Friday, December 4, 2009
I spent most of my time being Mom - doing activities with the kids, thinking about their diets, their sleeping habits, organizing their toys and arranging play dates (most of which I could barely find time for in my juggling act prior to leave).
Over and above being Mom, I seemed to have gone through various phases during my leave:
The first couple months I spent in a post-partum state. Sleepy, emotionally labile, sensitive about my weight and just trying to establish new coping mechanisms with three kids. Fortunately, that phase seemed to go by quickly.
The next two months, while my baby was temporarily sleeping through the night, I spent most of my time on me - I worked out every morning, read a book, started a global health blog, established a presence on twitter, got involved in some volunteer work...yes, a busy couple of months.
The next phase was in the fall, flu season started and the baby stopped sleeping through the night. I spent at least one month again sleepy and this time driving to doctor's appointments or vaccine appointments all of which seemed to be inefficiently staggered.
Last month, I focused on doing research on schools (since my eldest will start kindergarten next academic year). I'm trying to determine my answer to public vs, private school and get to know the options in my area. I had been meaning to do this for the last year and I finally made this a priority.
Finally, in the home stretch, I am now interviewing for a full-time nanny. I've met at least a dozen ladies from all walks of life and have yet to find the right match. This process has taken much more time that I anticipated and after spending the last 7 months with my little one, I'm much more attached than I expected.
After deliberately neglecting my medical journals for the last few months, it's now time to dust them off and get reaquainted with the medical world. I'm nervous about all that I must have forgotten and all the patient follow-up that always follows me home. Yet, I'm excited to start being a doctor again - having spent so much time on myself, it will be nice to focus on my patients.
Thursday, December 3, 2009
Last year at this time, we were in the midst of adopting our daughter. One year later, it seems she's always been here. Time flies. I note some of my mothers-in-medicine colleagues have new babies in their homes. I would encourage them to take plenty photos to document how time flies.
Here, for example, is a demonstration of what a change just one year can make...
Just to update you in all areas of the Fat Doctor Life, I thought I should just list some general subjects.
- My weight: Highest ever. One foot in the grave. Not yet hopeless, but not sure what I need, want or can do right now. Praying for guidance.
- My career: Happiest job ever. Teaching, clinic work, may get back to some hospital work soon.
- My family: Son growing into a funny, smart kid. Daughter just had her first birthday and is starting to toddle. Husband is busy with work, the church and taking care of me. He remains my favorite person ever.
So the holidays are back now and the FD family has a full schedule of work parties, church programs and family get togethers. I'm busy but not complaining. This is the kind of busy that makes the world go round, the kind of busy that makes time...well...fly.It's good to be back.
Since I posted "A Random Day in My Life" a couple weeks ago, my days have changed in the most wonderfully exhausting way. After waiting almost 3 years for a baby, we got 'the call' a couple of weeks ago, and 48 hours later we brought home our beautiful new son from the hospital. Our adoption journey has not been easy, but the final result worth every minute.
Adoption Journey Part 1
Wednesday, December 2, 2009
What we'd like to do is have an entire week dedicated to posts like these--a Topic Week. In thinking about my fellow MiM contributors, I would honestly love to read any of their typical days from start to finish. Please consider joining us by submitting a guest post with what your typical (or random) day looks like -with as much or as little detail as you feel comfortable sharing. If you do, please include a short bio with your specialty and the general ages of your child(ren). Send submissions to firstname.lastname@example.org. We'll schedule posts throughout the week.
Thanks for reading and sharing.
