Tuesday, November 30, 2010
We recently retrieved the movie from the jaws of the Disney Vault. I think I liked it the first time I saw it, when I was a kid, but this time it just left a bad taste in my mouth. The music is good, I suppose. But Belle is so annoying. What a horrible role model for girls. Here is a woman who is "smart" because she reads books about princesses falling in love, and has absolutely no aspirations of her own to accomplish anything.
Yes, she wants to leave the town she lives in. And true, she doesn't want to marry the arrogant jackass. But the joyous ending for her is just falling in love with some guy who isn't an arrogant jackass (anymore). Who appears to only like her because she's pretty. Plus she does nothing to help him when he's fighting the bad guy... aside from loving him, I guess.
My daughter has a bit of an obsession with the Disney princesses, as evidenced by the drawings on her underwear, so I can't help but notice that all the movies are like that. Ariel and Jasmine are spoiled little brats. Cinderella falls in love with a guy so generic that he doesn't even have a name and is merely defined by being "charming." It's kind of sickening.
That said, I love Mulan.
We just rewatched it as travel entertainment, and each time, I like Mulan better. If you've never seen the movie, it's about a Chinese girl who poses as a male soldier so that her ailing father is spared joining the army. She completely kicks ass as a soldier and there is only passing mention of her romantic interest in her commander.
But you know what I really love about that movie? Not that Mulan kicks ass, but I love how in the beginning, she sucks at everything. She is terrible at every part of training, and her only comfort is that everyone else is equally terrible. I totally relate to Mulan! Granted, she gets really good within the span of a two minute training montage, but I still like her for it. And I love that she continues to doubt herself until she finally gains confidence in the last sequence.
I think it's such a great movie to show to young girls. Every time my daughter watches it, I want to yell, "Isn't she awesome??!"
Does anyone have any other examples of movies we can show our daughters to inspire them not to turn into whiny brats ogling some handsome prince?
Saturday, November 27, 2010
I started medical school at 28 with 3 little kids who were 5, 3, and 10 months at that time. I had energy to take care of home, husband, kids and study. I made it through residency with a few more gray hairs but was for the most part enjoyable. I had avoided the more strenuous and time consuming residencies because I wanted a family life, which I have truly loved. Then I paid back my time to the US Air Force and life got a little more stressful.
I am not sure if it was the lovely combat boots, the ever changing rules, the fact that I did not have control of my time or travels or the facing a young mother who was about to leave her young infant for a year long deployment. This takes a lot of “brain and heart” energy that I sometimes do not want to expend. I find myself feeling guilty over this but my husband, kids, family and friends need me to be “fully there” also and at times I am just emotionally and mentally spent.
Now as a civilian a typical day may consist of dealing with a depressed cancer patient and their stressed family members, a concerned mother worrying about her obese child, a middle aged woman with vaginal bleeding after menopause, a hypertensive diabetic patient with an oh by the way I have chest pain, or the patient who has lost their job and will soon be homeless and the list goes on and on. Between discussing odd symptoms, rashes, patient comments with colleagues, pouring through online and print resources and cramming the newest medications in my brain…guess what…I am worried about my patients and exhausted at the end of the day.
My weekends take me away to a place without the stresses of patients’ needs but amazingly enough my thoughts always go back to a patient or two. I find myself thinking of a new strategy to combat their hypertension, a positive word I can say to the worried mom, or make a mental note to call a patient on Monday morning to see what the specialist said. So, even though I am tired I cannot pull myself away from the things I love…family, friends and medicine.
I have yet to decide if this line of work is healthy for me but it certainly is addicting and for the most part enjoyable. I certainly pray a lot more these days than I did when I was younger with fewer responsibilities and more energy. I have learned and changed so much from my patients I can’t imagine who I would be otherwise. So as I walk through my day I must remember to take a deep breath, and enjoy these patient doctor moments because I will never be the same.
Thursday, November 25, 2010
Tuesday, November 23, 2010
--My senior resident telling me at the end of my 30 hour call that even though I was off duty, she expected me to go watch my patient get a colonoscopy. ("It might be painful, but you better go because it's worth it for your education!")
--Spending 14 straight hours rounding on 70 patients on a Saturday and finally getting home, only to immediately get called back to the hospital for chest pain the patient had been having all day and decided not to tell me about.
