Monday, January 31, 2005

pregnant couple friends

I had an overnight shift in the ER Saturday night/Sunday morning, and getting on the train afterwards to go home, I was dismayed to see that there were no empty seats for my half-hour ride downtown. My first thought: "I can't wait until I'm the size of a dump truck so I can guilt people in giving up their seats for me." But I am not yet the size of a dump-truck. So far I am only the size of a Honda Civic. So no seat for me.

After a very long nap on Sunday, we went out for dinner with Ray and Susan, who are our first official Pregnant Couple Friends. Well, we have another set of Pregnant Couple Friends, but they live in Florida, so whatever, forget them. I was kind of excited at the prospect of bonding with other baby makers--finally, people who know what we're going through!--but since we're all residents, we ended up talking about medicine for most of the night instead. Is it possible for residents to ever get together and not talk about medicine? The answer is no. Unless you convene a group of residents from separate and far-flung countries so that none of them speak the same language. But even then, I'm sure we would find some way to rehash The Stupidest Consult I was Ever Called On and My Worst Overnight Call Ever through elaborate hand signals or interpretive dance.

It's the last week of my Reading Elective, and I haven't done half as much goofing off as I was planning to. At least I finally caught "Closer" at my local multiplex. Those are some attractive actors, I'll tell you what. I wish I could go out and get a cute little bob like Natalie Portman, it's very Amelie and gamine, but I just don't think I could pull that off. Either that, or I would look like I was four, because that's the same haircut I had back in 1982, when my hair still obeyed the laws of physics.

Currently reading: "Raising a Reader: A Mother's Tale of Desperation and Delight," a book that Coleen mailed me a few days ago. Cletus had better grow up nerdy-style, reading books like a fiend, or we're shipping him back. There were some interesting tips in this book, and a nice booklist at the end (we give away lots of these books at our Peds Clinic for the Reach Out and Read initiative, so I've actually read many of them), but I can't stand it when people just can't get over how adorable and precocious their own children are. Gag me. Especially if I ever end up doing this.

Friday, January 28, 2005

she's got leggings, and she knows how to use them

Because of the unusually cold weather lately, my mom has been on my case about getting some leggings.


MA
You should get some leggings.

MICHELLE
Why?

MA
To wear under your pants!

MICHELLE
Oh, you mean like thermal underwear?

MA
Yes, but leggings!

MICHELLE
Yeah, I was thinking of doing something like that. Those scrubs do get a little bit breezy with nothing underneath them.

MA
YOU'VE BEEN WEARING SCRUBS WITHOUT LEGGINGS?
(Faints with horror)


This led to some detailed description about the acquisition of leggings. What leggings look like, what colors are available, where to purchase them for cheap. Now, I'm not a huge fan of leggings (they speak to me of ripped sweatshirts and the 80's, and have the unfortunate feature of making even the slimmest individual look like they have a giant fat ass), but I figured they were benign enough if worn as an inner layer, tucked away from the sight-line of the world. So I agreed to get leggings. I just didn't actually go out and buy any leggings, because the idea of making some special trip out into the subzero weather to buy skintight Lycra was just not appealing.

Then, yesterday:


PHONE
(Ring ring)

MICHELLE
(Picking up)
Hello?

MA
It's Ma.

MICHELLE
Yes.

MA
Did you get the leggings?

MICHELLE
Uh...no, not yet.

MA
Why not? Why didn't you get the leggings?

MICHELLE
Because...I didn't get around to it yet.

MA
Listen, I'm in your neighborhood, next to the leggings store--

MICHELLE
The leggings store?

MA
--and if you want, I could pick you up a few pairs. They're 3 for $10.

MICHELLE
Well, I guess, if it's not too inconvenient for you, or out of your way...

MA
Instead of size small, I could get a size medium to fit YOUR STOMACH. But anyway, it'll be fine because they're STRETCHY.

MICHELLE
Uh, OK then, thanks. I guess I could use them now, it is pretty cold out.

MA
I'll drop them off in a few minutes. I'll drop off the leggings.

MICHELLE
Stop saying "leggings!"


So the leggings, they are not so fashionable. And they do make my ass look huge, though I'm really not a large-assed individuals. They give you body image problems, these leggings do! But oh man, do they work. I had to take the 1/9 to clinic today because of the whole disaster on the A/C line, meaning that I had to walk an extra six to eight blocks to get to work, as opposed to the half-block that I usually have to navigate from the A train. And that wind was ripping through me, and my fingers were numb, and I was getting little icicles on my beard like in those IMAX movies about climbing Mount Everest--but my legs, my LEGS were relatively insulated. For the first time this winter, my legs were warm. All because of those leggings. Those horrorshow Flashdance leggings that I was wearing under my pants.

Yay for leggings!

Currently reading: "On Writing," a non-fiction book about the craft of writing, penned by Stephen King himself. I liked the memoir parts of the book the best, but there are some interesting "writer's workshop" bits and tips on getting published that I thought were pretty interesting too. I'm bummed though, that the second edition cover art was changed around to this spooky attic tableau, to make it more "horror" looking. People, he didn't write a horror novel this time! Just because he's STEPHEN KING doesn't mean you have to juice everything up within an inch of its life--just leave it alone instead of tarting everything up all the time.

Thursday, January 27, 2005

grilled veggie sandwich of deliciousness

I just made the greatest sandwich ever. It takes a little bit of work, so maybe you should save it for a dinner sandwich, but it is good, and healthy besides.

What you will need:
One red pepper (though any color should be OK, it's just prettier with red)
One zucchini
Two portabello mushrooms
Herbed goat cheese (or no herbs, if you're not an herbalist)
Olive oil
Salt
Pepper
Bread (I got a loaf of challah, because I'm Jewish like that)

It may also be nice to have:
One of those George Foreman Grills or some equivalent--however, I'm sure an oven would work just as well.

What you need to do:
1.) Wash the vegetables and cut them up. Might I suggest just cutting the pepper in half and squashing it a little so it lies flat, and slicing the zucchini on the diagnoal into 1/4th inch slices? You don't need to slice the portabellos, they're already in grilling form.

2.) Drizzle veggies with olive oil, and sprinkle with salt and pepper.

3.) Smush in Foreman, or put on pan in oven. Cook until...cooked.

4.) Meanwhile, slice the bread, and toast. Spread with goat cheese. Be sure you got the spreadable kind, not the weird crumbly kind, or this will be difficult.

5.) Layer on veggies. May I suggest one portobello, one pepper half, and a few zucchini slices?

6.) Eat it in front of others to make them jealous.

(Serves 2, so I guess you could share with the jealous person if you were feeling magnanimous.)



* * *


A special thank-you to Mimi for reminding me about this website: Babies Named a Bad, Bad Thing. For anyone who has ever seen some kid running around with the name MacKayleigh Shavondalee and thrown up a tiny bit in your mouth.

Currently reading: Honestly, I've got nothing right now.

Wednesday, January 26, 2005

reading this and that

So I'm finally doing some actual academic reading for my "Reading Elective," trying to bone up on some anesthesia basics before I switch residencies in July. And let me be honest, it is blowing my mind a little bit. It's just so completely different from the medicine I've been practicing so far, with so much to learn in the way of machines and equipment and pharmacology and re-learning high school chemistry (who knew Dalton's Law of Partial Pressure would ever come up again in any meaningful way?). My biggest fear is that I'm going to be a total idiot when I start up. A totally DANGEROUS idiot that's going to kill someone's grandmother.

It's moments like this when I really start thinking hard about my switch, moving from one field where I feel like I've developed some minimal degree of mastery and throwing myself into another field where I know nothing. And then I start thinking cozy, reassuring thoughts like, "Oh, if I just stay in Peds, I could be done in a year and a half, and have my nice little General Peds practice, and then I wouldn't have to do all this scary new stuff and everything would be PERFECT." But I know that's not the right choice either, and I know a lot of my trepidation has to do with me being pushed (or rather, pushing myself) out of my comfort zone. Seems like there's a lot of that going on lately. Changes afoot.


