Sunday, January 29, 2017

credible threat

Probably one of the ways to not fall into a funk of not writing is just to keep on writing. So with that in mind...this thing!

I'm on call at the hospital today, which—OK, look, no one likes being on call, right? Given the choice between walking the halls of the hospital at 6:30am on a Sunday morning and, I don’t know, having French toast with your kids at home, I think most people would choose the French toast. (Plus or minus on the kids.) But there’s something about being part of the bigger machinery that makes things work. There are unglamorous, less fun, more onerous parts to every job. But you spread them out and everyone takes a turn at it and that’s how you keep things moving forward. This weekend just happens to be my turn. So in that sense, no, I don’t mind it that much.

The other day, when I got home from work, I received this email from the administrators at Cal’s school. Here is the body of the text, excerpted in part:

Last Friday afternoon, we were alerted to the presence of some graffiti in our 7th grade boys’ restroom. It read, “I’m shooting up the school on last day of January.” Some students took a picture of the message and shared it before we learned about it. […] We began an investigation with our administration and school police officer and continue to follow various leads. As of this time, no other graffiti has occurred. The threat references the last day of January as the date that something would take place. While we are always concerned about any threat to students’ safety, we are not alarmed. Although we have nothing to suggest any credible threat, we have reached out to the […] Police Department for additional follow-up and to provide a larger law enforcement presence than normal.

Now, you’ll recall from yesterday's post that Cal is 11 years old now, and in the 7th grade. My God, the 7th grade. I don’t know if this makes me egocentric or what, but the most remarkable thing about having a kid that age is that I truly, vividly remember being that age myself. Not in the way you recall being six or seven—at that age, some memories stick out, but the edges are fuzzy, timelines occasionally discontinuous, characters fungible. No, I mean I really remember being in the seventh grade. I remember where my locker was, and who had the locker above me. I remember the classes I took—not just what books we read and projects we worked on, but I remember the thoughts I had during the classes; about my classmates, about what I was going to have for lunch, about the unfortunate macramé-d sweater vest my French teacher insisted on wearing week after week. Remembering yourself as a preteen is different from remembering yourself as a young child, because after a certain point, though you still had room to grow and mature, that was you in there already, soft but fully formed, the person you were set to be all along.

Cal and I are similar in a lot of ways. He’s smarter than I was, but the way we think about things—the way I thought about things when I was his age—are the same. Sometimes when he tells me things about school, I think about it in the shoes of my own self in that same situation at his age. I don’t know, maybe that’s unhealthy? I’m not projecting myself onto him or anything, and I don’t insist that he does things my way (or the highway, boy). It’s just hard not to associate yourself strongly with your children, particularly as they get older and that parent-child gap starts to shrink ever so slightly.


That said, I have no experiential knowledge of how it would feel to truly worry that one day, some kid might come into the seventh grade hallway, fully armed, and start shooting at people.

The world, as we all know, is a different place these days. Those of us with young kids in certain parts of the country (maybe all parts of the country? I’m actually not sure) know that we don’t just run fire drills anymore. We run disaster drills. We run “active shooter” drills. I don’t think they’re explicitly stated as such—particularly in the younger grades, I they try to keep the scenarios as vague as possible—but this is the world we live in, that we need to rehearse what to do in the event that someone comes into the school with a duffle bag full of guns and just opens fire. It’s so common we have a whole language around it. “Active shooter situation.” “Another school shooting.” Did you know that the columbine is a flower? Maybe you did, but many probably don’t, because it’s not “a columbine” anymore. It’s: “Columbine.”

Part of the problem with the Trump ascension is not so much that we don’t know what to fight against, it’s that there’s so much to fight against that we all get overwhelmed. Which fight do we take on? Which atrocity should we protest first? Which rights should we prioritize to defend? Healthcare access? Reproductive freedoms? Immigrant and refugee protections? Gun control? Environmental protection? The basic human tenet of not acting like a total dickhead at all times? There are so many things that people can’t even pick just one or two, and I think, for me at least, it started to feel like too much. Like: IT’S OFFICIAL NOW, EVERYTHING IS THE WORST, TIME TO LEAVE THIS EARTH AND EJECT MYSELF STRAIGHT INTO OUTER SPACE, BECAUSE THIS WHOLE THING IS SO BROKEN IT’S BASICALLY UNFIXABLE.

So, back to the email. Do I think that this bathroom graffiti threat is real? No, I don’t. I think it’s probably some little punk-ass shithead doing what he does best, which is being a little punk-ass shithead. (We all were, to some degree, at that age, because one of the important tasks of adolescents is learning how to be a human being, and even the best 7th graders aren’t quiiiiiite there yet.) But just the fact of any of it. The fact that he (I’m just presuming “he” because it was written in the boys bathroom) thought to write that particular message. The fact that some kids saw it and got scared and took a picture. The fact that the administration had to investigate. The fact that the police are involved. The fact of the “increased law enforcement presence” as a result. All of it.

