Saturday, January 30, 2010

Getting Home

I was snowed in to a small town thirty miles outside of where I live, for a couple of days. The South shuts down in bad weather, since it only happens once every other year or so. I had to work at a smaller hospital I rotate at, occasionally. So I holed up in a hotel. It was kind of fun. I watched the snow fall all last night - an anomalous weather moment, in this location, for me. It was gorgeous watching the giant flakes hit the covered swimming pool outside my window.

Today, I slept in (not a workday!), read in bed, had a long run and shower, and packed up to head home. I waited until one or two in the afternoon to leave so A) all of the sanding trucks had done their job and traffic would be at its peak and B) so I had plenty of daylight hours left for possible mishaps.

At about 1:00 p.m., I headed across the street from the hotel to eat at Subway. I was feeling super cool in my twenty-year old combat boots, jeans, and purple t-shirt covered by an open plaid flannel button-down shirt I had in college. How fitting that I was in my college town. I didn't dry my hair, so I was sporting what my partner Michelle calls my "sexy bed head look," a statement to which I laughed and replied, "no, it's my New Year's Resolution. The lazy, I'm not drying my hair everyday look." I had on my fingerless IPhone gloves. I was wearing bad weather gear that rendered me unrecognizable, the day before, at the hospital I rotate at. When the guy that was staring at me in Subway honked while I was crossing the street back to the hotel, I was pretty sure he thought I was cute and wasn't honking because I had just slipped and almost fell on the ice (but I could be wrong). I climbed in my car - ready to face the road - get back home to my kids. Blared some good, muddy blues, a guy whose voice is so rich and soulful I just want to climb inside it and live there forever. Called my dad, who was doctoring in my home town today, and had first-hand familiarity with the road conditions. Told him, five minutes into my interstate drive, that I had it all under control, roads were great, I would make it no problem.

It is this kind of moment that we all need to watch out for. The ones where you feel supremely confident, happy, almost ego overinflated. Because that's when it all comes crashing down.

I was driving down the interstate gazing dumbstruck at the scenery. My old college town looked like a little Swiss village - I wasn't used to seeing it this way, and it was so beautiful. All of a sudden my windshield wipers, which I had checked and cleared prior to leaving, stopped working. They became re-glued by snowy debris and ice that was flying up from the hood. I decided, well, it's not really snowing, maybe this won't matter. Then four trucks flew by me at 70 miles/hour, knocking up sand and snow and mud and dust all over my windshield. It mattered. I slowed to a crawl, peering through the muddy windshield. I turned the music down to concentrate. I suddenly realized two cars were behind me, and put my hazards on so they would know I was in trouble, and not just stupid. I was going to have to pull over on the icy snowy banks, to fix this.

About the time I was fighting to see though the mud, I had come to the realization that I had somehow gotten off on the wrong exit. I was going the opposite direction from home. I was stupid. I was heading into worse weather, and I could tell by the dicier roads. It would be easy to fix this, I would just have to turn around, and I was trying to remember the nearest exit where I could do this. I already knew, based on talking to my Dad, that the town I was staying in had gotten hit a lot worse by the weather than the big city I lived in. Good Lord. But first, the windshield wipers.

I got out of the car, and started hacking away at the snow and ice with trucks flying by, honking and knocking up more snow and mud on me and my car. One car slowed down, with blinkers on, and pulled up in front of me. I was scared and felt vulnerable. Here I was trying to fix a problem, and I was going to be raped or murdered on the side of the road. A guy about my age got out, he had a funny hat on, and asked if I needed help. I know that 99.9% of people are good, probably this one included, but I wasn't taking any chances. I called out to him that I was OK, just needed to get my wipers working. I thanked him for his offer. He smiled, nodded, went back to his car, and drove off. He probably sensed the fear and desperation in my voice. He was a good guy, and when it took me 20 minutes to get my wipers working again, I silently cursed myself for not taking him up on his offer for help.

Safe again, back in my car, wipers working, I drove to the next exit. It was a very small town, one that hadn't had much traffic or sanding trucks. I drove slowly over the overpass, praying I wouldn't end up like so many other abandoned cars I had seen on my short stint. Made it, and realized it would be tough merging back onto the cleared interstate from the snowy, icy exit ramp. I waited for a break in traffic, and jumped in. Cranked up the music. Drove back home.

The only other bad road was my own street, but I got home fine. Walked inside the house and melted from hugs from the kids. Sicily and John were so excited to see me, and we began to prepare for the dinner guests we were receiving - a couple and their two kids from Sicily's old school. They had us over, back in September, and it took an alarming four months for us to coordinate our schedules to return the favor. We ate spaghetti, drank wine, and the day's challenges melted away.

What we go through for our jobs. It's not just me - all of the lab technicians, supervisors, and gross room assistants were fighting bad weather, and staying in hotels, to keep the hospitals functioning, and take care of patients. I felt such camaraderie, and satisfaction from a job well done. There is so much drama in this world - so many people attacking and suing and fighting and reacting from whatever the hell they missed out on in childhood. So it's especially nice to experience moments like this, when all of the good comes out in everyone.

