because morgan freeman is great

I couldn't stay up to watch the entire Oscar telecast last night, because I had to get up early to get to work this morning, and I knew that I would hate myself all the more if I knew I was tired and groggy and cranky all day in the NICU for staying up late to WATCH THE OSCARS. So I went to bed in the middle of Antonio Banderas "singing" that "song" with Carlos Santana about el otro lado del rio. Um, Antonio? Wash your hair. You remind me of a patient that I saw in clinic last week. I was annoyed with the patient right from the get go, because he was a punk teen boy who walked in (read: no appointment) with the chief complaint of, "I have acne." Uh, and this is an urgent visit why? But OK, I wasn't swamped that day, so I figured I'd humor him. So I was just taking my history, trying to get a sense of what all was going on, when I asked him:


MICHELLE
So, how often do you wash your face?

TEEN BOY
I don't know.
(Looks to mom for help)

MOM
(In Spanish)
Talk to the doctor!

TEEN BOY
I don't know. Maybe once a week?

MICHELLE
Ah.

So really, the only "good" awards that I caught were Best Supporting Actor and Actress. I like Cate Blanchett, and think she's lovely and all that, but I didn't see "The Aviator" (nor do I have the will to--same goes for "Hotel Rwanda") so I was just sort of "meh" on that one. But I was really glad that Morgan Freeman won for "Million Dollar Baby." I just think he's the greatest. He's like the Gentleman Actor, all courtly and such. And the voice! Let's not forget that voice! I wish he could narrate my day to day life. It would make me feel important, anyway. "And then Michelle walked off to the supply room, to get more blood culture bottles. The same blood culture bottles she'd been filling day in and day out for the last two years." Cue uplifting music, slow pan out, triumph of the human spirit, what have you.

Speaking of drawing blood cultures, today was just another day in the tiny little eensie-weensie funhouse. The strange thing about spending any amount of time working in the NICU is how your entire perspective gets miniaturized. Like how the normal newborns you see suddenly look huge, and how everything starts getting measured out in microscopic aliquots. Today I had to draw blood off a patient for some sort of special send out lab test, and I was getting all stressed about how much of the red stuff I had to suck out. "Make sure you get at least 1 cc," the lab instructed. 1 cc? Did they know how much blood that is? What did they want me to do, suck the kid dry? (To give some real-world perspective on how small a volume we're talking about here, 1 cc is roughtly a fifth of a teaspoon. But we're talking about a unit where we'll regularly give a kid a blood transfusion of 15 ccs of blood--in other words, a tablespoon full. So you see, 1 cc is a lot.) I felt pretty bad about taking that much blood from the little guy, though I also have to admit that I was pretty pleased with myself for being able to draw it successfully.

Currently reading: Nothing right at this moment, but up on deck is "Reefer Madness: Sex, Drugs, and Cheap Labor on the American Black Market" by Eric Schlosser, who you may know as the author of "Fast Food Nation." Despite the dry title, this was, believe it or not, another impulse buy at the bookstore. It sounds a little bit like a textbook for a Sociology class I guess, but hey, whatever. I'll read anything.

things not to do when your wife is pregnant

(Scene: yesterday, after dinner)


MICHELLE
(Getting up to go to the kitchen)
Well, now I'm going to have some ice cream.

JOE
Uh, no you're not.

MICHELLE
Why? Why not?

JOE
Because I kind of muh-muh muh-muh-muh...
(Descending into indistinct mumbling)

MICHELLE
What?

JOE
(Slightly louder)
Because I kind of ate it all earlier this afternoon.

MICHELLE
What? When?

JOE
When you were out in the living room watching TV.

MICHELLE
You ate all the ice cream?

JOE
Yeah.

MICHELLE
So there is no ice cream.

JOE
No.

MICHELLE
The house is devoid of ice cream.

JOE
Yes.

MICHELLE
Cletus just tapped me out a message in Morse Code. He says he hates you now.

JOE
I'll get you some more ice cream.

MICHELLE
You always do this! And you never get more ice cream! You never get anything good at the supermarket! You just buy, like, a bag of carrots, and pretend like it'll replace the package of Nutter Butters that you demolished. You just think that if you're not the one doing the actual buying of the junk food, it makes you a healthy person somehow.

JOE
I'll get you some more ice cream.

MICHELLE
And the worst part of it is, I just went to the supermarket an hour ago! And before I left, I asked you if you needed me to pick up anything! That might have been an opportune moment to mention, "Uh, honey, I just ate all the ice cream, maybe we should get some more."

JOE
I didn't know.

MICHELLE
Didn't KNOW that you finished off the whole tub of ice cream?

JOE
I'm going to go down and get you some ice cream now.

MICHELLE
No. Forget it. I'm just going to eat...(searching refrigerator for suitable proxy)...cottage cheese instead.

JOE
If you want me to go, I'll go.

MICHELLE
(Sulking)
I'll get some tomorrow. You'll probably just get something gross, like...I don't know, rum raisin or something.

JOE
Does Cletus still hate me?

MICHELLE
Yes.


Currently watching: The Oscars. Because I'm kind of a sucker that way.

the xy factor

Why do I always choose the wrong supermarket line? Yesterday, I had a choice between two seemingly identical lines, and I chose the one where the cash register decided to break down. Past wrong choices have been choosing the line behind someone trying to pay with personal check, and standing behind someone who was disputing a ten-cent difference between an item's advertised price and it's actual price. Dude, I'll give you ten cents. But please, stop arguing with the manager about the price of your stupid E.L. Fudge cookies, because I don't want to grow old and DIE standing on line at the supermarket.

As much as I'd rather not have been on call Friday night, it's nice having the rest of the weekend off. Much of our free time in the past day or so has been spent disseminating news about the ultrasound, and the peepee we saw therein. Even though I really couldn't have cared a rat's ass either way whether we were having a boy or a girl (though now my paranoid mind is now obsessing over X-linked genetic syndromes and the relative lung immaturity of premature male infants as compared to their female counterparts), it's just nice to know. It makes everything seem more real, and less in the abstract. "Yeah, but don't you want to be surprised?" advocate some proponents of the wait-until-the-kid-comes-out school of finding out the sex. Well, I'll either be surprised later, or surprised now. And I never much liked delayed gratification anyway. Sure, as a medical resident, my whole life is delayed gratification, but I don't have to like it all the same.

There is kind of a patriarchal chauvanism in Asian cultures about having a boy, though. Some will deny it, and many will not subscribe to it (my parents, for instance, who have three girls, purport that they've never minded this CRUEL TWIST OF FATE), but it's definitely a cultural attitude. For instance, this conversation with my mom, right after I told her about the ultrasound-identified weiner.


MA
So, you finally made a boy!

MICHELLE
Uh, what do you mean, "finally?" We don't have any other kids.

MICHELLE'S INNER MONOLOGUE
"Made a boy?"

MA
Oh, yeah. I just mean we're finally going to have a boy in the family.

MICHELLE'S INNER MONOLOGUE
Yeah, after having all these crappy girls, finally, a BOY.

MICHELLE
Well, Joe and I don't have any other kids, boys or girls. Well, except for Cooper. So we're happy either way.

MA
Oh. Maybe I was projecting.

MICHELLE
Gee, you think?


Anyhoo, I feel like the grandparents (and great-grandparents) were just waiting on tenterhooks to find out the sex so they can finally go out and shop for the baby. We explained to them (more in the event that the ultrasound didn't yield the requisite views) that it didn't really matter what we were having, because we really weren't into the whole pink-and-blue thing anyway. But I don't think it mattered. Now that we've announced the boy-ness of Cletus, we're just going to get a slew of blue clothes, sports equipment, and...I don't know...toy guns or something. (Whatever. I don't know of boys. All girls in my family, remember.)

