the very least.  He wouldn't be allowed out of the house, so I'm not so worried about his wandering the neighbourhood, although it's a slippery slope, and I'm sure it wouldn't be long before "Mum my can't I meet my friends at the wherever?"  The other issue of course is little girl then feels hard done by, if BGG is allowed to stay home, and she has to go to vacation care.  Another Mum at my work faces the same dilemma - her eldest is a girl, and she has two younger siblings.  Her daughter is already telling her she's too old to go to vacation care - at least my son hasn't cottoned on to that just yet, but I know it's coming (I wonder if I can still sneak him into vacation care with my daughter?)

I know many have trodden the boards before me - what does one do when vacation care disappears?
Or are the apron strings too tight?

Vacation care is an Australian version, I think, of Summer Camp - run by the YMCA (and other places), for days when school is not on, and held Monday to Friday of all school holidays (breaks?).  It's for ages up to 12 years and held at your child's school.  It's day care only, dropping off each morning, picking up each evening.  

Daycare better than me?

Last year, when I was on call a lot and very busy at work, I couldn't get enough time with my babe.  I always wanted more, more, more.  And I still feel that way--about the time I spend with her.  But lately, I've been feeling like I just don't do enough.  When I'm home, I sometimes just want to relax--I don't always want to be doing educational activities, or practicing walking, or force-feeding her.  Sometimes I just want to be at home with her and I don't want the work that comes with it!

But because we now have a nanny who does not provide much educational content during the day, when I get home I feel that I need to do more with her.  And because she is home all day, it's always up to me to provide healthy nutritious meals that are variable enough for her that she actually wants to eat them.  I frequently don't feel that I do a good job in either of the above aspects and I wonder if I would be better off sending her to a daycare where she is exposed to learning and a variety of food and time to play outside and when we get home, we can just spend time together and cuddle and kiss and love.

I know now for a fact that if I was a stay at home mom, I would not be a good one.  I just don't have the energy it takes to provide my Doll with all that she needs!  I'm grateful for my job, and I always want more TIME with my baby, but I just want it to be quality time where I'm not stressed with her.

Does anything I'm saying make any sense?

Nanny Search??

My husband and I recently decided that daycare is no longer a good fit for our daughter, for many reasons.  We are now starting to look for a nanny.  I am reaching out to the MiM community to see if anyone could give any words of wisdom on finding a good nanny??  I have signed up for care.com, but there are so many nannies available and I can't figure out how to weed out the good from the bad!

Also, if anyone has used a nanny cam, can you recommend a good brand?

ALSO, if anyone has a good idea for keeping personal items safe within the home, how would they recommend I do so? (I assume get a safe? But curious if anyone has any other ideas.)

Thanks!!!

Hot (Scheduling) Mess

There has been a lot written lately about work-life balance. In a session with my Therapist last week, she laughed and said “you’re a Resident, for this last year of residency, I really just want you to survive!” We spent the remainder of our session coming up with ways that I can pay people to do things I don’t have the time to do. And she made me promise to work harder to eat better, sleep more, and exercise more; my turn to laugh. Next week, our family will be trying out a week of made-from-scratch meals from a local organic market while I finish a busy week of nights. And we are looking for a second cleaning person after the first one proved to be a bad fit with our family.

Scheduling time away from work for things like research, board exams, and doctors appointments is an exceedingly stressful aspect of my life. Because we get our schedules pretty late, I try my best to email the our Scheduling Attending and Chiefs at least several months before I think I’ll need time off. Nevertheless, I sometimes get my schedule and there are conflicts and then I have to forward back my original email requesting time off and the hot-scheduling-mess begins.

Last year, when I took my Step 3, I emailed the Scheduling Attending and waited so long for a response that the dates kept filling up. I had to extend my eligibility period and finally had to use research time to take the test. I have heard countless stories from other Residents recounting their shared experiences (many have to use vacation time) and how stressful it is to try to do things you have to do.

This year, my son will be spending my last Intensive Care Unit month with his grandparents while my husband is away doing research. He will spend the first 3 weeks with my parents, but once their vacation time is used up, he’ll spend an additional week with my in-laws. At the suggestion of my husband, I emailed the scheduling Attending and requested off a single day and offered to make it up during my vacation.

I feel guilty that we need our parents to watch him. I feel guilty that I asked for a schedule change. However, it would have been a very stressful and traumatizing experience for all of us if I tried to travel, get Zo acclimated, and get myself ready for life without my family for a whole month in 2 days. And then to make me feel even worse, I get an email saying that the Scheduling Attending talked to my Residency Director and my Clinic Attending and she would like to know if I really need that extra day off. They understand my unique situation but they want to double-check before they reschedule me.

As I began to stifle my tears, my husband came over to rub my back. I explained my distress and he reiterated that even though it’s hard, I have to ask for what I need. He reminded me to not feel bad and that “it’s the culture” of medicine that makes it difficult for folks to realize that what we are asking for is not unheard of.

After taking a break, I responded that yes I do need the day, that I would personally call the 2 patients I have scheduled, and that I again would be more than willing to make it up using a vacation day.

Thus ends this installment of my hot-scheduling-mess until the response email. Dunnn dunnn dunnnnnnnnnnn.

Involved, but not quite a “Lunch Lady”

Today was my first day volunteering at Zo’s daycare. He attends a quaint Spanish-immersion daycare and we love it! My husband and I can’t say enough about the amazing ladies who run the daycare. The children are loved and now Zo knows more Spanish than both of his parents.