* * *


So to procrastinate (see above) I've been looking a little bit on New York's urbanbaby.com message board, just to see what the scene is out there and maybe get some tips from parents in the know. Well actually, how I really heard about urbanbaby.com is from a Peds resident who's currently looking for a job with a private practice in the city after graduation--apparently, a lot of parents gossip about their Pediatricians online, and she wanted to see if she could dig up any dirt on anyone she knew. I didn't learn much in the way of Peds World gossip, but what I have picked up is that some of these New York moms are BITCHES. Seriously. Not all of them, sorry to the normal ones, acknowledging that the really snotty ones are in the minority--but man, is that one vocal minority. It reminds me of those flame wars that used to take place on the online bulletin boards in college, only with even less accountability, since no one's usernames or e-mail addresses show up in the posts. Some examples:


Mom 1: Did anyone get the new bootie cover for the Bugaboo? I'm considering buying it, but I want to make sure it's worth it. [For the general public, which included me, the Bugaboo Frog is this fancy schmancy high-end $700 stroller.]
Mom 2: Yes, I got it, and I love it!
Mom 3: I got the [some other brand] bootie cover, and it works just as well, as well as being cheaper than the $150 one sold by Bugaboo. And I think it looks even nicer!
Mom 4: Why don't you just admit that you cheaped out and got the [some other brand] cover, instead of pretending that "it looks nicer." How could it look nicer? You just didn't want to pay for the best one.
Mom 3: Excuse me, but I paid $700 for a stroller, where do you get off calling me a cheapskate?
Mom 4: I just call them like I see them.
Mom 3: Bitch!
Mom 4: Skank!
Mom 3: Whore!
Mom 2: I got the blue one with fleece inside!

---------

Mom 1: I'm a first-time mom and thinking about hiring a baby-nurse or a nanny to help out after my child is born. Anyone have any experience with this?
Mom 2: Why don't you just give your child away until she's 18? That would be the most convenient thing, you lazy fuck.
Mom 3: What's wrong with you? She was just trying to ask a simple question.
Mom 2: Lazy rich bitches should even have kids if they're just going to hire nannies and nurses. Take care of your own child! Didn't you see "Nanny 911?"
Mom 4: Not everyone who hires a baby nurse or a nanny is rich. And not everyone can be a stay-at home mom like you, Little Miss Spoiled Upper East Side Trophy Wife with a husband that's probably cheating on you with his secretary! Some of us want to go back to work!
Mom 5: If you loved your child you would quit your job and stay at home. I was an I-Banker for 12 years and I quit the second I found out I was pregnent.
Mom 4: "Pregnent?" Nice spelling, bitch. Where did you go, Vassar?
Mom 5: I went to Yale and then Harvard fucking Business School, fucktard!
Mom 1: Jeez, sorry I asked.
"Mom" 6: HELLO AND GREETINGS I AM A NANNY LOOKING FOR WORK I LOVE YOUR CHILD LIKE MINE OWN PLEASE CALL ME!!

---------

Mom 1: What do you think of last names as first names? I'm thinking about doing this.
Mom 2: That could be cute. Like if your last name was "Connor" or "Riley" or "Mackenzie"
Mom 3: Gag. "Mackenzie." Go to babycenter.com, you fucking loser.
Mom 4: Hey, my last name is Mackenzie. What's wrong with that?
Mom 5: I like that name for a baby, but spelled "Mykinzyee"!
Mom 3: Oh, you are so dead.
Mom 6: My last name is "Goldenstein." Do you think this would work as a first name?
Mom 3: You're an idiot.
Mom 6: It was a joke, you bitch!
Mom 3: Skank!
Mom 6: Stupid whore!
Mom 3: Hey, I may be a whore, but I'm not stupid! I went to the Harvard School of Prostitution! [Etc. etc. etc...]


So now I'm a little scared of these moms. Because they're crazy. Obviously, this is all amplified for comic effect, but all of these little online exchanges are based on real ones I read. Is it a New York thing, do you think, or is it just generally too easy for people to be mean when it's anonymous? I also think I'm going to start staying away from these forums, except possibly for entertainment value. It's too scary out there.


* * *


Finally: Oh my lordy, did you see this story out of Brazil? A 17 pound baby? Gaah! I hope they named him El Gordito--they could call him Gordy for short.

Currently reading: Lange's "Clinical Anesthesiology." Any anesthesia residents/attendings/nurse anesthetists want to weigh in, either on their experiences starting out in the field or on good clinical reference books? I would love to hear your input.

Tuesday, January 25, 2005

en fuego

I finally found these scented candles that I've been looking for. I originally picked up three of them at CVS, but have been unable to find them since. The reason I like these candles (I prefer the "Mountainview"), besides the fact that they come in a pleasing tea green color, is that they smell good. Well duh, right? Yeah, but have you noticed how many candles don't smell good? Or that have a strange and wrong smell, like "Coffee Cake" or "Peach Cobbler" or "Turkey Dinner with Mashed Potatoes" (OK, maybe no that last one), implying that you would want your house to smell of such things? I don't want my house to smell like food. I want my house to smell like clean-ness, as though I just scrubbed everything down and left all the windows open and oh my, doesn't everything smell fresh. I burn candles so that my house doesn't smell like food. Like after I seared up some shrimp and scallops for dinner last night, I lit the candles, because damn, the whole house smelled like a Red Lobster. But maybe some people like having their house smell like Red Lobster, and there are special "Shrimp and Scallop" candles marketed towards them.


* * *


Thanks for the advice and all regarding the nanny issue, everyone. I know it seems like we have a lot of time to look, but that shit can sneak up on you, and I don't want to spend my entire maternity leave frantically interviewing people and deciding in a rush. We had thought about looking into getting an au pair, an option that seems to have worked for a lot of people, and is more affordable besides--but I think that au pairs are only allowed to work 45 hours a week, which is much less than what we'd be needing. Also, I'm not in love with the idea of leaving some 18 year-old with our newborn, nor am I in love with the idea of having someone living with us. Haven't you seen "Single White Female"? That bitch was crazy, all dyeing her hair and murdering people with shoes and shit. So maybe that's not such a good option.

In terms of upping our salary offer for a nanny, believe me when I say that I would love to be able to do that, but we just don't have that much boullion stashed away. I mean, unless we skimp on , you know, food and toilet paper and stuff. We do have savings, and we're expecting to have to dip into those savings, but given that we've never done this before, we have to plan a good chunk of our expenditures next year to be unexpected incidentals, like...I don't know...diapers and such. (I guess that's not so unexpected. But how much does this stuff actually cost? I have no clue, and never had to look--in the hospital, all of that baby crap just appears for free.) So while I'd love to be able to offer $12, $15, hell, $18 an hour (the upper limit salary suggested by New York Magazine, which would make the nanny's salary significantly higher than that of either of her employers), we just don't have that kind of money.

As for the grandparent option that some people mentioned--an option that a lot of residents fall back on--I don't think that's a viable choice for us. It would be a nice solution, to go to the grandparent's house one day a week, thereby giving time for VITAL INTERGENERATIONAL BONDING (as well as allowing us to cut back on the number of nanny hours per week), but I don't think it's going to happen. Joe's parents would love to help out, but they live in Ohio. Which, as you know, is this whole other state. So there's that. My parents live in Manhattan, but they both work full-time, and when I gently probed my dad about the idea (Just an idea! Just a suggestion!) about the option of maybe taking the kid one day a week, trading off days between my dad and my mom so that it would only average out to every other week that either would have responsibility for the kid on their day off, my dad sort of said no. Well, he didn't say no like, "NO!" but he said it like, "Well, you know that we're always here for EMERGENCIES, so you can always call us in an EMERGENCY situation...but maybe not on a standing schedule." So that's not really very helpful.