--After an entire afternoon of coding a patient multiple times and finally agreeing it was hopeless, when the nurse said, "The patient's daughter wants to hold his hand as he goes."
After a while, I got a little better at holding it in till I got to my car, where I'd really let loose.
When I mentioned my frequent tears in a previous post, I think a few people may have called me "emotionally unstable" in the comments or something along those lines. All I have to say to that if that's the case, there are a hell of a lot of emotionally unstable med students and residents out there.
Of the residents and med students I've worked with, I've gotten to see a lot of them cry. In my intern year ICU rotation, I saw practically every female resident working there cry at some point. My senior resident cried when she realized the next morning that she missed a pneumothorax (wouldn't have mattered). She also cried when the coroner yelled at her post-call for incorrectly declaring a patient. I even saw the "badass" senior resident on the team crying one afternoon.
In med school... wow, it happened a lot. After exams, before exams, just randomly in the locker room. I remember during my surgery clerkship, we were having a workshop on tying knots, and one student was having trouble with her knots and burst into tears. I still remember what she said: "I don't even feel that sad. I'm just SO TIRED."
I guess my point is that you shouldn't be made to feel like an emotionally screwed up freak if you cry at some point (or multiple points) in your medical training (or beyond). Unless, of course, you're a man and you cry. Then you're weird.
(I have never once seen a male resident or med student cry before. I wonder why that is. Do they just not feel it or are they better at holding it in?)
Monday, November 22, 2010
When I first saw him, I’m pretty sure I let out an audible gasp.
It was love at first sight.
As I approached, I began to get goose bumps.
Could I really be thinking, what I was thinking.
Married, Doctor-moms, in their mid-thirties shouldn’t do such irresponsible things.
But, I couldn’t help it, it just felt so right.
Then his intoxicating scent hit me….a perfect blend of leather and new car smell.
As, I sank into those beautifully stitched seats and took my first test drive, I was officially smitten. He cornered like he was on rails and his torque sent my stomach into a tail spin.
Then I had to break the news to my husband.
Honey, I’m buying a new Camero. A ruby red Camero with leather seats and a kick-ass radio.
Really my husband says? That doesn’t really seem like you?
I know. That‘s why I want it.
Don’t you want a Honda Odessy like all your friends?
We already have an SUV for hauling the kids, so my car essentially drives me back and forth to work which is only 5 miles. I was not even considering buying a new car until mine literally got washed away in a natural disaster*, giving me only days to find a new one. In the past I’ve always carefully researched for months which slightly used car was the proper choice, then proceeded drove it forever. This time, I didn’t have the luxury of months to pour over Consumer Reports, so I just went with my gut.
In the grand scheme of things its not that big of deal what car you drive, so why not have fun with it?. Really, in the words of Mindy McCready, “Guys Do it All the Time.” Most of the Orthopods at my hospital buy a new European sports cars every few years. I spent about a third as much. Hey, I’m just doing my part to help stimulate the economy.
Let me just say that our relationship has flourished. I LOVE my car. It’s a fun escape from my real world. For 15 minutes twice a day , I am no longer a suburban soccer mom, I am the cool kid; the race car driver; the rock star; maybe even the homecoming queen. I am one with the road. I find myself taking the scenic route home , soaking in the sights. Enjoying the purr of the motor as I drive through the country side.
So, I have a new man in my life. Perhaps I am having a little midlife crisis as my mom has suggested.
I don’t really care though, cause my new car is Bitchin’.
*In all seriousness, please take a minute to look through the pictures in this link. Though, mostly ignored by the national media, the Mayday Flood of 2010 was absolutely terrifying to live through.
My name is Crystal and I am currently an undergraduate student at UCLA. I have 3 daughters, 6, 4 and 8 months. I also have a husband. I will be graduating in with a double major in Anthropology and African American Studies.
As a "career changer," I am currently looking for the best pre-medicine post-bac program that will lead me to pursue medical school. I have a deep passion for medicine and currently I cannot find ANYONE who could help me (even here at UCLA). I feel very lost going through this process right now, because to most people that I have talked to (especially counselors), my situation is very unique.
We currently reside in the family housing at UCLA and my children attend the day care/school here as well. I guess my problem is that I am trying to find a program that offers acommodations to families (housing, preschool, scholarships/financial aid etc...)