It’s not the fact of what is ultimately an adolescent prank in poor taste, so much as the fact that we’ve lost the privilege of truly being able to view it as such. Say what you will about gun rights (and, again, I live in the South—I’ve had this conversation before), but in the end, the resultant culture is one where there is a little less freedom for all of us. I don’t have the freedom to send my kid to school tomorrow and be able to get through my day without worrying, in some dark back corner of my mind where all these types of thoughts collude, that he’s going to get shot. That’s a big concession. These are huge societal losses that we’ve borne.

But when I get overwhelmed with all the things that are wrong and getting wronger by the day, I think: OK. Stop for a second. Slow down. There’s a lot we need to work on, but it’s not going to all happen at once, and it’s not going to all be just on a few of us. There are lots and lots of good people out there who want to help. So I pick things that I want to work on right now. It’s not always the same thing, sometimes it changes week to week, depending on what’s coming up and what seems more urgent in the moment. But I pick a thing, or a few things, to focus on. Other people will pick other things and focus on those. And in that way, it’s like taking weekend call. We spread out the work. We each do a little bit and in that way, eventually, we get to take care of everyone.

I think being overwhelmed at the scale of the job before us shouldn't make us shut down and disengage. I think it’s a reminder of how deeply we care about so many different things. And in the end, that's never going to be a bad thing.


The Little Thing I Did Today: Called my two state senators and left voicemails opposing the immigration ban imposed by President Trump. (Wow, it never stops being weird. "President Trump.") If you live in Georgia, it's interesting to note that neither of our Senators have actually spoken up in favor of such a ban (to my knowledge), so a vocal opposition to the executive order from their constituency might make a difference. 

To help, here: a list of all the U.S. Senators, and their positions on the immigration ban if ever publicly stated. Contact info included, along with social media handles. 

Saturday, January 28, 2017

ch-ch-ch-changes




This blog, from the beginning, has been a journal about change. I started writing here in the year 2000 (though some of the older Homestead archives have since been eaten, believe me, they went alllll the way back, and yes, there was an Internet then) and from the beginning, it’s been a chronicle of x/∆y. Medical school. Marriage. Residency. A different residency. Parenthood. Moving to the South. Every year was something big and something new and oh hell, how are we going to do this now and the constant, underlying theme through it all was change.

At the time I kind of petered out on the blog (and know that I never really intended to step away entirely, but the slow fade just kind of…happened) part of it was that the rate of change had slowed. Things were calming down, and we were settling into our lives in a way we’d never had a chance to before. Joe and I were both attendings and in stable jobs. Our kids were getting older. We bought a home and lived in it for a while. There were days with patients and nights on call and parent teacher conferences and summer camps and carpool lanes. And while things continued to be busy, they also became shockingly normal. Calm. Maybe even a little bit boring, though I mean that in the best possible way. It just felt, though, that in this journal about change, there wasn’t much left to write about.

I don’t think I feel that way anymore. There are a lot of ways to view this post-Trump ascension world we live in now, but I don’t think I can say anymore that life ceases to change. But neither can I continue to insist that it is boring, so...there's that. I think a lot of people—regular people, normal people, people like me—have a lot of energy and a renewed sense of civic responsibility in the face of this new administration, but often if feels difficult to know where to channel all that energy, you know? What do we do now? Where do I put all this? How can I help? How do you do stuff?

Look, I’m just a dumb doctor. I do what I know how to do. I work with patients. I help people individually in sometimes big but usually small, concrete ways. I speak the language of medicine and science and research and data. My campaigns are waged at the bedside, or in the operating room. I’m not a politician. I’m not a legislator. I’m not a lobbyist. I’m not a judge. I don’t know how that world works, or the avenues into it. But I want to change that. I want to learn. Then I want to do it. And I don’t want to do it alone.

I’ve done a few things since Election Day. These are just very small things, things I know how to do, in order to chip in, help shore things up, fix things, and teach my kids how to do the same. But it’s not enough. These things are important, but they are also too small. I know it takes thousands of little drops to fill a bucket, and I want to keep on adding those drops, but I’m ready to start doing more, and I just need to figure out how. So now we’re going to start, and we’re going to do it together.

Here’s a small list of some of the things my family and I have done since November 9th. It’s not a complete list (there are probably some things I don’t quite remember, I didn’t write them down or anything), but I also didn’t talk about it much on social media either, because my instinct was always that anonymous good works are the best kinds of good works. However, now I think the need for collective action and coalition building supersedes those instincts, and also, more than ever, we deserve to know that we’re not alone on this. So, an incomplete list.



But these are tiny actions, and not nearly enough. Lately it has been suggested to me that one means of political action is, quite simply, talking out loud. I mean, after a fashion. Via the Internet, on social media, ways in which ideas can be shared widely and communities built broadly. I know this is not a new idea at all—it's pretty much Twitter's entire modus operandi, at this point—but I never felt that it was as satisfying talking about doing stuff as actually just shutting your mouth and doing the stuff. But I think what I'm learning now is this. Sharing ideas is activism. Talking to people is activism. Starting the conversations and keeping them going is activism. And then we'll get to what comes next.

