Saturday, October 23, 2010

germ theory

I freely admit that I have a somewhat overanxious approach to hand hygiene. Blame the eleven years of medical training, but I wash my hands at least twice an hour when I'm at work, and so as corollary get a little itchy if my kids don't at least wash their hands after playing outside, after toiletting or before meals. I know I can be a little extreme about it at times (sometimes I instigate a fresh round of handwashing if the kids are pawing at me and their hands feel a little tacky), but I can't help it, it's a reflex. I just get the willies about dirty hands, and I'm long past trying to rationalize it.

(I am also past rationalizing why I feel itchy whenever I see the CONTACT ISOLATION sticker on a patient's chart, even if I haven't even touched them yet. It is beyond reason, can't be explained, it just is.)

Cal is actually pretty clean for a five year-old boy. Blame nature or nurture, but he never really liked getting dirty and for the most part keeps himself reasonably free of dirt and contagium, if not sweat. (Cal sweats a lot, which is part of the reason we keep his hair so short.) But Mack is an entirely different creature. Despite all best efforts, he is just grimey. He likes dirt. He likes mud. He likes putting things in his mouth. In a wide open field, he will find the one patch of sodden, dirt-soaked gravel, pick up a handful of mucky rocks, try to pop them into his gaping craw, and then, afterwards, pick his nose lustily. But don't believe me, the pictures do not lie.

Let's zoom in, shall we?

It's not just this. Every single close-up picture of Mack shows some evidence of a thin scrim of dirt or sand or crumbs or crystalized boogers. He is messy. He is slimy. He is snips and snails and puppy dog tails.

I am trying to get over my deeply ingrained revulsion of uncleanliness (remember, of course, that my obsessive personal cleanliness is to your personal benefit, patient on whom I am placing an epidural or central line or who I am just generally touching) but sometimes...sometimes it gets hard. Like earlier this week, when I took the kids out for dinner to a restaurant with outdoor dining, and in the middle of the meal Mack slithered to the floor (which was the sidewalk of a street, a street that people walk on with the soles of their shoes), started heartily rubbing the concrete with his palms, and then, before I could even respond, crammed both hands into his mouth. Child, that is disgusting. I just want you to remain alive, you understand. Alive, and free of toxoplasmosis. And granted, Mack is always bouncing between one viral illness to another, a fact that I attribute to both the fact of his general grottiness and the fact that he has a school-aged sibling--but he is hale and hearty and probably is developing a stronger immune system than the rest of us put together. Mostly from the fact of him sticking his finger up the dog's butt and then licking that same finger seconds later. It's all immunology in action. And as long as I don't have to witness it, I'm fine with it in theory.


* * *

A little more about the new camera, since there seemed to be some interest (and I will assert as usual that I have no corporate ties to Panasonic or any affiliated enterprises).

I don't consider myself a photographer. I'm an enthusiast certainly, and I enjoy photography, though for the most part this is limited to me understanding the various qualities of light that make taking pictures of my kids advantageous. But I do enjoy photography and I have a very basic knowledge of photographic principles, and as such, I would like to present my layman's review of the Panasonic Lumix GF-1.

First off, if you are interested in this camera, read the technical specs and details here, and then read a better review here. For me, the review is as follows. I love my SLR (a Nikon D90), but I found that of late, I was using it less and less simply due to the bulk of carrying a giant SLR around. As seen recently, during our day trip to The Rock Ranch, it was a gorgeous fall day and I really wanted to bring our "big camera" to get some good pictures of the kids, but I was already toting a stroller and a diaper bag and a cooler full of snacks; the last thing I wanted to do was to bring yet another bag with a heavy SLR to tote around my neck all day. (I ended up just using my iPhone, which took some good, though not great, pictures of our day.)

Enter the Lumix GF1. I had read some reviews of this camera in weeks leading up to the purchase, and about the Micro FourThirds technology that was allowing for near digital SLR pictures with half the digital SLR size and bulk, but it wasn't until I saw the quality of the portraiture that I decided to pull the trigger on getting the GF1 myself. (Also, full-disclosure, Joe was out of town at his Academy meeting and I was all alone and kind of mad at him and prone towards an impulse buy--though an impulse that, now in retrospect, he fully supports.)

I've taken close to 500 pictures with this little camera in the past two weeks, and I am fully comfortable saying that it is an incredible device. First off, let me say this: it's the lens, not even necessarily the camera, that makes the purchase for me. I got them both together as a kit, but the fact that it's a prime lens (meaning a fixed focal length lens with no zoom capability), and the fact that it's so small, that makes it a real winner for me. I'd worked with a prime lens before, and though a few years ago I found it a little limiting (don't know quite why, but I distinctly remember at the time feeling like the lack of zoom capability was like being hobbled)--since that time I'd gotten quite used to taking pictures with my dinky little cell phone camera, after which point the need to frame pictures by physically moving closer or farther from my subject felt like much less of an impediment.

Anyway, the camera works great for my purposes. Unlike a point-and-shoot, there was minimal lag between pushing the button and the shutter firing (this was a distinct frustration for me back in my point-and-shoot days, that the shutter would deploy full seconds after pushing the button at which point the kid or dog would no longer be doing whatever endearing thing I was trying to take a picture of), the light sensor of the camera is great, and the lens is top notch. The camera itself feels substantial, like metal and glass, and while I would argue that it could have a more secure grip, getting a wrist-strap has more than taken care of my fear of dropping the whole works. Having a lens with a wide aperture has also allowed me to take a lot more low-light pictures than I would ordinarily be able to (I will use the flash if I have to but overall I vastly prefer relying on natural light), and though the narrow depth of field is problematic when trying to take pictures of a kid that never stops moving, EVER (read: Mack), it does produce rather gorgeous (if I may say) pictures of a subject who holds still, or does not mind posing.

