Sunday, May 24, 2009
Saturday, May 23, 2009
Juliaink has brought a unique perspective to this blog, both as a psychiatrist in academics, as well as mother to two grown children. She writes eloquently and thoughtfully, and at times, passionately.
I think my favorite is still The Speech I Never Gave though I also like the one I did on mentors/models.
The Speech I Never Gave gave me goosebumps and one I wish was required reading for every female medical student. And her post on mentors was honest and rich.
Thank you, Juliaink, for having the courage to write about what moves you, and to share your opinions on issues seen through your multiples lenses as a mother, physician and concerned citizen. Thank you for your stories.
Friday, May 22, 2009
My husband was convinced that she was simply calling him "Dada" because he was a man, not because he and Gokey are long-lost brothers or anything. To illustrate this, he pointed to Adam Lambert and said, "Who's this?"
Melly hesitated a second before answering: "Mommy!"
Oh man. For the record, I wear way less eye make-up than Adam Lambert.
Admittedly, this entry didn't have a lot to do with being a mother in medicine, but hey, somebody had to post about the Idol finale (yay Kris). I'll also take this opportunity to announce that according to Melly, my job has now been upgraded from "diaper" to "dopter". Not bad, eh?
Thursday, May 21, 2009
Artemis, a neurologist in a private practice and mother of two teenaged boys, has written with us from the launch. She writes with honesty, insight and wiseness. Her posts make us reflect on our many roles as physician-mothers.Artemis writes:
I like both the very first post I did (June 6, 2008), and the March 29, 2009 post.
I remember the June 6 post well, called "Moms in Medicine." Her post really solidified for me why we were coming together: to share stories like this, to support one another, and to celebrate being mothers in medicine.
The March 29, post, "No, Mom, Billy does NOT want to stay for dinner" was a humorous anecdote of a dinnertime conversation that could easily occur in any of our homes.
It's been wondeful getting to know Artemis through her posts this past year. Thank you, Artemis. We are lucky to have you writing with us.
Monday, May 18, 2009
T is one of the original contributors to MiM and over the year, has contributed honest, witty, real posts about being a pediatrician mother in a 2 physician/researcher family. T writes:
"As I think back to my first MIM post one year ago, get out much, let me report on all the progress my husband and I have made. END of post.
Alas, I'm inclined to say that we've made no progress on the get out much as a twosome front. We still spend our evenings and weekends As A Family. Haven't identified a babysitter. Haven't seen a movie. One or both of us has put them to bed every night of their lives. We did go out on a "date" recently, but it was to an auction/fundraiser at our kids' preschool and they were there in an adjacent room!
Nonetheless, there's been progress of other sorts, indeed. Just Five is learning to swim and to read (now enjoying chapter books read together like Franny K Stein, Nancy Drew, Ramona the Pest, Ralph S Mouse, and others). Almost Three continues to eat all foods and play all instruments. Both know how to be Children in Medicine. They expertly cough into their elbows, wash skinned knees, brush every part of every tooth every night, and answer common questions from parents of patients when Dr Mommy's on call (okay, almost). Oh, and I'm not old yet.
And, though our Couples Time tends to be by day on the phone or at home after the kids finally go to sleep (after hours tends to be late in our family), I'm decidedly still in love with my husband who happens to be a Father in Medicine, or more accurately a Father in Research. And I've participated in (read, laughed, commented, collaborated, posted, cringed) as a first time blogger with a group of fabulous women with varied voices about what makes us who we are, Mothers in Medicine."
T, indeed, is a comforting voice here and we've all felt her reassuring and supportive comments. She makes you feel understood, not judged, and a part of a true collaborative. Thank you, T, for all of your contributions this past year, and hopefully, many more to come. (Also, you should take advantage of Recently Local Grandma VERY SOON.)
Tuesday, May 12, 2009
I am uncomfortably aware that my interests as physician, mother and citizen are diverging. As a physician, I want beneficiaries to be able to see me at reasonable rates with minimum hassle for both of us. Out of network coverage, health savings accounts, and any other mechanism that subverts managed care seems the most desirable when I am sitting behind my office desk.
As a mother, on the other hand, I am devastated that the last remaining not- for- profit HMO in my state is being dropped by the employer who provides our insurance. Growing up, my asthmatic daughter never had an attack before 6:30 in the evening. Only by the grace of Kaiser did she avoid emergency rooms and hospital stays. The idea that we (and she) no longer have an evening urgent care clinic to go to gives me shivers. She has had several ER visits since moving away and has no regular doctor. No one but me now reminds her to have check ups and refill her prescriptions, as the HMO used to do.