Tuesday, January 26, 2010

Guest Post: When They Say It's Gonna Be Hard, They Really Meant It.

I write this post as I have just concluded 2 hours at a coffee shop studying with a classmate, drove home the 40 minute drive listening to an audio CD of board review, got home at 7:30pm to try to work out to an aerobics DVD for 40 minutes (not before scarfing down a slice of strawberry cheesecake.. FAIL), then scramble to put together 2 powerpoint presentations on postpartum hemorrhage and placental abruption and anesthetic managements thereof. And oh yes, showered as well. And I'm already past my bedtime. (and I managed to skip dinner in all of this)

And this was done without my husband at home nor my 9 month old baby boy. Imagine what my day after work would have been like if either of them were home.

When hubby and I were discussing when would be the right time to have a child, I vehemently told him that other residents in our program had babies during our 2nd year of residency when we were primarily on consult months (i.e. easy rotations). I kept telling him we should do it, I really wanted a baby during residency b/c I didn't want residency to be the sole reason why we would decide not to have a baby. I failed to note that most of the other residents didn't have attendings as husbands, or if their husbands were physicians or residents, their schedule was more reliable than an emergency medicine attending's schedule which varied day to day, shift to shift (and hence make daycare virtually not an option).

Everyone said it was gonna be hard, but I knew in my heart I wanted this baby and I was going to make it work. When our little C baby arrived, I was towards the end of my 2nd year of residency (and hence, the end of the easy consult months).. welcome to the world of 3rd year of anesthesia (and subspecialty rotations)... back to back cardio-thoracic anesthesia rotations... throw in a month of pediatric anesthesia, and oh yes, mix it up with some vascular anesthesia, add a lil ICU... all the while with a crying pooping fussy little baby boy... AND breastfeeding/breastpumping every chance I could get. All the meanwhile with a hubby who was working nights 7pm to 7am every couple of days.

Yeah I knew it was going to be hard, but this was a whole 'nother area of stress I wasn't accustomed to.

Luckily my parents have helped out immensely, but they are 45 minutes north from where we live. Parents in law are 25 minutes away as well, and mother in law stays with us when hubby works a span of a few days/nights. And when she can't stay with us, we haul C baby to my parents and he spends the nights there. A nanny would have been a great option, but since hubby works sometimes 3 days and then gets off for 5 days and then another few days and off for a few days, the varying schedule just was too difficult.

So now I'm sitting in an empty house with nobody here but our C dog passed out on the couch next to me as I type this. And even without anyone home, I still find that I just don't have enough time to do everything that I need to do. But I welcome sleep now... even though I won't be able to snuggle up next to my C baby, at least I have my iPhone with my 52356 pictures/videos to look at before I go to sleep. And 5AM I start this process all over again.

It was a hellova hard journey and it still is hard, but it was worth every minute. Especially when I hold my baby in my arms and he holds me back and happily sucks on my cheek when I get home.

(That doesn't mean I don't cry every single time I have to leave him for a few days. I still do. Even though I know he will be fine... I'm his mommy first and always)

I'm a 3rd year anesthesiology resident in the South, married to an emergency medicine physician. We have a 9 month old baby boy, C baby and a 3 year old Maltese doggie, C dog.

Sunday, January 24, 2010

Hey, Jealousy

I am jealous of my husband. There, I said it. A little over a year ago, when our lives were too chaotic to manage with both of us working full-time, Mr. Whoo quit his job in the world of finance to stabilize the home front and get us prepared for the upcoming move. No doubt, it was the best decision ever. Our lives got exponentially better. Shopping, laundry, and errands got done. The kids were no longer in day care 10 hours a day, and we functioned much better as a family unit. Fast forward to now. We've been in Newville for about 6 months, now, and despite a concentrated effort, there are no desirable/worthwhile jobs in my husband's field of expertise. He did decide to take on a "partnership" in a business run by his cousin (which, don't get me started on that cluster, I'm not sure it was the greatest idea) in which he generally manages financial affairs, billing, accounting, and marketing, all for a pittance (not that it matters, but still). This is all done via computer and telephone, so he still is doing the lion share of household chores and kid wrangling to and from school. Here's where the jealousy part comes in...he can do whatever he wants, whenever he wants to do it.