It's ironic, really, how this is all panning out. Can't afford to go back to work after the baby, but neither of us can afford to take off from our jobs either. After all, the longer we put off finishing residency, the longer we're delaying earning an attending-level salary. So this is all just a little bit stressful. I guess I'd better start buying those lottery tickets now. Either that, or maybe I can meet a dancing chimneysweep who can introduce me to his magical governess friend with a flying umbrella, who is not only interested in working for a turn of the century salary, but also maybe singing a few songs along the way to teach us valuable life lessons.


* * *


And in the world of New York news, there was a fire in the tracks of the C train yesterday that destroyed some sort of relay station and has caused mass chaos described as "the worst damage to subway infrastructure since the terrorist attack of Sept. 11, 2001". At first, when I heard "track fire," I was just like, "Just spray it with the extinguisher and let's move on, people," but apparently, this relay station was a VERY IMPORTANT relay station. So important that they expect service for the C to be suspended for the next 3-5 YEARS, with significant curtailment of service on the A during this time period as well. Hey, I need those trains to get to work, dammit! Luckily, because of where I live, I can still take the 1/9 uptown. And who knows, maybe with all this shutting down of the A/C, they'll put more trains in the 1/9 fleet and it'll be a faster commute uptown for me overall. Hello lemons, let me introduce you to sugar and water.

Currently reading: "Nickel and Dimed." Just worth a re-read. Also possibly related to nanny-finding stress.

Monday, January 24, 2005

nanny 911

The problem with this nanny search thing is that we just don't know where to start. We did manage to cobble together an ad and post it on a popular online advertising service, just to see what kind of response we would get, but the e-mails I've received so far are of two varieties.

1.) HELLO I AM WANT TO WORK FOR YOU I AM NICE LADY AND LIKE YOUR BABY I JUST GET OUT OF JAIL AND NEED JOB CALL ME CALL ME!!!

2.) I have been a nanny around the city for 10 years, and I think that the hours that you are expecting your nanny to work and the pay that you are offering is outrageous! I have a college degree! I worked out the number of hours you're asking for and the pay you're offering, and it amounts to about $9 an hour. $9 an hour is slave labor! I hope you stupid, stupid people come to your sense by the time your baby is born, for your own sake and your child's! You are horrible people, and I am insulted and disgusted by your ad! (Sound of spitting.)

To the first type of response: Yeah, lady. Don't call us, we'll call you.

To the second type of response: This one I find a little tricky. Sure, I would love to pay people more, because I think we'd get better candidates that way. But we just don't make all that much money to begin with, and already, we're budgeting that all of one entire person's annual take-home salary is going to be directed towards paying for this person. And yeah, we know the hours are long, but those are the hours we work--as residents, we don't exactly have a lot of flexability with getting out early or staggering our shifts. Shifts? What shifts? Every day, from the crack of dawn to the crack of dusk (does dusk have a crack?), unless one of us is lucky enough to be on call and working 24 hours straight through the night.

In addition, I feel bad that those people were so insulted by our ad, but if it makes them feel better, Joe and I both have medical degrees, and we work even more hours per week for that same pay or less. So now who's the slave? And honestly, if the job is not for you, you really don't have to apply. You don't have to get all nasty in my inbox about it.

Nonetheless, meaness filtered out, the input is taken into advisement. Now hear this: most people would prefer to work fewer hours with less responsibility and more pay. Join the club.



* * *


This weekend, because it was cold and snowy and forbidding outside, I was watching TV (on VH1, they were running an "I Love the 90's" marathon, and the episode I caught was about 1999--there's a nostalgia show about that? That was just, like, last year!) and caught a couple episodes of "The Ashley Simpson Show." Oh, I'm sorry, ASHLEE Simpson. I gues it's phoenetic. I was curious about this show for a couple of reasons, first because I could not figure out why the hell Ashlee Simpson was famous (it's like that Lindsey Lohan phenomenon, except even more senseless), and why people hated her so much now. I am sorry to report that I have no answers to either of those questions.

The "why she's famous" issue is a mystery to many, I'm sure, but from what I can glean, she's the "rebellious" "punk rock" younger sister to some more famous golden-girl pinup type, and therefore that gives her some sort of automatic leg up in the industry, as well a shitload of exposure. Also, she dyed her hair brown and wears a lot of black kohl eyeliner! Instant edginess! (See: Avril Lavigne.) Why people hate her so much I also don't understand. Sure, she's kind of stupid and not terribly talented, but that's just like 95% of the other artists on MTV. So why the venom, New York Post? My guess is because she doesn't have boobs as big as her sister's.

Currently watching: "Mulholland Drive," which I just rented from Blockbusters. We actually watched this in the theater when it first came out, but were totally confused by it, and therefore thought it unbearably obscure and pretentious. But then I kept thinking about the movie obsessively for, like, weeks after we saw it, and read some more reviews that clarified a few things for me. And then I was like, "Oh...now I get it...kinda." So I figure it's worth watching again.

Sunday, January 23, 2005

snow day

So the snow was crazy, wasn't it? It finally tapered off sometime this morning, though it may have stopped even earlier than that--it was hard to say after a certain point if it was fresh snow falling from the sky or just old snow that was getting blown around and redeposited. Pretty for now, but I'm sure by the middle of next week all that will remain are these giant ice mounds on the side of the street where the plow heaped eveything up, with a nice little dog poo core that won't thaw until mid-March. Lovely.

Even though all the local merchants were shoveling and salting like crazy, the sidewalks still aren't all cleared off, so it was a little hard to get around still this afternoon. So Joe and I just walked over a couple of blocks and finally finally finally watched "Sideways". I guess everyone else had the same plan, because the theater was packed, despite the fact that the movie came out, like, two months ago. I guess that's what happens with all the award season hype. What, like I'm going to see "Hide and Seek" when I have "Sideways," "Million Dollar Baby," "Closer," and "The Life Aquatic with Steve Zissou" all showing at the same theater? Girlfriend, please.

Anyway, if you want to see a solid, likeable movie starring the brilliant Paul Giamatti in an honest movie about male friendship--and also crippling mid-life depression and inertia--you should pop on over and see "Sideways". I love Paul Giamatti, and if you look at his filmography, you realize that this guy has been in everything. (Overlook the unfortunate Martin Lawrence vehicle "Big Momma's House" and skip to "American Splendor," which also stars indie film sweetheart Hope Davis.) My enjoyment was only hampered by the fact that I had to pee really badly the entire movie, starting from the scene where they go visit Miles's mom (which, if you've seen the movie or read the book, you know is all the way in the beginning), and we were trapped dead center in an aisle with, like 40 people on either side. And I really don't like missing part of a movie, and I really really don't like disturbing other people, so I somehow managed to hold it until the end, although I was having some trouble walking straight by that time. I remember vividly for some reason that the same thing happened to me when I watched "The Last Emperor," only that movie was, like, three hours long and, being eight years old at the time, I had a much smaller bladder capacity.

So I'm on this reading/study elective until the end of the block, before I return to the NICU in February. So this week might be a good time to catch up on all those other movies that I've been waiting to see until now. I mean, in between the hours I'm going to put in studying very, very hard, of course. Ahem.

Currently reading: Finished re-reading "A Heartbreaking Work of Staggering Genius." So good. My sister actually got to meet Dave Eggers when he was doing some sort of college promotional tour, and I was so jealous I almost had to kill her. Kill her and steal her autographed copy of "AHWOSG," a book that I gave her for Christmas so the fact that she has as the autograph whereas I am autographless is just infuriating. But now I'm really fresh out of books to read. Maybe I should scour my bookshelves for books that I never got around to starting and therefore forgot about. Or maybe I'll head on over to Borders tomorrow (in between the hours I'm going to put in studying very, very hard) with a list of recommendations from the Comments section and see what they have in stock. I know I could find them all online, and probably for cheaper, but sometimes you just want that instant gratification.

Saturday, January 22, 2005

on the matter of timing

Wow, the announcement about Cletus has really brought people out of the woodwork around here. Thanks for all the nice notes, guys!