The other thing that's making the reality of this pregnancy set in a little more is that we just recently started feeling Cletus's movements on the outside. I think I've been feeling movement for the past two weeks now, but it was hard to say in the beginning if it was Cletus or if it was just colonic gas moving it's way down to the business end of things. But in the past week or so, it's become fairly obvious. Joe just felt Cletal movement for the first time earlier this week, and he was excited about that. "It must feel weird for you," he said. Well, kinda. But it's fun, too. I'm trying to savor this part of the pregnancy, before Cletus gets so big that he can start kicking me in the diaphragm. Because breathing is important for life.

Anyway, "almostMD" in the comments section was asking if we could reveal our top choice girl name. Now that it looks like we're going to be using it any time in the immediate future, I can say that if we were having a girl, we were planning to name her "Nina." Thus fulfilling the five-letters-or-less mandate. But looks like that name will have to go back into storage for now. Unless we decide to name Cletus "Nino." We actually do have a real name picked out for the kid already, but I think I'll wait a little while longer before the unveiling. Specifically, I think I'll wait until we're at least at 24 weeks. As for the reason why, I will let my clinic preceptor say it all. "So, you're 18 weeks pregnant? Wow! Your fetus has almost reached the age of extrauterine viability!" Uh, yeah. Thanks for reminding me about all the transparent shrivelly 24-week preemies in the NICU, and that in a month and a half, our kid might be among them. Pediatricians saw weird things sometimes.

Currently watching: "My Super Sweet 16." Have you seen this show on MTV? Truly, it is awesome, even better than "Rich Girls." It has all the perks of the latter show (following around a passel of overindulged, entitled, spoiled rich teens, spurring righteous indignation of the "did you just hear what she just said/did/bought?" variety), but a new teen every week, so you never get tired of them.

how michelle got her bling back

Don't tell Joe, but I almost lost my wedding ring last night on call. But from this experience, I have learned a valuable lesson. When scrubbing into a C-section, do not put your ring in your scrub shirt pocket, forget about said ring, and then chuck the ring-containing scrub shirt into the hamper once it gets all gored up. Which, I guess, should be obvious to anyone who isn't an IDIOT (e.g. me). And yes, I know, I should tie it to my scrub pants, but then I have this fear that I'll forget the ring is secured there and then having it go flying irretrievably down the toilet during one of my little pit stops. When I finally noticed that my ring was missing, I retraced my steps and found my doffed shirt in the hamper in the Well-Baby Nursery. I expressed some relief to the overnight nurse who was working there, who gave me a dark look. "Good thing we aren't THEIVES," she said, her eyes all big and crazy. The Well-Baby overnight nurses are all a little odd. I'm a little apprehensive about leaving Cletus in their hands when I deliver at [University Hospital] in July.

(I don't even know why I keep saying [University Hospital] like it's a big secret anymore where I work. The name of the institution is plastered all over my ultrasound scans, for chrissake. But let's all pretend that I'm being discreet and that no one knows which hospital I'm talking about.)

Anyway, I'm tired, so I'm going to bed.

Currently reading: "Twentieth Century Eightball." Also still curiously still reading "Deception Point" in bits and pieces, even though it's so, so bad. You know how when something smells foul, you are repulsed, but keep taking little sniffs of it to reconfirm its grossness? And then you tell all your friends to smell it too, because you just cannot believe how much it stinks? This book is like that.

it's a scrotum!

First of all, the least important thing from a worried Peds perspective, even though it's the first thing that people want to know:

Cletus is a boy! I went in for my ultrasound earlier today thinking there was a distinct possibility that I might not leave with the oft-asked penis vs. vagina question resolved. "I mean, are you really able to tell the sex at the 18 week ultrasound?" I asked the tech. "Can you really see everything you need to see?"

"Well, it kind of depends on the baby. If the position is good, then yes. But if it's all crunched up into a ball, then maybe not." Then she squirted the warm goo all over my stomach and put on the probe. Cletus had his head practically up his ass. He was balled up tighter than a Popple. And so I figured that we weren't going to be able to spy much of anything.





As in our past experiences with ultrasounds, Cletus hated all the attention. Every time we tried to get a good view of some organ or limb, he would wiggle away, or put his hands up to hide the anatomy in question, or just shift position such that all we got was a view of his skinny ass. And then he would put up his hand, like, "Damn you papperazi, why can't you just leave me alone!" He's like a surly teenager, that one. Look behind the placenta, he may be hiding some cigarettes back there.





But finally, with some jiggling and some shifting of position, we were able to get him to show us the goods. And not just the boy parts. Every normal measurement on the scan was like a balm for my NICU-addled brain. Normal cardiac anatomy. Intact diaphragm, with the stomach bubble below. Five digits on each extremity. "This is some beautiful neuroanatomy here," the ultrasound tech said at some point, almost to herself. "Look at the thalamus and the ventricles. Textbook." And I felt all proud.





Unfortunately, Joe wasn't able to make it across the street after all. His OR case was scheduled to start the moment I went into ultrasound, and he was scrubbing when he got the page that the scan was starting. But I made them print out a bunch of pictures to show him. This one, a close-up of the lenses, I especially requested.





(Ophtho boy loves him some eyeballs, you see.)

So in all, this has been a great week for us, future-parent wise. We found a nanny. Our fetus miraculously has all its parts in the right shape and location. And we found out the sex! After revealing the money shot, the ultrasonographer told me, "Yeah, even before we saw the penis explicitly, I had a suspicion that it was a boy." I asked her what tipped her off. "Well, see how he kept moving his hands down there to grab at something?" She gestured towards the screen, where, sure enough, Cletus's hands were again moving below the belt line. (Look again at the first picture above, and you'll see his hand in the shot.) "I know then that there must have been something down there to grab at."

That's my boy.

Currently reading: More out of a sense of needing to tie up loose ends than anything else, I started reading the fourth Dan Brown book, "Deception Point." This is the worst book I have read in a long, long time.

early this morning

I got to work this morning to find that one of my patients had died just a few hours earlier. It wasn't totally unexpected, but there certainly had been nights where I would have expected it more. Nights that I went home thinking that she'd definitely be gone by the morning, only to come in the next day to find her tenaciously hanging in there, for what it was worth. She had a congenital malformation that was (the euphemisms to beat all medical euphemisms) "incompatible with life." We knew she was probably going to die, and we knew that it was going to happen soon, but still, I was surprised to hear it put so plainly this morning. "Oh, your patient just died." It's ultimately a good thing, the right thing, all the nurses were saying, or some version thereof. Her body just gave out. She'd had enough. And they continued to pack up the baby's things for the parents to take home--the stuffed animals she never got to play with, get well cards she never got to see, pictures of the family that never got to hold her. Behind closed doors, her parents were grieving privately. And out in the lounge, a bevy of grandparents were keeping an eye on the patient's 2 year-old brother, who was singing and running around the family lounge in the same footy-pajamas he was wearing at 4am, when his parents pulled him out of bed and bundled him into the car to race to the hospital in time to say goodbye.

I don't think that being pregnant has changed how I feel about having one of my NICU babies die. Certainly, I'm more paranoid about various congenital malformations and such, seeing nothing but the sickest babies in the tri-state area day in and day out. I'm guilty of scrutinizing my 13-week ultrasound to comfort myself that all of Cletus's abdominal organs are actually in the abdomen, and that everything else is basically where it needs to be. (Disregard the fact that I actually have no idea how to read an ultrasound, or the fact that the FASTER ultrasound didn't get the right views anyway.) So sure, I'm paranoid about my own kid, but the human tragedies of other people's kids still strikes me the same way. I'm sad for them, scared to intrude on the family's privacy, and second-guessing things that we could have done sooner or faster or better, if not to save the patient, then at least to lessen the suffering all around. I'm not more sad now because I'm going to have a kid. It's already sad. Maybe it'll change when Cletus joins us out here in Gaseous Oxygen World, but I don't want it to be more sad for me than it already is. We may lose one kid on the unit, but we can't forget about the fifty-odd other kids that we still have to take care of. I don't know if this ability to compartmenalize makes us callous or jaded or evil or what. I've worked in clinical medicine for the past three and a half years now, and I still don't understand how they (we) do it. I don't know how other people maintain persepective and equilibrium in these situations, but one thing that works for me is just to keep looking forward. Hey, it works for preventing carsickness too.