Then there is citizen me, who believes that national, single payor health insurance is the only way to correct the disparities that deny care to so many—including my middle daughter who is likely to be uninsured when she returns from abroad and has not yet found a job. As a doctor, I am wary of having the same type of people who man the kiosks at the DMV involved in managing health insurance, but as a mother I would welcome it, if it meant this child would not be uninsured, however briefly that is likely to be.
Like everyone else on this blog, I wish that politics did not divide and distress us. But some day in the not too distant future, I expect to have to vote on what it is I really want to see in health care reform. To the extent that my identity extends beyond myself to my children and my community, I frankly have no idea what it will mean to have the courage of my convictions. It would certainly help if I actually knew what those convictions were.
Monday, May 11, 2009
Warning! Your name or the name of someone you love may be disparaged in this post. Read at your own risk.
It boiled down to two possible names for my daughter: Claudia or Ariana.
Sunday, May 10, 2009
Initially, we were thinking about day care. A well established day care seemed somehow less frightening than letting a stranger into our house. However, most day cares in our very expensive area had a two year waiting list.... so basically, you had to get on the waiting list before you even were pregnant. And the prices were scary. The alternative was a "family home", where a registered person took a handful of babies in their home. They tended to charge less, have more openings, and fewer children.
I brought Melly to visit a family home in our area. I liked it immediately. It was very small: only two women and six children. But I still can picture the image of my helpless little 2 month old girl screaming on the floor of that day care. She was so young and I wanted her to have more individual attention. I couldn't leave her here. Not yet.
So I decided not to cheap out and I hired an agency to find us a nanny. I figured this way we'd get the absolute best quality nannies. The agency would check out the nannies, verify their credentials, and find us the nanny of our dreams. In exchange, we'd pay them $250 plus 10% of the nanny's salary for the first year.... pricey but worth it to get our "dream nanny". One agency guaranteed to find me someone in the four weeks before I went to work, so I hired them on the spot.
If it didn't compromise my identity, I would expose this horrible agency and how they turned out to be a lying bunch of scumbags. It took them over a week to send us one single candidate and she was the opposite of what we told them we wanted... for starters, she wasn't even able to work the hours we needed. I later heard an awful story about this particular agency: they instructed a nanny candidate to accept a job that she didn't want, then told her to cancel at the last minute (leaving the mother stranded), in order not to lose the client. We also read some news stories about nanny agencies who didn't check out their candidates as closely as they promised, such as one that sent over a nanny who was wanted for MURDER in another country. Scary. We lost our $250 deposit on this agency but at least we didn't end up hiring The Babysitter Bandit.
Meanwhile, my maternity leave was dwindling down and I was getting desperate...
With precious little time left, desperate times called for desperate measures: I advertised on Craig's list. I know you probably think Craig's list is just a way for murderous med students to meet their victims, but as it turns out, you can also get a nanny on Craig's list.
Several potential nannies didn't show up to their interviews and one even showed up on the wrong day (not a good sign). One was an older, very experienced and no-nonsense Mary Poppins type that my husband immediately liked, but I was wary, mostly because she wore too much perfume. Then I met Gloria. She showed up on time (score!) and the second I laid eyes on her, I immediately knew she was our new nanny. I just had a FEELING about her--this was the woman I had been picturing when I first started the nanny search. She seemed so loving, asked to hold Melly, and wasn't demanding like the more experienced nanny.
Unfortunately, my husband was stuck on Mary Poppins, so I had to convince him to give Gloria a chance. She also didn't have any actual nanny experience, but hey, the woman had three kids. We did a background check and called her (non-nanny) references, then did a practice day with her, in which she totally won us both over.
Two years later, I think Gloria was the best thing that ever happened to us. She was an amazing nanny, who took care of Melly like she was her own. I never had to worry about my daughter's safety when I was at work. One of the reasons we have been reluctant to move was that we didn't want to lose Gloria!
In the last year, we have mostly transitioned Melly to that family home we rejected when she was two months old. She's older now and we want her to have more social interaction with her "baby fwends" as she calls them. But I will always be grateful to Gloria for helping to raise Melly during that precious first year.
And that, kids, is the story of how I met your nanny.
(P.S. Happy mothers day!)
Saturday, May 9, 2009
Anesthesioboist joined Mothers in Medicine last fall. Since then, we've been graced with her phenomenal writing - a true aesthetic purist (hope I'm not putting too much pressure on her with that).
