monday monday

This morning Cal woke up and started singing to us and himself at 4:25am. Twenty minutes before the alarm went off.

Last night, when talking with my attending about a patient that we're going to do this morning, she closed the conversation wth the instruction, "Just make sure we have a defibrillator in the room."

And so the week begins.

Currently reading: This trailer for "Brokeback to the Future." HA!

stand by me

Hi! Sorry! I was gone, but now I'm back! So busy! With the work! And fending off chaos on the home front! And the work!

But big things have been happening here. One of which is this:






Sweet Enola Gay, he's standing! He started doing this last week without much fanfare. One day he just reached up and pulled himself up, and that was it. What the hell? Who told you you were allowed to stand up? IT'S ALL HAPPENING SO FAST. Of course, he isn't, like, rock solid on his feet yet...




...but I have to admit, he's getting pretty good at the vertical orientation thing.

The other news is that I gave Cal a dork haircut. I am filled with shame. I promised myself that I would never cut my kid's hair in some way that would cause them ridicule, rather I would take them to Trained Professionals and have him sculpted into a miniature George Clooney. But his hair was getting so long in the front! And on the sides! I mean, he's not a fricking GIRL. And Joe's mom kept fussing at it (Oh, did I tell you that Joe's parents came to visit last week? They did. The end.) and saying how it was so LONG over here and it was ITCHING his EARS and finally I started to obsess over it and decided I would just trim it myself. No one brings a BABY to the barber! Anyway, it would just be a little snip! Nothing, really! Only I was so worried about gouging his eyes out with the scissors that I just did it really fast and I cut one side shorter than the other and cut his bangs too short. It's OK if you mess his hair up a little bit and tousle it just so, but if his hair just settles down into its native state (i.e. plastered to his head) he looks a little bit Stooge-like.

Oh well. It'll grow out. (Which is exactly the same thing that my mom said to me after she cut my bangs in an UPSIDE-DOWN U-SHAPED FRINGE. Gah! Genetics trumps common sense again!)

So what else? Oh, vacation plans. So, you all win again. Tampa is off. We made the plans with Joe's friends to stay with them for a few days, but I found that I really wasn't excited about the idea of going. I mean, it's going to be our first family vacation, after all, and our first vacation together since Cal was born, and darn it all if I felt a little underwhelmed with the idea of sitting on someone's couch, making small talk and perpetually offering to do the dishes, fold their towels, and basically be a Good Guest. It's going to be OUR VACATION, after all, and I wanted to lounge around a pool and order room service and take naps in the middle of the day with a book on my chest, all sloth-like. So Joe and I talked it over, and we decided, hell, what's a couple more bucks here are there, we've gotta live life, after all, and we decided that we'll be going to Sanibel Island after all. Well, not the island itself, because lots of the lodging there is all beachfront cottage-style, not ideally suited to those traveling with an infant. But we're staying at a nice hotel just across the causeway from Sanibel Island. And they have five pools! And many restaurants! And wild dolphins that swim up to you at the dock and SAVE YOUR LIFE IF YOU'RE DROWNING. Well, maybe they don't save your life. But there are dolphins, I swear. We're leaving in a month, staying for three nights. I can't wait. It will be like the days of the Roman Empire, except more decadent, and no vomitoriums.

Now I have to go do some work. On the weekend. I KNOW. Apparently I got roped into giving this talk in a few weeks, with research and using Power Point and EVERYTHING, and I have to get my ass into gear. At first I thought it would be this low-key thing, just for residents at lunchtime, so I wasn't so stressed about it. But then this week one of my co-residents gave his talk, and it was all sophistimacated with graphs and high-powered statistics and lots of words that I didn't know, and the chair of the department showed up and sat in the front row and all. So now if I don't have some presentation with, like, freaking LASER LIGHT SHOW shooting out of it, it's going to be a huge letdown. So I have to get to work. And also I have to kick that other resident in the head for doing such a good job and setting the bar so high. Ass.

Currently reading: A review article about pulmonary hypertension. FOR MY TALK.

harvest moon

I thought I'd be miserable being back at work after my week off, but I actually didn't really mind it. In fact, I kind of like being at work. It makes me feel, I don't know...puposeful. Of course, there are times when I don't like work, like when I'm there starting a case at 3am (about which more later), or when random attendings are yelling at me for no good reason (why must they yell? with the loudness?) but in general, work can be kind of--dare I say--fun.