Most mornings, I leave the house before everyone gets up, so he gets the kids ready for school and out the door between 7:30 and 8 am. Then, the day is all his. He can go work out, any time he wants to do it. Then, if he wants to work, he works for a little while. There is no agenda, no set schedule for the day, it is his with which to do what he pleases. The problem is, I'm not really sure exactly what it is that he is doing! Kids are in school until 4-4:30pm. Shopping, laundry, and dishes still get done, but other chores have really fallen by the wayside (we used to have cleaning ladies to do all the "real" cleaning, so that is not getting done regularly and when it is it is done "man-style"). The rental in which we are living is crowded and too small for all of our "stuff" so it never looks uncluttered, and I'm not sure if that is contributing to the decline of cleaning activity or if it is something else. Now, unless I give him guidance, he is waiting for me to get home to tell him what to make for dinner, and I am starting to get a bit frustrated. Not only am I jealous of his autonomy, I am starting to feel like I am starting to judge what he does with his days...and this is not good for our marriage. I know he can' t do it all, but sometimes I feel put upon when he has all. day. long. to figure these things out.

The worst jealousy of all, however, is how much our kids favor him over me. I noticed it when he moved the kids to Newville a few weeks prior to my job being completed. When I finally got to Newville, Bean, who up until that time was very attached to me, was all about Daddy. Understandable, I thought, this will pass. Only it didn't. Now that I have more time to spend with my family, it seems my kiddos want less and less to do with me. My son fusses when it is my turn to lie down with him and night, and says hurtful things like how he is only "Daddy's son, not Mommy's." CindyLou criticises everything I do, because "Daddy doesn't do it that way." I know I shouldn't take it personally, because I know that they love me, and I have been working for so long of course they are going to attach to the parent they see the most. It still hurts, and I am jealous of his place as primary caregiver in their lives, because, well, I'm the *Mommy* dammit. For now, I am doing my best to spend the time that I have with the kids, and enjoying the activities that we never got to do as a family when I was working in my previous job. There is blame to lay on my shoulders, as well. I am trying not to come home and just disengage from the family because I spend all day long problem-solving and taking care of strangers, and therefore have little more to give emotionally. It is exhausting.

Hopefully, it won't be long until we navigate our way through this new life that we have found here. I still believe that having Mr. Whoo at home is far better for our overall family life when compared to having him work outside the home. How do you find your balance as a family? Anyone else married to a "stay-at-home" spouse? Any tips for thwarting resentment and insanity? Ways to reconnect with your kids? I value your opinions and advice!

Thursday, January 21, 2010

What IS the secret?

My husband and I awoke last Weds to a text message on my cell from my father-in-law saying "Hope this doesn't mean you are single-parenting again." We had no idea what he meant--had we been attacked? were things escalating in Afghanistan suddenly? Over the next few hours, we learned of the earthquake in Haiti and came to appreciate the seriousness of it, which was so remarkably underestimated by the first reports. We have both done international medical work. It is part of who we are. We hope to return to it as a couple when our kids are through with us. So, I told my husband (a military physician) that if he wanted to or had to go, I was behind him and the mission 100%. I said the V word with my blessing: Volunteer. Eight hours later, I got another text, this time from my husband, telling me he was leaving on Saturday evening and would be gone for 1-2 months. We began to scramble. The next day, yet another text from him: he was now leaving on Friday morning and would be gone for 5 months. Within this time, our nanny of more than 3 yrs gave us notice that she planned to leave ("just ready for a change"?!?!?!) in the middle of his deployment. I was having my own little tiny earthquake with little warning at home. At times, the only thing that kept my problems in perspective was the catastrophic enormity of the real earthquake, of which the people of Haiti had no warning at all.

My husband's last two deployments were planned, which gave us months to make all sorts of arrangements, time to ready our kids and ourselves emotionally, time to get the house and cars in good repair, etc. We had a nanny who gave no signs she might leave us. We got things in such order before his departures that I could keep up our usual family routines and standards for the most part. My husband just returned from his second deployment in two years 5 months ago. We thought we were going to be living normal united family life with solid childcare for at least another year. Who could have predicted all of this?

Ok, here's the weird part. Things are easier than usual. Way easier, strangely. Colleagues at work, neighbors, friends, people at my gym, checkout people at Costco who know us are all gawking and expressing condolences as they see me traipsing everywhere with our three small kids in tow with a fairly relaxed smile. "You are making this look EASY! What is the secret?" a lot of fellow moms have asked conspiratorily. Finally, after not answering the question enough times, I realized: I DON'T KNOW. But they are right. And it's not just an appearance. It is kind of easy.

The last two days, I have been preoccupied with this. Why IS life easier during this unplanned deployment of uncertain duration with childcare that now feels tenuous? It certainly shouldn't be. But it is. I finally made kind of a log of my day for the last few days and had a EUREKA!! moment. It's just a few things:

1) I am doing everything with my kids instead of for them. There is too much work in the household to be done now to do it all alone. I would never sleep. Or finish. Usually, I would be making dinner while the kids watch a TV show or unloading the dishwasher while the kids play after dinner or folding the laundry when they go to sleep. Now, we are pulling chairs up to the counter and they peel or mash while I chop--we are making dinner together. We are unloading the dishwasher together. Each kid even has a post-dryer laundry job (the 2 yr old finds all the socks and collects them in a pile, the 4 yr old sorts the clothes by owner and does some folding, and the 6 yr old does most of the folding with me). They love the independence and the chance to be involved. Suddenly the work doesn't feel as much like work to me or to them. I'm less resentful that I am a 24/7 servant because I'm not, and they are less resentful that Mommy is preoccupied 24/7 with chores and can't play with them because it's no longer the case. The work of our family has become a family activity. And because it's divided more ways, there is more time left over for real play. The results aren't all perfect, and it's not all being done the way I would do it, but it's good enough. And, at the moment, good enough is perfect. The new perfect. Which brings me to...