A few hours after my patient died and the spot had been cleared, I passed by that nursing pod again. Sure enough, there was already a new patient there in her place.

* * *

We have our anatomy scan tomorrow, a.k.a "The Big Ultrasound." We've already had two ultrasounds, but this one is supposed to be really detailed, so that we can get a good look at everything. And I mean everything. Though I have high hopes for spying little bits and pieces that might clue us in on whether Cletus is a gal or a fella, I'm fully aware that 18 weeks might still be a little to early tell with any certainty, or that (depending on ultrasonographer skill) prelim gonadal sightings may be totally off the mark. Part of it depends on Cletus too, and whether s/he decides to be slutty (spreading legs accomodatingly for ultrasounds waves) or prudish (covering up the goods). Joe's scheduled to be in the OR tomorrow, but hopefully his case will either end early or start late enough for him to run across the street and watch the scan with me. But even if he misses it, there's a Peds ER attending who's working on getting certified in ultrasound, and therefore offering to sono anyone and anything in sight. We just may take him up on that.

Currently reading: "Black Hawk Down." Forget my job. How do those guys do it?

the nanny has landed!

Guess what? Georgia said yes! She e-mailed us back today and said that while she had gotten a lot of interest from parents in her current nanny-neighborhood, but that she enjoyed our meeting on Sunday and felt comfortable with accepting a position with us come summertime. Joe called me at work to tell me the good news, and I was so happy that I just about cried. If you know how much we've been stressing about this nanny search, and how much talk and worry and financial planning we've invested so far, you would understand how huge of a deal this is. She's a nanny for two doctors at our hospital (first base: she knows our pain) who has two kids of her own (second base: she's experienced) with impeccable references from people we know (third base: the trust factor) who not only watches over the current toddler she's taking care of, but reads to him, plays with him, finds classes for him to take, even takes him to the damn Museum of Natural History on a regular basis (home run: molding the kid in a nerdling). We are thrilled and excited and so relieved. I feel like we proposed marriage to her and she said yes. Break out the non-alcoholic champagne! (Read: sparkling cider.)

The excitement about Georgia is only slightly dampened by the fact that I didn't get home from work until past 9pm tonight. I was holding the delivery room pager during the day and got saddled with two 28-week twins with various and sundry problems, both who ended up intubated by the end of the morning. I spent my whole day with the Bobbsey Twins and The Mystery of the No Like Breathing, and didn't get to see or do anything on any of my other patients until 6pm. There was no way around it today, but this only strengthens my feeling that the person on call should always carry the DR pager during the day. At least when I have to be there all night anyway, I figure I might as well pile on the pain so that others might have a normal work day and get out on time. But the non-call 15-hour work day kills me. Especially because I have to be back at work at 6:30 again tomorrow morning.

Currently reading: Well, still "Black Hawk Down," technically, but I didn't make any headway on it this morning because Joe drove me to work, and I couldn't read it on the subway tonight because my brain was too fried to concentrate. But it's in my work bag, which at least implies that I'm still actively reading it.

the fat lady sings


At 14 weeks.


15 weeks.


16 weeks.

I don't really feel all that much heavier since this whole pregnancy thing began, but my OB's scale and my quadriceps would disagree. Whenever I squat down to pick up something now (dropped pen, dog's food bowl, stray M&M that I will eat off the floor anyway if no one else is around to see me), the act of standing up is noticibly harder than it used to be. It feels like standing up from a squat while wearing a big, heavy hiking backpack. It feels like doing squat thrusts with a weight bar in the gym. It feels like I've gained 12 pounds and now my body is trying to figure out what to do with it all. I can't imagine what the ER is going to be like when I'm back there in April, since my entire day there consists basically of squatting down in front of patients, standing up, squatting down in front of other patients, and standing up again. Maybe I should get one of those little chairs and just wheel it around. Or better yet, a Rascal.

Speaking of being large and in charge, let us talk for a moment about the issue of maternity clothes. Now, luckily, I have a job where I can get away with wearing loose clothing and drawstring pants just about any day of the week, but once in a while, I like to dress like a civilian so that I might walk among the people. And I've come to the unsettling realization that maternity clothes are ugly. Not like I'm a fashion plate by any means, but they are. They are cheaply manufactured and ill-fitting and just plain homely. If you are a celebrity and can afford high-end maternity wear (or better yet, get it for free), then good for you, but for the majority of the population, we have to make do with our Gap and our Old Navy and our Motherhood Maternity and what have you--and friends, it's just a sea of polyester and nylon out there. So what is one to do? Hike down your too-short shirt-front for nine months? Look like sloppy mess clad head to toe in neon pink polyester? Or just give up and break out the muumuus?



Finally, to illustrate my point, above is the 17 week belly shot from earlier this weekend. Note not only the scary expanding uterus, but also the secret horrorshow of maternity wear known as the stretch panel pants. Sweet Christ, that's ugly. And yes, you are right to point out that at this juncture, I could still just wear normal jeans if I were willing to shell out the money just to get a pair of low-riders one size up from my usual--but then they'd be too long and they wouldn't fit in the butt, and anyway, what's the point of getting pants that you're going to outgrow in a few weeks anyway? Might as well be pragmatic and just jump straight to the ugly-ass preggo wear.

I wash myself with a rag on a stick.

Currently reading: "Black Hawk Down." Nothing like some nice depressing war journalism to get you all peppy for the upcoming work week.

the nanny diaries

I was on call Friday night, and and a punishing call at that--illustrating the principle that even on a 25 patient service where 24 of the patients are being good, that one kid acting up can ruin your whole night. Babies that don't squirm around when you poke at them are bad news. And a blood gas with a pH of 7.1 and a CO2 of 136 is very bad news. But in the end, despite the fact that I was hovering all night by that one isolette instead of plotting ways to break into the Launch Pad, I don't really mind, because a Friday call over a three day weekend equals a GOLDEN WEEKEND, and I'm never golden, since I have Friday continuity clinic which means that I'm never, ever on call on a Thursday. (Other programs have strategies to deal with this--for instance, a "float" clinic day, but our program is adamant that once you're assigned a clinic day, it's set in stone until the end of time. And maybe even beyond that.)

Blah blah blah, boring residency shop talk aside, it's been an exciting weekend for us because this evening, we had our first in-person interview with a real live NANNY. For our CHILD. I'll call her "Georgia" (not quite her real name), and we got her name from some mommy group listserve that one of my co-residents forwarded me. Aside from benefits of being a nanny that 1.) existed, 2.) needed a job, and 3.) spoke English, she had impeccable references from her current family, consisting of an adorable Eurasian toddler and two parents who are doctors at [University Hospital]. Aside from knowing these parents on a professional level, I've actually (coincidentally) treated their kid once before in the Peds ER. Asian mom, white-guy dad--they are our spiritual twin family! And Georgia is our spiritual future nanny! Or so we hope. For what it's worth, the interview went well, and while nothing is set in stone yet, she said she'd be ready to give us a final decision in a month. So we'll be crossing our fingers and toes until then, hoping she doesn't get propositioned by another family with deeper pockets, shorter work hours, and a more attractive fetus (though that last part is doubtful).