So. About this 3am case. Organ harvest. Basically, brain dead guy, family consented to donate his kidneys, and we were there to collect. It was something I'd never done before, though I'd done anesthesia for the corresponding surgery on the other end of the arrow (the kidney recipient, I mean), and even though I'm all for organ donation--everyone make sure that little box on your driver's license is checked right now, go on, I'll wait--there's something macabre about the term "organ harvest." I don't know, it calls to mind scythes and hoods and druids by moonlight. It sounds like, "Oooh, we grew this nice big juicy liver, and now it's ripe for the picking!" Ghoulish.

It was the easiest anesthesia I had ever done, because they guy was, you know, DEAD. And yet, so confusing, because he didn't look dead. In fact, on the table, he looked exactly like all my other patients--intubated, pink, warm, lines running out of him every which way. It was easy enough to get started--move him to the table, hook up the vent, a little blood pressure control, let him ride--but I was confused with what we were supposed to do at the end.


MICHELLE
So I've never done one of these before.

CIRCULATING NURSE
I've done one before.

MICHELLE
So, OK, I get that he's dead, but I'm here to basically control his hemodynamics and stuff like that, right? But then what happens after they cross-clamp?

CIRCULATING NURSE
Then you're done. You leave.

MICHELLE
I'm done? You mean I just turn off the vent and walk out of here?

CIRCULATING NURSE
Yup.

MICHELLE
But the patient's still here!

CIRCULATING NURSE
But he's dead.

MICHELLE
So who stays with him, then?

CIRCULATING NURSE
I do.

MICHELLE
And what do you do?

CIRCULATING NURSE
Well, after they're done and he's closed up, I bag him.

MICHELLE
Why do you bag him if he's dead? Why don't we keep him on the vent, then?

CIRCULATING NURSE
(As though to the village idiot)
Not ambu-bag, a BODY bag.

MICHELLE
Oh, right. Duh. And then what?

CIRCULATING NURSE
And then we take him.

MICHELLE
Back to the unit?

CIRCULATING NURSE
No, to the morgue.

MICHELLE
Oh, right. Dead.

CIRCULATING NURSE
Dead.

MICHELLE
You know, this would be much less confusing if he looked dead.

CIRCULATING NURSE
I know. After the first organ harvest I saw, I went home and crossed off the organ donating thing on the back of my driver's license.

MICHELLE
You mean to donate?

CIRCULATING NURSE
No, I didn't want to donate any more.

MICHELLE
Why? Even after seeing all the people you could help? Because I've done a couple of kidney transplants, and the patients, like, cry with happiness when you tell them they have a new kidney.

CIRCULATING NURSE
Yeah, I know, and maybe I'll change it back sometime, but I just didn't like how it was at the end.

MICHELLE
What do you mean?

CIRCULATING NURSE
Well, the last harvest I did, it was a young guy, and they took everything. Heart, liver, pancreas, everything. There were, like 20 people in the room. And after they all got what they wanted, everyone left, and the patient was just lying here, alone. I peeked behind the curtain to look for Anesthesia, and they were gone too. Everyone was gone except for me and the patient. And it kind of left a bad impression.

MICHELLE
Yeah, that is kind of sucky.

CIRCULATING NURSE
It was sort of a bad first experience.

MICHELLE
You should check that box off though. On your license, I mean. I would treat you nice if I had to do your harvest.

CIRCULATING NURSE
Yeah, maybe I will.

MICHELLE
Hopefully it never comes up, though. Hopefully you'll be so old and gnarled when you die that we won't want to touch your organs with a ten-foot pole.

CIRCULATING NURSE
(Laughing)
Yeah, I hope.


Currently reading: The latest issue of "New York Magazine" about the so-called Blog Boom. The Underwear Drawer is probably what would be firmly classified as a C-lister, though it seems you have to damn well hire a writing and business staff posting 24/7 to be on the A-list.

the mother manifesto

So apparently, it snowed. A lot. Supposedly this is the second worst blizzard ever to hit New York City, but I can't say that I've experienced The Forces of Nature firsthand yet, as we didn't really try to venture outdoors today. Because, did you see the coldness? And the icicles? Time enough to deal with that tomorrow. Instead, we stayed indoors to have cozy family time, and to SWIM NAKED IN OUR GIANT VAULT OF MONEY.

