i know how much you love it when i talk about politics




I'm no political pundit, nor will I be the first (or last) to say this, but as someone who would have voted for Hillary Clinton--though I will now gladly vote for Barack Obama--McCain's choice of VP strikes me as calculating and, frankly, insulting to the woman voters to whom he is attempting to appeal. It's as though in their play for the disenfranchised Hillary voters, they are presenting the idea that all female candidates for high political office are basically fungible, and that women will vote for women regardless of the platform upon which they are running. "Hey look, another chick! You like to vote for chicks, why not vote for ours?"

I do think, however, that Palin is a great move to appeal to the conservative base that's still leery of McCain's loose cannon history, though, because man, is she a conservative's wet dream. A gun-toting, anti-choice, former beauty queen, multiparous hockey mom, who also has a dash of "naughty librarian" about her. Take off those glasses, shake your hair down, and man! In the words of Rush Limbaugh, "Yeah, plus she's a housewife, before that, she's a babe. I saw a picture." Making a great case for your own candidate there, Rush. I know she's supposed to be a good governor (of Alaska), and very popular to boot (in ALASKA), but forgive me if I can't help but to think that the reasoning behind her selection was a little more calculating than that.

Anyway. I will leave punditry to the experts. I just had to get that off my chest. Moving on.

Edited to add: Posted in the comments, but wanted to add it as an addendum here too...The "beauty queen, multiparous" etc. qualifiers I included were not meant to be pejorative (though "gun-toting, anti-choice" were kinda, but just because I disagree with her on those issues)--I certainly don't think that physical attractiveness or having kids takes away from your intelligence or professional qualifications, whatever they may be. Rather, I was trying to point out why certain people find Palin to be much less "threatening" than some other powerful women in politics and in other realms, who tend to get more of the "cold bitch" label.

beginnings and middles

Well, not like I thought that the first week of school would be PERFECT or anything but...yes, part of me wanted the first week of school to be perfect. I fantasized beyond reason that Cal would instantly fall into place with the new environment, that he would jump in with gusto and he would love the teachers and the teachers would love him and we would all be sitting 'round the fire with Cal leading a rousing chorus of Kumbaya, a song that he had never sung before but learned flawlessly after hearing it once at SCHOOL. The reality of this first week was...well, it was a little different.

Two things happened the way I wanted it to--probably the most important things. Cal loves his new school, and his teachers (at least purportedly--not like they would tell us if it were the opposite) think he is wonderful. But this transition, which we are still working through, has not been the smoothest. First of all, let me underline the obvious--in the past two months, basically every single constant of Cal's life, save his parents and his dog, have changed. Everything is different, and he probably feels like he has had very little control over any of it, because, well, he hasn't. New city, new house, new nanny (well, two new nannies, actually--we are on number two now, and she is wonderful and seems to be settling in well), and now, a new school with new teachers, new kids, and new rules. So it is perhaps not totally shocking that he is reacting to this in some way.

Cal was basically toilet trained. His main problem is that he was shy about going to the bathroom with anyone other than me or Joe (he still won't go with our nanny, or his grandparents for example), but he was pretty reliable in general about holding it, letting us know when he needed to go, and actually going in the toilet, both in and out of the house. We even managed to get him to pee standing up, a coup accomplished not by Joe, who actually understands the mechanics of this maneuver, but by me, which was very surprising to all involved. (I just told him to aim for the water. This ready-aim-fire is probably fun for him in some gross boy way.) But since he started school, he has regressed in this arena. I expected some accidents at school, of course, owing to the shyness of telling the teacher that he has to go, but he basically started acting like he had never in his life been out of diapers. By day three, they started putting him in Pull-Ups as more of a hygienic issue than anything else. Though in my heart of hearts I knew this might happen and in fact sent him to school with about three changes of clothes, I hadn't sent him to school with any Pull-Ups (well, really the Pampers brand "Easy-Ups," but whatever, I call adhesive bandages "Band-Aids") because I didn't want to encourage him to fall back on old habits. But dude, he was peeing everywhere. And upon further consideration, I think that reverting to Pull-Ups in the short term at school may just be a way to remove one more stressor from the transition. You know, he has a lot to adjust to, why not let him worry about one less thing and concentrate more on the other social aspects of being at school. We know he is capable of being toilet-trained, he hasn't had an accident all weekend since he's been at home. But I think it will fall into place once he settles in, so let's just remove the puddles from the equation for right now and maybe we can all start doing a little less laundry.