Monday, November 30, 2009
Sunday, November 29, 2009
Thursday, November 26, 2009
Saturday, November 21, 2009
At the meeting I learned about a big review article (Roter, Hall and Aoki, Physician Gender Effects in Medical Communication: A Meta-analytic Review, JAMA 288:6 756-64)that showed that women physicians, at least those in primary care, spend more time with patients (10% longer visits—an average of only 2 minutes more per encounter). The researchers found women were better at enlisting patients as partners in their care, asking about the social context of illness, and focusing on emotion. I remember, still indignantly, being scolded by a resident for spending too much time “chatting” with patients on rounds. This study—a meta-analysis, please note-- firmly laid that shibboleth to rest. The extra time we spend with patients is not merely social conversation. Women use time with patients well, conveying medical information as thoroughly as male physicians. While the effect on medical outcomes was not reported, other people at the meeting provided compelling data that communication promotes adherence, and adherence promotes health and lowers costs.
These data are something we can all be proud of. I confess I would love to go back to my obnoxious resident and say it out loud: “So there !”
However, since it's been a little quiet on here, I thought I might give a little update on the last few entries I posted:
1) I started NaNoWriMo on Nov 1 and finished a "novel" of 69,091 words a few days ago. It is truly awful and I am terribly proud of myself. Now I can let Wonder Pets have a break from raising my child.
2) A couple of weeks ago, I camped out in the board of health and finally got an H1N1 vaccine for myself and my daughter. We got the intranasal one, so hopefully we've been shedding lots of attenuated virus for my still unvaccinated husband. My hospital still is not offering it, nor is our pediatrician (which may prove to be tricky when my daughter needs her booster).
3) I am currently reading Baby Proof by Emily Giffin, which someone recommended to me in the comments. See? I listen to you guys.
Also, I'm really enjoying life in fellowship. It's great. I'm not a resident, not yet an attending (all I need is time).
Thursday, November 19, 2009
I ask because I have a few grades that are, um, less than desirable for a med student wannabe. Not that I couldn't do well in those classes - I was just focused on other things (I didn't think I'd be going to med school at the time).
Monday, November 16, 2009
I had to be there in the morning -was presenting in a workshop - but didn't want to spend an extra night away from the family, so I booked the earliest express train I could. The 7 a.m. Acela Express.
The gate was full of business-types in suits and briefcases, heading to Philadelphia or New York. I felt out of place in my purple dress and suitcase. But, what a great ride. It was amazingly fast and smooth. Plus, I got actual work done. When I stepped off onto the platform in Philadelphia, I felt decidedly more comfortable and more than a little disappointed to have booked the plain old regional home.
About a year and a half ago, I wrote about a different train, the slower train that my career was on since finishing residency and having kids. I just read that post again and marvel about how quickly things have changed.
I find myself riding the Acela Express, literally and figuratively. (How I ended up on it, I'm not so sure. It's all kind of a blur.) For the past couple of months, I have looked up to see the scenery flashing by the windows and the stops have become far less frequent. I have blamed the convergence of several deadlines and projects, yet I also wonder if this is the new reality.
I can see why people choose the Acela. It is seductive, this speed. I can get places much faster. It is difficult to get off; the stops are few and far in between.
My problem now is not knowing if I can keep pace with the Acela. I've been more stressed than usual, working much harder, and burning the midnight oil. (And if I wasn't sure if I was stressed or not, I could just ask the sebum-producing glands on my face, or my stomach lining.)
I've talked about this with my husband (who is no stranger to the express train), who reassures me that this is all good. It's all about adapting to a new level of productivity and reaching the balance needed with it. I may feel out of balance now with work>life, but I will learn to adapt, as he has.
I hope this is the case. Because, I have to admit, this express train is kind of exhiliarating.
Tuesday, November 10, 2009
Recently someone online was recommending that I read Jane Austen's Pride and Prejudice. The thought of it made me ill. I try to do a little reading when I can, but Jane Austen is pretty heavy stuff. I jokingly replied that I was a working mom and that I really couldn't focus on anything that couldn't be read in fifteen minute spurts with a toddler screaming in my ear. Jane Austen doesn't really fall into that category.
The person replied that she was working mom too and "I'm sure I'm not the only one who's managed to read Jane Austen or other books with at least a little substance." Ouch. It took every fiber of my being to end that conversation and not get drawn into an argument. Every fiber of my being.