(Shout-out to the comments section! Woot! You know how sometimes you're about to post something, and you just know it's going to stir shit up? But then you post it anyway, because I JUST GOTTA BE ME. Yeah, so I figured that whole Stay At Home vs. Career Mom thing from two days ago was going to do it. That's a sure-fire way to get women-folk fighting amongst each other every time! Try it! But seriously, why the strife? We're all trying out best to do what's right for ourselves and our families, right? Right-o, then.)

I'm just putting the finishing touches up on my note to Georgia for Monday, containing all sorts of tidbits and updates about Cal from the past week. Yes, because SO MUCH HAS TRANSPIRED over the past week that it requires typed correspondence to detail it all. SHE MUST KNOW OF HIS NEWFOUND LOVE OF PEAS. Really, it's just that I'm crazy. It's filled with all sorts of gems such as, "Cal can pull to stand with assistance" and "I did Cal's laundry and sorted out the clothes that were too small for him." Wow. Deep. And I keep making the margins on the page smaller and smaller and smaller, because the Smother Mother note is already running two pages single-spaced, and in my mind if it were to spill over to three pages, that would officially cross the line into pathologic. So, to recap: two pages single spaced with half-inch margins = still OK, however, two and a half pages = clearly over the top. Good. Glad we cleared that up.

Monday's going to be a rough day for me and Cal both, because not only is it my first day back, but I'm on overnight call. The hospital is a jealous lover, he must have me to himself. As sort of an experiment, I stepped out to the store for an hour yesterday, and Cal got a little lathered up over that--so you can imagine I feel a little bad about throwing in a 28-hour absence right on the tail of our nice week together. It's sink or swim time, kid. See, developmentally, he's at that stage now where he thinks that if you're out of his line of sight for ten seconds, you're gone forever. Which, ha ha, silly, I'm just in the other room. Babies are, like, stupid. However, given that I'll be gone for more than 24 hours, maybe getting all crazy upset isn't out of proportion after all. I mean, you can file a missing person report with the police after 24 hours. For all Cal knows, I might never come back.

But I always will, Cal. I always will.

Currently reading: This article in the Times. Apparently, Dick Cheney shot someone. With a gun. I always knew he was evil.

safety first

Now that Cal is almost crawling, it's only a matter of time until he's fully mobile, which means that our decorative floor machete collection has got to go. So in the name of staying one step ahead of the game, Joe and I went to Home Depot today to stock up on childproofing supplies. You know, outlet covers, locks for our cupboard, that sort of thing. We replaced the smoke alarm that we broke after the old one went off when I was cooking eggs last weekend and WOULDN'T STOP BEEPING, WHY WON'T YOU STOP BEEPING? and the only way we could figure to turn it off was to, uh, drop it on the floor. We also finally got a fire extinguisher for the apartment. Now all I need to do is start a small test fire to see if our new purchases meet the challenge.

Currently reading: "Sign With Your Baby." DON'T LAUGH.

back to your regularly scheduled programming

It sounds terrible to say this, but when you work many hours a day away from your kid, there is a strong inclination when you do spend time at home to spoil your kid rotten, not unlike those divorcee dads who get get custody of their kids every other weekend, and on those weekends are all, hey kids, now let's have the funnest time ever with the funnest dad ever, new toys and candy for everyone, because who loves you, baby? That's how I feel lots of the time. Like Joint Custody Dad. Not this week, though. This week I felt like Tony Danza in "Who's the Boss?"




Now that my week of vacation is drawing to a close, I am getting increasingly sad. Nothing like spending 24/7 with your child to create the misconception in your head that he CANNOT SURVIVE WITHOUT YOU. Why, no one else could possibly catch on to the fact that crying = hungry and poo smell = poo in his diaper. These are things that only a MOTHER can know. In many ways, going back to work now is much more difficult even than going back to work after my maternity leave. When he was six weeks old he was in larval form, he didn't know if I was coming or going, and honestly didn't really care that much. Now he knows and cares. Now he has a personality. Now he gets upset when I walk out of the room. And these are the things that will conspire against me to make things hard Monday morning. Hopefully he'll stay asleep and we can avoid some scene (read: me sobbing).