While this was our first actual interview with a nanny, it's by no means our first foray into the prospective employer market. We actually were in communication with another nanny prospect a few weeks ago, a college grad who had answered an ad that we had posted on Craig's List a while back. She too, sounded great, but kind of in a scary way. It sounds strange to say this as a negative, but basically, she was too good to be true. Seriously. Not only did she offer to cook and clean and go running with the dog on top of taking care of Cletus, she had absolutely no problem with the salary or schedule we were proposing. And she had these ridiculous overqualifications, like a double major in Psychiatry and English with a double minor (people have double minors?) in Spanish and Early Childhood Developement. And she had the exact same sense of humor as me, even making similar jokes about "Single White Female" and "The Hand That Rocks The Cradle" as I had made with respect to hiring a nanny. AND (at this point I was starting to think that maybe I was dreaming up this whole correspondence) her e-mail closed with an Atticus quote from "To Kill a Mockingbird." I mean, that was really the kicker, a quote from one of my favorite books of all time. Clearly, she had to be a stalker. Either that, or I have a split personality, and was e-mailing myself.

Though it sounds paranoid at first pass, the stalker theory deserved some more attention. I've been keeping this online journal for more than four years now, and it's possible that someone had seen our ad on Criag's List, figured out that it was us, and decided to fuck with our minds. The thing is, I didn't put any identifying information on the ad. I didn't use our names. I didn't use our phone numbers. I used an anonymous e-mail address that forwarded to a new personal account that I set up specifically for our nanny dealings. And the name I used to register our Craig's List at was my married name, which I never, ever use, and for which a Google search would, I'm sure, turn up nothing. Most importantly, I never mentioned on these pages that the ad we posted was on Craig's List. So if it was a stalker, it was a clairvoyant stalker, because I don't know how the hell even our own parents would have recognized us from this ad.

So OK then, let's say then, for the sake of argument, that this girl was legit. Subsequent e-mail volleys only strengthened the eerie feeling that she and I were the same person. Her writing style, her weird sardonic parenthetical asides, her way of itemizing an e-mail response. I kept asking Joe, "Seriously, is this girl for real? I mean, does she really exist, or someone fucking with me?" There was no way to know. I contacted one of her former nanny references (another double-doctor family with infant twin boys--again, are you kidding me?), and their response was nothing less than glowing. Only I was still suspicious, because it was an e-mail reference, and the tone and prose-style was suspiciously similar to that received from the applicant herself. Could it still be someone elaborate ruse? No way to know for sure.

We had been scheduled to have a phone interview later that same week (an in-person interview would have to wait, since she was currently working in another state, as--get this--a copy-editor for a medical journal) but then, all of a sudden, it fell through. She heard back for another childcare-industry job for which she had applied, and she decided to accept, because it was a real job that included health benefits. And she was completely right to do that, I would have done the same, and a young college grad should try to look for a more upwardly mobile job than being our nanny. But the sudden end to our correspondence leaves me with more questions than answers. Primarily, did this person really exist or not? Because between all the perfect little pieces to her application, she seemed like a fictional character that someone concocted just to get us all excited.

Anyway, forget you, creepy stalker girl. Georgia is where it's at now. We're giving her a month to think things over and consider any other offers she might get, because I think that's only fair. But hopefully, by the middle of March, we'll have an answer in the affirmative and be able to relax. About this one issue, anyway.

Currently reading: "Black Hawk Down." I had to look around a bit to find a copy without Josh Hartnett on the cover, but finally found one lone copy on a back shelf at Shakespeare and Co. When I think about this book, all I can think about is that Dave Matthew's Band song from the movie trailer where he sings, "the space between..." in that incredibly whiney voice. Hopefully that will start to fade as I get more into the story.

the name game

No brilliant insight here, but I realize that one of the crucial differences between first year and second year of residency is that first year consists of people telling you what they want done for your patients, leaving you with only the onus of carrying out the little tasks (often with the organizational aid of little checkboxes...many, many little checkboxes); whereas second year, you're starting to do a lot more of the planning of what you want done for your patients. You start to feel more ownership and responsibility for the people you're taking care of. It's not just a job where you clock in and clock out just when all your To Do list is complete. In some ways, when you take more responsibility, you start looking for more work, making more work for yourself, thinking, "Well, shouldn't we be doing this? Might we not consider this?" even if no one else is prompting you to do so. I guess what I'm really talking about is initiative and accountability. And it's clearly not an intern/senior resident thing at all, because there are some excellent interns who take tons of initiative and responsibility for their kids, and some really crappy seniors who take none. I guess it's just part of professional development, and slowly gaining confidence in your own clinical judgement so that you start to use it more and more. I definitely feel like less of an automaton this year than last. And I also think that if second-year me could sit down and have a conversation with intern-me, that second-year me would definitely start chiding intern-me to use my damn brain once in a while, not just my hands.

And now that I've just bored everyone with my crusty old windbag rant, I will bring everyone back to a special fuzzy place by talking about baby names. If you know me and Joe, I'm sure it's no surprise to you that we already have some top contender baby names all picked out. No, Cletus will not be named "Cletus" in post-fetal life. Nor are we going to make rhyming a prerequesite anymore, like "Sid the Kid." We're going to act like normal, mature adults and choose normal children's names.

I'm going to save the unveiling of the actual top-choice boy/girl names for a later date, partially because I still feel superstitious and jinx-y getting all specific (especially before the anatomy scan next week), but also because it'll be more fun and surprising that way. But what I will talk about is names that we considered and rejected.

(Please note that if you don't agree with our name rejection criteria, or if we rejected a name that's your name/your mom's name/your baby momma's name, there was nothing personal about it. Remember, we have no taste or class, so your name is therefore beautiful.)

I need not delve into my hatred for the Mykinzee/Kayleigh/Madysyn family of names that are not only ridiculously "trendy," but also misspelled. We decided early on that there would be no choosing of names that involved excessive explaination or clarification. Nice, simple, non-loserish names. How hard could that be?

My first choice for girls was Kate. Simple, elegant, everyone can spell it. Note I say "was." I decided to jettison Kate in the end mainly because of the preponderance of Kate-like names clogging up the works. To many Katherines, Kaitlyns, Katies running around. I didn't want our kid to have to tote around a last initial just to be distinguished from the hoarde. ("Kate W." as it were.) So no Kate.

Joe's first choice was a girl was Ada. Which I liked, because it was short, and also because of the literary reference that implies that we are smart and sometimes read things. But then he ruined it instantly by saying that we could make her middle name "Sandwich." Ada Sandwich. "Why not Ada Burger?" I suggested. Then we started saying Ada before every food. Ada Cheesesteak. Ada Watermelon. Ada Knish. Then we decided that we probably shouldn't name our kid Ada, because if she turned out to be fat, the teasing would never end.

For boys, Joe was a big fan of the name Ben. Not even Benjamin, just Ben. I liked Ben too (notice our prediliction for names four letter or less), but every time he said "Ben," all I could think of was "Gentle Ben," the bear that had the talk show in "The Simpsons." And then he ended up mauling that audience member. Also, for some reason, I always had the urge to preface the name with these strong-but-stupid qualifiers, like, "Big Dumb Ben." I don't know why, but that just rolled right off my tongue. "Big Dumb Ben." Sorry, Bens of the world, I know you're really smart. I'm just nuts. And while I wouldn't mind our kid being big (eventually, though hopefully not too big until after he makes it outside the old uterus), but I certainly would be less OK with our kid being dumb.

