Before residency, I doubted I would find a mentor in medicine. Who but me could have varying interests, put her family in front of her career and still be wildly successful? Surely, I thought in my typically narcissistic way, I am one of a kind.
But then I met Karen.
Karen became residency director shortly after I joined the program. She is a busy woman, and I think we all figured she would put our needs last on her agenda, but Karen proved to me that time is relative.
She has three little kids, all well-adjusted and involved in their own sports and activities. Her husband has an equally high profile career and they don't have a nanny. But somehow, she was able to meet with us whenever we needed her. She counseled, mothered and taught us until we became doctors.
After residency, Karen and I became colleagues when I joined faculty. I watched her handle departmental dramas and marveled at how she quietly but swiftly worked her projects through the bureaucracy. She spent time with her patients and they were devoted to her. She lectured, published and kept up with relevant research. She had plenty of non-medical interests and activities and kept up with non-medical friends. And she never apologized for being a devoted and attentive mom.
When I decided academia wasn't for me, Karen blessed my departure. We don't talk much anymore, but I know her office door is always open should I need to talk, cry or laugh.
Wednesday, February 11, 2009
The Fabulous Mentor-Friend
I got matched up with my mentor by fate. I can't even remember how I ended up meeting with the medicine division chief as a student, but there I was, telling him how I wanted to get involved with some kind of clinical research in women's health, and he gave me her name.
An unusual name. Sounded vaguely familiar.
From the moment I met Fabulous Mentor (FM), I was in awe of her fabulousness. She was junior faculty, had tons of enthusiasm and a wardrobe to drool over. FM was a star in our high-powered academic institution. Radiant energy.
We started working on a research project together, and when I say 'together', I mean she made me feel like it was mine too. She'd ask me, a lowly medical student, my opinion about things and made me feel smart and important. Her generosity of encouragement and praise helped fuel me.
FM wrote one of my letters of recommendation for residency, and one day, she let me see it. There were exclamation points!!! There were words written in ALL CAPITAL LETTERS. It was a letter like I had never seen before. A letter to frame. I got into my first choice residency, staying at my same institution, and I wondered how much of a role she played.
Throughout my residency years, she was a constant advocate for me. We worked on a couple of other projects along the way, gaining me authorship and, importantly, learning how academics worked. I always felt so lucky to have this relationship with her that others didn't.
My husband and I announced our engagement to her and her husband over dinner one spring night. A few years later, I would go to her baby shower. And her, mine. We would write or call and talk about life or babies or jobs, long after I graduated medical school and residency.
It's strange how you can wake up one day and realize you are more than mentor-student, but friends. Although, it always feels slightly lopsided. I will always partly be that awe- and admiration-filled medical student hoping to be just like her someday.
FM is fabulously successful in her career now, of course. And I'm still looking to her for career advice, in between talking about babies and life.
Meanwhile, I find myself in the mentoring position with my own student mentees. Students whom I hope I can adequately guide, counsel, and, hopefully, inspire. They have been mainly women (by chance? by purpose?), women whom I hope will become friends, talking about life or babies or jobs one day, years from now. I'm paying it forward. I'm shooting for fabulousness.
An unusual name. Sounded vaguely familiar.
From the moment I met Fabulous Mentor (FM), I was in awe of her fabulousness. She was junior faculty, had tons of enthusiasm and a wardrobe to drool over. FM was a star in our high-powered academic institution. Radiant energy.
We started working on a research project together, and when I say 'together', I mean she made me feel like it was mine too. She'd ask me, a lowly medical student, my opinion about things and made me feel smart and important. Her generosity of encouragement and praise helped fuel me.
FM wrote one of my letters of recommendation for residency, and one day, she let me see it. There were exclamation points!!! There were words written in ALL CAPITAL LETTERS. It was a letter like I had never seen before. A letter to frame. I got into my first choice residency, staying at my same institution, and I wondered how much of a role she played.
Throughout my residency years, she was a constant advocate for me. We worked on a couple of other projects along the way, gaining me authorship and, importantly, learning how academics worked. I always felt so lucky to have this relationship with her that others didn't.
My husband and I announced our engagement to her and her husband over dinner one spring night. A few years later, I would go to her baby shower. And her, mine. We would write or call and talk about life or babies or jobs, long after I graduated medical school and residency.
It's strange how you can wake up one day and realize you are more than mentor-student, but friends. Although, it always feels slightly lopsided. I will always partly be that awe- and admiration-filled medical student hoping to be just like her someday.
