So I was in what basically amounts to my parent's attic today (people in Manhattan don't really have attics, but let's just call it that, for the sake of romantic imagery and V.C. Andrews creepiness), looking for this old train set that we used to have lying around. Cal has been on a renewed train kick lately, and I thought...well, whatever, I didn't find the trains, but I found something even better. In this old box, my mom had apparently saved a folder of many of my old essays from first grade. Some of them are even stamped for authenticity, with those old metal turn-wheel stamps that librarians used to use, and of which my first grade teacher (her name was Ms. Louis) was particularly fond. After cackling over these writings for a good ten or twenty minutes, I came to the conclusion that, if photographs from the era weren't proof enough, I was a deeply disturbing child.
But let's start light.
Um...OK. I can...kind of see your point there, young Michelle. This must have been some Halloween assignment. What is a teacher supposed to say to a "Halloween Story" like that? Must be why the page is blank.
Next up, what I presume to be a Thanksgiving story. Starts out promising.
OK, good, good. Turkey and kitten on the run! They don't have money, but they have each other! What will happen? Adoption by sympathetic child? A visit to the local animal shelter? Deus ex machina of some other variety?
Oh. (Crickets.)
Or how about this one? I'm guessing this was related to some Valentine's Day assignment, though really, a "Story of Love" (note: the "O" in love is a HEART! Which symbolizes LOVE!) like this needs no formal occasion.
She didn't say anything? Curious. Tell on.
Note the helpful illustrations. Now, the question that this essay brings up is: was there no means of referral for child psychiatry at my school? THERE'S A KILLER HIDING INSIDE A BLOW-UP DOLL! This is not normal childhood flight of fancy. This is...I don't know. Creepy.
But lest you think all I did was write stories wherein all the protagonists were indiscriminately (and some might say, "imaginatively") killed off, there are other writings too. As with this one, you can also see the bud that would eventually blossom into my medical career starting to peek out from between the lines.
Unfortunately, the second page appears to have been lost to the ages. Only one cure? What is it? YOU WILL HAVE TO WHAT?! Do surgery? Start imipenem? Engage in ritual sacrifice of both My Melody and Deery Lou? I guess like the mystery of the lost colony at Roanoke, we will never know.
After reading through the stack of first grade essays (there are many, many more, but I presume that you are not interested in reading rhyming poems about bunnies or stories in which Smurfs visited us at our school) Joe said, "Well, that's it."
"What's it? These are kind of good though aren't they? I mean, kind of weird at points, but overall, not too bad, huh?"
"No, I mean that when Cal starts school and starts bringing home his writing, nothing will shock or disturb me anymore."
You'd think that being on vacation, with so much free time, I would finally have a chance to get some damn work done around here, but so far I haven't been able to do much of anything this week. Ironically, the less free time I have, the more I'm able to make do with the little scraps of time I have here and there. Maybe because my mind is already in regimented work mode. OK, I have half an hour, so I should do this! Now I'll do that! Now I'll blow my captain's whistle and summon Cal down the stairs for bathtime! And no singing or delightful childlike revels! My children do not sing in public!
Thankfully, Joe was off today and offered to take Cal to the park for a few hours so I could hide out at Starbucks and get some writing done. Nice. I am now a living stereotype, writing my book at a table in Starbucks. Feel free to mock me. It took me a little while to get warmed up, but then I got on a little roll. Just in time for Joe and Cal to stop by on their way home.
To be fair, Joe did ask first if they should stop by. But there's no really good answer to that. I did want to see them, first of all, and if I told them not to come by, then I was Mean Mother. But if they did stop by, then there would be the disruption of my aforementioned roll, followed by the inevitable screaming of "Mama! Mama!" when Joe tried to take Cal home without me so that I could finish my bidness. Just like some damn scene out of "Miss Saigon."
I'm sorry, Starbucks, that you were subjected to our family psychodrama. Please know that I did not actually want to eat that egg salad sandwich, and only bought it out of guilt.
NEW YORK, New York, Nov. 28 -- The body of a 29 year-old woman was found in her apartment earlier today. The cause of death has yet to be identified, but preliminary coroner reports indicate that her brain, worn down after years of postgraduate medical training and deconditioned by too many episodes of "America's Next Top Model," apparently exploded out of her ears with catastrophic force during an altercation with her two year-old son, Cal.
"Yeah, I heard them talkin'," reports neighbor Dave Blackburn. "She was trying to get him ready to go to the playground. He kept saying 'no' to everything. Real annoying. Anything she suggested, he would just scream, 'NO! NO! NO!' Then she tried a different tactic. Tough love, you know? Instead of trying to reason with him, she just tried telling him, 'Look, here's what we're going to do,' and wrangling him into his shoes and jacket and stuff. That just made things worse. He just started screeching. Real loud. Set off a couple of car alarms. After a while with the screaming, I heard this kind of popping sound. Guess that was her brain, exploding and all. I seen it in the news." Blackburn added afterwards that Cal was, "A real cute kid. Never knew he had it in him."
Reached for comment, Cal had only this to say. "No! Don't want to! Want to go to the playground! No! Want to stay home! No! No want to stay home! Want to go out, ride bicycle!" After which point he descended into hysterics regarding the fatal juxtaposition of his shirt sleeve with his wrist. "No sleeve! No like sleeve! Fix it! Fix it!"
State-appointed lawyers are reportedly planning to plead not guilty by reason of insanity.
