Wednesday, October 29, 2008
Dr Unicorn
(Fortunately, like RH+'s post, I was able to get time off for Halloween, because you've just gotta go to that pre-school costume parade!)
Tuesday, October 28, 2008
Mommy Awards
"You did it! CONGRATULATIONS! World's Best Cup of Coffee! Great job everybody! It's great to be here." -Will Ferrell as Buddy the Elf in Elf
One thing's certain: I won't be getting any "World's Best Mom" awards any time soon. "World's Most Embarrassing Mom," maybe - we're getting to that age.
Some people might even wonder - ESPECIALLY if you scour the American Academy of Pediatrics recommendations, or talk to parenting-book authors/readers - how conscientious I could possibly be as a physician when one considers that I have, at various times in the past,
-occasionally co-slept with my kids when they were babies (right in line, I must interject, with, like, 90% of the rest of the world's cultures)
-used Disney's Fantasia and the like as a babysitter when I had to cook dinner
-let my kids jump on backyard trampolines
-let my kids eat raw cookie dough
-skipped back-to-school night
-let them eat apple pie for breakfast (just once - and it was homemade and yummy and we all did it)
-made them memorize their times tables BEFORE explaining multiplication conceptually
-been physically and emotionally unavailable to them due to an excess of call
-let their father take them through a carnival house-of-horrors when they were WAY too little to laugh it off
-been way too permissive about TV-watching and video games/Wii playing
-missed some performances / special days
-failed to nurse at least one of them for the recommended period of time
-used phrases like "Because I said so" and "Don't do that"
-taken them out of school for trips
-required them to stick with certain academic or extracurricular activities against their wishes
-been impatient and snappish when tired or preoccupied
-let them eat a sickening amount of Halloween candy all at once.
Then I think, all those nitpicky little recommendations in the books and guidelines are nice, but they're not gonna make or break our parenting "success." I was sitting around comparing notes on the subject with some colleagues once when I was a resident.
"I watched TV all the time when I was a kid, " said one. "Violent stuff, too - martial arts movies and everything."
"We didn't even own a TV," said another
"We only ate food from local growers."
"We subsisted on chips and soda."
"I read TONS when I was younger."
"I barely read anything before college."
"And look - we all ended up in the same place, with 'M.D.' after our names, being fairly good people, for the most part, right?" someone finally pointed out.
That one conversation enabled me to avoid beating myself up too hard for all my faults and failings. Here's my bottom line: my kids are happy. They are healthy. They are curious. They have a sense of wonder. In general, they are kind. They read lots. They ask lots of questions. They know we expect them to work hard for their learning, to do not just "good enough" work but their best work always, and to accept the fact that they can't have every material thing they want. They have an abundance of what they need, and much more besides.
Most important, when they see our faces greeting theirs, they see us light up at the sight of them. They know they are immeasurably loved. They know we intend to be there for them no matter what.
And despite all those years of medical training, we have family memories to cherish. A brass band concert heard from a picnic blanket one balmy July night. Making s'mores in the wood stove one New Year's Eve. Dressing up as a medieval family with a Power Ranger to trick-or-treat one Halloween. Stolen moments, when I was either post-call or, miracle of miracles, actually off duty. Precious, warm, treasured moments.
So when the kids run to the door exclaiming "Mommy!" and throw their arms around me in big bear hugs every time I arrive home from work, or come home after a long night of call, I take heart. I may not be the world's best mom, or the world's best doc, for that matter, but I've had more than my share of the world's best moments.
Monday, October 27, 2008
EXERCISE AT 4AM??
Seriously, I wanna know...
Sunday, October 26, 2008
"But aren't you a doctor?"
In residency, you become even more specialized. No more prostate exams or interpretation of peak spirometry tests for me! Of course, that doesn't keep people from asking you medical questions to which they think you should know the answer. Why do I hear rushing in my ears when I lay down? (I'm no ENT, but, um, probably just your blood circulating?) Could you tell me what this rash is? (I'm no dermatologist, but I'll bet if you put hydrocortisone cream on it, it will go away!) I'll never forget the day that Mr. Whoo and I were witnesses to a pretty bad car accident my intern year, and as we pulled over, I panicked "What am I going to do, check their *cervix*?" (Everyone was ok, thankfully, and neither my meager first aid/BLS skills nor my advanced cervical checking skills were needed.)
