My kids have a book I love. It's called Zen Shorts, and it's just that: a series of short stories, each with a Zen message. (Note: we are not particularly religious in general and completely non-Buddhist, in case that matters to anyone.) One of these short stories includes a well-known parable from Zen Buddhism. It goes like this. A young monk and an elderly monk are walking along. They encounter a high-class woman stuck at one side of a big mud pit fretting about how she will get across. The elder monk picks her up, carries her across, and gently puts her down on the other side. She is quite unpleasant to both of them, complaining all the while, and never says a word of thanks. The elder monk walks on silently as he did before. The younger monk ruminates on what happened for the remainder of the afternoon as the two monks continue their journey, marveling at how the woman could be so rude and disrespectful and asking why the elder monk didn't just put her down. Finally the elder monk says, "I put her down hours ago. Why are you still carrying her?"
My kids love the book, so we read the story often, and I have a Eureka! moment every time. THAT is how I want to be, like the elder monk. I have to cultivate this Zen thing. No, wait, I know, even better: maybe I'll even BECOME A BUDDHIST!!!
But the sad reality is that I am SOOOO not Zen. I am the young monk. No...worse. I am the anti-Buddha.
I have an extraordinarily hard time letting anything and anyone go. I have a lifelong tendency to accumulate clutter in my house and office--not DSM-qualified hoarding or anything, but real clutter--and in my mind. The sad fact of life as an oncologist is that yes, there are many people we save, and yes, we've come a long way, especially in breast cancer which is my specialty, compared to 10 or 20 years ago, but we still lose a lot of people. I remember the name of every single patient who has ever died in my care--all of them, even my patients in the ICU as an intern--and, in most cases, the names of their spouse and kids and various random facts about them, too. I don't know if this is because I doubt myself and wonder whether I could or should have done something differently that might have saved them. Or if I actually have too much empathy for patients and families. Or if that's even possible. All I know is that I take every death very much to heart. And, as an oncologist, if you're still carrying patients long after you should have put them down, you are in for real trouble.
Although I suspect that most of the readers of this blog are in fields other than oncology where death is fortunately not a regular occurrence, I wonder if and how you put patients down once you have done your job of carrying them across. When you have made mistakes, do you let them go? If you have lost patients, can you put it behind you? And if so, how do you do it? I know we don't have a doctor-patient relationship, but, please, can someone prescribe me a little Zen?
Friday, February 6, 2009
Wednesday, February 4, 2009
After the tantrum
I go to lie down after dinner, not feeling so well. So, JP goes about the business of putting Jolie to bed alone.
I hear them in the bathroom right next to our room. The step stool dragging. Doors loudly shutting. (The baby!) Whining overtones drifting to my ears. Sounds of impending mutiny.
Crying. Her loud crying.
The sound of JP walking out into the hall and shutting the door, the momentary magnified cries suddenly muted several notches. I hear his voice, strained. His limit, reached.
I drag myself out of bed and into the harsh bathroom light where Jolie stands half-undressed and suddenly more pliant. I get her dressed, brushed and into bed. She is tired, I decide. Maybe it was that popsicle after dinner. Maybe it was JP and I, mostly talking to each other during dinner, hungrily catching up on each other's work day. Multifactorial, I conclude.
Our fault, probably.
So, I decide that tonight, for the "5 minutes" that I'll linger in her room with the lights out, I will curl up beside her. I rest my head on her pillow, 6 inches from her face. I drape my arm around her and she does the same. I observe my daughter, 6 inches away, taking in the half of her face not sunk into the pillow. It is a beautiful, less in focus half-face. She loves this closeness, I can tell. Repositioning her arm around me, touching my face. She is wildly in love with this closeness. At one point, she lifts up her head to touch me with her nose, then back down.
I am taken aback. I am taking it all in.
"Is it two minutes yet?"
"Yes."
"Mommy?"
I wait for the question.
"I love you."
"I love you too."
"I love you too."
She takes her ring finger and rubs it gently into her pillow. Then uses her finger to touch her lips gently tracing them with a familiar pattern. Back and forth. Top and bottom. Dabs pillow. Trace. She does this without words, as if by habit, and I see it. It's me. Putting on my lip balm from my tin. It's me.
I laugh.
"Are you putting on lip balm?"
She giggles.
We're both laughing now, one turn after another. She keeps tracing her lips. Back and forth. Top and bottom.
It is five minutes or six or seven and she hugs me with all of her might.
And, I think: I need to do this more. Yes, she needs it too.
I hear them in the bathroom right next to our room. The step stool dragging. Doors loudly shutting. (The baby!) Whining overtones drifting to my ears. Sounds of impending mutiny.
Crying. Her loud crying.
The sound of JP walking out into the hall and shutting the door, the momentary magnified cries suddenly muted several notches. I hear his voice, strained. His limit, reached.
I drag myself out of bed and into the harsh bathroom light where Jolie stands half-undressed and suddenly more pliant. I get her dressed, brushed and into bed. She is tired, I decide. Maybe it was that popsicle after dinner. Maybe it was JP and I, mostly talking to each other during dinner, hungrily catching up on each other's work day. Multifactorial, I conclude.
Our fault, probably.