FM is fabulously successful in her career now, of course. And I'm still looking to her for career advice, in between talking about babies and life.
Meanwhile, I find myself in the mentoring position with my own student mentees. Students whom I hope I can adequately guide, counsel, and, hopefully, inspire. They have been mainly women (by chance? by purpose?), women whom I hope will become friends, talking about life or babies or jobs one day, years from now. I'm paying it forward. I'm shooting for fabulousness.
Mentors
I went through medical school at the edge of the first large wave of women admitted since the forties. In the 1970s, the whole concept of mentoring was murky. Daniel Levinson’s book on adult male development had highlighted the importance of mentorship, mostly in the business context and mostly from the point of view of the value of being a mentor. We called our mentors advisors. In college, my relation to my advisor was distant—I doubt she could have picked me from a police lineup—and medical schools had not yet recognized the need.
Beyond the deficits of the system, being a young woman in an environment where all the potential mentors were older men, I felt uneasy about seeking a mentor. The boundary between mentor and puppetmaster was too thin. Though I aspired to an academic career, I knew that the careers of my possible mentors were not for me. I wanted a family, and I was not prepared to work evenings and weekends on articles that might add weight to my resume but only add burden to what others were expected to read. How to be creative, individual, and sane were my goals, and the few senior faculty who reached out to me, or who I approached, could not really speak to my condition. The best one of them came up with was that I was promising but an underachiever.
Fortunately, though I lacked mentors, I had models aplenty. I admired extravagantly the men who taught me, mainly by example, how to be a teaching doctor. I remember seeing my physical diagnosis tutor examining a patient’s abdomen. He was a big guy with huge hands, and the gentleness with which he showed us the liver edge moved me almost to tears. I knew my hands would never look like that, and that I would have to struggle not to seem sharp and small touching people, but I did learn that a doctor’s touch could warm and heal as well as probe. Another tutor took us to see a man (whom he did not previously know) who was recovering from a stroke. The man’s worried wife was standing behind him. My tutor managed to demonstrate the extent of the patient’s continued paralysis, while his words to the patient and his wife conveyed how much he seemed to improving. Neither of these men will ever know the impact that observing their blended skill and compassion had on me, but neither will I ever forget those or other moments that so nourished my growth from student to doctor.
Now I am in a position to mentor students myself, and I find it tough going. They are so silent, so fearful of expressing themselves, of making errors or seeming uncertain. I can only hope that they see me the way I saw the people I admired. Perhaps someday something I did or said will be communicated to other students as an example of what good mentoring can be about.
Beyond the deficits of the system, being a young woman in an environment where all the potential mentors were older men, I felt uneasy about seeking a mentor. The boundary between mentor and puppetmaster was too thin. Though I aspired to an academic career, I knew that the careers of my possible mentors were not for me. I wanted a family, and I was not prepared to work evenings and weekends on articles that might add weight to my resume but only add burden to what others were expected to read. How to be creative, individual, and sane were my goals, and the few senior faculty who reached out to me, or who I approached, could not really speak to my condition. The best one of them came up with was that I was promising but an underachiever.
Fortunately, though I lacked mentors, I had models aplenty. I admired extravagantly the men who taught me, mainly by example, how to be a teaching doctor. I remember seeing my physical diagnosis tutor examining a patient’s abdomen. He was a big guy with huge hands, and the gentleness with which he showed us the liver edge moved me almost to tears. I knew my hands would never look like that, and that I would have to struggle not to seem sharp and small touching people, but I did learn that a doctor’s touch could warm and heal as well as probe. Another tutor took us to see a man (whom he did not previously know) who was recovering from a stroke. The man’s worried wife was standing behind him. My tutor managed to demonstrate the extent of the patient’s continued paralysis, while his words to the patient and his wife conveyed how much he seemed to improving. Neither of these men will ever know the impact that observing their blended skill and compassion had on me, but neither will I ever forget those or other moments that so nourished my growth from student to doctor.
Now I am in a position to mentor students myself, and I find it tough going. They are so silent, so fearful of expressing themselves, of making errors or seeming uncertain. I can only hope that they see me the way I saw the people I admired. Perhaps someday something I did or said will be communicated to other students as an example of what good mentoring can be about.
Guest Post: Jane
Lucky to have had many mentors and stand on the shoulders of those who have gone before me. Mom, Dad, and others too in many ways.
But I want to tell you about my third year medicine intern. I entered that rotation totally confident and blissfully unaware of the challenges of combining motherhood and medicine.