Anyway, this blog. I'm still just a doctor. This has always been a small platform focused on the minutiae of daily life, and will continue to be for as long as I can remember my Blogger password. (Hey, shut up, it's hard sometimes.) But the world is bigger than any one of us, and it's also up to us to take responsibility for all of it.

Now, to what you've all actually been interested in.




Cal is eleven now, and in the seventh grade. I know many of the people who have been following this blog since time immemorial remember when Cal was just born, and it's impossible for you to believe that he's in middle school. Don't worry, I feel exactly the same way.




Mack just turned eight a few weeks ago, and is in the second grade. He only recently stopped making a weird face every time I tried to take a picture of him. This photo was taken before that particular skill was mastered.




Nina, she will insist on telling you and everyone in earshot, is A Big Girl. She also insists on dressing herself sometimes, as you can clearly see, but has luckily tried to cut her own hair only once. She is four and a half years old, and in Pre-K.




Joe is 42 now and in the one millionth grade. No, but really, he's doing well. I'm not going to talk too much about his work, because that's probably pretty boring, but he's great at what he does, and it's an honor being on his team. Probably the most important thing you can do in life is choosing the right co-pilot, and somehow I lucked into a good one. I'm not a perfect person, and I have more flaws than I can reasonably enumerate. But whatever good I've done, and continue to do, is due to and in the service of these guys right here.

Anyway, this is just a brief mic check, and a post it note on the wall to say...I'm here. I hope you are too. So let's start talking. Let's get to work. Let's do this thing.

Discuss: What social or political actions you and your family taken, if any, since the election, and why? I understand that we don't all have the same political leanings, and I respect those differences. I live in the South, after all, I am accustomed at this point to having smart people disagree with my political views and having it descend into a slap fight only 50% of the time. (60% tops.) But the goal is the conversation, after all. In the end, the campaign of change has to be one of hearts and minds. So let's start here.

Tuesday, December 31, 2013

I overthink, therefore I am

This is the day where all my social media feeds are filled with people exclaiming, with varying degrees of vulgarity, "Good riddance, 2013! What a shitty year! Hope 2014 will be better!" Is it poor form at this point to say that I thought 2013 was pretty good?

Well, anyway. Happy New Year!

*          *          *


I don't think we go too too overboard with the Christmas gifts. At least I hope we don't--there's the tendency to lament the perceived extravagance and overindulgence of the modern secular Christmas celebration, but I think this self-imposed guilt can sometimes be a little much and tend to taint our enjoyment of the holiday as much as anything else. I remember one year in particular the kids were unwrapping gifts on Christmas morning (this was pre-Nina, so just the boys, but I think the stuff they got that year was, like, some puzzles, books, stuffed animals, a kiddie microscope for Cal) and Joe was kind of making a face and saying how disgusting it all was, I guess meaning the display of excess and the consumerism and whatnot.  At which point I said SHUT YOUR MOUTH because there's a difference between appreciating what you have and your ability to give your kids nice (if not entirely extravagant) things; and beating yourself up with bleeding-heart guilt because there there are those among us with much less. My point being that the two things can co-exist. You can choose to not hate yourself for being able to have a nice Christmas, and you also can donate your money and time to a worthwhile cause to help make someone else's holiday better. Anyway, it's Christmas, just let the kids enjoy themselves, it's not like they're getting video game consoles or a sportscar in the driveway or anything like that. A few Legos and some crap from the dollar bin at Target never made anyone a Bond super-villain. (Unless they used the Legos and Target dreck to build an excruciatingly slow crotch-slicing laser, in which case--yes, fewer gifts.)




That said, the reason that it was difficult to choose gifts for Nina in particular is because she's the youngest of three children and we already have a lot of toys. Cal and Mack were easy--some books, a mess of new Legos, some superhero crap, and we were golden. But Nina--what could Nina possibly want for Christmas? She's turning 18 months at the end of the week, and to be honest, she already has all the toys for this and the next three developmental stages. Wooden blocks? Check, Cal's Christmas gift four years ago. Little ride on tricycle? Check, Cal's first birthday present, inherited by Mack until he outgrew it--a little dirty but still in great shape. Plastic animals and people? Check, Mack has amassed a mighty collection. Thomas trains, wooden and plastic train tracks, a hogshead of die cast cars? Checkcheckcheckcheckcheck.

The only thing we didn't have, really, was girly stuff.

And I mean girly stuff as in really girly stuff, like Malibu Barbie's Dream McMansion and the like. In my effort to make sure the boys don't grow us as 'roid-raged meatheads, we had a lot of girl-ish things already, even before Nina was born, and certainly most of our toys are to my mind at least gender-neutral. Mack in particular has a self-avowed fondness for pink stuffed animals so we have our share of those, and while the boys never really got very interested in the baby doll already we've had lying around since time immemorial, they also don't think it's weird to have one around.