In the same vein, I still find myself overwhelmed with uncertainty when it comes to medical knowledge about my children. In fact, I am certain that my kids have been to the pediatrician more in their young lives than most kids are in all of childhood. I can't help it. It is the best example of a little knowledge being extremely detrimental. A high fever? What if it isn't just a virus? What if they have MRSA that I brought home from the hospital? Bean isn't wanting to bear weight on his leg after a fall? What if it is a bone sarcoma?? This week I had Bean to the pediatrician for a freaking cold. Even though my pediatrician is too kind to say it, I'm sure she is thinking, "Um, hello? Aren't you a doctor, too?" Are my diagnostic skills so shoddy that I cannot distinguish between a common cold and pneumonia? I guess, when it comes to my children, they are. Ever since I became a mother, I am better able to understand why physicians should not even attempt to treat their own family members. Not only are we too emotionally involved with the outcome of their care, those very same emotions cloud what little medical prowess we may have. Do you find your medical education a help or a hindrance when caring for your family?
Saturday, October 25, 2008
The Best Nest
I’ve been here over three years now, so the newness has worn off, still I feel really blessed to have found such a good fit. Sure, we have our moments but for the most part we get along. We genuinely respect each other personally and professionally. I know I can count on my partners if I have a bad hemorrhage in the middle of the night and need a second set of hands in the OR. More importantly, I can also count on them if I need some one to talk too.
We hired a new office manager recently, who came to us from a cardiology group. The first time one of us cancelled office to go to our child’s preschool play she looked at us like we we’re crazy. She has quickly learned that our families take top priority and that is our office culture. Our walls are plastered with pictures of the babies that we’ve delivered as well as pictures of our own families. We often gush on and on with stories of our children. Because we can. My patients who I haven’t seen in awhile will always ask about my son and what he’s up to now. I ‘m a doctor. A good doctor. But being a mom is a huge part of who I am as well.
Recent good question, “How do all those women get along?”
Answer: “fine most of the time”
Truth: Two medical assistants once got into a screaming match in the hallway over salad dressing (don’t ask).
Recent stupid question, “ Four ‘lady’ doctors in the same office…. Hmmmm… do you all cycle at the same time?”
Answer: “What the *&$#%^??????”
Truth: No.
So, as I prepared for Halloween next week, I realized that it was a Friday (our busiest day). I asked the receptionist to block any openings in my schedule. “Honey, we already blocked the afternoon, to get everybody home in time to take the kids trick or treating.”
Wow. I really do have the best nest.
Friday, October 24, 2008
Me Too
Thursday, October 23, 2008
Generation M--what would Abraham Lincoln say?
I have to say that I love multitasking. On the one hand, I resent being so busy that I have to do 4 things at once to have any chance of getting a solid night's sleep. Kind of. The truth is, though, that I love that feeling of productivity, knocking 5 items off my To Do List simultaneously during my commute, getting a day's worth of errands done in one big sweeping geographic circle with no backtracking and no dead time. I might even be addicted to it. I suspect that many physicians share this perverse enjoyment of multitasking, and if it wasn't in their blood when they started med school, it certainly has been beaten into them by the time they finish their internship. Add to that parenting as a physician (or maybe parenting period), and it's easy to see how multitasking gets reinforced in all of us. We multitask, we get rewarded, we multitask more, we get rewarded more.
So, I'm not the only one addicted to multitasking and thinking about it. NPR apparently can't get enough of it, either. They have had 3 stories about it in the month of October. And they are alarming. One segment reported that multitasking on a cell phone while driving reduced reaction time and driver attention to a degree similar to driving while intoxicated. Another talked about the results of functional brain imaging showing that we really don't multitask even if we think we do. We just switch quickly from one task or thought to another and back. But, in so doing, we really cause a kind of "brown out" in our brains. The electricity doesn't go out entirely, but it dims noticeably, enough to be an irritation to those in the environment. In one experiment, a highly accomplished professional musician was noted to make several mistakes while playing familiar pieces of music if asked to perform simple mathematical calculations in his head simultaneously. There were several other experiments, all with similar results.