The boys name that was tied for the top of my list, and which I'm still not totally ready to let go, is Miles. Miles! Like Miles Davis. Like that kid that Gordon and Susan adopted on Sesame Street. Like Paul Giamatti's character in "Sideways". Miles! This is a good name. I think it's starting to get more trendy, especially in New York, but I still like it. But Joe, though he won't fully admit it, seems to think this name is for nerds. Jerkface. Well, actually, I've managed to warm him up to the name somewhat, but we're giving his parents a vote on what names they like, since my parents are getting to choose the kid's middle name (which will be Chinese). And Joe's parents voted for the other top-choice boys name on our list. Which I actually like equally as much as Miles, so it's cool and all that, but still...Miles. I'm having a hard time letting it go. Other pregnant people, don't name your kid that! I still want to use it! I have dibs!

Anyway, feel free to suggest names of your own that you like. And special points to anyone who can convince Joe's family that the name Miles is awesome.

Currently reading: "Digital Fortress." Guh, this book is reaching out of the realm of suspension of disbelief and into the realm of un-fucking-believable. Come on, Dan Brown. There are only so many twists and coincidences that the average reader can swallow. But I guess it serves me right for reading this sober on the subway, instead of drunk on a beach somewhere.

the origin of the 9911 code

A natural reaction to yesterday's post about Joe mistakenly paging me "911" (emergency) instead of "9911" (our pager code, roughly translating to "I love you" or "I'm thinking about you") would be to ask the question, "Well, then why did you choose a pager code that looks so much like 911 then?" (The closing of the above question with "...dumbass" is implied.)

Well, so here's why. The 9911 pager code looks like 911 because it is 911. The story: third year of med school, Joe and I were on call one Sunday during our medicine rotation at an affiliate hospital. Ever the eager med student, I was following around my intern with such devotion and painful enthusiasm that I think (in retrospect) he may have wanted to kill me. So he reverted to the euphemism that, as a resident, I now understand to mean, "Please go somewhere else so I can goof off and check my e-mail and phone my girlfriend without you peering over my shoulder." He told me to go to the library to read, and that he would page me as soon as we got an admission or if anything of import happened to any of the patients on our service. After triple-checking with him that he had my pager number written down correctly, I dutifully scurried away to read some journal articles I had squirreled away in my pocket.

After waiting around forwhat seemed like forever (and checking my pager roughly every five minutes to make sure it wasn't broken or turned off), I found Joe and complained to him about how pointless this day was turning out. "So I'm just supposed to sit around all day just waiting for him to page me?" I ranted. Joe, unlike me, got luckier in the draw. His intern was a medicine prelim who didn't give a shit at all, and had sent him home early. Even though we were only halfway through our third year, we had already learned the following lesson well: if someone tells you to go home, don't second-guess them, don't think it's a trick or a test, and don't volunteer to stay anyway, thinking it'll earn you brownie points. Just go. So he did.

Fifteen minutes after Joe left, I got a page. I should first explain that [Affiliate Hospital] is quite a bit smaller than [University Hospital], so all the phone extensions only have 4 digits, not 5 digits like the extensions at the mother ship. So, for example, when dialing an internal extension, the number to call Pharmacy would be 4296 and the number to the ER would be 5662 and so on. The number I got paged to was 9911. Thinking that my time had finally come, that my intern had finally remembered me or that we finally had an admission, I dialed back in a hurry.


911 OPERATOR (Calmly)
Hello, 911 Emergency line.

MICHELLE
Gah!
(Hangs up phone)


In my hurry to call back, what I didn't realize is that I had dialed 9-911, essentially, 9 to get an outside line, and then 911. I had been pranked into calling 911. Were the police going to be mad at me? Could the call be traced? And did this mean that my intern still didn't care that I'd been sitting here for the past two hours?

I called Joe back on his cell phone. "You prank paged me, didn't you? Well, I called 911 by accident. I could have booted off the call of someone slowly bleeding to death in a gutter, calling for an ambulance. I hope you're happy."

"Wow," said Joe, "I can't believe you actually fell for that."

Currently reading: (Speaking of codes) "Digital Fortress," an impulse buy at the med school bookstore this afternoon. I realize that Dan Brown just writes that same book over and over again with only minor variations in character and location, but as trashy thrillers go, it's pretty readable.

never do that again

I was on the crosstown bus this evening, headed home, when I heard a faint beeping sound from deep within my bag. My pager was going off. As my pager rarely goes off when I'm not at work, I was a little slow in recognizing the sound and digging the dreaded noise box out of my bag, but when I did, my eyes bugged out. I was getting paged to an unfamiliar extension within the hospital, and at the end of the number was the suffix "911".

I was getting paged 911.

Let me be clear that I have been paged many, many, many times over my short medical career, but never in my life have I ever been paged 911. A "911" at the end of a return number means EMERGENCY, means LIFE OR DEATH, or at the very least, it means that if there's any page ever in the history of time that you weren't thinking of returning promptly, THIS PAGE SHOULD NOT BE THAT ONE. I've only ever paged someone 911 once, and that was one night when I was on call as ward senior, when, after 20 unanswered pages to IR, I got desperate because I was very afraid that one of my patients was going to die he didn't get a new central line that night. And now I was getting paged 911. While riding on a crosstown bus. Without my cell phone.

Stumbling off the bus at the next stop, I figured the 911 page could mean only one of a few things:

1.) One of my patients was very, very sick, and I forgot to sign out some vital piece of information that could make the difference between life and death.

2.) Joe had been killed. Or at the very least, maimed.

3.) There had been some sort of epic catastrophe at the hospital, and the Chiefs were paging me back in to man the battle stations as per the Disaster Protocol.

I haven't used a pay phone since the blackout two years ago, but I was pleased to find that they still existed in this city of cellphones. True, many of them don't work, and of those that work, most of them don't smell very good, but for chrissake, I WAS GETTING PAGED 911, AND WHY DO I JUST HAVE A MILLION PENNIES IN MY WALLET WHEN ALL I NEED IS ONE MEASLY QUARTER? It's like ten thousand spoons when all you need is a knife. Finally, I dug out the necessary change and, hands all a-tremble, I dialed the number.


JOE
(Picking up the phone)
Hello?

MICHELLE
AAAH! HELLO? WHAT?

JOE
Are you still here?

MICHELLE
ARE YOU DEAD?

JOE
Um, no. Are you still at the hospital?

MICHELLE
I'M AT A PHONE BOOTH! I JUST GOT OFF THE BUS! ARE YOU IN JAIL?

JOE
No. I just got out of uveitis conference, and wanted to see if you were still around so that I could give you a ride home.

MICHELLE
DID YOU JUST PAGE ME 911?

JOE
Oh, did I?

MICHELLE
YOU PAGED ME 911 911 YOU PAGED ME 911!

JOE
Oh. I meant to page you "9911"

[Background: "9911" is a secret pager code that Joe and I use. It's a long story, but it relates back to a prank that he played on me in med school. Anyway.]

MICHELLE
MAYBE YOU MEANT TO PAGE 9911 BUT YOU REALLY PAGED 911 WHAT THE HELL IS WRONG WITH YOU I THOUGHT SOMEONE DIED.

JOE
Oh. Sorry. So I guess you don't need that ride home.

MICHELLE
(Calming down)
No. I'm almost home right now.

JOE
OK, I guess I'll see you there, then.

MICHELLE
OK, see you at home.


So to recap:

1.) Everyone is alive.

2.) I should carry my cell phone with me.

3.) Never, ever page me 911 unless it's a real, live emergency.

Currently reading: "Of Mice and Men." That oldie but goodie. The copy I have is actually stolen from my 7th grade English class--you can tell from the sturdy scholastic binding and the book number stamped on the title page--because I forgot to return it with the rest of my books at the end of the year. And thus began my life of crime.

risky business

Today I left for work at 5:50am and got home at 8:10pm. Damn, that's a long day. And I wasn't even on call. Honestly, after a certain point, you almost wish that you were on call--if you're still in the hospital that late, you might as well make a night of it and at least get the next day off. No such luck, though.