So my curiosity got the better of me. I joined Facebook. See, sometimes I like to follow the links from outside pages to "The Underwear Drawer" just to see what people are saying. Like if I'm on someone's so-called "blogroll" (I'm sorry, being old skool as I am I just really hate that word, "blog"), or if they're just saying that I stink or whatever. So lately I've been getting a good number of links in from Facebook--I don't know if it's all one person's page, or if it's a bunch of different people, but I was curious and wanted to see from whence all these referrals were originating. (Perhaps underlying this curiosity is a secret, high-schoolish fear that somewhere out there, people are saying that I'm lame. I don't know who. People. If you think I'm lame, please feel free to do in your head so with my blessings, because mostly I agree--but just don't tell me about it. I will probably obsess over it for days.)
Anyway, the outside link referred to someone's personal Facebook page, which I couldn't read unless I joined Facebook. So I signed up. But now that I joined, I realized I couldn't read the page anyway because I wasn't this person's "friend." Well, of course I'm not her friend, I don't even know her. I just wanted to see how she (or he?) was referring people to my webpage. And also if they thought I was lame. But really, I don't want to know anyway, it's just--how can you not want to look a little bit? This is my downfall. Curiosity and the cat and all that.
So now I have this Facebook account that I have no idea what to do with, and it was fun for the first few seconds spying on people that I went to high school with, seeing what kind of high-powered jobs they have and whatnot, but...now what? This is it? Is this supposed to be some sort of dating thing? I made Caleb (one of my co-residents--hi, Caleb) explain it to me one day on call, but still, I don't really get it. I fear the technology! I am the Unabomber! And the worst part is, when I click on the "Friends" tab on my Facebook account, it says there, right in white and grey, "YOU DON'T HAVE ANY FRIENDS." Wow, thanks, Facebook. You've really made me feel wonderful.
You know what I really don't recommend? I mean, to those of you who want to remain sane? Do not take a two-year old to the Trader Joe's in Union Square in the middle of a rainy day. By the time you're done shopping and standing on the 500 person check-out line, you will be under the pyramidal Trader O's display, curled into a fetal position, mewling for your lost soul. The day that Trader Joe's figures out how to let us order our groceries online will be a happy day.
So...I'm on vacation this week! Huzzah and all that. This is likely to be the last vacation I will have for a very long time. For a variety of reasons, I have decided to forfeit the last two weeks of my vacation for the year, which I had originally scheduled for this Spring. As you recall, I done had me a baby my first year of anesthesia residency, and as a result, I have four weeks of maternity leave to make up at the end of my sentence--I mean, of my rich and rewarding educational journey. At first, I figured I would just suck it up and graduate four weeks late, but I've decided that I would like to graduate closer to on time, and as a result, I am giving up half of my vacation time this year. That's fine, those are the rules, I'm OK with that.
But this puts a lot of pressure on me to really make the most out of this week of vacation I'm on now. Every second, I'm thinking to myself, "Am I relaxing enough? Am I enjoying myself enough? Am I using this time productively? Are Cal and I bonding enough?" I'm really a fun person.
This was a nice Thanksgiving, wasn't it? Thanksgiving Day itself was the warmest I can remember it ever being, so warm that we actually were able to walk without coats across the park to the restaurant for lunch. (Except for that one year, my family doesn't really cook for Thanksgiving. Maybe because the secret ingredient of any cooking masterpiece is "love," and we are just cold, heartless people. Cold heartless people who eat at a RESTAURANT for Thanksgiving.) You may remember that last year didn't go so well (Cal never even made it to the restaurant, and then we almost got killed when our cab skidded at an intersection and almost ran into a traffic light), but this year Cal is older, and his nap schedule a little more pliable, so we dressed him up, packed a bag full of amusements, and hoped for the best.
And, you know, it was a success. The amusements helped of course (particularly the baggie full of toy trains and cars, which kept him going for at least an hour, not unlike at home), but I think that the bulk of the credit goes to Jean Georges Vongerichten and company. In years past, I believe that the implicit rule of the restaurant was that children were not allowed in the main dining room. We were relying on family-centric Thanksgiving vibes and goodwill towards a reasonably well-behaved kid to get us through the lunch, but I never could have predicted this exchange:
MAITRE D' (Taking orders) And for the young man?
MICHELLE Oh, you know, we'll just give him bits to eat off of our plates.
MAITRE D' Would he maybe like some nice chicken? Or a plate of penne with butter?
MICHELLE (Scouring the menu) I...didn't see that...
MAITRE D' We would make it special for him.
MICHELLE Really? Well, if it's not too much trouble...
MAITRE D' Not too much trouble at all.
MICHELLE Well...the chicken, then. Thanks!
Twenty minutes later, they brought over to Cal a gigantic plate of crispy, golden pommefrites and these gorgeously breaded and seasoned chicken tenders. Seriously, these were literally the best fries I've ever had. You just had to see this scene--it's a really fancy restaurant, so the fact that they would basically construct a kid's menu for us from scratch was really sweet. Cal was delighted of course, and ate a ton. Probably the only thing that would have made him happier is if the chicken and fries were served in a basket with some red and white checked paper on the bottom. But probably that would have been a bit much.