I came across a few post-bac programs (Drew, USC, Temple, Harvard) that I think would be a good fit for me, but I am trying to make sure I can find one that will ultimately be good for my family as well. I don't mind relocating. I just need some direction, especially because I have a family, I will be making this choice for them as well.
Do you know of any resources that could help me with finding the right program?
Thank you very much. Your website inspires me a lot. I had no idea that there were so many women going through the same exact thing that I am facing right now.
Saturday, November 20, 2010
Friday, November 19, 2010
Therefore, it stands to reason that I enjoyed our state neurosurgical society meeting last weekend. I don't like big national meetings, being an introvert at heart. Our state meeting, however, is small; this makes for a more intimate atmosphere and more outspoken dialogue. Colleagues from across the state can exchange ideas, new techniques, and opinions. We also discuss issues of importance to us locally, such as our lack of a motorcycle helmet law (UGH!).
I generally come away from these meetings with a new idea or two to implement in my practice. I fear becoming a "dinosaur," stuck in the rut of old techniques and outdated technology. My patients deserve my best efforts to stay current, as difficult as that sometimes is. Looking back at the last 9 years, I think I've done a pretty good job with keeping up to date, particularly as related to the spine (my professional passion).
This weekend, I sat in that chilly conference room second-guessing myself.
My colleagues are astonishing. One academic cerebrovascular surgeon showed a video depicting the results of the new non-profit organization he founded recently. Neurosurgeons travel to East Africa in groups to train local doctors in basic and emergency neurosurgery. He envisions such a training network all over Africa, bringing ongoing lifesaving care to thousands. They operate on brain tumors without microscopes, power drills, even electric lights. And the outcomes are remarkably good.
Another colleague, a skull base specialist, presented a series of "eyebrow craniotomies" in which he removes tumors through a single eyebrow incision and an endoscope. It's hard to get less invasive than that. Yet another brought me up to date on the neurophysiology of consciousness and the two biological definitions of time, all over dinner.
I had looked forward to seeing the only other woman neurosurgeon in our state, but she wasn't there. She was in another state doing a fellowship in interventional neuroradiology, learning to coil aneurysms. She already has a fellowship in neurotrauma, and she is laying the groundwork for a new residency program at her hospital system.
Driving back across the state, I tried to envision how my colleagues do all these marvelous things. I don't know how they find the time and energy. I admit that I struggle just to keep juggling all the basic balls: raising a kid, running a practice, taking care of a house and husband, the things we all do as routine. I am doing my dead-level best to just stay current in my field. Professionally, I am inspired by all the possibilities out there; I would love, for instance, to learn to do an eyebrow craniotomy. I probably should learn. Practically, I can't imagine taking time for more training or an overseas mission trip, or anything on top of my current load. I understand Bilbo Baggins when he said, "I feel thin, sort of stretched, like butter scraped over too much bread."
So, this week, despite my glimpse of the shining frontier, I feel myself inevitably settling back into my comfort zone. My familiar routines embrace me like a warm, cozy bed. Just as it's hard to get out of bed in the early dark, it's so hard to contemplate changing the patterns of my practice and my life in a dramatic way. I'm actually alarmed at how much harder it is as the years go by. Maybe it's time to push myself out of the zone and see how much more I can do.
On the other hand, perhaps it's wiser to stick with what I do best, as opposed to scraping myself over even more bread. How important do you think it is to keep stepping out of the comfort zone?
Wednesday, November 17, 2010
I'm not one of those mothers who calls the pediatrician for nothing. I would say that in Melly's first year of life, I called a total of twice, one of which was for simultaneous fever of 102, diarrhea, vomiting, and bilateral ear infections. (For the record, I had to beg for an appointment that time, which the nurse only grudgingly gave me. Should have been a warning.)
When Melly was about two, she woke up one Sunday morning and one of her eyes was swollen. This had never happened to her before and I was concerned, so I called the pediatrician's office. I was met with the following message:
Due to the high cost of after hours phone calls, all calls to the advice nurse after regular business hours will be charged a $20 fee.
At the time, I was a resident and my husband was a student. I thought about the $20 and decided her eye didn't look that bad and decided not to pay the $20.