I know that people always say that staying home to be with their kids is much harder than their jobs, and I don't know about the specifics of their jobs or their kids, but I have to say--my job is much harder than this all has been. This week of childcare and domesticity has been exactly what it was billed to be: a vacation. And I don't want to incite ire from either side by having this interpreted as me saying that Stay At Home Moms have it easy, or that Career Moms are somehow made of stronger stuff or anything like that (repeat: I AM NOT SAYING THAT)--all I'm saying is that this week, taken into context, has been a lot of fun for me. And hopefully, Cal had an OK time too.




I'm ready to go back, though. I didn't get as bored as I expected I might, and I'm not exactly end-of-summer-vacation-type excited to go back--but ready. I've been having work-dreams throughout my vacation anyway, so I guess part of my mind never really left the hospital. After a brief hiatus, back to real life, you know? It's fine.




It's still kind of sad, though.

Currently reading: "Marley and Me." It was cheesy in that Hallmark, "Tuesdays with Morrie" kind of way, but I did cry at the end. Come on, the dog dies, I'm not made of stone.

overheard

As I was waiting for the light to change on my way home from the store, I was standing at the crosswalk with two people, a black woman wearing a long coat that sported bold brown, black and white tribal patterns all over it with a matching hat, and a white guy walking two dogs.


GUY
Hey, I like your jacket.

LADY
Thanks.

GUY
And I like your hat. They match.

LADY
Thanks.

GUY
I love your jacket and your hat.

(Beat)

GUY
Do you want to marry me?

LADY
I'll think about it.


Currently eating: Nutter Butters.

Cal Currently eating: A plastic horse.

mystery IgE




OK, so maybe there's more to this allergy thing than meets the eye. I made the switch from rice cereal to oatmeal on Sunday, thinking that would fix the problem. And then yesterday I gave Cal a bottle of breast milk.

(Why, you may ask, am I feeding him from a bottle when I'm home? Milk line rotation, friends. Milk line rotation. See, I have something like 75 ounces chilling in the fridge from last week's efforts--roughly equivalent to a 3-day supply if I don't have any overnight call--and if I don't feed these to him and pump this week during my normal work hours, the fridge milk will all spoil and Cal will have nothing to eat when I go back to work. He'll have nothing, nothing, NOTHING...if he don't...have....youuuuuu. Hence, bottlefeeding and pumping during the day to keep things moving.)




I have not been witness to this as much as Georgia or Joe have, since I rarely bottlefeed him when I'm home, but Cal has gotten pretty cool in the past month or so with holding his own bottle. He just grabs for it and jams it in his mouth and goes. But sometimes he misses, and gets the nipple in his cheek, or his chin, or his eyeball. Yesterday was not an exception. But you can imagine my dismay when, near the end of the feeding, I took away the bottle and saw this:




It's the exact same type of skin reaction I saw when I gave him the rice cereal on Sunday. And given that the only commonality that I could pinpoint between the two feedings was a.) the dish soap that we use to wash his feeding stuff, and b.) the breast milk, I felt we had something of a problem on our hands.

(I took that picture so the other licensed MD of the household could see when he got home, by the way, not for the express interest of posting pictures of my child's skin eruptions on Ye Olde Internet. Not that it stopped me from posting the picture anyway. CHILD EXPLOITATION.)

So when Joe got home, we did what we med folks like to call a provocative test--we put a dot of dishsoap on a band-aid and stuck it on Cal's leg to see if that would incite the reaction. Then we thought, oh, how cute, Sesame Street band-aids, let's put one on Cal's forehead to see if he can recognize himself in the mirror and have enough self-awareness to try and take it off. (Long story short: he didn't. Other long story short, he didn't react to the dish soap either. So.)