Once I began paying attention, I realized that it was true; I really wasn't keeping all the balls in the air, as I thought. I was remembering to gather up the overdue library books and a shirt to return to the mall as I dashed out the door to my physical therapy appointment, which is on the same road as the library and the mall, but I was leaving the house without my car keys, then my wallet, then the library books, then the receipt, rushing back to the front door over and over. I was dealing breakfast dishes onto the table like cards in Vegas and unloading the dishwasher and throwing the laundry into the dryer and packing up my breast pump and absentmindedly putting a halt to the sibling bickering at the table, but I wasn't really listening to the kids or even noticing anything around me. I was missing a golden 10 minutes of making a real connection with my kids in the morning, hearing them say something goofy or precocious that would bring me joy repeatedly over the course of a long workday, or (God forbid!) eating breakfast while not in a vehicle. I had come up with creative questions for patients whose answers would provide multiple essential bits of history and also serve as ice-breakers or social chit-chat, but I wasn't really engaged in the process. I was missing the body language and the pauses. I was always one step ahead, trying to pick up a few minutes here or there because I was so overcommitted. I was being a mechanic, diagnosing and fixing a problem, instead of a doctor.
So, what's the message here, and where is Abe Lincoln going to come into the picture since this post is nearing its end? I haven't stopped multitasking. Sometimes I have to do it. Sometimes we all do. But I have stopped multitasking without thinking about it, and I've realized that we really don't have to do it all of the time to get by. In order to stop multitasking 24/7, I have also had to stop saying yes to everything and everyone, including myself. I just acknowledged that I couldn't do it all anymore--it's too much with 3 kids and 2 physicians in our family of 5--took a deep breath and felt relieved. And so, as Abe said: You can please all of the people some of the time, and you can please some of the people all of the time, but you can't please all of the people all of the time. Amen!
Wednesday, October 22, 2008
MiM Mailbag
Hi ladies!
I'm a fourth year medical student and planning on going into Family Medicine. Thankfully, I think that this is a pretty family-friendly specialty, but right now I'm trying to figure out how children might be worked in for me over the next few years. This past June, I had a miscarriage at 9 wks (had that baby not miscarried, I would be around 6.5 months right now, and would have been due in Jan.) I thought that this would be the perfect set-up, go into residency with a 6 month old. Obviously, (wo)men make plans and the gods laugh. But now, I am having this feeling of being dead-set on getting pregnant, and not having anything man-made (ie residency) interfere with my husband and I being able to have a child (hopefully) within the next year. That means that I would possibly be having a baby during intern year. So mostly, I have a few questions:
Am I crazy in thinking that intern year and newborn are doable?
Should I just take a year off if I get pregnant within the next few months?
I'm getting ready to start interviews, like, soon....should I bring up these issues at the interviews?
Any advice is appreciated, honestly.
Thanks,
A medical student
Monday, October 20, 2008
Future babies
Considering I've still yet to finish residency and then will possibly do a fellowship and likely my first real job will not be a permanent one, I worry a lot about having to make a job switch while pregnant. Is there anything more unpleasant than having to tell your new employer that you're X weeks pregnant and will be taking Y weeks of maternity leave in the near future? Surprise! Bet you didn't notice that during the interview, did you? Of course not, or else you never would have hired me!
(A sad truth: my pregnant friends had to dress very creatively during their residency interviews.)
I already had the pleasure of being three months pregnant going into residency, so I'm not looking forward to explaining another baby bulge to a new employer someday. I'm hoping I have the luxury of being at a job for at least a year before the stork pays my uterus another visit (that's how it happens, right??). Long enough for people to maybe get to like me before they grow to resent me.
Or maybe I'll find a job where the people I work with will actually be happy for me and not just congratulating me through gritted teeth. A magical job in Happyland in a gumdrop hospital on Lollipop Lane.
Of course, with the economy being the way it is, maybe I'll luck out and be unemployed for the next 5-6 years.