I grew up with a stay-at-home mother who volunteered at my school all of the time. Much to my chagrin, for a short while in elementary school she was a “Lunch Lady”. I never really realized just how much it shaped me to have my mother around so much. I may have complained in the moment, but knowing that she was around gave me a sense of stability that has truly shaped who I am.

Flash forward to today, as I sit during a “stay-cation” (not nearly as much fun as Cutter’s "Best Week Ever"), I am working on IRB revisions, completing training modules, a case report, and ordering interview dinner food, all while getting over a fierce upper respiratory infection. In the midst of the many moving parts in my life, I volunteered at Zo’s school today and it was SOO MUCH FUN, here’s how it went:

When I arrived at the agreed-upon 10am, Zo’s eyes lit up and he proudly told every toddler who tried to hug me “this MY mommy”. His teachers began singing a song in Spanish about cleaning up and getting into a circle and 85% of the children obliged. I then pulled out Zo’s favorite dinosaur pop up book “Dino Roar”. The kids, and especially Zo, loved it and we all growled and pointed at interesting pictures. At around 10:35am their amazing music teacher Miss K came in for their weekly music class! She led the toddlers in activities involving drums and little shakers. We danced and clapped our hands and she even reviewed some music composition with them. When she left, I read another of Zo’s favorite books about loving others called “One Love”. When it was time to leave as they prepared for lunch and nap time, Zo cried and I almost shed a tear.

I truly felt like the involved mother I some day hope to be. In a busy day, I incorporated Zo-time, me-time, professional time, and later in the day family dinner time. Far from my mother’s lunch lady days, I hope to maximize my available time and be present in my children’s away-from-home lives as much as possible. It truly was food for my soul.

On having an au pair

After doing daycare/preschool exclusively for a time (when we only had my daughter), a live-out nanny, and a live-in nanny at various times, we went the au pair route 1 1/2 years ago and couldn't be happier. It's just what our family needs right now. I wish I had known more about it earlier on, since it may have made life easier and richer back then. People may have had different experiences, but here's ours.

We've had two au pairs so far, and both turned out to be great matches for our family. The matching process reminds me a little of residency matching, but without the rank list. You search through au pair profiles, filtering by what's important to your particular family (maybe a strong driver or experience with taking care of multiple children or a particular religion), can read a "personal statement," watch a video they made to tell you more about themselves, scan their letters of recommendation, and their childcare experience. You can select  au pairs to interview (via Skype generally) and have a certain amount of time to render a decision whether you want to match with the au pair. The au pair must accept the match as well, and you agree on an arrival date.  It was a bit unnerving to select our au pairs, not knowing exactly how it would turn out in the end - would she like living with us? Would we like living with her? How would she be with the kids? Like residency matching, you go a lot by feel of a program and projected fit.

What we didn't anticipate was how much our au pairs would be like family to us. They have launched out on their own, excited to see the US - everything is new. You are their host mom and dad, and it does feel a little like that - parental and guiding, showing them the ropes and helping them have a good experience in a new country. Our au pairs have been from Mexico and Brazil; we've learned about their countries. Last year, I made a Mexican Christmas dinner with our au pair at the time N; this year Brazilian.

N was with us for only 6 months. This is not typical. The contract is for a year. However, N's family needed her back home; a family member was ill so she had to break her end of the contract and our au pair company arranged for us to match with someone new. M, from Brazil, has been with us for almost a year. We love her. The kids love her. She loves being here. She's extended her contract for an additional year (the maximum possible) which is great news. There's a ramp up period of about a month when they first arrive for driving lessons, figuring out routines, roles, etc, so having her want to stay longer is a huge plus. Meanwhile, we keep in touch with N who writes me occasionally and updates me on her career and relationships. She's getting married next year and has invited our family to Mexico for it. It's kind of like a mentor/mentee relationship.

In November, M's mom and her mom's friend came to visit, stay with us and travel. They were here for an entire month. This included a trip for the "Brazilians" as my husband and I nicknamed the trio, to Europe for 9 days and a weekend trip to NYC, but otherwise our house was full of warmth and Portuguese  for the remainder. It seems kind of crazy that we had all of these people in our house, but to tell you the truth, it was really nice to have them here. They are such sweet, wonderful people who were the perfect house guests. They made dinner for us all a few nights. We miss them.

An au pair's hours have certain restrictions; they can provide a maximum of 45 hours per week. With our youngest in half-day preschool, this gives us a chance to have a date night each week or coverage on the occasional weekend day I have to work. She picks up the kids from school, drives them to their swim lessons, gets them bathed. We juggle the days and hours when there is an unexpected snow day or sick day. That flexibility has been key. You have to have space for an au pair to have his/her own room and be okay with someone living with you.

I remember one day, during M's first months, she was Skyping with her family in our living room. Her family - her mom, dad, brother, and brother's girlfriend were all there on the screen saying hi to our kids. I looked over at the screen to find all of her family members on the computer screen with their two hands forming the shape of a heart on their chests, and my children mirroring them on our side. I thought:  this is such a good thing.

I drove M's mom and her mom's friend to the airport when they left; I hadn't realized the impression we left on them. They vowed that they would start some traditions back home since they enjoyed them so much while they were here: having wine with dinner each night and listening to classical music. And even though they said their thanks solely in Portuguese, I saw in their eyes what they meant.

We started a tradition last year of including N in our Christmas card photo with the family. This year's card has us all sitting on our local high school bleachers, each of the three kids on our laps - me, my husband and M. This will help us remember the years when our family was a little bit bigger. M cried when she saw the card for the first time, to be included. We couldn't imagine it differently.