I've been waiting so long to tell people about the whole pregnancy thing that I saved up all these stories and topics that I can finally talk about now, which is why these past few entries have been all kind of on the same track. Yesterday was all about scary exposures in the hospital, like how when the portable x-ray tech comes around to shoot his films, he's supposed to yell "X-RAY!" to get people out of the way so they don't get all irradiated, but then sometimes he says it kind of quietly, like, "x-ray!" and then he shoots the film RIGHT AWAY before you get a chance to actually move out of the way, and then you're freaking out all night that your fetus is going to have twelve heads or something. For example. Not that this ever happened to me or anything. (Crickets.)

Today I'm going to talk about the matter of having kids during residency.

Keep in mind, of course, that I really don't know what I'm talking about, because as of this moment, I don't have a kid. Dog, but no kid. But this is more of a philosophical discussion, or the matter of deciding to having a kid during residency, and the things that we've considered in making the choice that we did. A hard enough path when even one partner is going through residency when the kid is born, an even more inflexible situation when both partners are in the middle of residency, with the end nowhere near in sight.

I think, first of all, that it all depends what you personally want. Some people really, really want kids, circumstances be damned. And some people want to wait until everything is perfect and all their ducks are in a row and they're settled into private practice before they have kids. And some people really don't want to have kids at all. All of these choices are OK. You should want whatever's right for you, and you're the only one who can decide what that "right" situation is.

When Joe and I first got married, we were good little med students and very intent on being good little doctors. We had talked about when we wanted to have kids, and at the time, figured that we would wait until we were both done with residency, or even with a good deal of fellowship before we started to build a family. This is what med school grooms you to do, you see. Med school teaches you how to be a doctor, and we were very focused on having these wonderful, booming, academic, fulfilling careers.

And then we graduated from med school. And started internship. And we worked and worked and worked. And we still liked being doctors, most of the time anyway, but some of that med school gloss starts to wear away. And as I've discussed before, you start to realize that while medicine is a calling, and while it's a big part of our lives, we didn't want it to be our whole lives. There are other things, after all, than rounds and lab results and progress notes, though it's hard to imagine it sometimes.

And I guess at some point, we both kind of got sick of mashing our Real Lives to fit around the nooks and crannies left by our Work Lives. We felt like we had been more than fair to Work Life, and now it was time for Real Life to get a turn at bat. We both wanted to have kids (though we were still pretty up in the air with the when part of the equation), and decided for once in our pathetically Type A lives not to be so rigid and scheduled and planned about everything. We wanted to be like normal people, in other words. Just let the chips fall where they may. So while we weren't trying to have kids per se, we weren't really trying not to have kids either, you dig?

So when we got back from Hawaii and found out about Cletus, we were a little surprised (see above, about not trying per se), and of course while had some concerns about how we were going to swing it on a two-resident schedule and budget, but ultimately we were pleased because this is something that we both really wanted. And that's really the long and the short of it. You decide what's best for you and work everything else around that. Don't change what you want just because you're afraid to perturb the rest of the equation. Life is constant change, adjustment, compromise. And we're more than happy to make some changes around here for something that's going to be so important to the both of us.

Is this going to be hard? Well, yeah. Even without our jobs, it would be hard, now wouldn't it, two bumbling first-time parents with a new baby? I shudder to think. But is it going to be worth it? Well, yeah. It's going to be fun and exciting and fulfilling and all of that. And let's not kid ourselves, sometimes it's going to be really tiring and frustrating and annoying too. But look, if there's one thing we know how to do, it's work hard. Sometimes we even laugh a little bit while we're doing it, because really, how hectic and ridiculous are our lives? And hell, we've already finished med school and half of residency. Psssh, having a kid, how much harder could it be?

Famous last words, I know.

Currently reading: I couldn't find my copy of "The Shining" after all, though I suspect it may be at my parents house. So instead I'm re-reading "A Heartbreaking Work of Staggering Genius." Every time I read this book, I think how brilliant Dave Eggers is. I haven't enjoyed his subsequent work quite as much, but this book does not lie--it is genius. And all those books that pretend to be "The Catcher in the Rye" for a new generation should just stuff it, because here's where it's really at.

Friday, January 21, 2005

i'm just going to buy a hazmat suit

I'm glad I'm finally able to tell people now about Cletus the Fetus, because let me tell you, it was hard to keep a secret of that size. (Not that Cletus is huge--7.4cm crown to rump on the latest measurements--but I meant a secret of that magnitude.) Hard to keep the secret at work, from people who see me every day, but also hard to keep the secret here, where I tell all my stories. Because being a Peds resident while pregnant is a little bit like being an FBI trainee going through the training course at Quantico. There are hidden dangers everywhere. Or so it suddenly seems.

I'm not just talking about obvious things, like walking into the CT scanner while it's running, or getting nailed in the gut but some deranged teenaged psych patient. I'm talking about things that you learn about in med school. Seemingly unimportant at the time, but let me tell you, you'll be yanking out those old med school notes soon enough to re-read about first trimester exposure to CMV when you're pregnant too and hanging out with a passel of CMV positive drooly little suckers.

How, for example, to handle children with rashes. I know an ER attending who, while pregnant, absolutely refused to see any child with a rash. I think that's a little extreme--I mean, I don't think eczema's going to cause your unborn child to lose any IQ points, lady--but I guess her point is that you never know. Anyway, attendings can do whatever they want, but the idea that a resident could pull of such refusal in the ER is just unthinkable. Because when it comes down to it, ALL CHILDREN HAVE RASHES. It's just a matter of staying away from the suspicious ones. Unfortunately, we're usually the ones who decide if the rashes are suspicious or not, and usually by the time I get close enough to do that, the kid is already eating my stethescope and innucolating me with boogers. And sometimes it's a surprise rash. Like in clinic a few weeks ago, I saw a kid for croup. At least, that's what it said on the chart. But when I walked into the room, I see a kid with slapped cheeks and a lacy maculopapular rash all over his torso. Ah-so. Yes, yes, I know they're not supposed to be shedding anymore by the time the rash appears, but it's difficult not to stress about it when it's your own fetus at stake. Luckily, my OB is very good (or perhaps well-accustomed to taking care of patients who are doctors), so on my first visit drew titers for everything under the sun. After I walked out of the patients room, I ran to a computer and checked my own results. Thankfully, I'm IgG positive for both parvo and CMV (meaning: immune), but I challenge you to not freak out about that kind of thing when you're pregnant. Freaking out is the nature of the game.

Or how about on oncology? Taking call for oncology forced my hand to tell people at work about Cletus. I mean, I was ready to tell anyway, but I would have liked to do it nice and calmly, maybe over a cup of hot chocolate, not because there's some kid getting Ribavirin and one of the things on the signout list reads, "Please place ND tube overnight." Oh, hells no. Ribavirin, for those luckily uninitiated, is an inhaled med that we sometimes use for immunocompromised patients with RSV. It's also Pregnancy category X, meaning that on the door of the patient on Ribavirin is a gigantic red sign that reads DO NOT ENTER THIS ROOM IF YOU'RE PREGNANT, THINK YOU MIGHT BE PREGNANT, OR EVER WANT TO BE PREGNANT IN YOUR LIFETIME. (Well, maybe not that last bit.) Because it's extremely teratogenic, you see. And it's aerosolized, so the kid getting Ribavirin has to be all sequestered off in some little negative pressure room somewhere. Let me tell you, that stuff is scary. No one is supposed to go in while the treatment is running, but even after it's done, that stuff hangs around. Last year on Onc, I went in to examine a patient on Ribavirin between doses, and when I walked out of the room a few minutes later I was all dizzy and had a headache. Delightful.

Or how about Wednesday night on call. I'm in the team room when I head the shatter of breaking glass and a scream. It was Professor Plum with the candlestick in the negative-pressure room! I go running around the corner to see if anyone needs any help, and screech to a halt cartoon style three feet from where one of the nurses just broke a full bottle of chemotherapy all over the floor.

"I'll...tell the ward clerk to call Environmental Services," I stammered, backing away from the GIGANTIC PUDDLE OF LIQUID POISON, as the rest of the nursing team was putting up little roadblocks and flares around the spill and making little clucking noises of dismay.