I can understand why they might do this. Even if you're not a physician, if you've ever read Dr. Grumpy's blog, you'd see the ridiculous, trivial, non-urgent things people call about in the middle of the night. I bet parents are even worse than neurology patients.
But I also think it was horribly unfair. I can understand charging parents who call excessively a copay, but I don't feel like it's fair to put a parent in the position of deciding if their kid's swollen eye is worth the $20. And what if my kid had a health problem that required more monitoring? Would I just be screwed and have to keep paying $20 every time my kid got sick and I wasn't sure whether to go to the ER?
I've used two different pediatrics practices since then and neither charged a fee for after-hours advice.
What do you think? As physicians or mother or patients, do you think it's wrong to charge for after-hours nursing advice?
Monday, November 15, 2010
Tempeh, who has been through multiple deployments, and who is quite possibly The most supportive friend in the history of supportive friends and who has made offers weekly to help in some tangible way, joked a couple of months ago that I was overdue for a major appliance failing, a fate that befalls almost every newly-alone spouse of a deployed servicemember.
My appliances, thankfully, are all in good working order (I am furiously knocking on wood right now), but my once-rock-solid nanny situation disintegrated before my eyes.
I will save you all the gory details, but even before the sordid events that unfolded over the course of a couple of months, we had certain reservations about her as a childcare provider. Namely, that while she was perfect for an infant: loving, warm, patient, calm, she was highly ineffective with a toddler and a kindergartener: entirely passive, indulgent, and without a limit-setting bone in her body. Yet, we were willing to ride it out until the new baby came in a few months and her primary focus would be, again, a newborn. The older two kids would be at school all day.
But, then, the sordid events happened, involving a quite-possibly mentally unstable boyfriend to nanny who would not stay away from our house or our children despite our many requests, and to top it all off, reports from the school that she and said boyfriend picked up our two-year-old son from half-day pre-school and put him in boyfriend's car, without a car seat and sitting on her lap in the front passenger seat.
Stress? Yes, hello, it's me again. This all went down on my birthday, of all days, and right before a month for me that included 3 work conferences, including 5 presentations and being attending on wards.
We fired her immediately. My parents moved in temporarily. It was all very sad since she had been with us for over 2 years and was very much a part of our family. She had taken care of my son since he was 9 months old and he was/is very attached to her. When she moved out, she cried and hugged me for at least 10 minutes straight, telling me how very sorry she was and how I was like a daughter to her.
This has all highlighted for me how tenuous having a nanny can be. Great one minute. Disastrous the next. I can't tell you how many times my husband and I have told each other how lucky we were to have had our nanny over the past 2 years. Up until recently, it was truly great and made our lives many times over easier. And now, we're/I'm starting all over again. No one is going to be perfect, I know. But, it's scary how far from perfect they can be.
Friday, November 12, 2010
Wednesday, November 10, 2010
Well, who does, right? I mean, there are probably a few people who like it for some reason. But I'm guessing most people don't enjoy working weekends.
But I really, really don't like working weekends. When I have to get up to work on the weekend, I usually spend much of my time at work on the brink of tears, accompanied by a steady stream of resentment toward all the people who don't have to work that day. Then I usually come down with a cold the next day. So I feel like I might dislike working weekends more than average, but I could be wrong. That could be average.
Sometimes weekends on call aren't as painful as regular days. But sometimes they're much more painful. Sometimes they involve rounding on every patient on everyone's service with an attending who doesn't seem to understand that weekend rounds are for emergent issues only and judiciously uses the phrase, "Is there anything else?"
I suppose that there are several jobs that also involve working weekends (policeman? chef?), but there are also many that don't. My husband, for example, has never worked a weekend. And he has a good job with a good salary.
It bothers me that becoming a physician requires this commitment of working weekends, at least during training (which, as we all know, lasts for freaking ever). Especially when you have young children at home, this requirement ranges from annoying to heartbreaking. I'm sure lots of people will comment and say that they have a job that doesn't require any weekend responsibilities, but I don't think that's the norm for physicians. People get sick 7 days a week.
There's a part of me that wonders if you're the kind of person who really, really hates working weekends, and really, really hates waking up early, if maybe you shouldn't consider a different career based on that alone? Sometimes I wonder if I should have.