Sidebar: a conversation with Mack last week. (We were making bracelets for his friends--have you seen these little rubber band bracelet kits they have now? Apparently they are all the rage, at least if I am to interpret the ceiling-to-floor wall of bagged rubber bands at Target correctly, but what you really need to know is that they look like those rubber bands that people wear on their braces, and if you drop the bag they will fly out EVERYWHERE.) Anyway, the conversation:


MICHELLE
So what colors do you want to chose for your friend Charlie?

MACK
Uh...yellow, pink, blue, purple.

MICHELLE
OK, so we'll do that as the pattern? Yellow-pink-blue-purple. Start picking out the rubber bands.

MACK
Why does some people say I can't like pink?

MICHELLE
What people say that?

MACK
Girls. They say that boys can't have pink.

MICHELLE
Well, that's silly. They're just colors. Everyone can like any color. Like me, I'm a girl, and I like blue. And green. And yellow. They're just colors. They're for everyone.

MACK
Yeah.

MICHELLE
Do you like pink on your bracelet?

MACK
Yeah.

MICHELLE
Well I think it looks good on you! You choose what colors you want! Even Dad wears pink sometimes, and no one's going to tell Dad that he can't wear pink because he's a boy.

MICHELLE'S INNER MONOLOGUE



So anyway, my point is I try to be mindful about such things. To be honest Nina really hasn't expressed any preference at all about liking "boy toys" or "girl toys," (or even knowing the difference between boys and girls) and will happily play with anything, particularly if it's something that Mack has a particular attachment to so as to get the maximum possible reaction. But I'd like to think that if she enters a super-girly phase (the Disney Princesses and such) that I would go with the flow on that too, and not have too much of the opposite reaction, insisting that she only play with dinosaurs and Cal's old Black and Decker toy tool kit to make a big old feminist point about it. Whatever, she'll figure out what she likes, and I'll go with the flow. But either way, I don't want to push anything on her.

Anyway, to sum, for Christmas we got her some puppets, clothes for her baby (boy and girl clothes), some toy foods with a shopping cart, and a water/sand table that we'll hopefully move outside once the weather warms up--though until then we'll play with it here, which makes it easy to fill and clean up but also somewhat defeats the purpose of having a free-standing water table, because why not just take a bath already?


Her favorite gift, by the way, has been the puppets, so I recommend them in particular. I am also glad that I decided to go for the animal puppets instead of the people puppets, because while I love the idea of having the multiethnic people puppets for the kids to play with, the temptation to quote the Franklin scenes from "Arrested Development" would likely have been too great.


Well, onward and upward. Our New Year's Eve plans involve sparkling cider, snacks from Trader Joe's, and a "Simpsons" marathon courtesy of our increasingly outdated DVD collection. (But please note: we only have the box sets for seasons 2 through 7 because why bother with anything else?) Cal in particular has requested the B-Sharps episode, specifically citing the scene where George Harrison points Homer towards the platter of brownies at that party. "Well, what a nice fella." Kid's got good taste.

See you next year! (She said cleverly.)

Tuesday, December 17, 2013

liquid schwartz

Well howdy. Explaining why this blog hasn't been updated is only slightly more boring than reading the blog itself, but in short I had to give Grand Rounds last week, and since I couldn't work on Grand Rounds at work or while my kids were awake, basically every free minute I had up until last Wednesday was channelled into that presentation. Thankfully, it's finished! Now to resume my life of indolent goofery!

You may also be disappointed to know that I ultimately decided against using the "Exorcist" slide in the talk (Factor 1: too early in the morning, Factor 2: Catholic hospital) but it may please you equally or maybe even more that I did use this slide as an opener:




(He's his own best friend.)


*          *          *


As a brief and unsatisfying epilogue to the fractured (ho) story of Cal's clavicle, these following addenda:

Right before Thanksgiving, I reached out to the principal again, asking him if he could give me an update on his conversation with the school nurse after the incident. Given my background (and recall that I trained for two years as a pediatrics resident prior to anesthesia) I also offered to sit down with the nurse and work with her on a standardized medical policy for parent notification--if, of course, they wanted my help.

He responded...well, let me just copy and paste the body of his response email in its entirety.
"Thank you for contacting me regarding your concerns. Yes, I have communicated with the school nurse and the district supervisory nurse regarding the incident. Additionally, we have discussed and developed a plan for proper notification to parents."
(Signed, Pally Von Principal.)

Note, no actual elaboration of what this "plan" is, nor any perspective from this nurse herself. So...basically a deflecting non-answer, right?

Also (and I probably should have noted this in the previous entry so as to not seem quite as much like we are raising a doormat) the day of the injury, after he got home but before we went to the ER, Cal and I had a little talk about self-advocacy and appropriate responses. And I basically told him that grown-ups aren't always right. He had just finished reading "Matilda" a few months ago, so I referred to that a few times, how Matilda was oftentimes smarter than her parents and how Matilda's headmistress (The Trunchbull! The chokey! Oh man, I really love that book) was usually wrong. And that while he should obviously always be respectful of adults, if he felt strongly that something was amiss and that the adults taking care of him weren't taking it seriously, he should request to call his parents regardless. Then I quizzed him on our cell phone numbers. Then I crammed more Tylenol in his craw and tried to figure out his NPO status.