So you see, it's a dangerous world out there. Or at least in here. At least this puts to rest the question of what kind of parent I'm going to be. The EXTREMELY NEUROTIC kind.


* * *




(Oh, and to clarify, we're not actually naming the kid "Cletus." That's just what we're calling it for now, because "Cletus the Fetus" is kind of funny. But I don't actually want our kid to grow up to be a slack-jawed yokel.)


Currently reading: Continuing on my effort to stall for time until I figure out the next new book to read, I think I'll truck "The Shining" up to work with me. Unfortunately, my copy of "The Shining" is part of a four-novel Stephen King anthology, so it's a little cumbersome.

Thursday, January 20, 2005

cletus the fetus

Everyone, I would like you to meet Cletus. Say "Hi, Cletus."



(Cletus says "hi" back.)

So as you can infer from it's name, Cletus is a fetus. Cletus is our fetus. Cletus is the fetus that lives in my uterus. Which is, I guess, an overly awkward and medicalized way to tell you all that I'm pregnant.

And now, a few answers to some frequently asked questions:

Wait, you're pregnant?
Yes.

Pregnant?
Yes.

YOU?
Yes.

This is a joke, right?
Yes, ha ha! Fooled you! Actually, no, it's not a joke

How did this happen?
Use your imagination.

When are you due?
The end of July, if all things go as planned and those NICU preemies don't put some voodoo preemie hex on me.

Which makes you...
Thirteen weeks along. Yay, second trimester!

Are you excited?
Hells yeah.

How is Joe reacting?
He's Photoshopping little pictures of baseball caps and footballs on all our ultrasounds. Then, to appease me, he Photoshopped in a book, "in case the baby takes after you." So yeah, he's excited too.

How is Cooper reacting?
She's oblivious. But she likes kids. And she'll like having someone smaller than her to boss around. Oh wait, she bosses us around anyway.

What about your job? Aren't you switching residencies in July too? Aren't you going to be flipping out, starting two completely new things at the same time?
Ah, the true mark of a medical professional. It's undeniable that the first thing I thought of after I found out I was pregnant (after "holy shit!") was, "Yes, but what of my career?" This does not make me a bad person, I hope, rather a person who worked hard to get where she is professionally and isn't really looking to give that all up just because she's in a family way. True, it's not going to be the easiest thing in the world to pull off, but it's going to be doable. It's going to be doable because it has to be. This is not a new story, it happens to people all the time. Hell, my own parents did it back in the day (they're both doctors too, and were second year residents when I was born), and I turned out relatively well-adjusted. Unless you consider the fact that I'm SCARRED FOR LIFE. (Kidding, Ma. Kidding.) I talked with the higher-ups in the Anesthesia department, and there were nothing but lovely and cool about the situation, and I look forward to mastering the fine art of multi-tasking with some help from the spouse, our families, and some hired help.

So you have to find a nanny?
Yeah, we're in the process of figuring out how to look for one.

Yeah, but what if the nanny is a crazed psycho killer like in "The Hand That Rocks The Cradle"?
Don't even talk to me.

So how do you feel?
Pretty good, thanks. Earlier on, I was a little tired in the evenings, maybe a little queasy around dinner time (though I was remarkably quease-free in the mornings), but really nothing that different from how I might feel after a long night on call. And now everything is getting better, now that that pesky first trimester is behind us. I had to buy some new clothes, though.

So, are you fatty now or what?
Well, I'm in that curious limbo state where my regular clothes are a smidge tight after meals, but maternity clothes are still ridiculously huge on me. Luckily, scrubs always fit. I don't think you'd be able to tell I was pregnant if you didn't know how I looked normally, but there's a subtle gaining of curves in certain places and loss of curves in others. (But don't think about the details of what I just said too hard, because you're grossing me out.)

Is Cleatus a boy or a girl?
Yes it is. Well, at least I hope it will commit to one sex in the end. But the real answer is that we don't know yet. We do want to find out, though, and we probably will in a month or so, so I'll keep you posted on that one.

I can't believe you're pregnant!
That's not really a question.

Sorry.
It's OK.

So are you going to keep us updated on this whole family thing, thus adding another dimension to this webpage and transforming it into more of a "medical professional balancing work and family" type journal that we can follow along with? Just like those shows on "Lifetime, Television for Women"?
Well, it wasn't really my intent from the outset, but I guess the "balancing work and family" game is just going to be our reality from now on. So: yes. But don't worry, I won't get all sappy about it either.

That's really exciting. Congratulations.
That's not a question either. But thanks.


Currently reading: "Cujo." Still doing the Stephen King thing, while waiting to figure out my next move. I've taken all your book suggestions and placed them into my Amazon.com cart for future perusal, though.

Tuesday, January 18, 2005

let freedom ring

I was on oncology call Friday and Monday of the MLK weekend, a double whammy that I can ascribe to only one factor: racism. (It's the only explaination, really.) At least everyone else on call seemed happy to see me. The ward senior on overnight walked into the team room, where I was getting signout, saw that I was there, and started doing a little dance. "I love it when it's one of you guys on call!" she said, all the while doing the Electric Slide or some such thing. The onc fellow on call expressed similar sentiments before he left for the three-day weekend. "Sweet. At least two of the four nights, I'll be able to get some rest."

What everyone was getting so excited about was not so much that it was me on call per se, rather that I was a second year resident, as opposed to one of the interns, who also take onc call half the time while rotating through the service. I had the same experience myself as ward senior two months ago--the nights that I was on, I would take a look at the schedule, and if there was a second year on call for onc, I would breathe a sigh of relief, because that was one less service that I had to worry about supervising. Interns need to be checked on more frequently, and tend to need more backup, especially with a 30 patient service--but the general sentiment is that a second year can basically handle most things for the night.

And while this all makes me feel good and mature and competent, the flip side is that now I feel like every time I took onc call last year, people were looking at me and thinking, "Oh shit, that intern is on call. Well, there goes my night." Who knew?


* * *



So I just got my medical license in the mail. It is unimpressive-looking, printed on 8.5" x 11" mottled ecru cardstock, with no fancy holograms or watermarks that I can discern. Dude, I could have printed that shit up. Really, I would have expected a $150,000 document to look a little more impressive, or to at least come with a free stick of gum or a fake tattoo or something. Well, I'll gussy it up, stick it in a frame or some such to hang in my office (read: bathroom) until such time comes for me to display it publicly. That's right, folks, I'm not a quack.


* * *


Today was the coldest day of the year so far--which is not saying much, I guess, since it's only January 18th, that's like saying "Racing Stripes" is the best movie of the year so far--but certainly cold enough that we didn't discharge a patient from the hospital yesterday because they needed some close follow-up in the clinic today, and we were afraid if we let her leave the building, she might never come back. Which may or may not have to do with the weather. But I digress. Anyway, my point is, the coldness. It's even cold in the subway, which I really don't understand, it being underground and all. Shouldn't there be some Biodome effect, with all the heat trapped from the machinery or the baking human bodies? Or at least from the Earth's core--that 1/9 station at 168th street is something like 7 stories underground. I have to figure out a better solution to gird my legs in warmth, because those scrub pants just aren't doing shit for insulation. I've tried wearing a pair of track pants over the scrubs in the past, but between my parka and the sweater and the scrubs and the track pants, I can barely move my limbs. I'm like those kids in snowsuits that just fall flat on their faces because they can't bend their knees. Maybe I'll knit myself some leg-warmers. Who loves the 80's now, Michael Ian Black?

Currently reading: "Pet Semetary." When in doubt, you can always re-read some old Stephen King. He's kind of like Woody Allen in the sense that his 80's stuff is good, but his newer stuff has gotten too folksy and almost self-parodic for my taste (though I'm sure he doesn't mean for it to be that way)

Thursday, January 13, 2005

this song sounds like needles

My sister gave me a mix CD of a bunch of those dippy Top 40 songs that I secretly LOVE, though maybe not quite as much as she, who seems to own the entire "NOW That's What I Call Music" library (Vols. 1-17). One of the songs on the CD she made for me is that one by Maroon 5 that goes, "This! Love! Has! Taken it's toll! On me!" You know which one I'm talking about. Every time I hear that song, I think of the NICU.