I think my two favorites would have to be "Code Indigo" and "Mom's Apple Pie."
T., thank you for making us routinely swoon from the beauty of your words and insight.
Friday, May 8, 2009
Happy Mother's Day to all!
Wednesday, May 6, 2009
The following scientific definitions come with a nod to Wikipedia.
Heisenberg uncertainty principle, as originally proposed:
"In quantum physics, the Heisenberg uncertainty principle states that certain pairs of physical properties, like position and momentum, cannot both be known to arbitrary precision. That is, the more precisely one property is known, the less precisely the other can be known. This is not a statement about the limitations of a researcher's ability to measure particular quantities of a system, but rather about the nature of the system itself."
Heisenberg uncertainty principle, with children:
In parenting, the Heisenberg uncertainty principles states that pairs of siblings, like "Munch" and "Iggy", cannot both be known to arbitary precision. That is, if I can actually see my 3 year old daughter and reassure myself that she is not coloring on (as in directly on) our kitchen table, I cannot also be simultaneously upstairs to observe my 5 year old son using my two mostly full leftover tubes of Lansinoh to glue ALL of his Lincoln Logs to his closet door (true story). This is not a statement about my limitations as a mother, but rather about the nature of parenting itself. Well, that's reassuring. I love physics.
The Law of Conservation of Energy, as originally proposed:
"The law of conservation of energy states that the total amount of energy in an isolated system remains constant. A consequence of this law is that energy cannot be created or destroyed.
Another consequence of this law is that perpetual motion machines can only work perpetually if they deliver no energy to their surroundings. If such machines produce more energy than is put into them, they must lose mass and thus eventually disappear over perpetual time, and are therefore impossible."
The Law of Conservation of Energy, with children:
With children, the law of conservation of energy states that the total amount of energy in an isolated system, such as when we do not have grandparents visiting for a long weekend, remains constant. A consequence of this law is that my husband allowing me to sleep in on Saturday morning leaves him doubly trashed and incapable of functioning for the remainder of the day, even though I am peppy and grateful and ready to have a big family day. Another consequence of this law is that perpetual motion machines (aka mothers) can only work perpetually if they deliver no energy to their surroundings, which means that I basically have to quit going to work, going to the gym, going anywhere at all actually, in order to keep my head above water with these kids. Apparently, they haven't gotten to this part in preschool science yet. If mothers produce more energy than is put into them, they will cease to exist. Take heed, children and husbands...and note that Mothers' Day is just around the corner, and they don't call it the "Rejuvenating Spa Day" for nothing. It could save a life.
Second Law of Thermodynamics, as originally proposed:
"The second law of thermodynamics states that the total entropy of any system cannot decrease except insofar as it flows outward across the boundary of the system. By implication, the entropy of the whole universe, assumed to be an isolated system, cannot decrease. In fact the entropy of the universe is always increasing. We know this because we can identify processes that produce entropy from scratch, and the second law tells us that these increases cannot be undone elsewhere."
Second Law of Thermodynamics, with children:
With children, the second law of thermodynamics states that the extreme disorder and chaos of your minivan (substitute favorite location: kids' bedroom, playroom, etc) cannot decrease except insofar as you have a successful yard sale, consignment store transaction, or Salvation Army pickup. Note that if you move the clutter from the playroom to the attic or unfinished room in your basement, the entropy of your system remains constant. By implication, the clutter associated with childrearing in the whole universe cannot decrease and indeed is always increasing. We know this because we can identify processes that produce entropy from scratch (baby showers with swings, jumperoos, infant carseats and bases, activity gyms, pack n plays, and diaper pails before you even have anyone to use them). And the second law tells us that once you have this stuff, you will end up holding on to it for an inordinate number of years even once you are absolutely, positively, (almost) definitely done having kids. And when you do get rid of it once and for all--usually because your childless younger sibling, to whom you have ranted that you are "so done" having kids after a particularly frustrating day, tells you she is pregnant and wants your stuff--the empty space vacated in your home and cars will be promptly filled with Matchbox cars, Polly pockets limbs, Legos, and jigsaw puzzle pieces.
And finally, I was a literature major in college, so I am not aware of the corresponding law in physics for this one, but I know it must be there somewhere (science majors, speak up): Children expand to occupy the number of adults present. This refers to the phenomenon that I am currently living as a temporarily single parent while my husband is deployed for 5 months. It takes me half the day to get a shower on the weekend when I am here alone with them. When the grandparents or aunts and uncles come to visit, it takes all of us half the day to get a shower. Even if there are 4 adults present, everyone is occupied. Someone is changing a diaper. Someone is helping to build a pizza shooting robot out of Legos. Someone is cleaning up the food thrown all over the kitchen floor by the 16 month old during lunch. Someone is attempting to catch the muddy child and wrestle her into the tub before she leaps onto the yellow sofa. If this has never been reported as a phenomenon before and you take a notion to scoop me by submitting it to Popular Science, please consider naming it Tempeh's Law.