Anyway, all's well that ends...if not well, then at least eventually.


*          *          *


Well, now we're all caught up, but now I realize that I didn't actually tee up anything fresh to talk about today. But instead of pushing save and kicking this half an entry down the road like a tin can, I'm just going to slap it up with a promise that I will put up a real entry soon too. I do, in particular, want to write a little something about Nina, in particularly about her Girlness and Christmas shopping for her, and this strange feminist guilt I have about getting her real girly things. And then the strange feminist guilt I have about considering dolls and their accoutrement "girl things" because boys can play with dolls too, patriarchy! Though I wish that I could find that same stroller that Cal had when he was Nina's age, because damned if they don't just make everything in pink now.




(Above: Cal and some rando kid, circa 2006. This was back when we lived in Manhattan of course, so while such playground spaces and pocket parks came at a premium I would just like to point out how much more I prefer this kind of rubberized flooring to the default "mulch and wood chips" surfacing that seems to be the standard playground-issue here in Atlanta. It pushes up your minimum age to enjoy the playground by at least 6 months, between waiting for your kids to walk well enough and making sure that they're not going to eat all the wood chips when they do fall. Though high-fiber gluten-free diets do seem to be quite popular these days, don't they?)

Monday, November 25, 2013

prokinetic

Hello gadabouts! Sorry for the recent long-form radio silence, but my current schedule allows a few hours each week for generative activities, and two weeks ago it occurred to me that I was scheduled to give Grand Rounds to my department at the beginning of December. Am scheduled. Also, we don't technically call them "Grand Rounds," rather "Education Lecture" or (perhaps more to the point) "CME-Getting Exercises"; but I just continue to call them "Grand Rounds" for ease of reference.

Upon hearing that I was giving a lecture soon, and perhaps more thrillingly, that I would be giving my talk off a series of PowerPoint slides (well, Keynote if you want to get brand-specific), Cal got very excited, because--and I don't know if I've ever shared this particular quirk of his on the blog itself--CAL LOVES MAKING POWERPOINT SLIDES.


CAL
What are you doing? Can I help? Maybe I could make your slides for you!

MICHELLE
Well, maybe I'll pick a slide or two and you could help import the images or something, but a lot of it I think I'm going to need to do myself, because it's kind of technical. You know, science-y.

CAL
Like what?

MICHELLE
Well, like I have to look at a lot of scientific journal articles, and pick the information to present, and it might be a little complicated for you to understand at this point.

CAL
I can do that. What's the talk about?

MICHELLE
Well, it's about developing a standardized protocol for treatment of postoperative nausea and vomiting.

CAL
What's that? The last part, I mean.

MICHELLE
Postoperative...well, it means...sometimes after people have surgery, they feel nauseated, and they barf a lot. So it's about what kind of treatments we have to prevent barfing.

CAL
Your talk is about barfing.

MICHELLE
Well...kind of, yeah.

CAL
(Reverently)
Cool.


So anyway, my point being that the few hours I've had per week for generative activity has been shunted away from the blog and towards getting my barf talk together. Of which I've spent maybe way too much time deciding (between wading through RANDOMIZED CONTROLLED TRIALS and META-ANALYSES and CONSENSUS GUIDELINES of course) whether I should include this picture on one of the slides.




So...probably no, right?


*          *         *


Well, in other news from the world of Cal:




As some of you may already know, two weeks ago Cal broke his left clavicle at school. He's fine, didn't need surgery (as you can see from the film there is clearly a break but it is not displaced) and just needs to wear a sling for three weeks while avoiding cage-fighting for six weeks total. 

Cal's story is that he and a friend were playing tag at recess, when another kid ("A fifth grader," he told me ominously, as if that explained EVERYTHING) playing a parallel game accidentally tripped him mid-run, and down he went. And that's fine, these things happen, I'm certainly not blaming anyone (Cal, the fifth grader, any of the teachers) for the fact that Cal broke his clavicle, because that's what happens when you don't encase your kids in a Beanie Baby box and perch them on a shelf For Display Purposes Only.

I also don't blame the school nurse for not making the diagnosis of a broken clavicle when he reported to her office after recess, though--and I say this charitably--it was not a subtle diagnosis. Or...well, you tell me. A kid falls hard onto his left shoulder on the concrete of the school playground, a fall witnessed by his teacher, after which point his shoulders are asymmetric (like the left one is significantly lower than the right), he can't lift his left arm, and is crying about pain while pointing to the exact spot over his left clavicle where a clear angled deformity can be seen through the skin. Even so, I don't begrudge someone for not making that diagnosis, as clear as it may have been to me and anyone (including, may I add, the twenty or so elementary school kids who were shouting at me out the schoolbus window, "Cal broke his arm at school today!"). School nurse? Maybe more attuned to diagnosing disease of the infectious and rapidly-spreading variety than the orthopedic? Fine. I'll give you a pass.