So, I decide that tonight, for the "5 minutes" that I'll linger in her room with the lights out, I will curl up beside her. I rest my head on her pillow, 6 inches from her face. I drape my arm around her and she does the same. I observe my daughter, 6 inches away, taking in the half of her face not sunk into the pillow. It is a beautiful, less in focus half-face. She loves this closeness, I can tell. Repositioning her arm around me, touching my face. She is wildly in love with this closeness. At one point, she lifts up her head to touch me with her nose, then back down.
I am taken aback. I am taking it all in.
"Is it two minutes yet?"
"Yes."
"Mommy?"
I wait for the question.
"I love you."
"I love you too."
"I love you too."
She takes her ring finger and rubs it gently into her pillow. Then uses her finger to touch her lips gently tracing them with a familiar pattern. Back and forth. Top and bottom. Dabs pillow. Trace. She does this without words, as if by habit, and I see it. It's me. Putting on my lip balm from my tin. It's me.
I laugh.
"Are you putting on lip balm?"
She giggles.
We're both laughing now, one turn after another. She keeps tracing her lips. Back and forth. Top and bottom.
It is five minutes or six or seven and she hugs me with all of her might.
And, I think: I need to do this more. Yes, she needs it too.
Tuesday, February 3, 2009
Why is the sky blue?
I'm fortunate in that my daughter is not yet old enough to ask me any tough questions. The most complex interaction we have goes a little something like this:
Melly: "What's this?"
Me: "A butterfly."
Melly: "OH!"
Yes, I am the All Knowing All Powerful Mama.
My husband, however, is (unintentionally?) training me for the more complicated questions she might ask someday. He seems to go under the assumption that I know everything about the physiology of every animal. Some questions he's asked me recently:
"How long does a mouse live?"
"Where does lymph come from?"
"Would you still create poop if you didn't eat any food?"
(Yes, you read that right. My husband asked me this.)
He also has some very pointed questions about being a doctor, including:
"Why do you have to work 30 hours in a row?"
"Aren't you too tired to take care of patients after being up all night?"
"Why don't they just hire more residents and then you wouldn't have to work as many hours, right?"
Recently, he came across an article about how some huge percentage of doctors are unhappy with their careers and regret having gone to med school.
Husband: "If they regret it, why don't they just quit?"
Me: "It's not that simple."
Husband: "Why not?"
Me: "Well, the average med school tuition is more than $30,000 per year. With housing and other costs, you can end up borrowing at least $50,000 per year. So at the end of med school, when you're nearly a quarter of a million dollars in debt, you can't just quit right before your salary goes up. You're forced to continue, even if you're unhappy. You're locked in."
Husband: "My god, do people know about this?? You have to tell them!!"
Me: "I think they know."
Man, I am so much better at fielding questions about butterflies.
Melly: "What's this?"
Me: "A butterfly."
Melly: "OH!"
Yes, I am the All Knowing All Powerful Mama.
My husband, however, is (unintentionally?) training me for the more complicated questions she might ask someday. He seems to go under the assumption that I know everything about the physiology of every animal. Some questions he's asked me recently:
"How long does a mouse live?"
"Where does lymph come from?"
"Would you still create poop if you didn't eat any food?"
(Yes, you read that right. My husband asked me this.)
He also has some very pointed questions about being a doctor, including:
"Why do you have to work 30 hours in a row?"
"Aren't you too tired to take care of patients after being up all night?"
"Why don't they just hire more residents and then you wouldn't have to work as many hours, right?"
Recently, he came across an article about how some huge percentage of doctors are unhappy with their careers and regret having gone to med school.
Husband: "If they regret it, why don't they just quit?"
Me: "It's not that simple."
Husband: "Why not?"
Me: "Well, the average med school tuition is more than $30,000 per year. With housing and other costs, you can end up borrowing at least $50,000 per year. So at the end of med school, when you're nearly a quarter of a million dollars in debt, you can't just quit right before your salary goes up. You're forced to continue, even if you're unhappy. You're locked in."
Husband: "My god, do people know about this?? You have to tell them!!"
Me: "I think they know."
Man, I am so much better at fielding questions about butterflies.
Saturday, January 31, 2009
Obligation or not?
As physicians, we’re all aware of the frustrating “medical mystery.” These are the cases that initially look straight-forward, but then veer from the expected path when laboratory and/or imaging results fail to show the anticipated results. We do more digging, we sort through our text books, we perform internet searches. We reassess the patient; we comb through the history for something we’ve missed. Often, with diligence, we’ll find a piece of the puzzle that points us in the direction of a solution.
But what happens when that piece of the puzzle remains elusive? Where do we go? Most of us have a game plan for those cases that don’t seem to have any answers no matter where we turn. And often, our patients are satisfied with our attempts - even if no answer is found.
But what about the medical mystery that isn’t our patient – but the child of a friend or an acquaintance? What’s the best response when that friend asks for advice or an opinion? How much effort have you (or would you) expend in such a circumstance? I think that we’ve all expended some informal efforts regarding kids – an otoscopic evaluation here (a neighbor calls on a Sunday afternoon and wonders if a trip to the ER is warranted), a concussion assessment there (you’re at the playground and watch a child fall off the slide) – but what’s your comfort level regarding something that doesn’t seem to have an answer?
As with the mysteries mentioned above there many not be one specific answer (and certainly not a “right” or “wrong” response!), but I am interested in knowing your opinions when faced with this issue.
A
But what happens when that piece of the puzzle remains elusive? Where do we go? Most of us have a game plan for those cases that don’t seem to have any answers no matter where we turn. And often, our patients are satisfied with our attempts - even if no answer is found.