2) I have let go of perfection. Completely. Now, let me be clear, I let go of perfection to a large degree with the birth of my first child 6 yrs ago. But I mean REALLY REALLY REALLY let go. So the floor has dried Cheerios and who know what else stuck on it from breakfast. Yesterday. Who cares? The reality is that if I stay up late at night and clean my floor, the kids will just get more Cheerios on it again at breakfast. Of course, we can't leave it there forever, but we can leave it there for a day or seven. There is a pile of mail mounting on the dining room table like a volcano. Who cares? Maybe it will prompt me to write to that place in Farmingdale NY again and get off all those junk mail lists. Friends are coming over and the house is a mess. Who cares? Either they will be bothered, in which case they will feel sorry for us and we can have the playdate at their house next time (sounds good to me), they won't notice because their houses look like that too, or they will be secretly relieved because their houses look like that too. Everybody wins. And having let go of perfection brings me to...

3) I have more free time. Given the emotional impact on the kids of this deployment(my 4 yr old is taking this the hardest, but my 6 yr old has also struggled since his Daddy left the day before his birthday), I feel an urgency to sit down and play with them, read to them and not just for bedtime, be more engaged than I might otherwise be. Though I am not a fan of filth or clutter, I have to tell you that it's frankly kind of a relief to sit down amidst the dried Cheerios and piles of mail and read a book to my kids on the giant beanbag in front of the fire instead of cleaning up the house. It feels like I'm finally living the way I should have been living all along, focusing on what really matters. And, I would be remiss not to mention...

4) I am saying yes. Kids want to go see Princess and the Frog, on a school night--why not? The kids stare with wide eyes and big smiles when I say yes. They're in kindergarten and preschool. They'll probably still get into college. Friends invite us for dinner, I ask what time with one hand on my cell phone and my other hand shooing the kids out the door and into the car. If anyone offers help, I am accepting it. And not feeling bad about it. If they offer, I am assuming they genuinely want to help. And if they don't, well, that will teach them for offering! I find that we are spending a lot more time with friends, not just for the token Saturday playdate, but dinner on a random Tuesday evening, an impromptu s'mores party right after school for no reason whatsoever. And our extended family is offering to come for weekends that they otherwise would feel too busy to pull off. It occurs to me: I miss our friends. I miss our family. I don't see them enough. My kids don't see them enough. It shouldn't take an earthquake to make us spend more time with people who are important to us.

So, there you have it. I love my husband to pieces. I can't wait to have him home. And when he does come home, I think home is going to be an even better place. But since he left, I have been forced to change the way we do business. I am happier, the kids are happier, and bonus: since I am no longer a perfectionist, I don't edit or proofread, I just post. Which means I am finally posting again, too.

Wednesday, January 20, 2010

Getting Wired

I thought it was a good idea to link NY Times articles, so I thought I would link this one: If Your Kids are Awake, They're Probably Online. I read it today while I was waiting to go to a molecular meeting, and it scared me.

We've been reluctant to take the technological plunge, in my household, for kids. But this year my six year old Sicily was begging for a Nintendo DS, and it seemed unfair to make her share it with my four year old John. So they both got one, and we caved in and got a Wii as well.

After the initial excitement, the Nintendo's have largely remained on the kitchen counter, plugged into their chargers. Out of sight, out of mind. Sicily enjoys the fashion and cooking games once or twice a week, and John likes the cooking and PacMan. Now the novelty has worn off, like any new toy. I think they are a little young. With the Wii, they both are more satisfied to create little Wii Mii's and drop them into the mall than play any other games, as of yet. Now that they are back at school and activities - piano and swim - and we are into the swing of reading at night, the Wii is rarely on.

I worry about exposing my kids to too much Internet - as of right now it is largely limited to weekend mornings when my son grabs my laptop and brings it into my bed in the morning. We look at YouTube videos of snowstorms, tornadoes, and earthquakes, as well as snakes and spiders. We always end up on the birthday ecards at American Greetings - they both have enjoyed them for years. There was a hairy moment when John clicked on that Christina Aguilera and friends video "Lady Marmalade," advertised at the bottom of the screen, and we listened for a little bit, until Pink started massaging herself (Yikes!). I worried about the message he was getting, at four, so I closed it out and said the battery was dead. He still asks for that video, weeks later. "Mom! Play that song with the pretty girls dancing!" I claim it is lost.