Jane (not her real name) was married and mother of a young toddler. Her husband also worked for pay and they had a nanny watching the kid. This was in 1992. Jane knew I was newly married and told me how they work their family system. Jane had a code worked out with the nanny to use with her beeper.
Remember beepers with the one row of numbers that would appear after the caller typed them into their phone? No words, no keypads, no cell phones. Jane had gotten her nanny a beeper as well. If Jane was going to be home at the usual time, she did not call in. If Jane was going to be home in one hour, she typed in '1'. If nanny wanted to Jane to call home to talk, she typed in another code.
And, of course, if there were an emergency, either one would type in '911.'
This let Jane get messages of all sorts from the nanny and stay connected in real time while rushing throughout the hospital doing intern things.
While I had no clue about the variety of issues on the horizon for myself, I always appreciated the earnest and urgent need Jane had to impart her wisdom and experience and sisterhood.
I have not kept in touch with Jane, but hope we do reconnect some day.
Jane, if you are out there reading THANK YOU!
post by Tigermom
But I want to tell you about my third year medicine intern. I entered that rotation totally confident and blissfully unaware of the challenges of combining motherhood and medicine.
Jane (not her real name) was married and mother of a young toddler. Her husband also worked for pay and they had a nanny watching the kid. This was in 1992. Jane knew I was newly married and told me how they work their family system. Jane had a code worked out with the nanny to use with her beeper.
Remember beepers with the one row of numbers that would appear after the caller typed them into their phone? No words, no keypads, no cell phones. Jane had gotten her nanny a beeper as well. If Jane was going to be home at the usual time, she did not call in. If Jane was going to be home in one hour, she typed in '1'. If nanny wanted to Jane to call home to talk, she typed in another code.
And, of course, if there were an emergency, either one would type in '911.'
This let Jane get messages of all sorts from the nanny and stay connected in real time while rushing throughout the hospital doing intern things.
While I had no clue about the variety of issues on the horizon for myself, I always appreciated the earnest and urgent need Jane had to impart her wisdom and experience and sisterhood.
I have not kept in touch with Jane, but hope we do reconnect some day.
Jane, if you are out there reading THANK YOU!
post by Tigermom
What is a Mentor, and Where Can I Find One?
I used to think that the word "mentor" was derived from mens, the Latin word for "mind," or men, the Indo-European root for "thinking," and the suffix -or, meaning "one who does or creates" the thing described by the root of the word. Thus a mentor would be one who uses the mind or forms a person's thinking.
But of course the word mentor doesn't come from such a derivation at all. Mentor was the guardian of Telemachus, son of Odysseus, and in The Odyssey the goddess of wisdom assumed Mentor's form to aid Telemachus, one of her favorites among mortals (as well as to escape notice by Penelope's suitors).
Homer's Mentor is a mere minor character, however, without all the attributes of the "experienced and trusted advisor" the Oxford English Dictionary leads us to believe such a figure should have. Where do we get the archetype of a wise teacher who cares about, nurtures, and encourages the learner - who builds up the learner's intellect rather than doing the opposite, sucking out the student's soul, as J.K. Rowling's DE-mentors do?
For that sort of character we have François Fénelon to thank, whose enormously popular book Les Aventures de Télémaque, published in 1699, was "a continuation of The Odyssey from an educational vista," according to author Andy Roberts. It brought Mentor to the forefront as a major character with tremendous influence over the story's hero. "It is Fénelon," Roberts continues, "not Homer, who endows his Mentor with the qualities, abilities, and attributes that have come to be incorporated into the action of modern day mentoring." The word mentor came into modern usage in English in 1750.
I am rambling on about these literary and historic niceties because I enjoy them. But I am also having a hard time writing about an actual mentor. From what I can gather from my own experience and from other people, finding a mentor in medicine usually happens by a great stroke of luck; it's not automatic. You'd think that in a profession supposedly built on compassion and learning, mentors would abound. The word doctor, in fact, means teacher in Latin. But it's not that easy to find good mentors. It may be harder still for those who long for a mentor who is a woman.
I do have a couple of people who always come to mind whenever I hear the word mentor: my med school anatomy professor, Dr. Matthew Pravetz, who also baptized my youngest child; and from my days in pediatrics, Dr. Indira Dasgupta, a woman whose dignity, intelligence, compassion, and humor I hold in my heart to this day. There have been few people in my career who have helped me believe - as they did and as every mentor should help his or her "telemachus" believe - "You can do this. You are good. Your work will make a difference. I'll be there for you if you need me." Even the most independent-minded and confident person needs guidance at one point or another, or loses faith, or needs help. Mentors ultimately stoke the fire and help keep the faith. Happy are those who are blessed with some good ones
But of course the word mentor doesn't come from such a derivation at all. Mentor was the guardian of Telemachus, son of Odysseus, and in The Odyssey the goddess of wisdom assumed Mentor's form to aid Telemachus, one of her favorites among mortals (as well as to escape notice by Penelope's suitors).