A word of explaination about the NICU. Lite FM is always on in the NICU. (In case you're not familiar, Lite FM--and I'm sure there's a version of it where you live--plays THE BEST LITE HITS OF THE 70's, 80's, 90's AND TODAY, and is favored at such mellow places as dentist's waiting rooms and gas station Kwiky Marts.) There's no central music system in the NICU, but there are little portable radios brought in by various nurses dotted around the perimeter of the unit (which is rougly oval shaped, like a racetrack), and since all the radios are tuned to the same station, you get the feeling of a very large and elaborate surround-sound system as you tour the floor, walking out of the sphere of one radio's play zone and into the sphere of another.

Anyway, for some reason, both times I've been in the NICU--in May and in September, for those of you playing along with the home version of the game--that Maroon 5 song has been playing every time I have to poke a kid with needles. The rest of the time, it's a regular assortment of Celine Dion, Rod Stewart, Elton John, what have you, but the moment I whip out those little blood culture bottles or the ABG syringe, every time the IV setup or the LP tray gets set up, "This! Love! Has! Taken it's toll! On me!"

My hope is that, in the tiny slivers of aural memory that may be laid down at that stage, those kids remember that Maroon 5 song too. Maybe so much so that years later, when they're all hale and healthy and King of the Schoolyard, just hearing a few notes of that song, ("This! Love! Has! Taken it's toll! On me!") will be enough to make them cry a little, even if they don't remember why. Sweet, sweet memories of our brief time together.

Currently reading: "Candy Freak," again. My sister (my other sister, the non-CD-gifting one) wants to borrow the book this weekend, so I'm trying to re-read it quickly.

Tuesday, January 11, 2005

i'll hook you up

Yesterday on call, at around 2am, we got a call from the satellite pharmacy that they were almost out of methadone. Which is kind of a weird call to get at that hour, like, "Oh...I'll alert the media," until you consider that we had a DNR end-stage cancer patient on the floor on a methadone PCA running at some unbelievably high basal rate with equally astronomical bolus doses. The nurse came running up to me frantically after this conversation, sat down (you know it's bad when the nurse has to sit down to tell you something--either that, or they're just kinda tired, it being 2am and all), and said that with the current supply in the pharmacy, and at the rate that the patient was going through the pain meds, we maybe only had enough methadone to last until maybe 4 or 5am. There was a large supply of methadone in the main pharmacy, but that wouldn't open until around 8am, and the satellite pharmacist said that he couldn't get access until then.

Aside from the disbelief that the overnight pharmacy in a gigantic children's hospital with a 40 bed PICU and a 30 patient oncology service would RUN OUT OF METHADONE, I was more than a little alarmed at the idea of putting this patient through any more pain than he already was experiencing. But the kid was using a fucking shitload of methadone. His nurse and I quickly projected how much extra we would need to get him through the night, and figured that we needed to locate an extra 400mg somewhere in the hospital to bridge the hours to 8am, with a little bit of a buffer for escalating breakthrough pain. 400 milligrams. My friends, this is a GIGANTIC AMOUNT OF METHADONE. Consider that heroin addicts usually get 20-120mg a day on methadone maintenence, and then consider that this kid was getting at least that amount every hour. Fucking cancer.

Anyway, since the pharmacy seemed to be fresh out of the good stuff, I decided to run on up to the PICU to see if they had any extra stores that we could use for the night. With all their post-ops, they had a lot of kids on methadone drips, and therefore hopefully a healthy stash. However, hand in hand with that, with a lot of kids on methadone drips, I didn't know how much methadone they could spare. I ran from one end of the building to the other, talking to all three wards in the PICU (when did our PICU get so fucking huge, for crap's sake?), and at the end of all my wheeling and dealing, I had in my hand two vials of methadone, totalling 400mg.

"Do I need to, like, sign something to get this for my patient?" I asked one of the PICU nurses, not wanting to get anyone in trouble for taking something out of the unit Pyxis for a patient on another floor.

"Nah, it's OK," the nurse said, punching in her security code, unlocking the drawer of narcotics.

Running back down to the oncology ward, my hads full of enough methadone to kill a horse, I started to get all nervous. What if some crazed drug fiend cornered me in the elevator and stole all my patient's methadone? What if I got a shiv in the ribs for all my trouble? For that matter, how did the PICU nurses know that I'm not some crazed drug fiend? I could have made up that whole story about my dying patient and the PCA and the pharmacy running out of methadone. I could be running out of the hospital now to peddle pharmacy-fresh methadone to junkies on the street. And then I could finally quit this lousy day job.

I dropped the five million tons of methadone off with my patients nurse, telling her, "This should be enough for the rest of the night. Don't even ask how I got it, it involved prostitution." And then I walked , relieved to be unburdened from the responsibility of guarding that much opiate with me wee hands.

The patient was able to sleep for the rest of the night.

Currently reading: Meh, between books. What to read, what to read?

Monday, January 10, 2005

review: "ocean's twelve"

We finally went to see "Ocean's Twelve" last night, and lo, it kind of sucked. Barely a story. Incredible plot twists (and not incredible like "Wow! Awesome!" rather incredible like, "Oh god, are you kidding me?"). And phoned-in performances. Well, I guess I'd be phoning it in too if I knew that after my scene wrapped I could go back to partying on my yacht with my movie star friends on Lake Como. Which made me think: I wonder how Don Cheadle and Bernie Mac and the rest of the secondary cast felt not being included on the Cool Kids party at George Clooney's house? Like the nerds on the math team, I bet. He should have invited them along, at least. The Chinese guy could have done some cool Cirque du Soleil shit for everyone's amusement.

Well, at least everyone was very pretty, which at least met expectation. Except that Julia Roberts, who is usually a very lovely lady, looked kind of pale and strung out in the second half of the movie, which I don't understand. What, the hair and makeup people were too busy eating gelato to make her look good? But it is forgiven because she was a Pregnant Lady, and Pregnant Ladies can look however pale and stringy they want.

After the movie:


JOE
That kind of sucked.

MICHELLE
Yeah, it...yeah.

JOE
But at least we learned one thing.

MICHELLE
That we should be very jealous of George Clooney for having a villa on Lake Como?

JOE
No. That Brad Pitt is a good dresser.

MICHELLE
It's not like he picked out his own clothes. They have wardrobe guys for the movie.

JOE
Still.

MICHELLE
Anyway, they kept putting him in the exact same outfit, that silver sports coat thing.

JOE
Plus, he's single now.

MICHELLE
Right, I forgot! There's your opening!

JOE
Heh.

MICHELLE
"Brad, I don't know if you're doing anything next weekend, but...(ahem)...I mean, if you're not busy, maybe we could hang out sometime...(cough)...or not...whatever, no big deal."


I'm telling you, the man loves him some Brad Pitt.

I'm taking a reading elective this month, interspersed with some Oncology cross-cover. In fact, I'm on call tonight. Hey, it still beats the ER.

Currently reading: "The Children's Hospital Oakland Hematology/Oncology Handbook." Because I haven't done Onc since last Christmas, which is a really, really long time. Though still not long enough for my taste.

Sunday, January 09, 2005

welcome to the crap months

The ER treated me decently Friday night. I mean, don't get me wrong, it still sucked because it was an overnight shift in the ER on a weekend, but it could have been much, much worse. It still amazes me the different thresholds people have for bringing their kids to the ER, though. I don't know about you, but as a kid, I never went to the ER. (Or, as I'm finding that our Canadian colleagues call it, "The Emerg.") Hell, I hardly ever even went to the doctor, except for required things like shots and check-ups and the like. But then, for example, I get this one year-old patient last night at 3am with the chief complaint of "vomitting since 1am." So, for all of two hours. The kid is smiling, happy, cramming food down her toothy craw, looks like a rose. What's the problem here? Captain Kirk, this Earth "logic," I do not understand.