The other thing (and this probably goes with the rest of it) is that he is manifesting an ability to be amazingly stubborn. For the first few days, he was just absolutely refusing to do what his teachers were asking him to do. Even things that he likes to do, like putting on his backpack (he loves his new backpack), he was refusing to do, basically because he was asked. He would not help clean up, he would not lie on his rest mat, he would not sit in his cubby for roll call at the end of the day, he would not talk to the teachers when they spoke to him. I think this is partially a control thing--he was fine nattering on to the teachers and everyone else the rest of the time, and he clearly enjoys the activities that they do in the class, he just would not for the life of him follow direct orders. This, of course, was completely distressing and foreign to me--as a real weenie kid myself, I lived my whole childhood obedient and quiet and eager to please, distraught at even the idea of disobeying. The thought of my kid being a "problem kid" (even though there are plenty of reasons for him to be acting out, and not like it's anything the teachers haven't seen before) just floored me. But he started getting a little better by the end of the week, and I think that these issues, along with the toilet training regression, will smooth out over time once he starts to feel more comfortable and settle into his new routine.

But--BUT--the important thing is that he loves school. I was lucky enough to be able to pick him up from school every afternoon this week, and he is always in a great mood, telling me, "I love my new big school," and asking me if he can go back tomorrow. The teachers are wonderful and empathetic (I wrote them a little note, explaining about all the upheaval in Cal's life recently), and they've been really patient and warm about the whole thing, giving us updates sometimes even midday (via e-mail) and assuring us that they are not worried, and that Cal is doing great. We are "playing school" in the evening, practicing some of the routines so that Cal can get used to them, and we have instigated an incentive program at home, with M&Ms rewarded on a sliding scale for various potty-related tasks. (3 M&Ms for peeing with me or Joe, 5 M&Ms for peeing with our nanny, 10 M&Ms for peeing in the potty at school or, wonder of wonders, actually pooping in the potty. We are still working on it.) So it's been a long week, but a good one, I think.

The other thing that happened this week is that I hit the official midway point of this pregnancy, reaching 20 weeks today.




I haven't been taking any belly photos up until now, because frankly I was doing other things, and also, the size of my abdomen seemed to be highly dependent on the time of day, so a picture seemed like it would only convey a partial truth. The ballooning of my mid-section happened a little earlier this time around than last time, most probably because I am pre-stretched for comfort, but at the end of the day, I am significantly larger than in the morning, probably related to eating and smooth muscle relaxation and decreased GI motility and all the rest of it. So this is a picture from this morning, which probably most accurately represents the actual size of my uterus, minus the additive effects of lunch and dinner and about ten liters of gas. And yes, those are still moving boxes in the bathroom, what of it? WHAT, YOU WANT TO SAY SOMETHING ABOUT THE FACT THAT WE'RE NOT UNPACKED YET? Honestly, I've barely unpacked any of my clothes at all, mostly because many of the boxes contain winter clothes, which, even come winter, I will probably not be able to fit into, because I will be all gravid and stuff. The problem with having a due date in January this time around instead of July, like with Cal, is that all my maternity clothes are for the wrong damn season. Oh well, more reason to go shopping, I guess. This is the only time in my life, by the way, when I think that the current trend of billowing trapeze tops and empire waisted dresses is an attractive idea. Usually, I'm like, "THIS SHIRT MAKES ME LOOK PREGNANT," but now I'm like, "Woo, cheap-ass maternity top from Forever 21!"

because apparently, it is the law that i have to do this now






(They don't have kid features on the site, so Cal's avatar doesn't really look like all that much like him. And Joe's avatar look like he's contemplating taking a bite out of you.)

first day of school today




Unbelievable.