Notes from the Parents' Axuiliary
Now the dynamics have changed. Yesterday for me was “Take Your Mother to Work Day.” I volunteered in the campaign office where my daughter is an organizer. She put me through the training program with focus and poise. When I brought back my tallies, she patiently corrected my work, with generous dollops of humor and tact. To my surprise, I found that I am a Jill-come-lately to the mothers’ auxiliary of this campaign. Many other volunteers had brought parents to work with them. It wasn’t cute, like having kids in your cubicle, but it was a statement of loyalty and closeness that warmed my heart.
I guess I should not be surprised to follow rather than lead. My husband dragged me from the world of WhiteOut and erasable bond into the computer age, but it was the children who introduced me to Hogwarts, the internet (from which they still must still untangle me from time to time), and, eventually, to the worlds of opera, competitive ballroom dancing, and now voter organization. Lately, I have even tried to develop some enthusiasm for math and computer science. My daughter has been kind about it.
At one time, my sphere as a parent seemed narrow—medicine was my window into the world outside. A doctor’s experience is both wider and more circumscribed than many. We are involved with people that most others in our social class never see. They are always on our turf, however, and we too often meet them with their clothes off and with the richness of their experience cloaked in a veil of illness.
As the girls grow past college, the time they seemed farthest away, I am entering a wonderful phase of parenthood. My adult children bring back the broad horizons I once had, offering me opportunities to visit and live in worlds beyond my office and the hospital. To see them working, to engage in conversations in which they are the experts, and I the novice—these things bring intense satisfaction that mothers of young children can only dream about. Dream on, sisters, the day will come.
And did I mention that my daughter does a great job at her job?
Wednesday, October 15, 2008
Helloween
Once upon a time I dreaded his weekend plus away. My children were young, and with one less parent to supervise them on the weekend, mayhem would always ensue. Single parenting brings out my latent attention deficit disorder as two children, pets, and household compete for my undivided focus. One year my youngest decided to take a bath in my stand-up shower by blocking the drain. He sat happily in the bottom playing with boats and legos in one inch of water. I ran downstairs to grab his towel out of the dryer and noticed that the ceiling fan in the family room had suddenly become an upside down sprinkler – spraying water over the entire room as it trickled down the arm of the fan. I dove for the switch so as not to electrocute us all, and ran upstairs to investigate. The shower was overflowing – tsunami style – onto the floor above the family room as youngest continued to splash and enjoy himself.
Somehow, events that happen while husband is away never happen while he is home. In late July, husband went to visit his best friend in Indiana. During his four day leave of absence, the golden retriever (child #3) decided to do laps in the new pool in the backyard. The fur from the hairy beast clogged the filter as I tried to vacuum the bumper crop of hickory nuts squirrels were lobbing into the water. Upon his return, Husband’s pool expertise solved the mystery of why it took three hours of minimal suction to clean the nuts off the bottom of the pool.
Water seems to be a constant theme to husband’s weekends away – whether it is both children having an unintended water gun fight in 50 degree weather or leaking roof from torrential rains. Experience has improved my outlook on Helloween. I know that Husband will return recharged (hung-over). Most small crises are survivable, and the boys and I can do things that we wouldn’t ordinarily do with dad home – like have a sleepover on the sleeper sofa in front of the fire place. The boys get undiluted mom time, and I look forward to the adventures we have together.
I also look forward to my own me-time. That’s the deal. Husband gets his weekend and I get mine. So in a couple of weeks I’m taking off for a writing conference in Massachusetts –deep immersion into words, character, plot, and all things bookish. In the past, I’ve done beach weekends with the girls, a polymer clay retreat with my mom, bead shows and a solo writing conference to see favorite author, Sue Monk Kidd. These weekends are sanity-savers, a time to pursue who I am besides mom, spouse and physician (not necessarily in that order), so I understand Husband’s enthusiasm for his Helloween crew. So while my crock-pot is my domestic secret weapon, personal retreats – solo or with friends are my trick and treat for self preservation.
Monday, October 13, 2008
My kids hate me (and I'm sure it's because I work)
Last week was bad. My head was spinning after trying to compensate for short staffing at work. Then not only my son, but my 3-year-old daughter starts in on me. She throws a fit, gets in trouble, and has to go to her room without stories that night. I go in to talk to her. Through her tears, she tells me point blank that she 1) doesn't love me and 2) wishes I would die (!). I told her "you don't mean that." Of course, she says "yes I do!!"