I was holding the delivery room pager today and was called up to attend to various kids in various stages of popping out of the womb. There was the one gigantic kid that they had to remove by force (C-section for fetal macrosomia), one kid who pooped on himself in utero (light meconium in the fluid), and one kid born to a mom with Hepatitis B. After the latter delivery, the OB (who was of the elder statesmen, "Silver Fox" breed) asked me, "So, what are the recommendations on breastfeeding for mother with hepatitis B? Do we encourage or discourage?" And I was all like, "Uh...hmm...excellent question, very relevent. I will give you my answer, my EXPERT PEDIATRIC RECOMMENDATION...in...a few minutes." Then, when he left the room briefly to fill out some paperwork, I quickly Googled "Hep B and breastfeeding" and read up on the latest CDC recommendations. Thanks, Google. You make me seem like an actual doctor than knows things.

(The answer is that we do encourage breastfeeding regardless of Hep B, by the way. I should have known. Breastfeeding is the default answer for everything in Peds. Pediatricians love the boob.)

Speaking of Hep B and pregnancy, I was actually just barely on time for the above delivery, because two of the three hospital elevators were broken, and once I got up there, I had to hunt around to find a mask with a splash guard so that I wouldn't get Hepatitis B goop in my eyeballs (didn't you see "28 Days Later"?) and have to worry about shooting up Cletus full of Hep B immune globulin in a few months. It was not a very messy or explosive delivery, at least by the time I got there, but the daily fetal risk obstacle course was not yet finished. Later this afternoon, I had to accompany a patient down to radiology for a fluoro study, and the techs there were adamant--adamant--that I stand in the room while the study was being done.


MICHELLE
Look, I'm just here in case the kid, like, codes or something. I'm just going to be watching the monitor, I don't need to be standing right next to him.

PATIENT
(Crying, flailing)

TECH
What if something happens to him? We need you here! (to Radiologist)Tell her she needs to be here!

MICHELLE
I am here. I'm just five feet away from you, in the control room. If something happens, I'll be in here in less than two seconds, exactly as much time as it takes for me to walk three steps and open the door.

PATIENT
(Crying, flailing)

TECH
What if you can't see the monitor from there?

MICHELLE
I can see it. I'm standing right here. I'm only five feet away behind a sheet of glass, for chrissake. You know, the clear kind of glass.

TECH
(Indicating tableside)
You should stand here, next to the giant radiation machine.

PATIENT
(Crying, flailing, pooping)

MICHELLE
Look, really, the kid doesn't need me standing next to him to have the study done. Seriously, I'm only here to resuscitate in case he arrests, which is not going to happen. I don't stand next to him all day in the NICU either.

RADIOLOGIST
(Warily)
How will I know if he's arresting?

MICHELLE
(Long pause, considering a number of responses, some more tartly phrased than others)
Well doctor, aside from looking at the monitor that's right next to your face...if he arrests, he probably wouldn't be breathing or moving around anymore.

PATIENT
(Crying, flailing, spitting up)

RADIOLOGIST
(Donning lead apron and neck collar)
OK, but make sure you're keeping an eye on him.

Seriously, the way they were looking at the kid, you'd think he was a bomb or something. Don't drop him! Don't cut the blue wire! And whatever you do, don't let him go slower than 55 miles per hour! The weirdest part of this whole thing was minutes later, in the control room. I turned to one of the techs (none of them stayed in the actual fluoro room during the study either), and asked, just to be safe, "We don't need to wear lead while we're in this room, do we?" And she looked at me with a look that said girlfriend, please, and drawled, "No, it's OK in here. Ain't no way I'd be exposing myself to all that radiation."

Currently reading: The New Yorker 80th anniversary edition. There was that article about those people in Georgia whose dog was abducted in a carjacking, and I felt instant sympathy. Maybe we should get Cooper microchipped.

it's chinatown

We figured out the perfect way to have a nice Valentine's dinner in New York without having a reservation in advance. Just go to a restaurant that's not romantic at all. Joe and I headed down to Chinatown to Funky Broome--which, despite it's name and the review in the Time Out New York restaurant guide, is no more "funky" than any other restaurant in Chinatown. Well, I guess there were those neon pink wall light effects and the zebra-patterned chairs. But that only counts as "funky" if you're in an 80's-era music video. Come to think of it, the word "funky" is kind of 80's-style too, unless you're talking about weird smells--which we also experienced during our dinner, since we were seated next to the fish and lobster tank. While we were waiting for our food to come, the waiter came to net one of the unfortunate victims (I guess someone had just ordered fish), and we got a little splashed with scum water during their epic life-and-death struggle to the kitchen. The waiter won.

I was worried that it might be crowded because of Valentines Day and whatnot, but this fear was unfounded, since apparently the Chinese don't believe in love. So we had a tasty dinner out for a non-Valentine's-inflated price, and plenty of leftovers for tomorrow. It's win-win. But now I have to go lie down, because I can feel my LAD clotting off after eating all that Peking Duck.

Currently reading: Us Weekly. That's right, I love Us Weekly. I'm the lowest common denominator.

old grey mare she ain't what she used to be

The thing about going to work so early on a Sunday morning is that you run into all the people that are still out from partying Saturday night. The subway is a motley crew of homeward bound night-shift workers, sad sack medical personnel heading in to start their day in the hospital (hello, friends), and twentysomething inebriates in club clothing and in various stages of unconsciousness. I mean, I had my fun in the days of my (relative) youth, but was I ever able to stay out that late? These days, an 11pm bedtime while not at work is pushing me to the extremes of my endurance. How are these walking iPod ads able to rock out all night long? And how could it possibly be more fun than sleeping?

Currently reading: Some kid's chest film.

the gates

"Friday Night Lights" was disappointing compared to the book. I mean, it was a good enough sports movie I suppose, but they left out or glossed over a lot of the things that I thought made the book interesting, like the fact that the kids basically never got a high school education, or the double-standard of race relations in the town of Odessa when it came to student athletes. It addressed how much pressure the kids were under to perform and succeed, and how difficult it was to shoulder the expectations of an entire town at such a young age (as well as how miserable it is to expect your life's accomplishments to peak at age 17), but in the end, it kind of devolved into just another sports movie. And I prefer "The Bad News Bears" for that kind of thing.

So anyhoo, today we headed over to Central Park for the opening of "The Gates."



(Photo by Andrea Mohin for the New York Times)


(Photo by James Estrin for the New York Times)


It was an impressive exhibit and really something to see. Despite the fact that the day was cold and mostly overcast, the park was packed, and the hot dog and pretzel vendors were as happy as I've ever seen them. Why don't they sell roasted chestnuts anymore, I wonder? Maybe that's just a Christmas thing. Anyway, I get a kick out of the fact that there were so many people visiting New York from out of town just to see "The Gates," and that all we had to do was hop on the subway and head uptown. Which really reinforces my primary point about living in New York. It's great for lazy people, because everything comes to us.

One thing that I really noticed while walking around the park today, though (aside from the fact that the fabric of the gates looked more orange than "saffron" as billed), and that is that everyone in Manhattan has the same two strollers. Namely, everyone either has the Bugaboo Frog (a.k.a. the $700 stroller) or the Maclaren umbrella stroller in various models. I'm not kidding. If you live in New York, go to any middle to upper-middle class neighborhood and and notice what strollers people are pushing their kids around in. I'm not sure if there's anything actually superior about these rides, or if New Yorkers are just as brand-conscious about their strollers as they are about everything else.

Currently reading: This article in The New York Times about the possible emergence of a new, more virulent, multi-drug resistant strain of HIV. Working in a hospital and reading about this, it's more than a little scary. It's like we're going back in time or something. Which reminds me that perhaps "And The Band Played On" is worth yet another re-read. I gave this book to my sister for Christmas, and she said that it was good, but depressing. And that's kind of the point.

home improvement

In a flurry of redecoration, the likes of which this household has never seen, we've done some rearranging to clear out our old dining room in preparation for Cletus. We owe this kick in the pants to the powers of our new Ikea storage system. Hail to thee, Ikea!