So, just in case you have decided against becoming a radiation oncologist and now wonder why physics was required for med school, it was because those med school admission committees knew it was only a matter of time before you would want to pass on your genes. And when you did, with Physics 101 under your belt, you'd be ready. Or at least you couldn't say you hadn't been warned...I mean, consented.
MWAS has been writing here from the beginning, sharing her stories of being a pediatrician in a private practice and being a mother of two tween boys. She writes:
MWAS also created the signature Seriously, I wanna know... posts where she throws out a pressing question on her mind to all of our readers. The one on keeping last name/changing name/hyphenating and the one on fiction recommendations got almost 30 comments each.
When I went back and scanned my posts - the standouts were different than I expected - my writing has definitely changed over the year - which I love. I have a hard time just picking one favorite - Favorite things, 5 ways I know I'm not my mother at Christmas, & Bees and Birds are my selections.
Thank you, MWAS, for a wonderful year, and hopefully, more to come.
Monday, May 4, 2009
When I arrived at my office this morning, I had a walk-in patient waiting for me. In the winter months, it’s not unusual for a parent to try to “jump the line” and want to be seen first thing, and I try my best to accommodate parent and patient. I had promised to do a medicine re-check for my nurse’s child after I made morning hospital rounds today so that we could get her child to school, and my nurse back to work. My partner saw the walk-in who had stalked Lori, my scheduler, at the back door forty-five minutes prior to my arrival, while I saw my scheduled re-check.
Sometimes parents believe that medicine is a club – one that you can join if you have the right political affiliations or money or a very important job. Membership in this club gets them exclusive bonuses –kind of like frequent flyer miles or box tops – bonuses that include a physician’s home phone number or pager and the right to call them any time of day or night. Occasionally a parent will ask for my direct number- sometimes with a smile or a giggle as they promise not to call me at 2 AM for a diaper rash or spit-up. Acceptance into this club also allows members to talk about their child’s sex education in Starbucks, or ask for antibiotics (just in case) whenever they are leaving the country for Turks and Caicos for the next two weeks.
Being truthful with myself, I accept that I am part of a club of sorts. When my triage service calls about a family friend who bit his tongue and needed advice about whether to go to the ER or not, I call the family because they‘re friends, and they would show the same concern for my children. I’ve also referred my brother-in-law with appendicitis to Dr. Ileum because he’s a friend and I know he’ll take good care of my relative. I’ve also met a fellow partner and her child in the middle of the night when she suspected her daughter had new onset Type 1 diabetes. (She was right!) My family and close friends (I can count the number of families on one hand) are default members, and they know there are rules about membership.
The notion of an exclusive membership or concierge medicine doesn’t sit well with me. As humanly possible, I try to treat my patients as well and equally as I would treat my own family or friends regardless of socioeconomic status. There are boundaries, though, and limit pushers that make me put my foot down. I won’t write prescriptions on the fly for administrator or staff’s children anymore when I’m trying to make hospital rounds. It’s not fair to my patients to get distracted like that. I cannot prevent a patient with lice showing up on Sunday morning on my front porch, but I won’t let them expose my kids. My phone has caller ID, and we screen the calls heavily, so when I’m not on call, I’m focused on my family, and my personal time. It’s all part of a balancing act that I’ve had to learn bit by bit.
Sunday, May 3, 2009
Now I've lived apart from my husband for periods of time and it was not fun, but it was doable. But living apart from my child is a totally different ballgame.
I know the commenter meant no offense in this statement, and the truth is, women do this. I know of a few female residents who have sent their babies to live in their home country with the grandparents while they furthered their careers. I don't judge these women but it's not something I would ever remotely consider.
In my daughter's entire life, I have only been away from her for one single night. (Not easy to manage as a resident!) My husband has only been away from her for a handful of nights. For either of us, it is painful to even contemplate a year spent apart. I can do a fellowship in ten years from now if I want, but AGE TWO is only going to happen once. I'd never forgive myself if I missed out on it.... or if I put my husband in a position where he was forced to either give up his job or miss out on it.
For me, feminism does not necessarily equate with always getting my way in terms of career.