I told her I wasn't going to let her be mean to me, and I retired to my bedroom, where I promptly burst into tears. I told my husband "ss-ss-ssophie s-s-said she...she wanted me to DIE..." Friday night is not a good night for anything emotionally taxing to happen to me.
As I said, I know there must be kids who don't say these kind of things to their parents. Which makes me think, "what am I doing wrong?" Bingo-I am a full-time career woman! Of course my kids hate me, how could they not? Maybe I shouldn't work, then my kids would be awesome to me and really appreciate me all the time.
As soon as that thought crossed my mind, I realized how ludicrous it sounded. My kids will hate me (at times) no matter what. I'm not naive enough to think that spending more time with them will make them hate me any less; I may just be around for them to express that to me more often! Pathology may be a thankless job at times, but being a mom is in a thankless league of its own!!
I told a friend Saturday that what surprised me most about being a mom was not the work involved, but how ugly the ugly times could get. And I had to screw up my courage to write this post, because it is really hard to admit how awful your own kids can be sometimes. Those of you who read this will belong to one of two camps: those who have, either by virtue of their much younger or infinitely better behaved children, are aghast at the events above; or those who read this, laugh, and say "oh yeah, sister, been there! In fact, that's the tip of the darn iceberg!!"
Wednesday, October 8, 2008
Weaning guilt
It is killing me. Nightly.
What kills me more is what happens when I dutifully trudge back downstairs to the kitchen to fix him a bottle of expressed milk and give him the bottle.
Party time.
He grabs the bottle with both hands, shoves it in his mouth, and proceeds to twist and fondle the bottle like he has just been reunited with his best friend. He slaps it with one hand. Giddily moves it from side to side. He drains it, then.
I should be happy, right? He is providing a prime opportunity for me to finally wean him, just as I planned months ago. Six months was my goal. Nine months was my reach. I'm under doctor's orders to stop at 9 months (osteopenia, long story). He is a champ at eating solids and is very close to walking. But, even though the time appears to have come, I still don't feel ready.
Last night, I searched "nursing strikes" to reassure myself that this new rejection was due to him actively teething (hello bite bruises up and down my arms) and yes, the articles reassured me that nursing strikes happen for all kinds of reasons. (My bruises suggest teething, or perhaps my involuntary screaming when he bit me last week was poorly received.) They also emphasized the transient nature of these strikes and to push through.
In my internet searching, I also came across many sites that basically pounded The Guilt into me for even contemplating weaning before 12 months. About how no child would self-wean before 12 months, possibly not before 18 months. They talked about earlier weaning would only be for Mom's benefit (read: you are a selfish hog) and could result in less secure children. They said that mothers often misinterpret a nursing strike or normal developmental changes in the child to mean that they are becoming disinterested in nursing (read: you are ignorant and should not be allowed to procreate).
Poison in my eyes!
I thought of my 3-year old who I started weaning at 9 months during a very similar nursing strike. I remember feeling similarly sad and rejected, solemnly repeating the words, "It's the end of an era," to my husband and anyone else who would listen. Was I wrong then too?
Here, I was, thinking that I was almost deserving of a medal for working full-time, pumping 3 times a day to keep up, and downing Mother's Milk Tea every single day (I'm not a tea person, and definitely not a nasty tea person) to feed my son exclusively with breastmilk for 9 months. And then I read this article which makes extended nursing sound so beautiful and bonding that I'm left feeling inadequate.
I think it might be time. But, no one makes this easy.
Tuesday, October 7, 2008
First day of school
My father-in-law once told me (regarding parenting) to remember that we know better than them. (he said this as I was struggling to force antibiotics down)...but I often recall this phrase. I know that my 2yr old will enjoy and benefit from the socialization and learning she will get at school. And most days I'm sure that even if I was home I would want her to go to school for her sake...but then I'm not entirely sure I'm being objective.
I guess for now, I'll enjoy the moment, her excitement to go to school and hope that when I pick her up tomorrow she has a smile on her face because it will surely make it harder if she's not happy.