But what I do mind? I do mind that fact that I didn't get a single call about Cal's injury--not one single call, text, e-mail, anything--and in fact did not know anything had happened until I picked him up at the bus stop and received him wincing down the bus steps, in tears, his friend carrying his backpack for him because even a fourth grader could tell Cal could not carry it himself. That the school nurse basically told him to walk it off and sent him back to class, where he sat for two more hours with a broken clavicle without me or Joe--both of us listed as emergency contacts and both of us never without our cell phones--getting single call so that could pick him up, check him ourselves, and cram in some Tylenol before taking him to the emergency room for a plain film to confirm what we could clearly see with our non-X-ray vision. THAT I DO MIND.

After he got back from the ER and we knew that he didn't need surgery, I wrote an e-mail to the principal to let him know about the situation. And again, I wanted to be perfectly clear what exactly it was that I was upset about. As a medical professional, I am more than aware about the perception of Asshole Patient Syndrome--namely that medical people sometimes expect unreachably high standards on their own medical practitioners, and can be, well, assholes about their own care or the care of their children. I reiterated that I was obviously holding no one to blame for Cal's accident (I think I may have used the phrase "these things happen" not one but three times in that e-mail, mostly as code for "DON'T WORRY I'M NOT GOING TO SUE YOU") and I again reiterated that while the fracture was quite evident, I did not hold the school nurse to the same standards of diagnostic acumen as an ER nurse or even a first year medical student. Fine. Maybe it wasn't obvious when it happened. Maybe it looked worse three hours later. Whatever

But I made a strong point that I was very dismayed (while, I hope, aggressively maintaining the mien of cordiality tinged with disappointment about the school's interpretation of in loco parentis) that although this was the kind of injury we should have been informed about, preferably close to the time it happened or at least at the point that he was in the nurse's office; we did not hear one word from the anyone at school even after that downward dog-shaped clavicle ambled off the bus in a miasma of osteoblasts and tears. In fact, if I hadn't e-mailed them, I probably would never have heard about the event, except from Cal himself. 

And frankly, we might never hear about it again. I just suggested to the principal, nicely (I thought) that he review with his school nurse what kind of medical events should trigger a call to a student's parents. He e-mailed back (addressing me as "Dr. Au"--I specifically did not make a point that Joe and I were medical professionals for fear that it would come off badly but either he knew that from our file or he saw it in my e-mail footer) that he would "look into it." And I can only assume that he has, since he hasn't e-mailed me back any follow up since. 

In the weeks that have followed, whenever I pick up Cal from school and walk by the administration, all of them know his face (or perhaps recognize his sling) and exclaim to him with bluff cheer, "HEAL UP THERE, BIG GUY!" and "LOOKING GOOD! FEEL BETTER!" But never, not even as an aside to me, has anyone ever mentioned any kind of addendum to our e-mail exchange, or apologized to me for not being contacted in the first place. Honestly, I don't even want an apology at this point for not being called, because that's somewhat beside the point. But some follow-up would be nice.

So my question is this: what would you have done in this situation, keeping in mind that I don't want anyone to be punished or lose their jobs or anything like that--I just want to make sure that no other kids break bones or have seizures or swallow chicken bones and have to sit writhing in class for two hours. Also: do you think that the fact that Joe and I are doctors makes any difference in a negative way, in the sense that it gives the impression, warranted or not, that we are holding the school nurse to unfairly high standards? 

Please to discuss.

Sunday, November 10, 2013

car talk

I had to take my car in for some maintenance earlier this week. (Not the suburban kid hauler, I already took that one in a few months ago, this time it was the car that I usually drive to work, a 2005 Toyota Camry that we bought used about four years ago and which has been remarkably reliable since, despite the fact that I rear-ended it squarely with another car the very next morning after finally getting my driver's license.) I had a flat back tire after rolling over some kind of screw, and while one would think that changing out a flat tire and putting on a spare would be the end of it, apparently I still had to take the car in to get a real tire on (the spare is not a real tire? Why?), replacing the spare in my trunk, and getting the wheels realigned.

This is exactly what I told the car people to do, but for some reason they took the liberty of hooking my car up to the FREE 27 POINT DIAGNOSTIC ROBOT (note: I did not ask for the robot) and shortly thereafter came into the waiting room with the lugubrious mien of someone about to inform me that my car had rectal cancer. Because apparently my car also had a (something something) leak, which was important because the (something) fed water to cool the engine (something something), not to mention that the (something) was missing four (somethings) requiring the whole works to be replaced, not to mention that steering (something) was totally jacked up and in sum, my car was destined to explode into a thousand fiery pieces unless I shelled out $3,500 to get all that stuff fixed.

THREE THOUSAND FIVE HUNDRED AMERICAN DOLLARS.

Leave aside the fact that I just came in to get my tire changed. Also leave aside the fact that we bought this car used (though in excellent shape), so the total of the repairs proposed was more than a third of the price we paid for the car itself. Finally, apologies for the totally hackneyed "girls don't know nothing about cars" routine that I am personifying here--lots of ladies know a lot of stuff about cars, including how to change their own flat tires, but please forgive my stereotypical hand-fluttering in the face of impending automotive maintenance because I really, really know nothing about cars, INCLUDING HOW TO DRIVE ONE until about four years ago.