I think people don't really understand that we don't really do all that much for kids with garden variety viral syndromes unless they're bone-dry or dying or something. I've given the whole "Clears, Tylenol, watch her urine output" talk so many times that I wish I could just print it out on a card and just hand it out in the waiting room to save people time. Parents always ask me, "Yeah, but isn't there a MEDICINE you can give me to stop her vomitting? Can't you write me a PRESCRIPTION for something that will cause all of his nasal congestion to melt away instantly?" Well, not so much. And then the parents get all pissy because what the hell are we, USELESS? Well, most of the time...yes. Which is why you should avoid coming to the ER at all costs, because believe me, this news isn't going to sit well after a six hour wait at 2am.


* * *


The supermarket in my neighborhood finally put away it's little Christmas soundtrack. Thank god. It's strange wandering around the Dairy aisle on January 7th still hearing Nat King Cole singing about tiny tots with their eyes all aglow, and folks dressed up like eskimos. (Though I still prefer that to that "Feeeeed thuuuuh WOOOOOO-oooorld" song, which makes me want to take all the little cocktail toothpicks at the olive bar and stab them into my ears.) Not moving on after Christmas is over is just a little creepy, like that episode of "King of the Hill" where Bill keeps on dressing up like Santa Claus straight through to St. Patrick's Day. Everyone seems to have been a little slow letting go of Christmas this year, though I'm not really sure why. My building didn't take down the decorations in the lobby until fairly recently, with the twinkly lights and fake tree and such--though in a move of supremely bad judgement, they decided to leave up the fake plastic mantle and hearth, with plastic embers flickering mellowly inside. Who even knew they made such things?

Now that the holidays are over, we're looking ahead at a long corridor of several very dark, very cold months to get through with absolutely nothing very exciting awaiting us on the other side. You just trudge through the crap months (January, February, March, hell, even the beginning of April, depending on where you live) like a joyless drone, or perhaps one of those faceless models in those M.C. Escher drawings, until one day, you notice that the sun is still out, even though it's 5:30pm. And then it gets a tiny little bit warmer. Not a whole lot, but just a little. But then, just when you start getting your hopes up, thinking that Spring is finally here, it gets super-cold again. Maybe it even snows. And then there are those few freaky days where everything is frozen and icebound while all the store windows have displays of models frolicking on the beach wearing pastels and flip-flops, exhorting you to get your NEW SPRING LOOK. Damn you, tanned models! But then everything thaws out for real. And the trees come back to life and all the flowers come out and you sneak out during your lunch break (if you have a lunch break) to go eat out in the courtyard, under the sun. And you're very, very happy that it's finally Spring.

But until then, maybe I should get one of those lightboxes.

Currently reading: Finished "Louis Riel: A Comic Book Biography." It was OK...I guess. Now I'm not really sure what I want to read next. Maybe I should actually do some medical reading for school--I mean, work. Whatever.

Friday, January 07, 2005

double-header

Today I'm spending a full day at clinic, taking my one-hour commute home, getting some sleep, and then heading back into the hospital later tonight for my 11pm-8am shift in the ER.

A double-header. I'm not happy about this. Hours-wise, it's not different than just being on overnight call, but overnight in the ER after a full day at work is different. At least on the wards there's some possibility of tucking in your patients and getting some sleep yourself. The ER is just non-stop. Sometimes it feels like a factory, with sick kids popping off the assembly line at this constant, steady pace. And sometimes the conveyer belt gets screwed up, like in that "I Love Lucy" episode in the chocolate factory, and kids start spewing out triple-time.

In addition, I noticed that I'm the only resident scheduled to be in the Peds ER overnight. Putting ONE MEASLY RESIDENT in the PEDIATRIC ER in the DEAD OF WINTER--is this really such a good idea, folks?

I'm just not happy about this at all.

Currently reading: Finished "Clyde Fans: Book 1" which I really enjoyed. It had an air of simple melancholy and regret, and the art was beautiful. Now working through another Canadian cartoonist's latest offering, "Louis Riel: A Comic Strip Biography." So far I'm not as into it as the former selection. I guess I'm just not that into Canadian frontier history.

Wednesday, January 05, 2005

term paper

This is like high school again. It's 9:30 on a Wednesday night and I'm sitting in front of my computer trying hastily to pound out a written assignment that's due early tomorrow morning. Only I'm not in high school. Or college. Or even med school. I'm old, dammit. Why are they making me hand in a writing assignment? And am I expected to hand it over in a plastic report cover?

I suspect the real answer (well, to the first question, not the second) is because my outpatient block is ending this week, and there has to be some tangible proof that progress was made or that some learning or self-reflection took place in order for the program to justify the funding that paid for various and sundry activities in which I took part. My writing assignment is about a "house call" that I made to a patient's apartment, and what I learned from that experience. I know I'm supposed to write about how much I can learn from seeing a family in its own space, about my patient's culture and living situation and giving power back to the patient in a non-medical setting, blah blah blah--but really what I learned that it is possible for people to sleep quite soundly even when the TV is blasting Spanish soap operas at the highest possible volume. I don't know how that dad did it. Probably years of practice.

So I'm doing the writing assignment but really resenting the fact that I have to do this writing assignment, because what am I, twelve years old? And I know that my preceptors couldn't care less about the assignment itself, as long as I have something to hand in tomorrow morning, but that makes it even worse, because who really does care about this assignment anyway? And why am I doing it? And did I really just use the word "paradigm" twice in the same sentence? Aargh. Where's my thesaurus?

Oh my god, this really is high school.

Currently reading: Just finished "Breakfast After Noon," and just started "Clyde Fans, Book 1." I'm working through the slew of books I ordered with the Barnes and Noble gift certificate I got for Christmas, and I have to admit, many of the books I bought are comic books--or "graphic novels," if you need to be more elitist about the genre, which I don't.

Tuesday, January 04, 2005

like the corners of my mind

I noticed that a lot of people have been working their way through my archives recently, so out of curiosity, I started looking back on some of my really old med school entries. And this little trip through Memory Lane has reminded me of one important thing:

The first two years of medical school sucked.

The consolation for those of you currently suffering through the first half of your medical education is that it does get better. Seriously. Trust me. I know everyone keeps telling you that, and you're not really sure whether or not to believe them, but I think it should be clear to anyone that nothing is as painful as sitting at a desk cramming information into your swollen brain for 12 hours a day, seven days a week. Well, maybe getting your kneecaps sawed off would be more painful. But the constant studying scenario runs a close second. The first two years of med school are insular and dysfunctional and robs you of all social skills or conversation topics. Third year is better if, for no other reason, that you have reason to interact with others again. That, and you have better stories to tell. I think if anyone tried to make a comic about the first two years of med school, the comic strip would spontaneously combust due to the mind-numbing boringness of the subject matter. Because nature abhors a vacuum, and therefore would set that comic strip on FIRE.

I wish I could brag about how exciting my life is now, but I can't, really. All I know is that it's better than this.


* * *

I have to go to the our affilate community hospital tomorrow morning to give "The Baby Talk." No, not the stories of where babies come from (everyone knows that when a mommy and daddy love each other very much, the stork flies in with the baby in its beak...duh), rather a newborn care education class for new moms before they're discharged from the hospital. In this talk, I am to deal with such scintillating topics as:

  • What To Feed Baby. Otherwise entitled: No, Baby Does Not Need Strawberry Qwik Mixed Into His Bottle, Even If "He Likes It."

  • How To Carry Baby. Otherwise entitled: Do Not Put Baby Into A Baby Carrier Where The Leg Holes Are Bigger Than The Baby Itself, Because You Will Be Very Sad When Baby Slithers Out And Falls On The Floor In The Subway.

  • How To Deal With Baby Crying. Otherwise entitled: Yes, Shaking Baby Will Stop Baby From Crying. But Maybe FOREVER.

  • When To Bring Baby To The Doctor. Otherwise entitled: If You Page Me At 3am Because The Baby Is "Constipated" (read: last pooped a nice soft mound ten minutes ago), I Will Kill You.