Their school has an Apple lab where they are learning basic computer skills. But I dread the day when they will need computers and the Internet, for their assignments. I have heard about restrictions that can be placed on Internet access by cable connection lines, and I am all for that, even thought I don't know the details or logistics yet.

I think, based on my parent's decision to not have TV's in our room growing up (about which I groaned on a regular basis, but am ultimately glad of), that I will do the same for computers. Place one in a central location, where they can be monitored using them at night. No smart phones (easy to say now), and I definitely plan to place strong restrictions on access to the computer and video games. The studies in the article are compelling, and they just make good sense.

I am posting this because I am strongly interested in comments or ideas, especially from people with children older than mine who are already tackling this issue. I got some of my best nursing, sleeping, and eating advice -- when my kids were younger -- not from books but from mothering blogs and chat rooms. The moms in the trenches, or those having just crawled out, seemed to have the best advice. And since every child is different, I learned I had to try and fail a few times before I found a solution that worked for each of my own kids. Thought I might start a little early with the Internet, after reading this article.

Tuesday, January 19, 2010

Are we over-snacking our kids?

I came across this great article in the New York Times about snacking. It's ironic timing for me as yesterday when I went grocery shopping, I was scouring the cookie/cracker isle for packaged, semi-processed, almost-healthy snacks I could grab along to the kids' activities. (Of course, I ended up with so many boxes there's no room for them in my pantry).

Anyhow, this article talks about the culture in American society that we now expect that there will be snacks for kids and adults at EVERY activity that kids do - regardless of duration. That instead of coming home and going outside to play, kids now come home and seek to satisfy their cravings. And because so few of these snacks are home-made, this must be contributing to the declining health of our youngsters.

I can speak for myself that as an internist, I worry a lot about the obesity epidemic in this country, especially among children. Yet when it comes to my kids, I don't think much about the QUANTITY of snacks, but I try to get the 4 food groups into the day, try to make sure there's at least one vegetable on the table at dinner and try to avoid purchasing processed foods from the grocery store. I think about the quality of snacks but I really don't' think much about the number of snacks. In fact, I'll be the first to confess that I use snacks as a way to get the kids into the car, out of the house, avoid tantrums ... really it's my most frequent bribe because I considered it relatively harmless.

I'm not sure I'll change my parenting style but this article has definitely made me think about it!

MiM Mailbag: Advice on marriage survival and being a resident mom


I just came across your blog and really enjoyed reading the posts (while I put off another question set as I procrastinate studying for Step 3).

I’m an Internal Medicine intern, and I have a 10 month old baby boy. I had a mentor prior to medical school - my boss (a psychiatrist) while I was a research assistant for her had two kids in the beginning of her research career. She told me several times “being pregnant during your 4th year of medical school would be ideal.” My husband and I are a little older than the average medical student and wanted kids sooner rather than later, and thus our son was born right before match day.

This year, as I’m sure most people can relate, has been tough, being a new mom and a new doctor. My program is a rigorous academic center where few women have children and as one attending said in my first month on the wards back in July “oh you have a baby? Wow… good luck.” And chuckled. And she was a woman.

Now, I’m so tired. So so tired. I just finished up three months of call (one of which was q3 in the ICU) and capped it off with two weeks of night float duties. And now I’m on a short clinic rotation but spending my precious three day weekend studying for step 3. I can’t seem to catch my breath.

I’m pleased to say that through all this, I still find moments where I love my job (strangely enough in the ICU, never thought I would actually WANT to be there) and my son is thriving. My marriage, however, is taking a hit. I just don’t know how to stay connected to him. He is not in medicine and seems less and less interested in the cool stories about patients that I have. We still definitely bond over our baby and he is doing an amazing job with him while I’m at work. I know intern year is hard on every couple, but if there are any other stories out there about marriage survival when you have a child and a resident, I would love to hear them. I need a little boost to help me through the rest of the year (because every R2 and R3 keeps telling me “don’t worry, it gets better next year…” – and I’m really counting on that).

Again, thanks for all the great posts on this blog. I will keep reading (when I have time!).


Sunday, January 17, 2010

Breastmilk vs. Formula: the epic battle

Breastmilk vs. formula is one of those topics that is highly controversial on the internet. When my daughter was of breastfeeding age, I was scared to even broach the topic on this blog. However, she's almost three now, which is an age where I would probably be given a lot of funny looks for breastfeeding, so I feel safe talking about it without being accused of child abuse.

I think most women would agree that breastfeeding is better than formula. However, there's a culture of women (very vocal on the internet) that will yell at any mother who does not breastfeed. You must at least try to breastfeed. Any woman who doesn't breastfeed is selfish. Formula is full of chemicals and is harmful to your baby.

But for a physician mother, especially one still in training, it can be hard to provide exclusive breastmilk for a baby. I know women who are great mothers who just couldn't swing it with their schedule. Giving your baby formula is not child abuse. Saying that is an insult to babies who actually ARE neglected or abused, of which there sadly are many.