Sorry for the lack of updates lately, work has been busy and life has been full. But having a good time. More later when I get a chance.

Remember when I used to have that "Currently Reading" section at the bottom of each post, where I'd talk about books that I was, you know, currently reading?  Mostly on the subway?  Remember when I stopped including what I was "Currently Reading?"  Well, I will tell you why.  The reason is because maybe about two years ago, I got an iPod.  And then I wasn't so much reading on the train anymore, I was listening to my iPod.  Or, in some cases, watching TV on my iPod, like back when "Lost" was a good show and I still had yet to memorize every single episode of "The Office."  Since those days, I am not so much with the TV anymore, and I don't really listen to music unless I'm in the OR setting up before a case (it helps me work faster), but I think I have officially listened to every single broadcast of "This American Life" in the iTunes library.  Seriously Ira, time to stop with that TV show, you need to not be playing those rerun shows on the radio and tape some new episodes, because what am I going to listen to on my way to work?

laying the groudwork

Though the real test won't be until Ling Ling is actually, you know, born, I think that Cal is taking news of the new baby surprisingly well.

I started off easy.


MICHELLE
Cal, do you like babies?

CAL
(After appearing to give the matter some thought)
Yes, yes I do.

MICHELLE
That's good. Babies are nice.


Several weeks later...

or as cal calls it, "a pack-pack"

Cal starts school next week.  He has a classroom "party" (read: one hour mutli-kid playdate in his new classroom) Friday, and then we're off to the races next Tuesday. We thought we were all set on the backpack front (he was going to use this little backpack left over from my high school days--I used this as more of a purse, because no self-respecting teenaged girl in mid-90's Manhattan would wear an actual PURSE, what are we, SUBURBAN or something?  Times are different now, of course, teenagers being all high-fashion and whatnot, but anyway, I do not have any knockoff Hermes Birkin bags to pass off to my offspring) but then we got a notice from the school that the backpacks had to be 15 inches large at least, so as to easily accommodate all the crap that Cal will be lugging back and forth.  Lunch and napping blanket and art projects and whatnot, you know.  Needless to say, he will rarely be carrying this bag himself, as he is wee, and, as we have established before, a delicate flower.  But anyway, we decided to get him a new backpack, maybe even one that wasn't fifteen years old.  So we got him this:





We ordered it off of eBags, and Cal picked it out himself, after scrolling endlessly through various iterations of the same (green backpack with bugs, yellow backpack with dinosaurs, blue backpack with fish, etcetera). He is very excited for his new backpack, and very proud. I told him that I was going to order it for him, as sort of a first day of school present, and he wandered away, singing happily to himself. About ten seconds after I completed the order, Cal came back downstairs, looked at me questioningly, and asked, "Did my packpack get here yet?" You have much to learn in the ways of online shopping, son.

(As, apparently, do I. Dammit! I just went to the site, and noticed that now everything is 20% off, the day AFTER I placed my order. Who has a sale on a Sunday? Those bastards.)

As those who follow my Twitter stream are already aware, today was my first day doing my own case in the OR, a fem-pop bypass.  It went well.  Honestly, when I started the case, I was a little rusty, as I expected I would be.  That coupled with patient-related difficulties and the unfamiliar environment with somewhat different setup and equipment than I'm used to using, it felt a little like Amateur Night at the Ha-Ha Factory--but I settled into things and the emergence was, if I may say, quite nice considering the co-morbidities involved, both supratentorial and otherwise.  So that went well.  Still, I've been getting up really early, even earlier than usual because of my usual neurosis about getting lost, not being able to find equipment, negotiating various procedural snafus related to new hospital systems and whatnot--and I have to say, I'm pretty tired.  This weekend, I'm going to sleep and sleep, at least until the sun comes up.  How's that for decadent?

So.  The news.  Believe me, I wanted to break it sooner.  Our families have known for more than a month already, and a lot of our friends already know as well.  But as for the Big Announcement, well, I thought that it was best, in the name of professionalism, to tell my new co-workers before I publicized the news on the Internet.  You know, to be polite.  And it's an in-person conversation kind of thing, I didn't start work until yesterday, so...there you go.

now you can know that i had other reasons for being anxious

I have had to start nerve-wracking conversations in the past. Instigating The Break-Up Talk. Telling patients about iatrogenic complications. Trying to subtly indicate to someone who just gave a huge lecture in from of lots of people that their fly was open THE WHOLE TIME.