But what about the medical mystery that isn’t our patient – but the child of a friend or an acquaintance? What’s the best response when that friend asks for advice or an opinion? How much effort have you (or would you) expend in such a circumstance? I think that we’ve all expended some informal efforts regarding kids – an otoscopic evaluation here (a neighbor calls on a Sunday afternoon and wonders if a trip to the ER is warranted), a concussion assessment there (you’re at the playground and watch a child fall off the slide) – but what’s your comfort level regarding something that doesn’t seem to have an answer?
As with the mysteries mentioned above there many not be one specific answer (and certainly not a “right” or “wrong” response!), but I am interested in knowing your opinions when faced with this issue.
A
Friday, January 30, 2009
Boy's Club
Being a woman in medicine is not as difficult today as it was for our predecessors, but I'd venture to say that we still haven't gained true equality. My medical school class was the first class in school history to have an equal number of male and female students. The classes that followed ours actually were weighted in favor of more women than men. Yet, as I roam the halls of my hospital, I am acutely aware of how much of a "boy's club" still exists. There are small reminders in the physician's lounge areas of the surgical suites. The lounge attached to the female locker room is the "nurse's lounge." The lounge attached to the male locker room is the "doctor's lounge." In the hospital's general "doctor's lounge" there is a single restroom, in which the toilet seat is always left up.
In the operating room, invariably, it is my rooms that get the fresh new scrub techs that don't know a Kelly from a Heaney clamp, because they don't want to tick the male doctors off. My rooms also tend to run farther behind, "because (I) don't throw a fit." I'm sorry, since when was "throwing a fit" acceptable professional behavior? It happens more often than it should.
The reminders extend to the floor, as I round on my patients. At times I have to search high and low just to find the nurse that is taking care of my patient. I see my male colleagues, without lifting a finger, get a nurse to round with them. No kidding, these nurses, with whom I have a very good rapport and professional relationship, will snap to attention, grab the physician's charts, and follow them on rounds writing verbal orders as they go. Boggles the mind. I am friendly with the nurses, but in high stress times, I tend to bark orders just like any other physician. I have been called out for being "too harsh" in certain circumstances, and made to sit down with the nurse in question to apologize. I tread very carefully in my tone of voice, in order to not be misconstrued. In contrast, there was an incident in which a male physician grabbed a nurse and *shook* her because she did not complete an order that he requested (in the best interest of the patient.) Today that doctor and that nurse were laughing and joking together like it never happened. I have to wonder if I would even be working if I had dared pull such a stunt.
In the office, the fun continues, as my front office staff gives me hell for cancelling patients for a delivery, but will turn around in a heartbeat and croon "Aw, poor OtherDoc (my male colleague) has to go for a delivery. Of course we'll take care of it!" When the office orders lunch, they serve it to him in his office! You know, because he has "important doctor stuff to do!" Not to mention the varied and sundry insults that seem to happen on a daily basis. Patients that call me "sweetie" instead of *Dr.* Whoo or refer to me as "that nurse right there." Office patients that insist on calling me by my first name (which I never gave to them). The visitors that come up to me at the desk while I am working on charts to ask me to go fetch them some ice. This never happens to my male colleagues. It just doesn't.
We've all covered, in detail, how the difficulties extend into our home lives as we struggle to wear the mother, wife, and physician hats simultaneously. Women in medicine may have come a long way (baby), but from where I stand, we are the Thursday's children of medicine. We have far to go.
In the operating room, invariably, it is my rooms that get the fresh new scrub techs that don't know a Kelly from a Heaney clamp, because they don't want to tick the male doctors off. My rooms also tend to run farther behind, "because (I) don't throw a fit." I'm sorry, since when was "throwing a fit" acceptable professional behavior? It happens more often than it should.
The reminders extend to the floor, as I round on my patients. At times I have to search high and low just to find the nurse that is taking care of my patient. I see my male colleagues, without lifting a finger, get a nurse to round with them. No kidding, these nurses, with whom I have a very good rapport and professional relationship, will snap to attention, grab the physician's charts, and follow them on rounds writing verbal orders as they go. Boggles the mind. I am friendly with the nurses, but in high stress times, I tend to bark orders just like any other physician. I have been called out for being "too harsh" in certain circumstances, and made to sit down with the nurse in question to apologize. I tread very carefully in my tone of voice, in order to not be misconstrued. In contrast, there was an incident in which a male physician grabbed a nurse and *shook* her because she did not complete an order that he requested (in the best interest of the patient.) Today that doctor and that nurse were laughing and joking together like it never happened. I have to wonder if I would even be working if I had dared pull such a stunt.
In the office, the fun continues, as my front office staff gives me hell for cancelling patients for a delivery, but will turn around in a heartbeat and croon "Aw, poor OtherDoc (my male colleague) has to go for a delivery. Of course we'll take care of it!" When the office orders lunch, they serve it to him in his office! You know, because he has "important doctor stuff to do!" Not to mention the varied and sundry insults that seem to happen on a daily basis. Patients that call me "sweetie" instead of *Dr.* Whoo or refer to me as "that nurse right there." Office patients that insist on calling me by my first name (which I never gave to them). The visitors that come up to me at the desk while I am working on charts to ask me to go fetch them some ice. This never happens to my male colleagues. It just doesn't.