The mechanic left me with the price quote in that I'll let you have a minute to compose yourself way, saying that if I wanted to get everything fixed I would probably need a loaner to drive home so he would go ahead and get that for me. (He then added, with a tone of infinite largesse, that the loaner would be provided to me free of charge.) After unfreezing myself, I went to chase after the guy, because given that I had detected absolutely no problems with the driving and reliability of the car aside from, you know, the flat tire for which I came in, so barring any immediate safety concerns I would at least like some time to look over the diagnostic report and get a quote from a second car repair company.

Ten minutes later, he returned with the loaner. I told him that I'd like to hold off on repairs until we could get a second opinion. He looked at me for a beat, then called to the back workshop, where I assume my car was being fed through an MRI. "Yeah, the customer wants to hold off on the repairs. Uh huh. Oh. Really? Wow. Did you already...oh. OK." He turned to me. "They already started working on it. They took the water pump off the (something something) already."

"Already? Can they...you know, put it back?" More phone conferrals. The mechanic then told me that they could indeed put it back, but that I was lucky because they hadn't taken the (something) off the (something) yet, because (something something) antifreeze everywhere!

"I would like my car back please."

Any hour later, it was returned to me, with the new tire, which was the only thing I wanted changed in the first place. The following morning, Joe took the car to a AAA down the street from us, where they hooked the car up to a FREE 36 POINT DIAGNOSTIC ROBOT--nine more points than the other robot!--and found very little wrong with the car at all. (Joe brought the service list and the quote from the first place so he would know what to ask them to check extra carefully.) They replaced some of the missing (something somethings--like some kind of a bolt) and swapped out another (something that was dirty), but in all the bill totalled $500, which, while still a lot for a car that I wasn't intending to have serviced at all, is a far cry from the $3,500 that I was originally quoted.

And now here's the question for you. How much of it was bad luck of the draw at that first car place, and how much of it do you think is the fact that I (know-nothing-about-cars lady) took the car in to the first place, and Joe (know-little-about-cars-but-looks-like-he-does man) took the car in to the second place? Unfortunate happenstance, opportunism, or a little of both?

(Aside re: the post title. I love NPR as much as the next PBS-pledge-drive-canvas-tote-lugging-to-the-farmer's-market liberal, but there are two shows that I could never, ever get behind despite the fact that everyone else loves them dearly. One is "Car Talk." Those braying Boston accents! Why not just sharpen a pencil in my ear? And the second is "A Prairie Home Companion." Not only is it aggressively folksy, but it actually isn't funny at all, and you get the sense that the people in the audience will just laugh at anything just to show each other how cultured and good-humored they are. Bah!)

Thursday, October 31, 2013

quotidian

Cal was supposed to bring a pumpkin to school on Tuesday for some sort of jack o' lantern carving activity in his class. There was an ostensibly academic twist to it (I think they were weighing and measuring the pumpkins first, converting ounces to pounds or stones to hectares, whatever antiquated non-metric systems we still insist on teaching despite the fact that they make NO SENSE) but let's get real, the true purpose of such an activity is to claw out all the pumpkin guts and show your friends the clotted mass of stringy entrails while making a variety of throw-up noises.

Cal left his pumpkin at home by accident, so when I went to drop it off at his classroom (ordinarily in such cases I leave the forgotten item at the front desk and someone from the office ferries it upstairs to the classroom so as to minimize disruption--however, in this case the pumpkin was gigantic and when I offered to carry it up myself they happily left the hoisting to me) I kind of got roped into coming back in later that afternoon to help Cal's teacher with the activity. Honestly, my first instinct when the teacher asked me if I could be an extra set of adult hands (in the setting of 26 fourth graders wielding a variety of hollowed out gourds and serrated blades) was to beg off because look man, I'm busy. But that response was a reflex, ingrained from years and years of having to say no to stuff. Because I actually wasn't busy that day. And having the time to do things like this in the kids' classroom was precisely the reason that I went part-time in the first place.




Which brings me to the topic for today, which I have deliberately been shying away from because the kind of honesty with which I want to discuss this is precisely the kind of thing that causes fistfights to break out in the comments section of The New York Times "Motherlode" blog. (Leaving aside the truly questionable decision to call a parenting series "Motherlode," because random puns aside, parenting is only for ladies, y'all!)

Joe and I agree that since I have made the move to go part-time at work, the quality of our home life has never been better. The benefits are obvious--I have more time to spend with each kid, I am more connected with what they are doing at school and at home, we can actually schedule doctors and dentist and teacher appointments, we are all eating better, acting out less...the list goes on and on. And there are moments every single day when I think, "Thank god we finally decided to do this." The mornings I spend with Nina after the boys are off at school. Time that I get to carve out to spend with Mack alone, which I hardly ever had a chance to do before. Having time for actual conversations with Cal, who for all his idiosyncrasies as a young child is actually turning out to be a pretty cool and funny kid. These are the obvious good things. These are the things that make it clear that the decision to dial back at work was worthwhile.