But I have to say, you haven't had a real anxiety-provoking conversation until you have to tell one of the partners of your new private practice group, on your very first day of work, that you are 17 weeks pregnant.




More later. OF COURSE.

They gave me a name sticker and said I could choose any locker I wanted. Not being superstitious or triskedekaphobic, I chose the convenietly located one that everyone else was clearly avoiding.

Wow. I never had my own desk at work before. I feel like Dwight Schrute.

I'm not sure what happened, but sometime between Monday and now, I got a lot less nervous about starting my new job.  I attribute it to the visit I took up there this Thursday.  Somehow actually walking around the ORs and talking to people made me realize that it's just another hospital, after all, and that I'll be one of many, many people working there.  Just like always.  So that made me feel better.  Also what made me feel better: free corn Pops in the attending dining room.  Now if only they had Apple Jacks, I would be nearly comatose with calm.  When I was a third year med student, one of my attendings told me that on the first day of a new rotation, our main goal should be to find the bathroom.  I think that is a fine and admirable goal.

All worries that I had that the MARTA in the early morning hours would be some desolate, shadow-y Rape Cave were dispelled these past two mornings when I practiced my morning commute and found the stations and trains almost more packed than the A train at 5:45am. Dude, a lot of people take MARTA to work. When I got to my stop, where, it probably doesn't need to be said, the work day starts early, I think I estimated about 50 people getting off the train with me. It is safe, and, if the past two mornings are any indication, it's actually pretty reliable. Plus (and this is better than New York, which, while sporting a very extensive mass transit system, also has a very old subway) they actually have these monitors overhead that tell you when the next train is due to be arriving. "Next Northbound train arriving in 3 minutes...," that kind of thing. And, no bullshit, three minutes later, there's the train. Brilliant! I am pleased.

Since by virtue of this commuting trial run (a testament to my anal retentiveness that I felt the need to do this trial run not once, but twice) I was already at the hospital yesterday morning, I took the opportunity to get my ID and reacquaint myself with the general layout of the floor and the ORs. It is very confusing, but I'm sure I will sort it out soon enough. I even found my way to the female attending locker room, which people kept apologizing to me about as being "small" or not as nice as the male attending locker room. It was small, and more than half the lockers were unmanned (whatever, unwomanned--quite the visual reminder that whatever the numbers in med school now, in this hospital, in the OR area, there are way, way, way more male attendings than female attendings) but it was clean and neat and honestly much nicer than what I'm used to. Having never worked at a private hospital before, I actually had to restrain myself on my re-exploration tour from repeatedly saying, "Wow, that's so nice! Wow, an attending dining room with free food? THAT'S SO FANCY." But yes, there is an attending dining room with free food. For, like, meals. I have never seen such a thing. This, I have to say, is really going to top my old meal option of vending machine Pop Tarts.

I also got my hospital ID. I was going to wait until Monday to do all this administrative stuff, but I realized that I might have a problem actually getting in to the ORs on Monday without my ID, since every other door is one of those "Staff Only" swipecard entrances. As it was, I was waiting outside the double doors of the OR area for 5 minutes, waiting for someone to exit so I could run in the open doors to get to the administrative offices. The interesting thing I noticed about the hospital ID cards in Atlanta (and maybe I'm just generalizing, but it's the same on Joe's hospital ID, at a different hospital) is that they print your first name REALLY BIG, and then your last name and title really small. Doesn't it seem, in general, even for purposes of differentiating between individuals to others, than people know your last name?  I mean, even for the fact that there are probably a lot more people named "Michelle" at the hospital than people with the name "Au"?  I asked someone about that, and they said that it was probably an effort to create more of a "friendly" atmosphere between doctor and patient, but honestly, my patients don't generally call me by my first name (though some do, which is OK) and I generally introduce myself with my last. Anyway.