We've all covered, in detail, how the difficulties extend into our home lives as we struggle to wear the mother, wife, and physician hats simultaneously. Women in medicine may have come a long way (baby), but from where I stand, we are the Thursday's children of medicine. We have far to go.
Tuesday, January 27, 2009
Announcing our next Topic Day: Our Mentors
On Wednesday, February 11, we will have another Mothers in Medicine Topic Day, a day where we will feature posts on Our Mentors. Readers are welcome and encouraged to submit stories on this topic. Write about your mentor. The mentor you wish you had. The mentor who inspired you to do medicine / surgery/ research / be a physician-mother / be a better physician / volunteer / (fill in the blank). Share a funny mentor story. Anything related to this topic is game.
To join us, please send your stories to mothersinmedicine@gmail.com by Monday, February 9 to be included. We'll be scheduling posts to publish regularly throughout the day.
To see our previous Topic Days, click here.
To join us, please send your stories to mothersinmedicine@gmail.com by Monday, February 9 to be included. We'll be scheduling posts to publish regularly throughout the day.
To see our previous Topic Days, click here.
Monday, January 26, 2009
The Nanny Diaries
I watched The Nanny Diaries a few days ago. I really hate when stupid movies make me cry, but I couldn't help but shed a few tears when the child runs to the nanny for comfort instead of his own mother. Kind of struck close to home.
Of course, I'm not much like the upper east side moms in the movie who don't work but have a live-in nanny. I have a nanny because my husband and I both work full time. But that doesn't mean I don't feel guilty about leaving my daughter every day. Or become paranoid that she likes the nanny more than she likes me. We used to joke around that Melly liked our nanny best, then me, then my husband.
I returned to work from my maternity leave when Melly wasn't even two months old. I was forced to trust a complete stranger to watch my infant every day while I went to work. It all felt so pointless. Why did I have a child if I was just going to abandon her every day? This wasn't the way it was supposed to be.
The nanny was part of the reason I clung to breastfeeding as long as I did, even though my work didn't really allow me time to pump. I figured that was the one thing that only I could do for her.
As time passed, it became easier to leave my daughter every day. And thank goodness, Melly strongly prefers her parents to her nanny. (Even though our nanny is wonderful.) She cries when I leave but not when the nanny leaves.
Still, I can't help but feel a lot of guilt that someone is raising my child besides her mother.
Of course, I'm not much like the upper east side moms in the movie who don't work but have a live-in nanny. I have a nanny because my husband and I both work full time. But that doesn't mean I don't feel guilty about leaving my daughter every day. Or become paranoid that she likes the nanny more than she likes me. We used to joke around that Melly liked our nanny best, then me, then my husband.
I returned to work from my maternity leave when Melly wasn't even two months old. I was forced to trust a complete stranger to watch my infant every day while I went to work. It all felt so pointless. Why did I have a child if I was just going to abandon her every day? This wasn't the way it was supposed to be.
The nanny was part of the reason I clung to breastfeeding as long as I did, even though my work didn't really allow me time to pump. I figured that was the one thing that only I could do for her.
As time passed, it became easier to leave my daughter every day. And thank goodness, Melly strongly prefers her parents to her nanny. (Even though our nanny is wonderful.) She cries when I leave but not when the nanny leaves.
Still, I can't help but feel a lot of guilt that someone is raising my child besides her mother.
Sunday, January 25, 2009
For better or worse
Are you a better doc because you have kids? As a pediatrician, I am asked this quite often. By students, by patients, by patients' families, by trainees, by colleagues, by neighbors... I try to answer sincerely, but since I resist the notion that one isn't as good at being a pediatrician before having kids, I don't want to fallback on the easy answer that I'm "better" at it now that I have two darlings myself (having experienced breastfeeding, nursemaids elbow, sleep associations, febrile UTI, and the like). In some ways, because I want to rush home promptly if not early from work to be with my kids, and arrive late to work periodically when I practically never did so before I had kids, maybe (for these and other reasons) I'm worse! When asked, what do you say?
Friday, January 23, 2009
Five happiness-inducing habits
A few months ago the UK government's science and technology think tank Foresight concluded its Project on Mental Capital and Wellbeing.
The report includes an evidence-based list of five simple daily habits for mental wellbeing. These activities, which are likened to five daily servings of fruits and vegetables, are recommended to every person in the UK:
1. Connect with other people, be they family, friends, colleagues or neighbours.
2. Be active. Go for a run, walk around the block after dinner, putter in the garden or take the kids sledding.
3. Take notice. Be aware of the details of daily life - the beautiful, the humorous, the surprising. Be conscious of the world around you and your reactions to it.
4. Keep learning. Take a photography course. Learn to knit. Tackle a work problem in a different way.
5. Give. Show kindness to others. Volunteer. Support a charity. Donate blood.
2. Be active. Go for a run, walk around the block after dinner, putter in the garden or take the kids sledding.
3. Take notice. Be aware of the details of daily life - the beautiful, the humorous, the surprising. Be conscious of the world around you and your reactions to it.
4. Keep learning. Take a photography course. Learn to knit. Tackle a work problem in a different way.
5. Give. Show kindness to others. Volunteer. Support a charity. Donate blood.
The report, the result of a two year study involving over 400 international experts, concludes that making these five activities a part of daily life can have a profound impact on people's happiness.
These recommendations crystallized a few things for me.