But of course these are the things that just make parenting in general a joy, and between these clearly treasured moments are the interstices, the webbing, the connective tissue that binds the important bits in a dense fiber of the banal. Because for every morning I spend with Nina watching the sun rise over the Chattahoochee there is of course an entire day of chasing down lost shoes and changing diapers and washing clothes, cleaning up one mess in the kitchen while Nina is creating the next mess because allowing her to create the next mess is the only way I can buy time to clean up the first mess. For every special afternoon with Mack there is the endless run of school pickups, school dropoffs, making sure that lunchboxes are packed and thermoses are not lost at school, corralling shoes and socks and sweatshirts and more socks, items which surely must walk around at night after we're asleep because otherwise there's no explanation for how they spread out and hide all over the house. And for every pumpkin carving activity I do at the kids' school, there is an hour of sweeping up sticky pumpkin seeds, picking up strips of newspaper and magazines that have glued themselves to the linoleum with bioglue, and wiping down desk after desk with antibacterial wipes and hoping to god that the janitorial staff at night come equipped with mops. (Though to be clear: I was more than happy to help, and Cal's teacher was a brave, brave man to even consider staging the mass class pumpkin carve-a-thon without a second adult around. We could have probably used another two or three adults, to be honest.)

It is in these moments, with the brooms or with the wet rags or running in and out of the supermarket or picking up the dropped (well, hurled) sippy cup again for the five hundredth time that I think: It doesn't have to be me doing this. This does not involved an advanced degree, or special training. ANYONE could do this. Or, perhaps more precisely to the point: I took a 40% pay cut in order to wash dishes and do laundry? DOES NOT COMPUTE.

(This is the part where people start polishing their pitchforks. Hey, you missed a spot!)

Look, I know that it's not the special advanced skill with which I drive to carpool or wash the dishes or make the school lunches that the time worthwhile--it's the fact that I'm doing it for my kids that makes it special. I get that. And I also get that, with parenthood, the amazing moments are not in the majority--that it is, in fact, the intermittent and punctuated nature of the awesome moments that make you get up each day and do all the non-awesome stuff over and over and over again. And that's probably true about most things in life, though I'm beginning to find that there's something different about spending a full day parenting rather than a full day being a doctor: it feels less special.

(And here is where you start jabbing the pitchforks. Jab on, gentle village people! Miss ye not the tender essential organs!)

And when I say "special," I don't mean to say that my kids aren't special, or that my parenting them isn't special. It's just that in the mundane moments, it feels like anyone could be doing this. I didn't need to go to college or medical school or spend five years in residency training to do that stuff. My educational background, or training, or the years I spent before I had kids doesn't inform my daily parenting in any meaningful way. It's just me, doing what millions and millions or other people are also doing at the exact same time--probably I'm not even doing as good a job as many of them are, because HAVE YOU SEEN PINTEREST? Just me, momming it up like a character in a Sunny Delight commercial, part of the hoarde, one of a type, a piece of a marketing demographic. And that's the part that doesn't feel special.

And the thing that bothers me is that I never considered myself someone who needed to feel special, or who cared about status. I don't make people call me "doctor," I don't wear my diplomas around my neck on a giant chain, and I think I've worked most of my professional life to try to put aside whatever ego may manifest in my persona because quite simply I don't think it serves any purpose. But obviously it must have mattered to me more than I thought, because while I recognize the luxury of spending more time with my children, and for all my whining I have plenty of help in keeping this family going; I still sometimes think, this is it? THIS is what I miss work two days a week to do?

Because at work, it sometimes seems like the significance of what you're doing is obvious. That the answer to the question, "What did you do today?" could be succinctly summed up by saying: I'm a doctor, I take care of patients. Boom. Instant credibility. Credibility to whom, unclear--perhaps it's just to justify things to myself. But on the days that I'm "off" with the kids...


JOE
So, what did you do today?

MICHELLE
Well, after breakfast I dropped the boys off at school, then I took Nina to the park. Then we came home, and while she took a nap I cleaned up the kitchen. Then I started to prep stuff for dinner, but then she woke up, so I gave her lunch. Then I cleaned up after lunch. After that we kind of played a little bit out back, and then it was time to pick up the boys again. So we did! And then I finished making dinner. And then everyone ate and I cleaned that up.

JOE
Sounds good.

MICHELLE
...

JOE
What?

MICHELLE
You know, when I say it all like that it sounds like I didn't do anything.
But then how come it took up the whole damn day?


Obviously this is something I'm still working out in my brain, and clearly part of it is that there are societal indicators of what is considered "important work" that I have allowed to imprint on me (despite the fact that I obviously know that raising my children is important work, therefore the need to take more time to do it right). Also obvious to me is that this probably reflects poorly on my personality in some way--some sort of egomaniacal needs that are not being met by the quotidian tasks of parenting three young children being chief among my deficiencies. But I am curious, particularly after reading this article in the Times a few months ago--does this experience of "status loss" or this sense of becoming unmoored from part of your identity ring true for anyone else who decided to take one step back from a career that has in many ways defined them?