This is going to be Cletus's room, once we get some baby crap in there. It formerly housed our dining room table and little else. Really, I should put "dining" in quotes, because we never really used it to eat. In fact, I think the last time that we were in this room was Christmas, and that was because someone gave us this 500 piece jigsaw puzzle and we needed a big empty space to assemble it.

Here's the view looking out from Cletus's room to the new dining are. You can see that all we did is to push the dining table out into the foyer, where we're actually more likely to use it, now that we don't have to step into a whole separate room to sit down and eat.

Here's a closer view of the same. The new Ikea shelf-thingy is the perfect system for storing all those wedding gifts we never use. Like those five million glass vases that we somehow have. And the breadmaker. If you overlook the pile of cardboard boxes destined for recycling by the door there, this room actually looks kind of nice, like real adults live here.

So now we feel sort of proud. It was OK to live like a couple of shiftless college students when it was just us, but now that we have a kid on the way, we feel sort of an obligation to make a nice home so that the Child Welfare people don't barge in and put Cooper and Cletus in foster care. We want to look legit. And we also want to have a nice place for Cletus to sleep, although it would be pretty funny for him/her to be like Kerney's kid in the Simpsons and say, "I sleep in a drawer!"

By the way, Cooper now loves the new BLUE! couch. At first she was a little scared, as were we all, but she's since warmed up to it. Of course, as a dog, she is color-blind.

Currently watching: "Friday Night Lights." My dad just lent us the DVD. He seems to be going through some sort of football movie kick, having watched both "Friday Night Lights" and "Rudy" (the football movie starring Frodo's boyfriend, Sam) in the same week. Which is kind of strange, since my dad doesn't even like football.

hello, blue couch

See, here's the difference between me and Joe. When I have time off from work, all I do is sleep and loaf around and watch the "Real World/Road Rules Battle of the Sexes" marathon on MTV because I'm lazy like that. Joe, on the other hand, is a whirling dervish of productivity, not unlike the Tasmanian Devil, only less destructive. He did our taxes. He organized our closets. He cleaned out the file cabinets. And yesterday, while I was on call, he had our new Ikea furniture delivered and assembled it all himself. He is like the Bionic Man.

Aside from getting the above storage system in a pitiful attempt to organize our lives, the main reason we needed to go to Ikea is that we needed a new couch. Thanks to the Coop Dog, our old couch was neither looking nor smelling very good, and after giving up the idea that five gay men were going to descend upon our home, renovate it and give us all new furniture as well as a sassy new take on life, we just decided to bite the bullet and buy a new couch ourselves. As for the choice of an Ikea couch, I know their stuff is kind of cheap and not very sturdy for he long haul (the dining room chairs that we bought there are just about falling apart--remind me not to invite any fat people over), but we figured that with a teenaged dog and a new baby, we probably shouldn't get any furniture that isn't basically disposable after 5 years.

We were originally going to order this one model of couch in a dark, espresso-colored brown (not sold online, so I can't link to a picture, nor can I remember the name, though knowing Ikea, it was probably the EKSKUNDGROBEN couch or something like that) not only because it looked attractive, but we figured that the brown would really camoflage the poop stains well. Only when we called the Swedes, they informed us that the brown couch was sold out, and that the only choice of color for that particular couch model was a very light beige (OK, but kind of 70's looking) or white. A white couch? How can they expect anyone to maintain a white couch? There would be a person-shaped dirt print on that couch within weeks. So at the last minute, we went with EKTORP couch, in blue. I would have preferred the green, but again, out of stock. Dear Ikea--order some more couches. And also, FedEx me a plate of those Swedish meatballs, would you? Thanks.

The blue looked relatively innocuous on the website (click on the pull-down color menu to "Hillsand Blue," and you can see it's depicted as a subdued navy color) but when it came, it was...a little more blue than we had anticipated. I mean, this is a BLUE couch. You walk into our living room, and it screams, "BLUE!" Not quite a Cookie Monster blue...but close. I thought the dog's bed was blue (seen in the lower-right hand corner), but next to this new couch, it looks positively greyish.

See? Also in typical Ikea fashion, they seem to have forgotten to include the legs for the couch in the "assembly required" package, so we're still waiting for those to come. Meanwhile, the couch is sliding all over the floor. The blue, blue couch.

Currently reading: "The New Yorker." Did you see that Chris Ware illustrated this week's cover? Cool.

the launching pad

The NICU cracks me up sometimes. I was walking around just now checking on my kids and just as always, every single radio in every single pod was playing Light FM. Rod Stewart was singing "Have I Told You Lately That I Love You?" The unplugged version.

You fill my heart with gladness / Take away all my sadness / Easy my troubles / (voice breaking with emotion) That's...that's what you do... (thunderous applause, whistles)

I don't know why this is funny. Rod Stewart is funny. Ha, his name is Rod. Also funny is Clay Aiken, who's always singing "You lift me UUUUUUP so I can stand on mouuun-TAINS!" when I'm running around pre-rounding in the morning. Clay Aiken is funny. Also, he looks like Cynthia Nixon from "Sex and The City."

Yeah, so I'm on call in the NICU tonight. I'm hoping for a good one--all the planets are aligned for me to (knock on institutional formica) get some rest. The main factor playing into my good call night is that I'm not carrying the delivery room pager overnight. There's double-coverage on the other NICU team (this place is so huge that we're split up into "teams" covering roughly 25 patients each) so one of those other guys is going to carry the pager for tonight. I am so happy about this I can't even tell you. My kids on my floor can crap out all they want, but the assurance of knowing that I won't get called upstairs at 3am for some 24-weeker twin C-section is priceless.

Of course, just the possibility of sleep isn't enough for me. There's also the quality of the sleep. I'm sure I don't need to tell you that the mattresses in the call room are for shit. Yes, in our luxurious bunk beds are mattresses the approximate texture and hardness of a coroner's autopsy table. It's all cold and hard and clanky, and if you're lucky enough to get to lie down on them for any amount of time, your back will not be thanking you for the nice night you just spent together. I love getting rest on call, but those beds, they kill.

But. BUT. There's this place next to the NICU resident call room called "The Launching Pad." What the launching pad is is this mini apartment for parents who are getting ready to go home with their little NICU graduate. The night before discharge, the parents and baby (or babies) spend the night in the apartment, which is set up to recreate the home environment. There's a rocking chair, a little changing table, a bathroom, a nightstand, and a big digital clock. And lo, friends, there's also a bed in there. A GIGANTIC, QUEEN SIZED BED with a REAL, QUEEN-SIZED MATTRESS made for HUMAN BEINGS. With pillows! And sheets! And a comforter! (For comfort!)

Let me further state that there is never anyone in the Launching Pad. I mean, sometimes there is, maybe once a week (if that), and those nights, one of the nurses puts up a sign on the door that reads, "LAUNCHING PAD IN USE! PLEASE DO NOT ENTER WITHOUT FAMILY PERMISSION!" or something to that effect. But one thing that you learn in the NICU is that kids don't always go home so fast. Well, sadly, some don't go home at all. And some stay with us for months before they leave. We have maybe on average one or two discharges a week. And what happens to the Launching Pad when there aren't parents and babies in there spending the night? That's right, it just sits there. Empty.

Did I mention that there's this queen-sized bed in there?

OK, so I'm probably not going to break into the Launching Pad to sleep tonight because I'm just generally too obedient and authority-fearing, but oh, I am so tempted. Because these bunk beds in our real call room make me feel like I'm at camp. And not a fun camp with bonfires and sack races and picture frames made out of popsicle sticks and painted elbow pasta. It's a camp where your parents send you when you're bad, to shape up, or else they're shipping you off to military school. Hail to thee, Kamp Krusty.