First, they offer an explanation for why a day at the clinic is almost always extremely satisfying, whereas a day at home with the kids must be carefully crafted to provide close to the same level of happiness. I'm not talking about long-term gratification or blissful moments, where at-home mothering easily holds its own. I'm referring to my state of mind at dinner time, when I review the day.
Medicine has an advantage in that it inherently ensures that I connect with colleagues and patients, take notice of the details of others' lives, learn continuously and give to others. I tick off four of those five boxes just by going through my day. I check off all five when I hunt for free parking and walk eight blocks to the clinic.
Staying home with the kids, few of those five activities occur spontaneously. When the path of least resistance is followed, a length of time at home seems to naturally tend towards isolation, inactivity, monotony and boredom. Most of my days at home are pleasant ones, but only because of the work I put into making them so. Scavenging in the woods, photographing ruddy cheeks and muddy boots at the beach and meeting up with friends for afternoon tea at Honey's Doughnuts make for good days, but require concerted effort on my part.
Second, the list validates the time I take during the day for pleasurable pursuits. Knitting while the kids nap, bringing The Element of Lavishness
But I see that all of my hobbies include several of the five happiness-inducing habits: photography involves learning and taking notice; writing requires taking notice, connecting with others and learning; and gardening entails being active, learning and taking notice.
Now I can articulate why tucking away pockets of time for these activities during the day is not frivolous: it may quite literally preserve my sanity.
(This is a combination and reworking of two posts from my personal blog.)
Thursday, January 22, 2009
A Day Off
What do you do when you get a day off? I always imagine that families in which the mother isn't working weekends are always up to some great adventure. Taking the kids to the petting zoo, or picking berries on the farm, or just inventing clever games at home. You know what I want to do when I finally get a day off? Not a damn thing. I don't *want* to do anything. I want to sit. I want to veg out with a book or movies or my laptop. I don't want an itinerary or an adventure. I just want to be. So of course, then I feel incredibly guilty. Here I get a precious few hours with my darling children, who are growing up faster than I can believe, and I don't want to *do* anything with them.
How are my children going to remember me? Mommy, finally home from work, lying listlessly on the couch, book in one hand, computer near the other? This isn't how I want to be remembered. When I try to go and do kid-friendly activities, I find myself incredibly short tempered and longing for the comfort of home. I know that 4 days off a month is just too little down time, and things will get better once my job situation changes. In the meantime, what do you do with your little ones when you have the time to spend? Any suggestions for low key activities for 5 year olds and 18 month olds? I want to start making some good memories for my kids that don't involve the movie theater. Thank you in advance!
How are my children going to remember me? Mommy, finally home from work, lying listlessly on the couch, book in one hand, computer near the other? This isn't how I want to be remembered. When I try to go and do kid-friendly activities, I find myself incredibly short tempered and longing for the comfort of home. I know that 4 days off a month is just too little down time, and things will get better once my job situation changes. In the meantime, what do you do with your little ones when you have the time to spend? Any suggestions for low key activities for 5 year olds and 18 month olds? I want to start making some good memories for my kids that don't involve the movie theater. Thank you in advance!
Tuesday, January 20, 2009
Adoption Journey Part I
So today someone asked me the question I’d been dreading for quite awhile: “So, what’s your husband going to do in the fall when boy wonder starts kindergarten?’
A lump began to rise in my throat.
“Well. Ummm. I’m not sure” I stammered.
We haven’t really discussed it. The truth is that two years ago when we started this adoption journey, I would have never dreamed it would have taken this long. We both assumed we’d have a toddler by now.
Our son has albinism. It is autosomal recessive genetic disorder. Our son is beyond amazing and is barely effected by the condition, however we know that a majority of people with albinism will be significantly visually impaired. When we decided to grow our family, domestic adoption was the path that seemed right for us.
It was exciting at first. We told everyone we knew about our journey, for their prayers and support. Additionally, the books (I’ve read many) suggested to network in case friends/ family knew a potential birthmom. We took classes and filled out paperwork it was a tendious process but at least we were “doing “something.
Then we waited.
We were a year into the process when we met our first birthmom. Things were amazing. We were so excited we could hardly stand it. We knew we should be cautious, but things seemed so certain. Then days before delivery things fell through not because she changed her mind, but because of a strange legal glitch. We were devastated and left staring at an empty nursery.
A few months later we met birthmom #2. She was very young and early in her pregnancy, still she seemed sure of her decision. Plus all the books say the averaged couple has “1” failed adoption. Of course we all know these things don't always follow the books. Four months later she changed her mind and decided to parent. This was hard, but we knew it was a possibility,
Yesterday, I got news that birth mom # 3 has backed out. This was a strange situation and I had little hope of it working out from the beginning. Still, part of me is left wondering, “Um… seriously God. What now?”
The irony being that I deliver babies. Constantly. This of course confuses boywonder. For awhile after the first adoption fell through, he would ask when I went for delivery if “it was our baby” I was delivering. No, not yet. And my heart would break just a little but every time he’d say it. He rarely says it now. So much time has passed. It’s also getting challenging to deal with all the follow up questions from the “zillion” people we’ve told.
At work its hard to be sympathetic to the patients who get upset about an unplanned pregnancy. The worst is people who get seriously upset about the gender of their baby. Honestly, I’ve never been able to muster much sympathy for them. I know that the process has given me a new depth of empathy for my infertilty patients and others going through challeging situations.