It comes with a host of other lenses as well, but I did not look at any of them outside of the prime f/1.7 lens, because to my mind, toting around a big lens rids this camera of its key advantage, which is portability. Anyway, I'm no photographer, but as mentioned I haven't touched my SLR since. So if you're looking for a cheaper, smaller, lighter SLR alternative, look no further. I'm sure that there are drawbacks versus a full SLR, but for the casual photography enthusiast, they are neither evident nor limiting.

Anyway. Have a good weekend, everyone.


  1. I was riding the bus today, which I HATE because I can never find a place to wash my hands when I get off.... and there was this toddler sucking her thumb. And then she'd touch the seat, and then she'd suck her thumb. And then she'd touch the pole, and then she'd suck her thumb.

    It was seriously nasty. I had to repeatedly reassure myself that she wasn't *necessarily* directly innoculating herself with every germ on the planet. Just most of them.

  2. Wait, isn't everyone supposed to wash their hands after spending time outside? That's the first thing we do when we get home.

    Aiman, my son, is the same way as Mack is with grime and dirt. I can't blame him though because at his age (and up until Cal's) I used to dig little holes in the dirt, fill them with water and make "authentic" mud pies. Then I used eat them.

    I used to really, really enjoy the taste of dirt.

  3. The same scenario has been unraveling in our family (for a little while longer though, as my boys are older now). Older son began using a napkin at every meal when he was barely 18 months old. The idea of getting something sticky and messy on his fingers was more than his toddler sensibilities could handle. He could not be compelled to even consider finger painting. Incidentally, he also sweats, a LOT, since neonate-hood.

    Younger son never met a dirty floor he did not want to hug, never had a piece of clothing he didn't want to decorate with a stain, never found food that did not taste better eaten with fingers (yes, that included soups), never failed to become best friends with mud, sand, dust and dirty rocks.

    He has gotten better with age. He washes his hands after coming home from school, after playing outdoors, after performing excretory functions, before meals and after messy activities without prompting (for the most part ;).

    On the plus side, his immune system is a fortress with a massive fierce army.

    Your boys are loved, cherished and healthy. They are a joy to behold now (even for us strangers) and will grow up to be wonderful human beings. And that is the most important part!

    (I might have to sign up for an ID, so I can stop posting anonymously. We'll start with initials for now.)

  4. Wow!! This is one of the best post i have read so far.

  5. "IN THEORY." Oh, I feel your pain. I really want my daughter to be the grubby little dirt-dauber that she is, but I was raised by an OCD mother and that training is hard to shake. (Though it has served me well in clinical environments.) And while I can rationalize away my aversion to my daughter's encounters with all the crud our species has evolved to deal with, I cannot get over the fact that synthetic toxins are inevitably getting ingested/absorbed along with it. There is a logical reason to not want your offspring licking a city sidewalk, and it's not dog poop. (Or, I mean, dog poop is one of the least of your worries. Feel better?)

  6. Anonymous6:29 PM

    You know, the sad thing about washing hands carefully & properly is that people may look at you like you're weird. One of my co-workers said to me "You spend the longest time washing your you're a surgeon or something". I was thinking "You're just dirty and don't know how to wash your hands properly." :)

  7. Good thing you don't work for NPR. Your honest sentiment about contact isolation could get you in hot water!

  8. GlassHospital: I know! I'm just about ready to fire myself, actually.

  9. Anonymous11:36 PM

    I have the sudden need to wash my counter tops with bleach

  10. I'm studying for my ph.d. in immunology, and have a 2 year old son with the exact same habits as Mack... and it also GROSSES ME OUT. Anything and everything goes straight into his mouth. He also likes to use his mouth as a third hand when climbing.

    You'd think that I, having a more in depth knowledge of the whole hygiene hypothesis, would be more lax about this sort of thing than my husband, but no.

    Thankfully, once he reached 20 months, the hands stopped going into his mouth as often, and I spend less of my time cringing.

  11. Thanks for you review of your new camera. If you have a moment, I have a quick question: do you think this would be a good camera for taking pictures in the OR? I'mm a plastic surgery resident and therefore obligated to take pictures of EVERYTHING I see and touch and do. Dragging an SLR in my bag o' tricks everywhere with me is practically a varsity sport, so I have been making do with my iPhone 4 camera, which I conveniently happen to have with me ANYWAY. But one day when I grow up, I think I will want something , you know, real. Your new camera sounds like a good option. What do you think?

    I have been a reader of your blog for a while now, since med school, and have always enjoyed it. Lately, I particularly love reading how you have segued from residency to attendingdom. I look forward to reading your book when it comes out!

  12. Hard to convince kids that they really need to actually wash their hands (thoroughly, with soap and water and friction) when they can hardly tear themselves away from whatever they are doing to pee! But I insist.
    I can handle my own germy loveable kids, but admit to feeling like I have failed if I come down with what they had, because that means I haven't cleaned, de-germed and washed well enough myself!

  13. You might be eligible to get a free Apple iPhone 7.