* * *
I had to work on Friday, but Saturday morning we set off for Baltimore to spend the rest of the weekend (OK, Saturday afternoon) with Joe's sister and her three kids. We had a great time, especially Cal. I wish we could get all those kids together more often, it's nice seeing them all play together so nicely, having fun what with their youthful exuberance and whatnot. Almost wants to make one to nod solemnly and make sage, sweeping statements about childhood and the transient nature thereof, etcetera, but for one thing--I am not MY DAD.
Even the part of the weekend that I was dreading the most, that being the drive back from Baltimore to New York on Sunday morning (I figured if Wednesday was the busiest traveling day of the year, surely the Sunday after Thanksgiving must be the second busiest traveling day, all those travelers needing to flock back from whence they came) but it actually wasn't that bad at all. Four hours door-to-door. I did, however, manage to break (and yes, this is the proper medical term for it) my ASS BONE, slipping on the steps to the basement at Joe's sister's house. I misjudged the width of the first step, and that, coupled with my tractionless bare feet and the fact that I apparently have no self-preservation reflexes AT ALL led to me ending up halfway down the stairs on my back with a broken ass. It's not quite my coccyx, this I have ascertained. In fact, if you will indulge for a moment the fact that I have been palpating my own ass for the better part of the past 12 hours, it feels like I have bruised one of the landmarks on the sacrum that we use to do caudal blocks. Yes, I have bruised my sacral cornua. Is this possible? I smell a case report!
So, the book. The book is coming along. Here's how I have it roughly structured so far--it's still very early (this phase is akin to organogenesis, if you want to pull out the old pregnancy metaphor again), so don't hold me to it later. But here's how I think it'll pan out. There are going to be roughly nine chapters, plus or minus one. Hopefully, before each chapter, there will be a comic strip, partially to set the chapter up, but mostly because I just like the idea of having comic strips in the book. (Still have to see that my publisher is on board with this part, though. I don't think it's a huge deal to include illustrations, but who knows, maybe it is, printing-wise.)
I am working on the writing in a piecemeal fashion. It's not going to be like Atul Gawande's stuff in that his book is more like a series of essays. (Excellent essays obviously, but they can be read as standalone pieces, and in fact, many originally were. It feels presumptuous even mentioning such an accomplished writer anywhere near my own, but he's the name that most people are familiar with, so just for a frame of reference.) Mine is more of a narrative over the course of medical school and residency, but it's not 100% linear, so I feel OK skipping around. Like last week, I was thinking about something that happened that I really want to get down, even though that particular story would appear late in the book. So I just wrote it and have it saved as a separate file so I can plop it in at the appropriate point. And some parts of the story have already been written, for the proposal and whatnot, so I just have these little chunks floating around, waiting for me to write the parts that fit in between. It's not a murder mystery or a thriller or anything like that, so I don't think that this skipping back and forth is going to be to the detriment of the finished product. (Also, I'm not too worried about getting the plot and characters confused, because it's, you know, non-fiction, so I can pretty much remember who said and did what when. Until the premature senility sets in.)
In terms of the tone of the story, I think that the blog gives you a pretty good taste. I mean, I'm going to be explicit in saying again that the book will not consist of recycled blog entries (I mean, maybe one story or two will sound familiar, but if so, they will be rewritten for the book version). Basically the flavor is going to be a first-person narrative of the humbling and occasionally absurdist nature of medical training, in which ordinary people are put into extraordinary situations--between the big, career-defining moments and the small war stories that get told at 3:00am--and how through it all, we learn to become the kind of doctors we want to be. I can't promise that it's going to be wall-to-wall laughs ("THAT KID WITH A BRAIN TUMOR DIED! HA HA HA!" No, not that) but I think you can kind of see that there is humor and ridiculousness to extract from many situations. And barring anything else, I can always laugh at myself.
Anyway, I hope this answers some questions. I'm trying to find a day to meet with my editor (that sounds weird, "my editor") for lunch, so that'll be fun. Because believe me, I have some questions myself. Like, "How does this all work, anyway?"
My question about college sweatshirts is: why are the arm holes so big? This is a size small, by the way. You probably can't quite appreciate the scope of it, but the armhole goes about halfway down the side of the shirt to the waist. I don't know if they're just designed for burly people or for comfort or what, but the arm holes are so wide that I can't cram all the fabric into my winter coat sleeves. Never once in my life, until I got this sweatshirt, did I ever think to myself, "you know, I don't think my armpits are big enough to fill out this outfit." Maybe I should go to the gym.
So I like to listen to podcasts of "This American Life" (the radio show on NPR) while commuting to work, because I am a nerd and this was my destiny. I am particularly enamored of the host, Ira Glass, who I always envisioned as looking like a cross between Woody Allen and Moby.
That's the thing about radio. You can make the stars of your favorite show look however you like in your head. I have wondered, however, what Ira Glass really looks like. I deliberated for a long time against actually trying to Google and image of him, figuring it would only destroy my mind-picture and ruin all subsequent podcasts of "This American Life," because I would forever be thinking, "Oh man, I can't believe that Ira Glass looks like that." Like when I looked up a picture of Elvis Duran after listening to his morning show incessantly during high school. I don't quite know what I though Elvis Duran really looked like, but I can tell you that I did not expect that he would look like Mr. Belding's evil twin. However--back to NPR now--curiosity got the better of me, so finally today, post-call, when all the really productive stuff happens, I finally found a picture of Ira Glass.
Wow. Did I call it or what? I did not expect the dash of Hugh Grant sneaking in there, but on the whole, I am pretty satisfied. Now the question is: is it possible to hear big black glasses in someone's voice? Or does it just take someone with big black glasses themselves to instinctively recognize a member of their own tribe?