My story:

I struggled with breastfeeding initially. I wanted to do it very much, but it was not one of those things that came instantly and easily to me. I had a very hungry, jaundiced baby who wanted to suckle nonstop, which was becoming more and more painful. With a rising bilirubin level, I consented for my daughter to have a couple of ounces formula in the hospital, which she sucked down in about five seconds. I felt guilty about this, because people told me that if she was given formula, she'd get nipple confusion and it would hurt my supply.

When I brought her home, I was determined to feed her only breastmilk straight from the source. She had a voracious appetite (she was at the 50th percentile for height/weight at birth, but was at 95th percentile by two months and stayed there) and I didn't get much pumping done, so we had no supply tucked away early on, which meant that I had to be up for every single feeding. I was stubborn and wanted to do it all myself. But when I was hospitalized with 103F fever at two weeks postpartum, my husband and I decided that he would give her one bottle of formula per night so that I could have the luxury of four straight hours of uninterrupted sleep.

I told this to a friend of mine who had been giving me advice about breastfeeding, and she belittled me for allowing my daughter to have a bottle of formula per night for the sake of my sleep. I was being selfish. Once again, I felt guilty.

When I went back to work, I was attached at the hip to my pump. I would hook it up while I returned pages on my cell phone, praying nothing would come up that couldn't be put off for fifteen minutes. When I came home from work and saw a bottle of breastmilk on the counter that was half empty, I'd be furious about the wasted two ounces of milk. We did have a can of formula in the cupboard, but I was proud of the fact that we rarely used it.

At six months, I moved on to a much more demanding rotation where I was the only resident looking after twenty patients. I put away my pump and just nursed in the morning and at night (until one year, when my daughter self-weaned).

When I look back on all the stress I had worrying about my daughter getting a few ounces of formula, I feel angry at myself. I was a loving mother. I cared about my baby and took very good care of her. It was stressful enough to manage residency and a baby without feeling like an ogre because my daughter was getting a few ounces of formula. Whenever a working mother tells me she gave up nursing because it was too hard, I immediately give her my sympathy. I would never say anything judgmental, because I'm sure she gets enough of that, most of all from herself.

If I have another baby, I don't know if I will do anything differently. I loved nursing and I think I stopped at the right time. But I definitely will keep a can of formula in the cupboard and not allow myself to feel guilty if I need to use it.

The Fourth Law of Mommodynamics

For years now, I have lived by the laws of Mommodynamics:
1. Energy is finite.
2. Clutter, like entropy, tends towards an infinite maximum.
3. Matter is neither created nor distroyed, it is merely misplaced.

Now, to my amazement, I recognize a fourth law has been operating all along, behind the other three: the law of conservation of clutter. This law requires that every time I find a lost object, an object of equal importance will go missing. This weekend it was my watch, which turned up under some papers on a countertop, and my cell phone, which instantly disappeared from my coat pocket. I have noticed the same sly switching going on with my faculty id and my drivers licence, my ward key and my office key, my metropass and my credit card--whenever I have one of these ready to hand, the other one slips off into the shadows for a giggle and a rest. After a frantic search which rivalled the rummaging of a cocaine addict in search of a fix, I just found the missing cell phone, under a potholder in the kitchen. I can hardly rejoice--lord knows what has just gone missing in its place!

Wednesday, January 13, 2010

Guest Post: Mentors

My mentors have been very important to me.

My first mentor was a Pediatric Metabolism specialist at the New England Medical Center in Boston. I met her shortly after I fell in love with Pediatrics, in my third year of Medical School. I was impressed with how she remained involved with her patients as she continued to manage their metabolic conditions into adulthood. These were patients she had diagnosed as young infants!

My second mentor was the program director at my Pediatric Residency program. In fact, I had ranked this program first because of my experience working with her in Pediatric Infectious Disease in my fourth year elective. When I became pregnant with my first son, she told me to take off as much time as I needed because I would learn more about child development by being a mother, than at any other time in my career!

My third mentor was my continuity clinic preceptor at the private Pediatric practice near my residency, twelve years ago...I joined this practice after finishing my residency and am still there today. My mentor, however, despite her clinical excellence and devotion to her career, left the practice of medicine five years ago after having her son due to the challenges of trying to balance her career with the needs of her family. Her husband is a surgeon.
One of the senior physicians at my practice continues to fill the role of mentor to me. When I have questions about psychiatric or developmental issues (this is his area of expertise), he has so much to offer me.

Recently, I have been able to act as a mentor to others through precepting and lecturing. And I have had the opportunity to give talks to school nurses from several school districts about food allergies in school, one of my interests.

As I think back, I realize I had mentors in my life well before my medical school career. There was my favorite English teacher in ninth grade, my undergraduate thesis advisor, and many other teachers throughout the years!