I’ve labeled this post adoption Journey Part I as a statement of faith that someday (hopefully soon) I will proudly post adoption Journey part II where I will post pictures of my beautiful child. Until then thanks for letting me vent.
I’m also thankful to fat doctor for sharing her successful adoption story and being so transparent through her process.
A lump began to rise in my throat.
“Well. Ummm. I’m not sure” I stammered.
We haven’t really discussed it. The truth is that two years ago when we started this adoption journey, I would have never dreamed it would have taken this long. We both assumed we’d have a toddler by now.
Our son has albinism. It is autosomal recessive genetic disorder. Our son is beyond amazing and is barely effected by the condition, however we know that a majority of people with albinism will be significantly visually impaired. When we decided to grow our family, domestic adoption was the path that seemed right for us.
It was exciting at first. We told everyone we knew about our journey, for their prayers and support. Additionally, the books (I’ve read many) suggested to network in case friends/ family knew a potential birthmom. We took classes and filled out paperwork it was a tendious process but at least we were “doing “something.
Then we waited.
We were a year into the process when we met our first birthmom. Things were amazing. We were so excited we could hardly stand it. We knew we should be cautious, but things seemed so certain. Then days before delivery things fell through not because she changed her mind, but because of a strange legal glitch. We were devastated and left staring at an empty nursery.
A few months later we met birthmom #2. She was very young and early in her pregnancy, still she seemed sure of her decision. Plus all the books say the averaged couple has “1” failed adoption. Of course we all know these things don't always follow the books. Four months later she changed her mind and decided to parent. This was hard, but we knew it was a possibility,
Yesterday, I got news that birth mom # 3 has backed out. This was a strange situation and I had little hope of it working out from the beginning. Still, part of me is left wondering, “Um… seriously God. What now?”
The irony being that I deliver babies. Constantly. This of course confuses boywonder. For awhile after the first adoption fell through, he would ask when I went for delivery if “it was our baby” I was delivering. No, not yet. And my heart would break just a little but every time he’d say it. He rarely says it now. So much time has passed. It’s also getting challenging to deal with all the follow up questions from the “zillion” people we’ve told.
At work its hard to be sympathetic to the patients who get upset about an unplanned pregnancy. The worst is people who get seriously upset about the gender of their baby. Honestly, I’ve never been able to muster much sympathy for them. I know that the process has given me a new depth of empathy for my infertilty patients and others going through challeging situations.
I’ve labeled this post adoption Journey Part I as a statement of faith that someday (hopefully soon) I will proudly post adoption Journey part II where I will post pictures of my beautiful child. Until then thanks for letting me vent.
I’m also thankful to fat doctor for sharing her successful adoption story and being so transparent through her process.
Monday, January 19, 2009
The Challenge of Being Pregnant, Mom and Doctor...
It's interesting being a Mom, doctor and pregnant. I often have to choose which hat I'm going to wear to respectfully endure a situation.
Here's an example - my husband's grandmother (Ma) is visiting. She has a very strong personality. I love her and I'm absolutely thrilled that she is visiting, especially for my children. I'm pregnant and have now revealed that I will be having the boy who will carry the family name. (I'd like to believe this is an irrelevant point but given the generation gap, I'm pretty sure it contributes). Very soon after she arrived, Ma gave me a stern lecture about carrying my kids. I have a 2-year old and a 4 year-old. Neither 'have' to be carried but you all know how it is....sometimes they just want 'up' and sometimes you just want to carry them down the stairs because it's SO much faster. I said very little but she had a lot to say. "You're the doctor, you should know that if you carry too much weight, the baby will come out."
I should give more background - back in the day when she was in her 30's and 40's she was a midwife. She continues..."I saw many women who lost their babies because of placenta problems and stress on the body. You must not carry the children! Learn to say know and ask for help"
This is easier said than done. My husband is currently travelling for two weeks, I'm alone with the kids and it's virtually impossible to avoid carrying them for one reason or another. So I continue to carry them, only with the additional voice of guilt from Ma playing in my mind.
On the one hand, I want to respect her experience in life, she's lived many more years than I have. But the doctor in my mind is saying "nowadays, we have ultrasounds so I know where my placenta is and I'm really only putting my own back at risk which is a calculated risk in the moment!"
Perhaps if I didn't know better, I would be more worried about the baby, I'd ask more for help, or arrange for hired help and life would be easier? I can't decide if my medical knowledge is a blessing or a curse.
I've tried to respectfully tell Ma using few words that the baby is not at risk when I carry the kids but she still glares at me when she sees me holding my 2-year old even for a minute...Putting on my Mom-hat, I respectully put my daughter down and look around for help.
Here's an example - my husband's grandmother (Ma) is visiting. She has a very strong personality. I love her and I'm absolutely thrilled that she is visiting, especially for my children. I'm pregnant and have now revealed that I will be having the boy who will carry the family name. (I'd like to believe this is an irrelevant point but given the generation gap, I'm pretty sure it contributes). Very soon after she arrived, Ma gave me a stern lecture about carrying my kids. I have a 2-year old and a 4 year-old. Neither 'have' to be carried but you all know how it is....sometimes they just want 'up' and sometimes you just want to carry them down the stairs because it's SO much faster. I said very little but she had a lot to say. "You're the doctor, you should know that if you carry too much weight, the baby will come out."