But of course, I then went to look at my bookcase to verify that my reading list is not completely vapid (although I've been getting most of my books from the library lately). All right, there was perhaps an overabundance of books with the word "shopaholic" in the title. (Recently read Kinsella's "Remember Me?" So good!) I've been making rounds on the NYT Bestseller List with "The Time Traveler's Wife" and "Prep." I've also got a book called "Murder on the Rehab Unit" which, as a rehab doctor, I was compelled to purchase (although apparently, not read).
All in all, I'm not entirely sure I've read anything "of substance" lately. Actually, I don't think I've read anything "of substance" in years. Unless of course, you count all the zillions of articles that I read for work, the textbooks, and of course, EMedicine and UpToDate. I guess that's why when I read something for myself, I like it to be fun and light.
What about you? Is Jane Austen something you trudge through in your spare time? Do you try to go for the books of substance or do you unwind with the guilty pleasures?
Saturday, November 7, 2009
6:00 get on tread mill at gym
6:10 officially wake up
6:20 fight the urge to get off the treadmill and begin dancing around the gym when “Hollaback girl” comes on my ipod. (Crank up the mph to 7.5 instead)
7:45 eat Cliff bar on my way to coffee shop
7:47 arrive a coffee shop where barista already knows my order
8:00 arrive hospital
8:10 round on postpartum patients
8:30 begin seeing patients in office
8:40 first patient is in her early 20’s. She looks at me glassy eyed as I discuss health issues, encouraging safer sexual practices, quitting smoking and healthy eating. Ummmmm….. I really just need a refill on my pills. Fine, I say.
While I’m doing her pap, she stops texting long enough to say “Why would you EVER want to be a gynecologist???”*
“I enjoy delivering babies and helping people live a healthier life.” me
“Oh” “You know I really HATE this!” her
(By the way, 90% of people say this during their pap smear)
“Yeah I’d be a little concerned if you actually liked it” I reply with my canned response.
The next patient wants to discuss hormones. She starts by saying “Well Oprah says….. “ at which point MY eyes glass over…
9:20 Labor and delivery calls with a patient in labor. I walk over and check her in. 2 cm with first baby.
See several other patients
Avoid several drug reps
Office manager stops me to sign some checks
We pay HOW MUCH for PAPER???? She tells me were getting a good deal because we’re buying in bulk. I believe her.
12:15 done with morning patients
12:20 do circumcision
12:30 eat canned soup and cookies
12:40 Labor patient is 3 cm
1:00 Afternoon patients start
I see an annual exam who I delivered 2 of her babies. We compare notes on Halloween costumes and chat.
Next patient comes for a “hormone check”… but is really just depressed.
Next patient doesn’t need me to fix her….. she just needs to talk to someone. I let her talk as long as my schedule allows (probably longer) and then get her a referral to a counselor.
Next patient comes in for a “yeast infection that just won’t go away that’s now blistering.” Sorry honey, but it’s Herpes….. pass the tissue box. That wasn’t a pleasant conversation to have.
Next I get caught up discussing Twilight with a patient (you better believe already have my New Moon tickets and my Team Edward T-shirt).
3:30 Labor patient only 4 cm. Call husband let him know I probably won’t be home for dinner.
3:40 OB comes for 12 week checkup. US reveals no heart beat. She had no reason to think anything was wrong. They had been trying to get pregnant for over a year. Telling her that she had lost her baby made me feel physically ill. I hold her hand as she cries. Big tears. My own eyes sting as I fight to hold my tears in. I take her to the back door to let her out so she wouldn’t have to walk through the waiting room, as I closed the door I get a stat page to L and D. I race across the parking lot to the hospital…. The baby’s crowning. I quickly gown and in one push, a beautiful baby girl is born. I lay her immediately on the mom’s belly. Blood, vernix and tears are everywhere. The daddy cuts the cord. I have to guide his hand because he’s crying so hard he can barely see. Pictures are taken. Hugs are exchanged.