Could it be the breast milk, then? I mean, THAT'S CRAZY TALK. Right? Right? I mean, he's been taking breast milk for six and a half months straight with no problem. And anyway, HOW COULD YOU BE ALLERGIC TO BREAST MILK? That's just straight up DSM IV criteria INSANE. La Leche League is going to hunt me down with a bow and arrow just for thinking it. However, upon contemplating the situation some more, I realized that the batch of milk I used to mix up his rice cereal and the milk that I bottle fed him were both pumped on the same day. Maybe it's something I ate? But what did I eat that was different than usual? And am I actually supposed to remember what I ate for lunch a week ago? It was some kind of food that I had to put in my mouth and chew--that's the closest I can come.




So, still unclear. The mystery continues, call the Bloodhound Gang. (If you've got the crime, they've got the time.) But, the upshot of all this is that Cal may not actually be allergic to rice. Which means that he can still stay in the family.


* * *


Do you want to see the scariest guy in the scariest apartment in the world? Of course you do.




Of course, it may not be a guy, it could be a lady. But here's why he's scary:

• Totally bare living room, even though he's been living there for a long time.
• Only one light fixture, one super-bright bare bulb in a table lamp with no shade. Seriously, it is SO BRIGHT--it hurts my eyes to look at it, and I'm across the street.
  
• He just sits there next to the bulb facing the TV and he does...not...move.

I guess he's not really scary so much as sad. Why don't you move, scary man? Why don't you turn off your light? Where's your lampshade? Somebody needs a hug! But you have to admit, when it's midnight and you're looking out your window at the building across the street and all you see is THAT ROOM and THAT LIGHT and THAT SILHOUETTE it's a little bit creepy. Like either he's a serial killer, or he died weeks ago but he doesn't know it yet, like Bruce Willis in "The Sixth Sense". (Sorry, did I just ruin that movie for you? Oh come on, everybody knows that plot twist already. HE WAS DEAD THE WHOLE TIME! Shriek!)

Currently reading: "My Friend Leonard." It's readable.

Currently watching: "Real World/Road Rules Challenge: The Gauntlet 2." Well, this weekend anyway. Why can't I stop myself from watching these things? Why? And why does Beth suck so bad?

atopy

I'm sure this is an issue that has been raised before (it almost sounds like the lead-in to some stand-up comic bit, like "And what's the deal with airline food?") but why do all children's pajamas come with some giant disclaimer regarding their flame retardency? Do we gauge all children's clothing on its conflagratory potential, or is it just sleepwear? And why? Are kids more likely to catch fire at night? Are we Amish, reading by candlelight? Are we smoking in bed? Barbecue-ing in bed? Eating Bananas Foster in bed?

If someone could please clear this up, I would be grateful.


* * *


So it seems as though Cal got the memo, because these past two mornings, he has slept in until 6:30am, which, for us, constitutes "sleeping in." It's not quite daylight at that hour, but there's just a teeny speck of light, like someone took the big old dimmer switch in the sky and put it on the lowest possible setting.

These past few days have been a festival of domesticity. Feeding baby, playing with baby, washing things, going to Bed Bath and Beyond for new pillows. See, I saw this thing on the news the last night I was on call about COULD YOUR PILLOWS BE KILLING YOU? and the report said that if you don't change your pillows, like, every few months, they could be harboring MOLD and DUST MITES and EVIL HUMORS that could kill you in your sleep. So of course I totally buy this and start freaking out, because we haven't changed our pillows in something like three years (some of the pillows are more like five or six years old) and Cal is already showing something of an atopic tendency, possibly related to the killer pillows, but more possibly because he's related to me, the most allergic person on the planet. So yesterday I went to Bed Bath and Beyond and got all new gimmicky ALLERGEN-REPELLENT PILLOWS and threw out the DEATH PILLOWS and now the dust mites and mold will have to find a new home. Sorry, guys.

The thing is, for a few weeks, I've been convinced that Cal is allergic to something, but I just couldn't figure out what it was. Sometimes he would break out in these blotchy red patches and the skin around his eyes would look kind of swollen, but I just couldn't for the life of me figure out what the allergen was. We already use fragrance-free detergent and the rashes didn't seem to be coinciding with anything that we were feeding him during the evening hours at least, so what the hell could it be? (In the corner of my mind, I had this fear that he might be allergic to the dog, which would precipitate some horrible "Sophie's Choice"-type scene at the train tracks--but I didn't think it was the dog either.) But anyway, yesterday I was feeding Cal some rice cereal--RICE CEREAL, the first solid food that Pediatricians recommend that introducing into a baby's diet, RICE CEREAL, which he has been eating for a MONTH--and at the end of the feeding, his chin and neck and his wrists and basically anywhere that the rice cereal touched had become red and blotchy and swollen, with wheals. WHEALS, I say.