Currently reading: Lab results. Lots of lab results.

results

Halfway through my day in the NICU today, I remembered that I was supposed to get a call about my FASTER trial test results today. I guess somewhere between running between the kid on ECMO and trying to draw blood from an arm the size of my index finger, I just plum forgot about it. I thought that the genetics people might have left a message on my cell phone, but no dice. Then I called home to check our answering machine. Again, zilch. It was 4:00pm by this point. I wanted my test results and I wanted them now.

So at this point, I figured I should just call my doctor's office. That's what regular people do, right? Call their doctor for test results? I'm speculating here. (I have to admit that the first thing I actually did was log onto the patient information system and try to look up the results myself. Unfortunately, I think the lab is a send-out, so it wasn't listed with my other blood tests.) What I neglected to remember, however, is that nothing, nothing is straightforward at [University Hospital]. After calling my OB's office, I got shuttled around to not one, not two, but six different departments, all either denying involvement with the FASTER trial (bad) or just not picking up the phone at all (worse). Don't people answer their phones at work anymore? How would you all feel if I didn't answer when you paged me? Furthermore, do not mess with a resident in working in the NICU by not calling with her prenatal testing results on the day you said you were going to, because I'm staring at kids on ventilators with malformed skulls and screwed up hearts and imagining them all to be my fetus and it's SCREWING WITH MY MIND.

So for lack of any better solution, I just walked down to the genetics department myself. That's usually the way to get things done as a resident, I've found--just plant yourself in front of the people responsible (be it the lab supervisor, the x-ray tech, the pharmacist or what have you) and do not leave until they help you. Unfortunately, it didn't work this time. They said that the FASTER trial was handled by another office. Of course.

Anyway, to cut to the chase--the FASTER office just called me at home. I guess they work late over there. And what they said is that from the results of the blood tests and the ultrasound, we were in the lowest risk category for Down's, Trisomy 18 and spina bifida. Nice work, Cletus! Keep doing this well on your tests and you'll be heading to med school yet!

Now to commence worrying about our anatomy scan in three weeks.

Currently reading: "Just Another Kid." You can tell that she wrote this one after she moved to Wales, because no Midwesterner says "bloody hell," and certainly no American kid tattles on her brother because he "wee'd" in his bed.

tko

So we finally saw "Million Dollar Baby" last night, and it deserves every laudatory review it received this season. I was literally thinking about it for the rest of the night--I even had a dream about the movie, if that doesn't sound overly freaky. So good. Why can't more movies be like that? I never thought I'd say this, but I think I have a crush on Clint Eastwood now, even though he's slowly metamorphosizing into a piece of rawhide. And additionally:



MICHELLE
I think Morgan Freeman should narrate everything. Ever.

JOE
Yeah, he has that great voice. Even better than "This is CNN" guy.

MICHELLE
Oh, you mean Mufasa?

JOE
Yeah, Darth Vader.

MICHELLE
I'm with you on that one.


Joe's out tonight with some manly men at some Superbowl party down in the Village somewhere. I didn't go because 1.) I don't care about football, 2.) I can't drink because of Cletus, so that even takes the fun out of sitting on the sidelines, and 3.) I have to wake up at 4:30 tomorrow morning to start in the NICU. Yeah, so apparently, there's this 4:30 AM now.

I think the last time I went to a Superbowl party was two years ago, during my fourth year of med school. I also didn't care about football at the time, but there was sweet sweet non-forbidden teratogenic beer, and this really good artichoke dip that some guy made, so I was OK for the night. However, I remember very vividly that the party took place the night before the Urology match results came out, so there were a couple of stress-cases in the bunch, alternately reciting their rank list in a ritualistic "Rainman"-like way or drinking themselves determinedly into quiet oblivion. Ah, med school. Good times.

Currently reading: "Just Another Kid." I think I read Torey Hayden's first book "One Child" when I was--well, I was in 6th grade, so I must have been 10 or so--and I really got into that whole child psychology angle of the story. Since then, I have read all of her books, even though they are a little Reader's Digest-y and formulaic, just because I found something very comforting in stories about Troubled Youth and The Person Who Cared Enough To Make A Difference. However, despite the fact that I went into Peds (initially at least), I just don't think I have that kind of patience. I once saw a kid in my practice who had some paralyzing phobia of ogres (yes: orgres) after being scared last Halloween by another kid in a "Shrek" mask, and I could not punt her to Child Psych fast enough. Anyway, it's a totally reasonable fear--I'm scared of Mike Meyer's totally played out Scottish accent too.

contrasts

My OB's office is really nice. Every time I go there, I can't help but to compare it to my own clinic. I know it's not fair to compare a private attending's office to a resident clinic, but I compare anyway, because I'm dumb. Behold:

HER OFFICE: Madison Avenue, right next to the Calvin Klein flagship store.

MY CLINIC: Broadway and Dyckman (which old-timey New Yorkers should know is pronounced "Dyke-man," not "Dick-man"), next to the Broad-Dyke Butcher Shop. I know it's terribly clever, given the location, how they came up with the name of the butcher shop, but heh, it's called "Broad-Dyke."

HER OFFICE: Thick carpeting, padded seats, floor to ceiling modernist oil paintings, recessed full-spectrum lighting.

MY CLINIC: Linoleum, metal office chairs, buzzing florescent horror bulbs, TV bolted to the ceiling incessantly playing "Rollie Pollie Ollie," or whatever that freakish show is where computer generated spheres yammer at each other.

HER OFFICE: Magazine selection includes Vogue, Harper's Bazzar, New York Magazine (though not the superior New Yorker, with which it is often confused), and American Baby, the parenting magazine that offers such helpful pregnancy tips as, "Tired? Why not put your feet up in your plush recliner and snuggle up in your $1,000 cashmere throw?"

MY CLINIC: One ripped up copy of Parents magazine in Spanish.

Then again...

MY CLINIC: One and a half hour wait in the waiting room for your "scheduled" appointment.

HER OFFICE: One and a half hour wait in the waiting room for your "scheduled" appointment.

Aww, two worlds coming together. Isn't that nice.

I think that my OB must think I'm the biggest slob ever, though, because every time I see her, I'm post-call. It's the only time I can ever make it to an appointment in the daylight, so there's really not much other option. But seriously, every time I see her, I'm in wrinkled scrubs, my hair all messy, my glasses all grimy, and my body 36 hours from it's last shower. Luckily, at this point my appointments mainly consist of getting my blood-pressure taken and peeing into a cup, but dude, you have to stand close to me to take my blood pressure. I'm a smelly post-call girl. I hope they know I'm a resident, and it's not just that I've, you know, fallen on hard times.

Yesterday's appointment was probably the quickest ever, but mainly because I only needed blood drawn for my quad screen. They said they'll call me on Monday with the results. I'm not overly nervous about it, because I'm only 26, so statistically the chances of something funky happening with Cletus are lower--but I think you always imagine the worst when you work in a hospital. The proportion of messed-up babies to non-messed up babies is significantly higher in my world-view. After you've worked in the NICU, and you know just how much can go wrong at any point in the process, you marvel that any healthy babies are born at all. But I guess that makes me kind of a downer. During dinner with Ray and Susan this weekend, they asked us if we had a preference for Cletus being a boy or a girl. We don't, and I put it this way, "Hey, as long as Cletus isn't born with holoprosencephaly or a hypoplastic left heart, we'll be happy! Heh heh, yesiree! Are you with me?" Then I rapidly changed the subject because they started to get this Look on their face like they thought I was the evil jinx master for even bringing up such topics.

Currently reading: Re-reading "Maus." Have you read this book yet? You should.