The grandma looks at me and says , ” You have the most amazing Job in the world.”
“I’m very blessed”
4: 15 I thank my NP for helping see my patients while I was out
5:00 Finish seeing patients and start catching up on charts
5:20 Get home
5:40 Eat left over pizza
Play with son and talk to husband
8:00 Multiple books read to son as I put him to bed
8:15 Drink large glass of red wine and watch Flight of the Conchords on DVD with Hubby curled up the couch. Laugh.
9:00 Reflect on the craziness of my day. How I can go from tears of profound sadness to tears of joy in a matter of minutes. How I can love and hate my job so my all in the same day.
9:45 Fall asleep in bed reading a book.
*Which inspired me to write this post
Friday, November 6, 2009
Ariana at 3 weeks, wearing a sweater I knit during my pregnancy. Had she been a boy, I would have still made him wear it home from the hospital.
Eight years ago I agreed to join a friend for an evening knitting course taught by a black heterosexual volleyball player named Steve out of a converted Vancouver warehouse. I've not stopped knitting since. It has proven to be the perfect antidote to medicine and parenting.
I'm working on a spruce-coloured cabled vest for my five-year-old, and when I knit a few rows in the evening the steady soft clicking of the needles work the yarn into perfect V's of stockinette stitch that are blessedly tangible. Row by row, cable by cable, visible results emerge. Measurable progress is directly proportional to the work I put into the project. Such is not the way of medicine or parenting.
The stitches behave. My needles cooperate. I control every aspect of the garment-making process. When I put it aside for a week, it is exactly as I left it when I retrieve it. Unlike disease, patients, offices or children, it has no life of its own. There are no surprises.
Leif reading Beatrix Potter on a Sunday afternoon. Vest not limited to professorial pursuits; also good for walks in the woods or autumn beach visits.
There is every opportunity for perfection. It is possible to knit an item flawlessly. If this were only true at home or in the office: all errors can be undone, most with nothing more than a crochet hook.
In The Artist's Way Julia Cameron discusses the importance of filling the well - replenishing our creative resources. She gives another reason to knit:
Any regular, repetitive action primes the well . . . Needlework, by definition regular and repetitive, both soothes and stimulates the artist within . . . [and] may tip us over from our logic brain into our more creative artist brain. Solutions to sticky creative problems may bubble up . . .I do love the organic, messy, unpredictable nature of medicine and mothering. But that's what fills most of my days, and a moment stolen to give my hands over to bamboo needles and wool grounds me, lets my whirling thoughts settle and the most worthwhile rise to the top. An inch or two of knitting later - of perfect, even, countable stitches - I am ready to get on with real life.
Toque for early morning September blackberry picking.
Monday, November 2, 2009
First of all, I want to thank you guys for sharing your lives and experiences with the general audience. I am a person who aspires to work in the medical field some day and reading this website allows me to think that maybe I can have both work and family equally balanced. Recently I have come upon a question that I was asking my self and was completely stumped. I was wondering, if you guys be so kind to help me and give me advice on this matter, I would greatly appreciate it.
The question as follows: How do you guys deal with the guilt and sadness in the event of missing a chance to spend time with a loved one because of work? What do you guys do to make yourselves feel a bit better and be able to continue? Now I'm not referring to missing daughter/son's dance/theater rehearsal, or Auntie's 50th birthday celebration, though those events are quite important; however that kind of guilt one can live with and eventually assuage--I am referring to the lost of a loved one, or friend and that dinner or visit was that last chance one would get. How do you guys work under that cloud of what if that chance is that last chance? Or do you guys eventually learn that life is what it is and come what may? I hope I am not generalizing too much here and not being too naive and callous in asking this question. If this question offends you guys in anyway, feel free to tell me off.
Thank you for your time.