But even then, I couldn't quite believe it, so I sluiced off the rice cereal and looked more closely at his neck. Red, swollen, but the intertriginous areas (the parts of skin hidden in the folds) were spared, which to me seemed pretty classic for a contact dermatitis. The kicker of it was that during the feeding, Cal had grabbed the spoon and started rubbing rice cereal into his hair, and a few minutes later, his scalp where the rice cereal had touched was similarly red and splotchy. I suppose to be fully scientific about the whole thing, I should have done a skin test--put a dot of rice cereal on his leg or something and watched to see what happened, but I think I'd already done enough damage that day.

See, the thing is, Cal gets rice cereal in the morning while Joe and I are at work, so I have no idea at what point he started to react to the stuff in this dramatic way. Certainly I'd noticed some low-level allergic signs in the past few weeks, but not with the SWELLING and the WHEALS and all that. Even last weekend, when I fed him rice cereal, I didn't see anything near this kind of reaction. And certainly, Georgia never mentioned anything, even in just these past few days. Still, I felt guilty. If I were home more often, feeding him myself, surely I would have noticed sooner. It's not like he was anaphylaxing or anything like that--if anything, he was just a little itchy--but still, for a few moments, he looked like a clinical picture in an immunology textbook.

So I switched him to oatmeal this morning, and while I won't say that he's definitively not allergic to that (after all, it seems like it took him a few weeks to build up those rice cereal antibodies) he certainly enjoyed it. So I guess we'll just wait and see.

As for the larger problem--how it will be for him to grow up in a half-Chinese household ALLERGIC TO RICE--that we will have to deal with later.

Currently reading: "My Friend Leonard," the sequel to "A Million Little Pieces." Eh, I am liking this book less than its predecessor. I mean, I know they're both fake, but this book reads more fake than the first. Also just very quickly re-read "Brokeback Mountain" during Cal's nap (it's very short, obviously), because I just wanted to digest the story a little better the second time around. So sad. Why couldn't they be together? Why? Stupid scared Ennis del Mar.

the doctor is out

Cal is developing a personality that I can only describe as "impish." How else could you classify the expression in this photo?




(And no, "Half-Man Half-Mouse Plotting World Domination" is not a facial expression. Also, see how Joe dressed him that day, like he's going to go out and hunt some deer, with the camo and orange and all?)

I was on call overnight last night, but I barely even noticed, so great was my excitement that MY VACATION STARTS THIS WEEKEND. Yes, that's right, I have a week of vacation, my first stretch of time off since Cal was born. (Joe and I have some vacation time together later this Spring, hence the talk of travel plans, but this week off is just me and The Boy.) I hardly know what to do with myself.

Before Cal, a week off from work with no travel plans would probably be configured something like this:

• Sleep in
  
• Go to the movies and catch up on the current releases
  
• Have a stack of good books on hand to read while I have lunch out every day
• Sleep in

But see, life is different now. Who knows what kind of sleep schedule Cal would have had if left unperturbed, but unfortunately, our day-in-day-out routine of leaving for work well before dawn has warped him. He now routinely wakes up at 5:00am, even after I explained to him that he doesn't have to wake up early on Sunday. DO YOU UNDERSTAND ME, CAL, IT'S SUNDAY, THE DAY OF REST, SO SAYS GOD HIMSELF. I know that sleeping in isn't such a big deal for someone who can fall asleep anytime, anywhere, even one time while sitting up, but believe me, when you grow up and get a job, you will understand the sweet, sweet siren song of the bed. So yes, anyway, we have ruined our child, he is now a grody morning person who will probably grow up to go jogging at the crack of dawn in SPANDEX and be intolerably chipper while doing it. So no sleeping in, now or ever.