This past Friday, I was on call for Pediatrics, my last call of the rotation. (But never fear, children of New York! I will be back on the Peds service over Christmas and New Year's! Just what you asked Santa for, I'm sure.) Because I was on call that night, I spent the day rounding with the Peds Pain team, and we were making one last pass through the ICU before I was to head back down to the ORs. The new wing of the ICU, where we were, has floor to ceiling windows, facing South.
MICHELLE Look at that. That's a gorgeous view.
ATTENDING Absolutely beautiful.
MICHELLE I kind of want to take a picture of it.
ATTENDING How?
MICHELLE I have a camera on my phone.
ATTENDING You should do it.
MICHELLE This'll just take a second.
ATTENDING (Taking out his Treo) I'm going to take a picture too.
(We stand there for a few seconds taking pictures.)
MICHELLE OK, lets get out of here before they think we're crazy.
ATTENDING I don't mind if they think we're crazy. I just want to get out of here before they start asking us to do more consults.
Back in the OR, having finished up an ortho case, I began setting up for a liver transplant, which I was told would start at 10pm that night. I was not thrilled with the idea of staying up all night, but I like challenging cases, and I haven't done a liver in a kid yet, so that part at least would be fun. Now, one thing that may surprise you about me (brace yourselves) is--I'm kind of anal. Especially about my setup in the OR. My desk at home looks like a bomb hit it, and all the clothes that Cal has outgrown are heaped up into garbage bags, awaiting sorting, but when it comes to a meticulous setup, I am king of the sphincters.
It's a disease.
I went upstairs to pre-op the kid (she was sitting up in the ICU with her parents, awaiting further instructions from our transplant team), and, walking out into the hallway, I heard one of the Pediatric Surgery fellows with his assembled entourage talking about a kid in the ER. I overheard the words "vomiting" and "acidotic" and "possible ex lap," (that is to say, an exploratory laparotomy) and figured that this might at some point in the night come to concern me.
"Sorry," I broke in during a pause, "is there a kid you're going to ex lap tonight?"
"Possibly," the fellow shrugged. "Depends on what the scan shows."
"OK, I'm just checking. Because we're going to be starting a liver in a few hours, so..."
The fellow shook his head. "Not my problem."
I try again. "Well, what I mean is, if I'm in the liver, and you want to start this other case, I'm going to need to call some backup."
He didn't want to hear it. "Not my problem. Nursing has a separate team. Doesn't matter."
"Well, I guess, but you're going to need a separate anesthesia team too. We only have one Peds anesthesia person on overnight. If we're running two concurrent cases, I'm going to have to pull someone from the adult side. I'm going to need to know in advance."
"Not my problem," he said again. I just told him to let me know as soon as he figured out whether or not the case was going to go, and then walked away. Let's see it "not be your problem" when you're trying to do this case without an anesthesiologist, I thought to myself, but of course, not being an antagonistic person, I didn't say this out loud. (This is also called, "being a wuss.")
The OR front desk called me to let me know that the start time for the liver had been pushed back to midnight, and there were no cases booked until then, I figured it was safe to walk out of the building to get some dinner. On my way back, I stopped by the new Starbucks and got a large (oh, sorry, "Venti") latte, figuring I could use the caffeine. What I had neglected to note was that Starbucks coffee has roughly twice the caffeine content of regular coffee, so after finishing that cup, I was really, really, really awake. Just in time for the front desk to give me another update: the liver had been pushed back again, this time to 7:00am.
Well, it looked now like the transplant wasn't going to start on my watch, but given the uncertain nature of other cases being booked (the PedsSurg fellow had also mentioned in passing that the ER downstairs was absolutely packed), I didn't feel like it would be a good idea to go home and risk getting paged back. Luckily, anticipating such a holding pattern scenario, I had brought my laptop into work that day. So I went back to my call room, fired the thing up, and did some writing for a few hours.
By 2:30am, I still hadn't heard anything, but still didn't feel safe going home, so I lay down and slept fitfully for about an hour and a half. (The mattress in the call room is made of drywall, I believe.) By four, I wandered back out to the OR area. No one to be seen. The lights were off at the front desk. I weighed my options. I went back into the OR where the liver transplant was scheduled to go later that morning and made sure everything was all set up and ready. And then I jumped into a cab and headed home. I was in my own bed by 5:00am.
So even though there hadn't been a case in the OR since about 8:00pm or a page on the Pain pager since 9:00pm, I ended up pretty much spending the night in the hospital anyway, despite being on "home call." I played the odds, gambled, and lost. I'm no good at this kind of thing.
Last May, I received an e-mail. I get a good amount of e-mail from readers of this website, most of which I never return because my heart is shriveled and dark like that of Ebenezer Scrooge before his psychotic break (er, that is, before he "turned good") but this e-mail was a little unusual, because it was from a literary agent. This agent said that she had been referred to this page from an editor at one of the many big publishing houses in the city, blah blah blah, insert laudatory nonsense here, but anyway...had I ever thought about writing a book? She closed by saying that her office was in Manhattan (specifically, in the West 50's--the real estate market can call it "Clinton" all they want, but no real New Yorker is ever going to call it anything but "Hell's Kitchen"), and if I was interested, she would take me out for lunch so that we could talk more.
Being a good cynical little New Yorker, of course, I immediately figured this was a scam.