My father, a theoretical Statistician and University professor, was my first and most important mentor. He had so much faith in me, was always interested in what I had to say, and always knew I could achieve whatever I wanted to. This support from him made all the difference to me.

When my father died a year ago, I received many thoughtful notes from people I had known for many years. The most poignant letter, though, came from the first PhD student my father had mentored. He spoke of my father's love of teaching and how he had inspired and supported him in his own development. I was amazed to read this, I had not seen this side of my father. However, I realized only then that my father had supported my intellectual growth in this way as well.

-Pedimom, mother to 2 (ages 9 and 11)

Sunday, January 10, 2010

Saturday - Girl's Day

My four year old John and his dad left early for a car show, mummy movie at the Imax theater, and the Pharaoh exhibit at the Arts Center downtown. So I had a full day with Sicily.

First we showered and got ready. She came out in jeans, a long eggplant purple velvet hippie bohemian skirt, and an I Love Penguins t-shirt. Although she looked fabulous I chided her, in spite of myself.

"Sicily, we are going to a musical. You love to get dressed up, and you don't get the chance to do it very often. Shine for me, please."

She came back out in a beautiful lime green corduroy dress, white tights, and a low ponytail.

"Mom, will you please do my hair for me? Dry it, and fix it?"

I'm not the best with hair, but my sister gave me an elegant flower-shaped rhinestone pin for Christmas a couple of years ago that I love to wear in my ponytails to fancy events. So I offered it to Sicily, and she was enamored. We got all dolled up, and headed to lunch at Wendy's, her choice.

They were featuring Mad Libs, so over chicken nuggets, french fries, and a Southwest salad, I taught her the meaning of adjectives, verbs, and nouns. She peppered the Mad Libs liberally with nonsense words from Roald Dahl books I have read her over the last year, and the final product, which we read in the car in order to save the Wendy's patrons from lots of potty humor, was hilarious.

I got directions on my iPhone, and we headed over to the Baptist Church after filling the car with gas. We were the only Caucasian couple in the large audience of the predominantly African-American church, and I wondered, feeling a little like I was sticking out like a sore thumb, if this is what my partner felt like at work sometimes. Private practice is not nearly the melting pot of academics, especially in the South. I knew that we might be the only Caucasian people in the crowd, and worried, unnecessarily, over my six year old daughter Sicily's response. Earlier, while we were getting ready, she asked,

"Mom, is the church going to be only Spanish? Like the time (her nanny) Nina took us to her church?"

"No Sicily, but it is a church attended by mostly black people. We may be the only light-skinned people there."

She looked up at me and smiled. "No mom, you will be the only light-skinned person there! Not me. My skin is brown." She tans easily. I smiled, agreed with her, and loved that she has absolutely no qualms or hang-ups over skin color. I was silently projecting and worrying that she might make an observation aloud in the church that would offend someone. I resolved to quit my internal nonsense.

God the musical was incredible. It was The Black Nativity, by Langston Hughes. I read earlier in the week that it originally opened on Broadway in 1961 to rave reviews, even though two of the lead actors quit, because they were worried about the audience response during such a racially unstable time in our country. African chants, beautiful dance, choir music, amazing blues, silly rap, and gospel. During the intermission, my partner stopped by to say hello, and wondered if I was enjoying it. I nodded enthusiastically.

I asked her, "Did you see this for the first time when you went to St. Louis in mid-December?"

She smiled. "Yes."

"And you and your husband brought the entire St. Louis Black Repertory here, to your church, to share it with your church family? That was so quick! It is only the beginning of January."

She smiled again, a humble smile, but a pleased one. I wondered at the magic and power of possibility. Just imagine something, put a little work into it, and you can make it happen. She showed me that, on Saturday. After she went back to her seat, I got a tap on my shoulder.

"Gizabeth, is that you?"

My chairman's personal assistant from residency was sitting behind me, next to the former head of histology. I shrieked with recognition and hugged her excitedly. We caught up on old times, and I thanked my old histology boss for making me go to the doctor when I cut myself on a gallbladder the first month of residency. She towed the party line, while I was trying to hide my cut and staunch the flow of blood, in order to "be tough." I ended up needing many stitches. She smiled at my recollections. "At least you didn't dump formalin on it, like (so-and-so)!" We all wished each other a Happy New Year.

Sicily and I headed to Starbucks, again her choice, after the event. I had promised her, when she got a little bored and tired during the musical. She's only six - it's hard to blame her. I remember getting bored at Phantom of the Opera in New York when I was young. At least she didn't start stripping like she did when I took her to see Annie when she was four (she gets hot when she's tired). I asked her, over coffee and cinnamon cake, what her favorite part of the musical was.

"When they were doing like this. In the microphone. Ssshhhh."

"When did they do that? I don't remember."

"At the end, mom. What was your favorite part?"

I had so many, it was hard to think of one. I repaired my eyeliner, on the way into the coffee shop, because I teared up at least three times during the performance. The music, dance, and stories were incredibly moving.