(And before anyone accuses me of exaggerating, I have seen every single one of these scenarios played out either at my clinic or in the ER. So no joke.)

On some level, the fact that I'm giving this lecture at all is rather ironic, because while I know a good deal about Pediatrics, I know nothing of what it's like to actually have a baby living in my house. Well, I kind of remember from when my youngest sister was born, but that was a million years ago, during the tail end of the Reagan administration. And now all these new moms are supposed to go home with nothing more than their little bags of formula company propaganda and my "expert" advice. So I can talk all day about AAP guidelines and vaccination schedules and blah blah blah, but when it comes down to the real questions that these moms might have: What's it going to be like when I get home? What's it feel like to get up every two hours all night to feed the baby? How loud does a crying newborn sound in a small apartment? Will I never be able to leave the house again? All I can do is shrug, stall, and hope that they ask their mothers, because I sure as hell don't know those answers.

* * *

And on a completely unrelated topic, I think that people look at Vicks Vapo Rub like it's some magical panacea, I really do. Some days I walk out into the clinic waiting room, and the entire area reeks of Vicks. Seriously, people use it for everything. Cough, congestion, sprains, stomachache. One of my patient's moms was slathering it all over their kid's eczema. Hell, you read "The Bluest Eye," Frieda's mom made her eat Vicks Vapo Rub. I only wish it worked as well as people think. It sure would save me from seeing a lot of walk-ins.

Currently reading: "Bannock, Beans and Black Tea." At first, I wasn't sure what all the hoo-ha was about, but the more I read, the more I like Seth's work. His writing and illustration has a simple elegance that reminds me of those New Yorker comics in the 40s. Also, still working through "The Kiss" (it's not a very long book, I probably only have 20 pages more to go), but I find that instead of really reading it in depth, I'm just sort of skimming through it to see what's going to happen what happens in the end.

Also, just updated the book club page to include the books I read in November. Look for December's booklist, coming soon!


Monday, January 03, 2005

kleptomania

I notice that every day, I keep bringing little pieces of the hospital home with me. Literally. I don't mean to do it, I think I just stuff things into my pockets to make things more convenient, so I don't have to keep running back and forth to the supply closet or the med cart, but inevitably I forget to empty my pockets and I end up accumulating all this stuff at home when I empty my clothes. Today I seem to have pinched a bottle of albuterol and several bullets of nebulizer-ready saline. Usually in the ER, I end up stealing piles of tongue blades or ear wax curettes. Wihle on the wards, I come home with pockets full of butterflies, IVs, and paper tape. And on every rotation, I seem to accumulate more and more single-wipe alcohol pads, until the pile threatens to consume my entire apartment. I'm not trying to be a thief, the hospital can have its stupid stuff back. I just always seem to forget that I'm a walking supply closet until I've walked right out of the building.

As anticipated, it was a busy day at clinic. I think I saw something like 21 walk-ins, and since there were no other residents at clinic today, they gave me two exam rooms to work out of. I like having a constant flow of patients between multiple exam rooms, it makes me feel rather efficient and bustling. I only wish that it worked more like a private Peds office, where the staff up front could actually help triage a little more, or anticipate some diagnostics so that they could be done by the time the patient hits my room. Or, barring that, it would be nice to have a complete set of vitals once in a while. But I realize that asking for more efficiency in running an academic practice is a little like asking Gilbert Gottfried to lower his voice. It's just not ever going to happen. So I guess I'll just get my own vitals.

Today I made the world's greatest fruit salad. Actually, it's so good, it deserves all caps, THE WORLD'S GREATEST FRUIT SALAD. The reason it's THE WORLD'S GREATEST is that I cut out all the crap filler fruits. Out were the rind-pieces of honeydew, the unripe cantoloupe, the cardboard-tasting blueberries. This FRUIT SALAD is truly THE WORLD'S GREATEST because I only included fruits that I liked, in reasonable proportions. Behold, it contained:


  • Kiwi (cut the correct way, into thick slices, not wedges)
  • Strawberrues (cut the correct way, into thick wedges, not slices)
  • Pineapple (pre-cut, because I don't have a machete)
  • Papaya (pre-cut, because who wants to deal with all those little rabbit poo-like seeds)
  • Raspberries (they were "golden" raspberries, which I'd never seen before--yellow!)

I was going to throw in some mandarin orange slices too, thereby making it THE WORLD'S GREATEST ASIAN FRUIT SALAD (for as we know, anything with mandarin orange slices becomes instantly "Asian," like the Asian chicken salad at Wendy's) but then I thought that might be cheating, since the orange slices are marinated in syrup. But I can't eat citrus that has any white pith on it. Either I have to peel off all the white stuff, or I have to eat it all artificially prepared for me in the form of mandarin orange slices or the like. I trace this fiber aversion to my early childhood, when my dad would make me eat the white parts of the orange even after I I spit them out. Which, as you can imagine, was fairly traumatic, not to mention disgusting.

Currently reading: "The Kiss." I remember this book made a big splash when it came out, probably due to its taboo subject matter. But it's reasonably well written too, and I'm enjoying it well enough so far. But I guess the moral of the story is: don't let your estranged mentally disturbed father slip you the tongue.

Sunday, January 02, 2005

hello, 2005

All day that Beastie Boys song "Intergalactic" has been running through my head. I don't know why. It's not even the whole song, only the first part. I keep busting out with "Intergalactic Planetary, Planetary Intergalactic" in a robot voice. And then I do a little stiff-jointed dance. Like a robot, you see. I cannot explain it. Perhaps it is Y2K005 madness.

We had a lovely weekend away at the B&B. Joe was supremely happy because we went to the outlet mall and got him several new pairs of pants. I also got him some new sweaters at Calvin Klein (steeply discounted, don't worry) because all of his old sweaters dating back to his grad school days at Berkeley are gigantic stretched out cotton shapeless horrors. Not like I'm the fashion police, but come on. A man who works out should not wear a muumuu. And since there are apparently no gay men breaking down our door threatening to make him over, I had to take matters into my own hands. So I got him better sweaters and told him to wear them because "they look like something Brad Pitt would wear in 'Ocean's 11.'" (Or perhaps like in "Ocean's 12" as well, but I have yet to deterimine that, having not seen the movie yet.) And then Joe happily agreed to wear said sweaters because he loves Brad Pitt. He does. Don't tell him I told you, but he has a man-crush on The Pitt, the same way I have a lady-crush on Angelina Jolie and all I can think of when I see her is that she's real purty. Only no sweater could allow me to emulate Angelina Jolie, because her boobage is unreal and untenable on my frame.

I was happy with our weekend for two reasons. One is that the B&B had the most amazing showerhead on the planet. The shower itself was nothing to scream about, just a nozzle in a claw-foot tub, but friends, let me tell you that I was this close to breaking out the pliers and stealing that showerhead for our shower at home. (It was one of those giant deals that rains down water on you like you were standing the Amazon basin. Only with less malaria.) The second great thing is that one of my all-time favorite movies "Annie Hall," was on PBS Saturday night. If only they had a double-feature with "Hannah and Her Sisters," I would have been in heaven. Woody Allen film nerd heaven.

Well, new year, same old grind. I'm back to work tomorrow, at my clinic dealing with whatever post-long-weekend flotsam washes up in my walk-in box. And I'm sure I can count on wasting at least half of a prescription pad tomorrow, writing the wrong date on all the scripts I'm handing out until I finally catch on that it's 2005.

Currently reading: Reader comments about my last post. I appreciate all the different points of view, even if they're different from my own, and I especially appreciate that all my readers are intelligent and well-spoken, even when they disagree with each other. I know I do tend to be somewhat leftist, but I guess that's what growing up in New York will do for you. To quote Woody Allen in "Annie Hall" (which is why this line is still fresh in my head): "Don't you see, the rest of the country looks upon New York like we're left-wing, communist, Jewish, homosexual pornographers? I think of us that way sometimes and I live here."