I even had a whole vision of the scam structure. I figured, here was a person who trolled on the blogs, looking for vulnerable victims. Upon locating such a person, said scam artist would e-mail, posing as a literary agent, prey on the blogger's intrinsic sense of vanity, and lure them in with all this fancy book talk so as to rob them blind. I took a little while to answer (during which time I did a bit of research as to what constitutes a real literary agent and what should set off alarm bells) but in the end figured that thus armed, it could not hurt to at least meet with this person. At the first mention of a "reading fee" or any such nonsense, I would know enough to turn tail and run away, but with a healthy sense of suspicion, at the very worst, I figured would get a free lunch out of things. I was on vacation in a few weeks anyway, so I e-mailed back and we set up a time and day to meet at her office at the beginning of June.
Suffice it to say that Sharon (that's my agent's name--Sharon) is not a scam artist. Turns out she is not only a very professional and accomplished literary agent (and former literary editor herself), but also happens to be a really nice person. We probably spent about 40% of our lunch talking about literary prospects, and the other 60% talking about our jobs and our kids. Very nice to meet cool people overall, even nicer to meet cool people over Cajun food.
One question that I had right off was--how the hell does this work, anyway? I mean, why did she e-mail me in the first place when I haven't actually done anything yet? In all of my limited exposure to the world of publishing (that is to say--from reading Stephen King's writing memoir, and not much else), I always thought that you had to actually write a book first, then find an agent, and then hopefully get an editor to read it. Sharon very kindly skipped over the part where she might have told me that I clearly didn't know anything about anything, and instead explained that these days, most non-fiction books are sold on the basis of proposals, not finished products, and that it would, in fact, be harder for her to sell my book were it already fully written. Her job, to put it succinctly, was to find the potential for a book within me, teach me how to go about marketing my idea, and then help convince editors that this could indeed be a book that people might want to read. But first, I would have to write a proposal.
(Is this really boring? You don't have to read this all if you don't want to, I'm not really sure if this is really all that interesting to anyone except for my parents, but I personally would have loved all these little details before embarking on this whole thing. Kind of a black box process from the outside, you know?)
Anyway, a couple of hours after the lunch I got an e-mail from Sharon with a few sample non-fiction book proposals that she had just sold, just to give me an idea of what a book proposal was and how I would go about writing one. I spent a good deal of time just looking over these other proposals which, while very different from what mine would end up being (one was a memoir from a Moonie, the other was a cooking guide), gave me at least some idea about structure, content, how a book proposal should read, and how I should try to sell my ideas.
There were some parts of the book proposal that were relatively easy to write--the overview I think I basically dashed off in a few days, and the annotated table of contents I had already mentally laid out, as I had some idea from the outset of how the book should proceed. But the hard work came with the writing samples, wherein I basically had to write a few chapters of the book to represent the whole. In short, these would be excerpts from a book that did not yet exist outside of my head, strong enough to stand alone, but interesting enough that it would make people want to read the rest. The writing samples, obviously, took the longest for me to pull off. Especially because, you know, of my actual real-life job, and the fact that I never really had any time to work on anything once I got home and Cal got a whiff of me. But you know, I had a lot of night work while I was on OB, so I tried to write during those times when I wasn't in the OR doing a stat section or starting epidurals. 2:00am to 4:00am is a magical time, people.* I also cobbled together a few daylight sessions here and there, working during some of my non-clinical days on cardiac and stealing an extra hour or two on the weekends when Joe was home. I worked on this thing basically the whole summer. Maybe I could have gotten it together faster if I had more free time, but possibly not--there's nothing like having time limits and restrictions to really force you to be efficient. Well, anyway, I wrote when I could, and by Labor Day, I had the first draft of my book proposal to e-mail back to my agent.
[* However, for the benefit of anyone in my program that may be reading this, I did not do any real writing until after July 14th, because I was studying for the boards. All night every night! Studying! So hard! For the boards! Ah ha ha! I'm fired, aren't I?]
I sent Sharon my proposal first draft and I waited. And waited. There was a lull in the action. What I didn't quite realize was that August is kind of a dead time in publishing, and that I had timed my proposal submission to come right when everyone was getting back to their offices and swamped with all this crap on their desks that had been ignored for the last several weeks. So I just sat tight. I didn't want to be annoying e-mailing incessantly, asking her, "SO, WHEN ARE WE GOING TO SEND OUT THE PROPOSAL?" (not dissimilar to when parents in the ER would come up to me every two seconds asking me "SO DID THE X-RAY REPORT COME BACK YET?") so I just figured she just must have thought that it was not very good and was trying to silently drop me from her client list, like a girl trying to give a prospective suitor the brush-off by just never calling him back.
But eventually the post-summer logjam cleared up, and Sharon and I batted the proposal back and forth a few more times, getting it shiny, before we (OK, she) compiled her little packages and mailed it out to about a dozen publishers in the middle of October. She warned me that after the proposal went out, we might be playing the waiting game for a while. Sometimes proposals can take months or even years to sell, she told me, so don't be too concerned if we didn't hear anything for what seemed like a long time. Well, waiting I can do. It was a little hard in the beginning, but after a couple of days I just sort of forgot most of the time that we were in the middle of shopping a proposal around, and things just, you know, went back to normal.