"When the kids were performing. And singing. They were hesitant, and cute. It was funny. And when the men were kvetching over their jobs as shepherds. Singing the blues about hating their jobs, and losing their wives because they weren't making enough money to support their family. It was so funny, in a bittersweet way. And I loved when they were reigning in the people who were hunched over, acting like sheep, trying to wander off the stage."

"Let's just play rock/paper/scissors now, mom."

I went to the bathroom at the coffee shop, and told Sicily she could just sit in her seat instead of come with me, if she wanted to. I still get nervous about doing this, even though she is pretty grown up. As I walked out a minute later, I couldn't find her. My heart stopped. I caught the eye of another woman, and she glanced down behind a chair to show me where my child was hiding. Relief flooded me. I played along with Sicily's game, and pretended to search the whole store for her.

"Mom! I'm right here."

"My God Sicily! I've been looking for you everywhere! Where on Earth did you go?"

She laughed. "Magic, mom. I disappeared. Were you worried?"

Of course I was. But we were having so much fun, I didn't want to ruin the day by getting mad at her. I would discuss hiding in restaurants while I was in the bathroom later. "Not in the least. Glad you magically returned to your seat. How about we go home and check on John?"

"OK, mom. But let's go slow. I want this moment with you, without John, to last forever."

I missed John. And wanted to catch up with him and his day. But I understood, and we drove around the block a couple of extra times, singing at the top of our lungs, before we went home.

Just an Observation

So the week before Christmas I got to attend my son's first holiday program at school. My husband and I watched with video camera in hand, as he and the other kindergartens sang along to to familiar Christmas carols. I waved to several other parents I knew across the gym and had caught up with a few collegues as well (The majority of the doctors at my hospital send their kids to the same private school). As the first-graders took the stage, I noticed the chief of surgery's son was singing a solo. He was adorable and did an amazing job. Surgeon's trophy wife was there taking video, but surgeon was noticeably absent. As the program came to end and we all gathered for cookies and cocoa (yum!) I looked around and noticed that despite overall an equal number of moms and dads, where physician parents were involved, it was only moms. Probably 6 female physicians/moms were there and no physician dads (though probably 10 of their kids were represented).

Just an observation.

Sunday, January 3, 2010

Why I Thought I Would Post My Holiday Letter, Then Decided Not To

I consider myself a connoisseur holiday letters, which I have sent and received pretty consistently since I first had children. Since my friends and I are roughly of an age, most of our children have left, or almost left, home. This year, I am struck that my letter and the ones my friends send still focus on the doings of our kids, with some people adding a bit of travelogue or home repair updates. It makes me wonder if having children means that ever after, we live and see the world through others’ eyes, sometimes at the cost of closing our own. I know holiday letters are not an intimate genre, particularly not the mass produced kind, but it seems that I and my mother-friends reflexively place ourselves in the background and move the kids to the foreground of our lives and our relationships. This posture of stooping over our kids becomes so engrained, it is hard to straighten up and reclaim interest in our thoughts and feelings after the kids have grown.

Being in medicine complicates things a bit. My non-medical friends would be baffled if I wrote about how amazed I am about the way that we are finally understanding the illnesses I treat at a genetic level, or how I believe I have experienced an inner paradigm shift in my understanding of psychiatric disorders since I discovered evolutionary biology. But other professional friends are equally reticent about their inner lives—they may report promotions or job changes, but not how they have been evolving and changing themselves.

In the end, I can’t decide whether the loss of interest in one’s self, or perhaps just the expectation that no one else would be interested, is a natural part of growing older, an artifact of being mother, the result of being in a fairly esoteric profession, or simply my own view of things. In the end, being a mother/doctor seems to have greatly expanded my sense of who I am, but with some loss of the value I once placed on reflecting about my experience and sharing it with others.

Of course, nowadays I can blog about it, and leave the kidalogue for my holiday reports.

Friday, January 1, 2010

Things kids love to do with their Mothers...

As we make resolutions for the new year, I'm sure we will all be thinking about how we can be better parent, spend quality time with our kids and nurture healthy relationships in the family. I came across this wonderful article with a list of the top ten things students around the world said they remembered and loved most about their mothers. It was reassuring to see that despite my craving to make ambitious plans for the year, it's the simple things they love. I thought I would share...

1. Come into my bedroom at night, tuck me in and sing me a song. Also tell me stories about when you were little.
2. Give me hugs and kisses
and sit and talk with me privately.
3. Spend quality time just with me, not with my brothers and sisters around.
4. Give me nutritious food so I can grow up healthy.
5. At dinner talk about what we could do together on the weekend.
6. At night talk to me about about anything; love, school, family etc.
7. Let me play outside a lot.
8. Cuddle under a blanket and watch our favorite TV show together.
9. Discipline me. It makes me feel like you care.
10. Leave special messages in my desk or lunch bag.