I should give more background - back in the day when she was in her 30's and 40's she was a midwife. She continues..."I saw many women who lost their babies because of placenta problems and stress on the body. You must not carry the children! Learn to say know and ask for help"
This is easier said than done. My husband is currently travelling for two weeks, I'm alone with the kids and it's virtually impossible to avoid carrying them for one reason or another. So I continue to carry them, only with the additional voice of guilt from Ma playing in my mind.
On the one hand, I want to respect her experience in life, she's lived many more years than I have. But the doctor in my mind is saying "nowadays, we have ultrasounds so I know where my placenta is and I'm really only putting my own back at risk which is a calculated risk in the moment!"
Perhaps if I didn't know better, I would be more worried about the baby, I'd ask more for help, or arrange for hired help and life would be easier? I can't decide if my medical knowledge is a blessing or a curse.
I've tried to respectfully tell Ma using few words that the baby is not at risk when I carry the kids but she still glares at me when she sees me holding my 2-year old even for a minute...Putting on my Mom-hat, I respectully put my daughter down and look around for help.
Guest Post: iud
Funny #1
Yesterday, four year old Z spied my IUD pin on the lapel of my white coat. “Mommy!” he exclaimed, excitedly. “You have a POGO stick on your white coat!”
I smiled at him. “Why, yes I do!” Four is not age appropriate for methods of birth control. We’ll get there, don’t worry. Besides, why spoil his fun?
“Mommy, you bounce on those!” (Insert joke here). “But, you have to hold on!”
I was laughing so hard I could hardly drive by this point.
“Mommy,” he said, seriously. “I want a pogo stick when I’m a big kid.” Oh, you may get one, Z, but it will probably be a little different than the one daddy bounces on currently.
Funny #2
Today Z and I were talked about how he misheard something I had asked him to do. I said “I think it’s because you have elephants in your ears,” borrowing a joke from his pediatrician.
“I do not have elephants in my ears, I have little drums,” said Z, indignantly. I started giggling and, was of course, looking at his ears and spied a little stray wax. So I started to do the unfightable mom instinct thing and stuck my pinky in there to get it, and Z said “No! Don’t take my drums!”
(Cross-posted at Mom's Tinfoil Hat.)
Friday, January 16, 2009
Membership
When I arrived at my office this morning, I had a walk-in patient waiting for me. In the winter months, it’s not unusual for a parent to try to “jump the line” and want to be seen first thing, and I try my best to accommodate parent and patient. I had promised to do a medicine re-check for my nurse’s child after I made morning hospital rounds today so that we could get her child to school, and my nurse back to work. My partner saw the walk-in who had stalked Lori, my scheduler, at the back door forty-five minutes prior to my arrival, while I saw my scheduled re-check.
Sometimes parents believe that medicine is a club – one that you can join if you have the right political affiliations or money or a very important job. Membership in this club gets them exclusive bonuses –kind of like frequent flyer miles or box tops – bonuses that include a physician’s home phone number or pager and the right to call them any time of day or night. Occasionally a parent will ask for my direct number- sometimes with a smile or a giggle as they promise not to call me at 2 AM for a diaper rash or spit-up. Acceptance into this club also allows members to talk about their child’s sex education in Starbucks, or ask for antibiotics (just in case) whenever they are leaving the country for Turks and Caicos for the next two weeks.
Being truthful with myself, I accept that I am part of a club of sorts. When my triage service calls about a family friend who bit his tongue and needed advice about whether to go to the ER or not, I call the family because they‘re friends, and they would show the same concern for my children. I’ve also referred my brother-in-law with appendicitis to Dr. Ileum because he’s a friend and I know he’ll take good care of my relative. I’ve also met a fellow partner and her child in the middle of the night when she suspected her daughter had new onset Type 1 diabetes. (She was right!) My family and close friends (I can count the number of families on one hand) are default members, and they know there are rules about membership.
The notion of an exclusive membership or concierge medicine doesn’t sit well with me. As humanly possible, I try to treat my patients as well and equally as I would treat my own family or friends regardless of socioeconomic status. There are boundaries, though, and limit pushers that make me put my foot down. I won’t write prescriptions on the fly for administrator or staff’s children anymore when I’m trying to make hospital rounds. It’s not fair to my patients to get distracted like that. I cannot prevent a patient with lice showing up on Sunday morning on my front porch, but I won’t let them expose my kids. My phone has caller ID, and we screen the calls heavily, so when I’m not on call, I’m focused on my family, and my personal time. It’s all part of a balancing act that I’ve had to learn bit by bit.
Sometimes parents believe that medicine is a club – one that you can join if you have the right political affiliations or money or a very important job. Membership in this club gets them exclusive bonuses –kind of like frequent flyer miles or box tops – bonuses that include a physician’s home phone number or pager and the right to call them any time of day or night. Occasionally a parent will ask for my direct number- sometimes with a smile or a giggle as they promise not to call me at 2 AM for a diaper rash or spit-up. Acceptance into this club also allows members to talk about their child’s sex education in Starbucks, or ask for antibiotics (just in case) whenever they are leaving the country for Turks and Caicos for the next two weeks.