In the interest of discretion, I will gloss over the next part somewhat, only to say that I first heard that we were getting some interest at the beginning of November. Then there was about a week of back and forth, some e-mails, some phone calls, and probably a good number of conversations that I was never even aware of (which is probably for the best--I could never pick up my phone in the OR anyway, but any time my phone rang and my agent's phone number showed up on the screen, I would start freaking out--I eventually just gave her my pager number so that she could reach me like everyone else). But at the end of it all, Friday two weeks ago to be precise, I got a call as I was leaving work that "Scutmonkey" had found a home at Grand Central Publishing.
So anyway, that's pretty much the whole story. I realize that so much of this is serendipity--maybe this is going to make some people want to punch me in the mouth, but I had never really set out to do this from the outset. I mean, I've kept this online journal for seven years now, and never once have I done even the bare minimum of what normal people would do to drive up traffic, networking with other bloggers, trolling for publicity or whatnot. (I guess I am just not very good about self-promotion, though I understand this is going to have to change somewhat. I just get all flustered and embarrassed--see how I had to post that video of Cal and the farts to get the announcement about the book deal off the top of the page. TOO MUCH ATTENTION! FEELING SHY!)
But of course, I had always thought about writing a book. I think probably most people who enjoy writing have at least fantasized about such a thing. I thought, well, maybe someday, but in the meantime, I just wanted to keep writing here, partially for you guys but also for myself, just to document the journey with some sense of accountability, and help me remember what it was all like. The fact that I find myself in this position now is just something I never quite envisioned. Sure, there's a lot of work ahead, and a lot of writing to be done, but--that's all fun, you know? Writing is fun. Hard work is, like, studying for Step 1 of the boards, or taking overnight call in the ICU. That stuff is just back-breaking. Writing, I enjoy.
The book is not going to be just a bunch of blog entries cut and paste together on paper, by the way. That would be a cop-out, and anyway, the medium is totally different. The thing about writing a book is that it allows for a longer narrative, lots of stuff and stories that I never even put up here, just because it was just too long and detailed and I didn't really think that it would fit. This is going to be fun. I can't wait for you guys to read it.
As for whether or not I will keep updating this blog--of course I will. Writing the book has nothing to do with updating the blog. In case you haven't noticed, for the past month and a half or so, I've actually made a concerted effort to post an update every day. Not always the longest update, sometimes just a picture with a caption or some little observation, but I have been trying to at least post something. This has been an effort, after the proposal first went out, to try and create some sort of discipline about writing. I just want to have a good work ethic about this whole thing. I don't need to write a whole lot, but I just want to at least write something every day. The exercise has helped, believe me. The book is really coming along. And hey, if anything, I have more to update about on the blog now. This writing gig is a whole new world for me, obviously very different from my day job. And it's nice to have all of you with me, along for the ride.
Listening to fart sound effects on the computer last night. Boys. I think this is the first time in the seven years of The Underwear Drawer that I may have ever said this, but--this video clip may not be safe for work. Depending on where you work, I guess. People who work in an endoscopy suite will probably be fine.
Sorry, I didn't quite mean to be quite so coy in that other post. I wasn't trying to be, really, just the superstitious part of me wanted to wait a little longer before spilling the beans, and yet was so excited about the aforementioned beans that I just wanted to tell people something, ANYTHING, even if it was totally abstruse.
I also should have known that if I said that I had exciting news, people would automatically assume that I was pregnant. I would assume that, were I you. But I am not pregnant. (At least I hope not, not after doing spending the day in cath lab earlier this week, standing next to the fluoro beam for five hours.) Believe me, a new baby would be fantastic, few things would make me happier than having a few Cal Juniors running around all up in here, and I hope that I will have such news to tell you sometime in the next year or two. But I just...I just can't have another kid during residency. Not that I really had a bad go if it last time, but I'm already graduating four weeks late to make up for the medical leave I took when Cal was born. If I had another kid, and therefore took another maternity leave, I probably wouldn't finish up here until the year 2015 or thereabouts. And I need to finish. Soon. This residency business has dragged on far too long as it is.
Anyway, I feel bad for maybe coming off like I was trying to generate furor and attention, so I'll stop worrying and nip it in the bud by just telling you.
I'm writing a book. That is to say, I got a book deal. (That sounds weird, doesn't it? Like something someone else would say. Someone who is not me.) "Scutmonkey," a memoir about "the rarely glamorous, often caffeinated, occasionally humorous, never boring process of growing up and becoming a real doctor," has just recently been picked up by Grand Central Publishing (formerly Warner Books). More details to come soon.
Part of me wanted to wait a little longer because not unlike with a pregnancy, I thought, "isn't it too soon to tell people?" But then I figured, hell, it's not like I'm telling you that early, because this whole process really began last summer. And then another part of me wasn't sure if I should say anything because I'm not really sure about the etiquette when it relates to such matters. Is it OK to talk about it? Is it OK to talk about details? Not crass details, of course, but, you know, process details? Because on one hand, I personally find such details kind of fascinating, as might others interested in pursuing that sort of thing. But on the other hand, if I write about the process as I go, and the stuff I learn along the way, is that somehow inappropriate? Am I going to get e-mails squalling, "OH SHUT THE HELL UP, YOU SELF-AGGRANDIZING ASSHOLE, NO ONE WANTS TO HEAR ABOUT YOUR DAMN BOOK"? Because I would not like to get those e-mails, no way. And I don't want to be an asshole either.