I suppose I could still go to the movies and whatnot (there are such things as babysitters, after all, didn't you read "The Babysitters Club"?), but the thing is, when you spend all your time at work away from your kid, the last thing you want to do when you're on vacation is spend more time away from your kid. I mean, not like I need him to be welded to my side or anything like that, but I do want to see what he looks like in natural light and everything. There is this thing at my local multiplex called "Reel Moms," where they have this one morning a week that you can bring your baby to the movies. They keep the sound lower and keep the lights up and you can, like, breastfeed while watching "Nanny McPhee" or some such thing. But I don't think that the "Reel Moms" promotion applies to every theatrical release, and improbably to any movies I actually want to see, due to Adult Content. For instance, even though I want Cal to grow up all open-minded and free and whatnot, I don't necessarily want his first movie experience to be one in which the protagonists get it up the butt. Maybe in a year or two, we can start off with some nice Disney or Pixar fare (oh wait, those two are the same now, aren't they?) before moving on to the butt-fucking films.

This will be an interesting week though, one that I'm looking at as kind of an experiment, if a contrived one. What is it like to live the life of a Stay At Home Mom? This is what I aim to find out. I know it's just for a week, and it doesn't really approximate the real thing since I know the situation is temporary and that I have a job to return to at the end of it all, but it's as close to being a Stay At Home Mom as I'm going to get, now or probably ever. I have to admit, I am biased, because I'm hoping the outcome of this experiment will be that while enjoying my time with Cal, I'll be (as at the end of my maternity leave) a little bit bored and idle and itching to get back to work. Because after all, if I LOVE staying at home and LOVE being with Cal all day and wish OH LORD HOW I WISH that I could do this all the time, every day, forever and ever, years of training and salary and obligations be damned...then I will have something of a major life crisis on my hands.

Currently reading: "In Touch Weekly." Oh come on, it's only $1.99! At your newsstands now! Did you hear that Britney Spears might be pregnant again? I did! Because I read "In Touch Weekly"! Also, now hear this: Paris Hilton is a party animal! Such valuable things I am learning.

last to know

It seems strange and somehow unfair, though obvious due to the nature of the job, that as anesthesiologists we often learn bad news about a patient's prognosis before the patients themselves do. In endoscopy yesterday, I was giving anesthsia for a guy who was getting scoped diagnostically for months of back pain. He was a young guy, otherwise healthy, job and kids...but he had this pain, see. So I sedated him and he drifted off, and when the GI attending passed the scope down, there it was, staring us in the face, a lesion that was almost certainly gastric cancer. An endoscopic ultrasound was passed, and there was more, clear to even my untrained eye, mets to the liver. In one second from healthy guy to cancer patient. And neither he nor his wife knew yet.

The procedure finished up and the GI team left the room, excited and buzzing and talking about the specimens to be sent to pathology, did you see the blood supply feeding the mets, did you see that primary lesion, I mean, did you see that thing? Sometimes I feel like the primary team can care more about the procedure than about the patient. I know that's unfair, but it's hard not to feel that way when the second that scope is out or that last dressing is on, everyone leaves the room or goes to return their phone calls and completely ignores the fact that the patient is still in the room, on the table, for chrissake. For the record, just because your part is done doesn't make him not your patient anymore. But anyway, I turned off my drip and in a normal speaking voice said the patient's name, just once. "Jack?" He opened his eyes right away, looked up, and smiled groggily. And something about the look on his face somehow reminded me of how Cal looks when he wakes up in the morning, warm and sleepy and ready for the day to begin. And at that point my heart broke just a little.

"Jack, the procedure's all done, you did great." It was not my place to tell him what we saw on endoscopy, and he didn't ask. "How did you like your nap?"

"It was nice. You did a good job, I didn't feel a thing," he said, still sleepy but waking up gradually. "Thanks."

"No problem." And then, because I couldn't think of anything else to say, I said again, "You did fine." And I thought about the lesion in his stomach and the mets in his liver and his kids at home, and felt a little sick.

"I mean, I was totally out, I didn't hear or see or feel a thing" he said again. And I said I know, I know.

Currently reading: "A Million Little Pieces." You know, I don't give a shit about all that controversy, I think it was a good story and I couldn't put it down. Do you see now that readers are suing James Frey because they read the book and now they feel "cheated"? Oh PLEASE. I mean, I can see people being mad if they believed it was all God's Honest Truth, but it's not like it RUINS YOUR WHOLE LIFE just because it's not.