Homer's Mentor is a mere minor character, however, without all the attributes of the "experienced and trusted advisor" the Oxford English Dictionary leads us to believe such a figure should have. Where do we get the archetype of a wise teacher who cares about, nurtures, and encourages the learner - who builds up the learner's intellect rather than doing the opposite, sucking out the student's soul, as J.K. Rowling's DE-mentors do?
For that sort of character we have François Fénelon to thank, whose enormously popular book Les Aventures de Télémaque, published in 1699, was "a continuation of The Odyssey from an educational vista," according to author Andy Roberts. It brought Mentor to the forefront as a major character with tremendous influence over the story's hero. "It is Fénelon," Roberts continues, "not Homer, who endows his Mentor with the qualities, abilities, and attributes that have come to be incorporated into the action of modern day mentoring." The word mentor came into modern usage in English in 1750.
I am rambling on about these literary and historic niceties because I enjoy them. But I am also having a hard time writing about an actual mentor. From what I can gather from my own experience and from other people, finding a mentor in medicine usually happens by a great stroke of luck; it's not automatic. You'd think that in a profession supposedly built on compassion and learning, mentors would abound. The word doctor, in fact, means teacher in Latin. But it's not that easy to find good mentors. It may be harder still for those who long for a mentor who is a woman.
There were many teachers, of course, who gave me terrific lessons I carry with me to this day; but a mentor is more than a good teacher or role model. A mentor is someone with whom you have a relationship - someone who truly cares about your formation and expends energy, real work, to help you through it, and wants to do so. A mentor believes in you and communicates that faith; a mentor listens, and can be trusted with your struggles and your successes; a mentor teaches and guides without resorting to a power differential to exert influence; a mentor has a personal stake in the education of the whole learner - intellectual, moral, physical, spiritual - and, therefore, cares deeply about the learner's character and responses to the world as well as his or her knowledge.
I do have a couple of people who always come to mind whenever I hear the word mentor: my med school anatomy professor, Dr. Matthew Pravetz, who also baptized my youngest child; and from my days in pediatrics, Dr. Indira Dasgupta, a woman whose dignity, intelligence, compassion, and humor I hold in my heart to this day. There have been few people in my career who have helped me believe - as they did and as every mentor should help his or her "telemachus" believe - "You can do this. You are good. Your work will make a difference. I'll be there for you if you need me." Even the most independent-minded and confident person needs guidance at one point or another, or loses faith, or needs help. Mentors ultimately stoke the fire and help keep the faith. Happy are those who are blessed with some good onesSunday, February 8, 2009
to a pediatrician, blue is not good
Well he's either cyanotic or it's really that cold out. That's what his preschool teacher, whom I respect and admire, asked me about at drop-off one recent 20 degree day. She didn't explicitly mention cyanosis, just a concerned question about whether it's really that cold out. An innocent, "why are his lips blue?" And his fingers too, upon closer inspection.
Am I stressed? Is this a tet spell?
Why are his lips blue?
Check pulses and the other ABC's (of resuscitation, not of the alphabet)? Stat EKG? Pulse ox? Echo? He's a healthy 2 year old. My healthy 2 year old. Not known to be short of breath while rocking out with his Daddy's guitar, not known to tire easily, might miss a nap but not a heartbeat. What to do? Is he blue?
Well, blue berry.
That's his breakfast. Frozen blueberries in warm oatmeal. Today more on his lips (and fingers) than in his mouth. I've heard they're pretty good for you, too.
Am I stressed? Is this a tet spell?
Why are his lips blue?
Check pulses and the other ABC's (of resuscitation, not of the alphabet)? Stat EKG? Pulse ox? Echo? He's a healthy 2 year old. My healthy 2 year old. Not known to be short of breath while rocking out with his Daddy's guitar, not known to tire easily, might miss a nap but not a heartbeat. What to do? Is he blue?
Well, blue berry.
That's his breakfast. Frozen blueberries in warm oatmeal. Today more on his lips (and fingers) than in his mouth. I've heard they're pretty good for you, too.
Friday, February 6, 2009
Could I get a little Zen here?
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?
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?
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.)
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