Being truthful with myself, I accept that I am part of a club of sorts. When my triage service calls about a family friend who bit his tongue and needed advice about whether to go to the ER or not, I call the family because they‘re friends, and they would show the same concern for my children. I’ve also referred my brother-in-law with appendicitis to Dr. Ileum because he’s a friend and I know he’ll take good care of my relative. I’ve also met a fellow partner and her child in the middle of the night when she suspected her daughter had new onset Type 1 diabetes. (She was right!) My family and close friends (I can count the number of families on one hand) are default members, and they know there are rules about membership.
The notion of an exclusive membership or concierge medicine doesn’t sit well with me. As humanly possible, I try to treat my patients as well and equally as I would treat my own family or friends regardless of socioeconomic status. There are boundaries, though, and limit pushers that make me put my foot down. I won’t write prescriptions on the fly for administrator or staff’s children anymore when I’m trying to make hospital rounds. It’s not fair to my patients to get distracted like that. I cannot prevent a patient with lice showing up on Sunday morning on my front porch, but I won’t let them expose my kids. My phone has caller ID, and we screen the calls heavily, so when I’m not on call, I’m focused on my family, and my personal time. It’s all part of a balancing act that I’ve had to learn bit by bit.
Tuesday, January 13, 2009
Healing at home
My kids' preschool teacher, Miss Amelia, is the kind of mom dreams are made of. She has 4 kids ranging in age from 2 to 10, all of whom are being homeschooled and come with her when she teaches two mornings a week. She lives 2 hrs away in the country but somehow manages to get herself and 4 kids ready and make the drive to school to receive her class of 8 preschoolers at 9:30am on the dot. She is never late. Her 4 kids always have creative, healthy, homemade lunches. They are intelligent, respectful, cooperative, helpful...miraculous. Her 10 year old daughter oozes patience and sweetness and wisdom beyond her years. One morning, my 4 yr old son got out of the car and immediately started wailing because he had forgotten to bring anything for show and tell. My systolic pressure shot up by about 20 points as I tried to figure out how I could end this scene without driving all 3 kids back home to retrieve a dinosaur from our living room. Meanwhile, the 10 year old sweetly said, "I'm sure we have something in our class treasure box you could use for show and tell. Would you like to look in the treasure box? Ok, it will be our secret, but only if you stop crying..." As he wiped his eyes and wandered off with her, walking on a cloud, I stared in amazement. She is her mother's daughter.
A few days later, I decided to take stock of how I was doing as a mom by sitting back and observing my own kids' behavior. Unfortunately, in the span of an afternoon, I heard my 5 yr old son telling my 3 yr old daughter, "I am closing my eyes and counting to 10. If ALL of those toys I just cleaned up aren't back in the toy box again when I open my eyes, we are not going to California next month..." or worse, my 3 yr old telling her teddy bear, "No, I can't play right now. The house is a mess, and I am busy!" with a familiar tone of irritation. Yikes! I think this reap what you sow business is the real deal.
This past weekend, I came down with a terrible cold. My kids had a friends' birthday party to attend. They had been looking forward to it all week. As I sat there coughing and feverish on the couch, I had to tell them I couldn't take them to the party because I didn't want to get all of the party guests sick. I braced myself and prepared for the fallout--here come the tantrums, I thought. They looked at each other, then walked out of the room silently. Two minutes later, they reappeared. My 5 yr old son was lugging a huge flannel quilt and a cup of water, and my 3 yr old daughter came bearing her favorite stuffed animal and her blankie. Together they worked, their tiny faces concerned but reassuring, their body language unhurried, gentle, and kind, to wrap me in the king-size quilt. My daughter put her bear and her blankie under my chin, and my son pulled the coffee table a little closer so that I could reach the cup of water without having to get up. Then before going off to play quietly with her brother, my daughter kissed my hot forehead and said, "Shhhh, I love you. You'll feel better soon."
And she was right. I did feel better. For all my shortcomings as a mother, and there are many, I am teaching my kids by example to be healers, at work and at home. For that, I am grateful.
A few days later, I decided to take stock of how I was doing as a mom by sitting back and observing my own kids' behavior. Unfortunately, in the span of an afternoon, I heard my 5 yr old son telling my 3 yr old daughter, "I am closing my eyes and counting to 10. If ALL of those toys I just cleaned up aren't back in the toy box again when I open my eyes, we are not going to California next month..." or worse, my 3 yr old telling her teddy bear, "No, I can't play right now. The house is a mess, and I am busy!" with a familiar tone of irritation. Yikes! I think this reap what you sow business is the real deal.
This past weekend, I came down with a terrible cold. My kids had a friends' birthday party to attend. They had been looking forward to it all week. As I sat there coughing and feverish on the couch, I had to tell them I couldn't take them to the party because I didn't want to get all of the party guests sick. I braced myself and prepared for the fallout--here come the tantrums, I thought. They looked at each other, then walked out of the room silently. Two minutes later, they reappeared. My 5 yr old son was lugging a huge flannel quilt and a cup of water, and my 3 yr old daughter came bearing her favorite stuffed animal and her blankie. Together they worked, their tiny faces concerned but reassuring, their body language unhurried, gentle, and kind, to wrap me in the king-size quilt. My daughter put her bear and her blankie under my chin, and my son pulled the coffee table a little closer so that I could reach the cup of water without having to get up. Then before going off to play quietly with her brother, my daughter kissed my hot forehead and said, "Shhhh, I love you. You'll feel better soon."
And she was right. I did feel better. For all my shortcomings as a mother, and there are many, I am teaching my kids by example to be healers, at work and at home. For that, I am grateful.
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