But I think it's going to be a really interesting journey, and I'm also really, really excited about the book. This is going to be a lot of fun. And I think you guys (with, hopefully, many other theoretical guys) are really going to like it.
So anyway, that's the big news. Sorry it's not a baby. But this is exciting too! Plus, no post-dural puncture headache afterwards! Maybe I'll tell you part of the story tomorrow of how this all came to be (not to be coy AGAIN, but really, it needs to be broken up, because it's kind of a long story). And thank you for all the comments yesterday. My future zygotes thank you too, and can't wait until that day in the future that they will actually get to surprise you all with an appearance.
Sometimes I like to take pictures of funny signs, because I am juvenile like that. Today, in the atrium of the lobby, I saw the sign picture above, which was funny not for what it said (it was for a reception and some sort of executive steering committee), but for this:
The above which I picture as being included with a bundled software package under the heading "Maxxx Impact Clipart!" So be quiet. TO THE EXTREME!!!
On a related note of secrecy and shushery, I have some relatively big news that I'm going to share soon. I want to wait just a little longer before I tell everyone, but keep watching this space. It is fairly exciting. TO THE EXTREME!!!
Down in MRI yesterday afternoon. Usually I pat myself down pretty completely before I enter the MRI suite, but my big fear is that I'm going to run into the room one day during an emergency, forget about the magnet, and have all my pens and change shooting out of my pocket into the coil.
SCRUB TECH They're webcasting the case in your room.
MICHELLE Oh lord. Really?
SCRUB TECH Yeah. There's going to be a camera crew and everything. For some sort of surgical instructional video. It's going to be on the Internet. You know. A webcast.
MICHELLE Well, good thing I'm wearing my EXTRA FANCY scrubs.
I think there are basically three ways that you can call someone doctor.
The first way is the normal way. Like when patients or families call you doctor. They call you doctor because that's how you've introduced yourself and that's what you are. This way is fine.
The second way is the friend way. Like when you bump into a friend from med school in the elevator. "Dr. Au! How the hell are you?" That kind of thing. Really, they would call you by your first name, because you're friends, but they call you "doctor" sort of like a little joke. Even Joe calls me "Dr. Au" sometimes. This way is fine too.
The third way is the dripping with sarcasm way. Like when I was a Peds resident, there was a nurse up in the NICU, one of those "I've worked here for 30 years" nurses who would kind of rake the junior residents over the coals. She would always call me "doctor," but not in a pleasant way. More in a I can't be bothered to learn your name, and also I want to remind you that despite the fact that your ID technically says "M.D.", in practical terms I actually outrank you by several strata. She would always drawl sardonically, "Just put in the order, doctor." I don't know, it's hard to explain. You have to hear it. Why do you have to say it like that? It's not like I ever insist that anyone calls me "doctor" anyway.
Or this one attending I work with from time to time. He also employs the dripping-with-sarcasm "doctor" tone, often when pointing out something completely obvious, as if you didn't know any better. "Don't you think you'd better ventilate the patient, doctor?" Well, yes, I do think I should do that, which is why I'm SQUEEZING THE BAG.
Sad as this may be, Easy Mac is one step up from my first choice dinner option, which would consist of whatever detritus Cal left on his plate at the conclusion of dinnertime (read: a mouthful of peas, maybe a smear of yogurt). And it is easily two steps up from my usual in-hospital dinner substitute meal, consisting of a Diet Pepsi and a bag of Garden Salsa Sun Chips. (To my credit, it should be noted that the latter is not only MULTIGRAIN, but has pictures of VEGETABLES on the bag. Therefore: healthy!)
I was on overnight call for Peds Wednesday night. Peds anesthesia at our institution is home call, meaning that once the scheduled and add-on cases in the OR are finished (usually by around 10pm, though it can vary), you have the option of going home. The caveat, of course, is that you have your pager on, and if there are any emergencies, your ass is coming back in.
For some people, the benefit of sleeping in their own bed far outweighs the hassle of having to come back in, especially if they live close by. However, I am of the opinion that the only thing worse than actually being confined to the hospital on call overnight is going home, only to be called back into work. In Joe's words, "It's the worst because you've tasted freedom." Additionally, not only do I live a $25 cab ride from the hospital (I have to take a cab in when on call to be able to get to the hospital within the stipulated 30 minute time frame), but I worry that it might be disruptive for Cal and Joe, getting up and down in the middle of the night, fielding pages, leaving the house in a flurry at 3am.
Last night, though, I thought I may have been in the clear. There were emergency cases on the docket, rumored or actual. I had tucked in the Peds Pain service. (We cover the service overnight too--another risk of going home is getting called back in for a pain consult, expired PCA order, malfunctioning epidural, what have you.) Even the nurses running the OR front desk had bolted. So I figured I was reasonably safe. I took a cab home and was home by 11:30pm.
At 1:00am I get a call about a kid in the ER who had swallowed a penny. And then we were off to the races.
So anyway, I gambled and lost. It happens. Post call day off is always a fine compensation, especially under unusual circumstances--Joe was also off from work that day. He had a flight yesterday evening to New Orleans for the annual "Academy Meeting" (I'm not sure what the official name is--American Academy of blah blah blah Ophthalmology something or other) where he's presenting some research. But we figured we'd have the morning off together, maybe a chance to grab some brunch, take Cal to the playground. However, upon closer inspection of his actual plane ticket (this is called "reading"), he realized that his flight was at 1:00pm, not 5:00pm as he originally had thought, so he spent most of the morning packing, and left for the airport by 10:45am.
