Thursday, May 05, 2005

resolution, for now

Hey all. Thanks for the input. Not that I intended to make it a beat-up-on-Joe free for all yesterday, because those of you who know him also know that he is a good husband, sensitive in general and all that--but I really do think (by his own admission) that he really hasn't thought all that much about what it's going to be like around here after Cal joins the mix. Also, I think that he was having a lot of anxiety about how to "do it all," having a successful work life while not being a neglectful parent, and was afraid to talk about it with me because he thought it made him some sort of an unfit father, not knowing that I was stressing mightily about the exact same thing. (I guess he hasn't been reading this page.) So he was compensating for the uncertainty factor by perseverating on the stressor with which he was at least already familiar--that stressor being work. Ah, sweet sweet immutable work. Teacher, mother, secret lover.

Residency is a strange thing. I would barely even call it a "job", it's a total cult-like lifestyle that warps how you think about everything, and forces you to put a priority on work when really, sometimes your priorities should lie elsewhere. One of my co-residents once told me (to illustrate a point that we were making about how residency turns you into a crazy person) that after his wife's father died, the first thing he thought about was, "Shit, how am I going to get off time from work to go to this funeral?" Or the co-residents who suggested to me sanguinely shortly after I announced my pregnancy, "What would be nice is if you gave birth, like, two months early. Then you could squeeze your maternity leave in before you start your anesthesia program." Yeah, that's the ticket, deliver two months ahead of schedule. What normal people think like that?

I think part of the delayed connection for fathers (I can only imagine, and not to generalize) is that they don't really have to think day to day, moment to moment about the fact that there's a fetus all up in their craw, sprinting for the finish line. It would be different if they had to feel the kid move around at inconvenient times, or go to the bathroom every two seconds, or outgrow their clothes faster than they can buy new ones, or hobble around with back and leg pain all the time, or contemplate every bite of food that goes into their mouth to assess whether or not eating that unwashed grape is going to "hurt the baby." I was pretty much the same way early on in the pregnancy. Without tangible evidence of Cletus the Fetus (as we called him at the time) bumping around in there, there were whole stretches where I would just...forget. Men can continue to do this until much later into term, I think. I mean, I'm not following him around work all day, poking him with my protuberant abdomen and screaming about how the kid is kicking me in the bladder.

That fatherhood instinct-delay, I imagine, is probably fairly universal. But there's another wrinkle to our story that think also plays a role. I feel like the fact that I have two years of training in Pediatrics is giving him a false sense of security in my abilities to handle things right from the get-go. I think he is lulled into complacency by the fact that I so far have had a whole lot of baby-wrangling experience, and therefore have everything under control, no sweat.

Here's the dirty little secret of Pediatrics here, people. Pediatricians who don't have kids themselves don't know what the hell they're doing. We just don't. Sure, we know more about kids than the average doctor, and I know what to do with a kid with otitis, or who is septic, or who has stopped breathing and needs to be resucitated. But normal kid things? Not a clue.

One of my attendings summed this up rather nicely when she talked about bringing her first kid home from the hospital. She was a Peds attending already by the time she had her first child, and was not only a former resident at my program, but a former chief resident (which in Peds, as in Internal Medicine, involves an extra year). The first week after the kid was home, her husband asked her how they were supposed to bathe the baby.

Bathe? The baby?

Yeah. Don't you know? You're a Pediatrician.

Yeah, but I never actually had to...maybe we just...lower her into the water? Dunk her in?

But what kind of soap should we use?


And should we actually immerse her, or just sponge her off?


And what kind of shampoo should we use?


Why don't you know these things?

I don't know! Someone else usually does that part! No one ever taught me how to actually bathe a baby!

For instance, what to do when the kid cries? My current strategy for crying babies at present is as follows:

PLAN A: Coo, "Oh, you want to go back to mommy!" (or Daddy, whatever the case may be) and then pass off the screaming pink thing as fast as humanly possible. Hopefully the real parents know what to do. However, if no parents are around...

PLAN B: Swaddle the kid up. Sometimes this makes them stop. Sometimes. If I have time, I may also...

PLAN C: Stick a pacifier in the kid's mouth. They're supposed to...pacify...aren't they? However, if all else fails...

PLAN D: Walk over to the kid's nurse and say, "I don't know what I did, but he's all upset in there. Maybe he's hungry or something." Then walk away under the guise of having urgent doctorly business to take care of instead of just admitting to total incompetence.

Other things that I don't actually know how to do. How to actually feed a baby? Burp a baby? Cut a baby's nails? And good lord, the crying, what if he doesn't stop crying? EVER?

At least I know how to change a diaper. That much, at least, I learned from my rotation through the Well Baby Nursery. But this has also created the mistaken impression in my mind that all babies have an unlimited supply of free diapers and wipes stashed under their basinettes. What, we actually have to pay for that stuff? We're so screwed.

But anyway, the Joe thing. After peeling away the mutual anger lingering from the night before (I thought he was running away from the issue, he thought I couldn't stop harping on the issue, and why coudln't I stop it with the harping?) we reached an understanding and are friends again. We're both stressed. We both want to be good doctors and good parents at the same time, and we're both concerned about how we're going to manage to swing it. And when it comes to Cal joining us on the outside, neither of us know what the hell we're doing. But at least we're in the same boat. Joe's going to ask for one week of vacation the first week of August. (Ophtho residents get four one-week vacation blocks, and they've just been asked to submit their requests, which is why this whole discussion came up in the first place.) I'm going to cross my legs and keep the kid on lockdown until then. And we're both going to remind ourselves that just because you're a resident doesn't mean you can't be a human being as well.

Currently reading: "Word Freak." I've talked about this book before. It's funny, because I find that my Scrabble game noticible improves each time immediately after I read this book. Which is maybe why I have to re-read it in eight to ten month intervals.

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