So it's just me and Cal until Sunday night. We had a good time at the playground yesterday (being connoisseurs, we tried out a new park today near the waterfront--very nice), and I guess we'll have to find some way to occupy ourselves this weekend until the father unit comes home.
The old hospital building, originally built in the mid-1920s. It's mostly offices and labs and classrooms now, which is probably a good thing. Aside from having such amenities as modern plumbing and electricity, the new hospital building also looks 63% less like a haunted power plant.
Ever since my first year, we have had medication labels on our anesthesia cart reading "VERCURONIUM." I figured this extra R was just a one-off printing error, but if that's the case, our institution must have bought the mother of all batches, because two years later, I'm still using the VERCURONIUM labels. Was it too much to expect that the makers of anesthesia medication syringe labels would have a proofreading department? Apparently so--there's another lot of labels (coincidentally for the same medication) that reads "VECURONIOM." Perhaps we ordered these stickers from one of those outlet malls, the ones where you can save on brand names, so long as you don't mind wearing slightly irregular socks, or jeans with crooked seams.
Piloting this year's new winter coat. I originally wanted to get Cal the same jacket in olive green, because while I like road cone orange, his stroller is the same violent shade, and I thought that the juxtaposition of the two would be enough to induce seizures. However, Joe insisted on the orange, because, in his words, "It'll make him more visible to oncoming traffic." Ah, the ultra-paranoid school of parenting. No arguments there.
They started sending me "Parenting" magazine in the mail at some point, probably because they thought I was a doctor with an actual office and a waiting room. While there are a couple of reasons to dislike a magazine like "Parenting," the one that irks me the most is the slogan that encompasses their one-note take on child-rearing: "What Matters to Moms." Moms. I'm sorry, but is this the 1950s? I mean, I know that for better or worse, women still shoulder the majority of the load of childcare duties across the board, but how can you have a magazine entitled "Parenting" and so easily and unabashedly discount the role that dads play? I mean, aside from having little sidebars about forcing dad to limit himself to either college or pro football on TV, not both, so that he might keep an eye on the offspring for an hour or two, thus giving us womenfolk a chance to run out for a pedicure or Midol or some such other female thing.
We are lucky in that at this point, Joe and I really do split the childcare responsibilities 50-50. It didn't always used to be this way, but after what I euphemistically call "a period of growth," we have pretty much settled into an evenly balanced parenting routine, one that even occasionally tips the scales more towards Joe's end, especially during weeks that I have a lot of call or when I am on a more difficult rotation. It's much easier now that one of us is no longer a resident, of course, but I guess I'll just point out the obvious: that I'm very attuned to issues of gender equity in parenting.
One thing that I've noticed in the hospital many, many times is the fact that lots of guys I work with (surgical colleagues, other residents) see the idea of taking care of their kids as anything but automatic. In fact, my pet peeve is the fact that many, many of them refer to the act of taking care of their own children as "babysitting." As in:
MICHELLE So, what are you doing this weekend?
SURGEON Oh, I have to babysit for a few hours on Saturday.
MICHELLE Who are you babysitting?
SURGEON My kids. My wife has to do something that morning.
MICHELLE Your own kids? That doesn't count as "babysitting." That's just called "parenting."
SURGEON Oh, yeah, I guess.
MICHELLE Don't you think it would be weird if your wife referred to taking care of your kids as "babysitting"?
SURGEON Yeah. Sad, isn't it?
MICHELLE Sort of.
Also, could we stop treating it like some freaking miracle when dads are actually involved? This attitude only champions and reinforces ideas that are ridiculously outdated. Like celebrity interviews wherein new moms are asked about the level of their partner's participation in the day-to-day of caring for baby. "He's been great! He changes diapers and everything!" Are we really still living in a world where the fact that a dad actually deigns to change diapers means that he deserves a commemorative plaque? Of course he should change diapers. Are society's expectations really so low?
The new(ish) slogan for our hospital. Not to quibble, because I think amazing sometimes things do happen within this institution, but it was inevitable that this would become everyone's new sarcastic catchphrase. Whenever there's a problem, broken equipment, some sort of boneheaded error, ridiculous delays, you can count on some smartass to turn to another smartass and drawl flatly, "Amazing things are happening here." It's the new "I can't believe it's not butter"!
Our one requirement for Cal's costume this year was that it be comfortable and not too hot, lest we replay The Great Monkey Debacle of 2006. So guess what his costume was?
Yes, Cal dressed up as a resident for Halloween. Depending on your point of view, this costume is either hilariously inside-joke-ish (detail: vertically folded piece of copier paper tucked into back pocket, covered with check boxes and scribbled numbers) or unspeakably lame. Opinions are mixed even within the household. I was cracking up just looking at Cal in costume, Joe thought the premise was a little dorky (I also think he was afraid that we would come off like pushy "my son the doctor" parents) but ultimately was glad that Cal was comfortable and not sweating his head off. Another plus was that this was also an incredibly easy costume to pull off--we had to order the kid's size scrubs, of course, but everything else (pager, stethescope, scrub cap) we obviously had. Cal even already has his own pair of Crocs. Easy.
Unfortunately, aside from the scrubs and shoes, Cal did not seem to want to keep on any of his accoutrement, so we were only able to maintain the scrub cap, pager etcetera long enough to snap a few pictures before they were cast aside. Pity.
