liquid schwartz

Well howdy. Explaining why this blog hasn't been updated is only slightly more boring than reading the blog itself, but in short I had to give Grand Rounds last week, and since I couldn't work on Grand Rounds at work or while my kids were awake, basically every free minute I had up until last Wednesday was channelled into that presentation. Thankfully, it's finished! Now to resume my life of indolent goofery!

You may also be disappointed to know that I ultimately decided against using the "Exorcist" slide in the talk (Factor 1: too early in the morning, Factor 2: Catholic hospital) but it may please you equally or maybe even more that I did use this slide as an opener:

(He's his own best friend.)

*          *          *

As a brief and unsatisfying epilogue to the fractured (ho) story of Cal's clavicle, these following addenda:

Right before Thanksgiving, I reached out to the principal again, asking him if he could give me an update on his conversation with the school nurse after the incident. Given my background (and recall that I trained for two years as a pediatrics resident prior to anesthesia) I also offered to sit down with the nurse and work with her on a standardized medical policy for parent notification--if, of course, they wanted my help.

He responded...well, let me just copy and paste the body of his response email in its entirety.

"Thank you for contacting me regarding your concerns. Yes, I have communicated with the school nurse and the district supervisory nurse regarding the incident. Additionally, we have discussed and developed a plan for proper notification to parents."

(Signed, Pally Von Principal.)

Note, no actual elaboration of what this "plan" is, nor any perspective from this nurse herself. So...basically a deflecting non-answer, right?

Also (and I probably should have noted this in the previous entry so as to not seem quite as much like we are raising a doormat) the day of the injury, after he got home but before we went to the ER, Cal and I had a little talk about self-advocacy and appropriate responses. And I basically told him that grown-ups aren't always right. He had just finished reading "Matilda" a few months ago, so I referred to that a few times, how Matilda was oftentimes smarter than her parents and how Matilda's headmistress (The Trunchbull! The chokey! Oh man, I really love that book) was usually wrong. And that while he should obviously always be respectful of adults, if he felt strongly that something was amiss and that the adults taking care of him weren't taking it seriously, he should request to call his parents regardless. Then I quizzed him on our cell phone numbers. Then I crammed more Tylenol in his craw and tried to figure out his NPO status.

Anyway, all's well that ends...if not well, then at least eventually.

*          *          *

Well, now we're all caught up, but now I realize that I didn't actually tee up anything fresh to talk about today. But instead of pushing save and kicking this half an entry down the road like a tin can, I'm just going to slap it up with a promise that I will put up a real entry soon too. I do, in particular, want to write a little something about Nina, in particularly about her Girlness and Christmas shopping for her, and this strange feminist guilt I have about getting her real girly things. And then the strange feminist guilt I have about considering dolls and their accoutrement "girl things" because boys can play with dolls too, patriarchy! Though I wish that I could find that same stroller that Cal had when he was Nina's age, because damned if they don't just make everything in pink now.

(Above: Cal and some rando kid, circa 2006. This was back when we lived in Manhattan of course, so while such playground spaces and pocket parks came at a premium I would just like to point out how much more I prefer this kind of rubberized flooring to the default "mulch and wood chips" surfacing that seems to be the standard playground-issue here in Atlanta. It pushes up your minimum age to enjoy the playground by at least 6 months, between waiting for your kids to walk well enough and making sure that they're not going to eat all the wood chips when they do fall. Though high-fiber gluten-free diets do seem to be quite popular these days, don't they?)

sunny side up

It's hard to know what triggers certain memories in your brain, and I can't figure out what made me think of this today, except...maybe it was the weather. Today was gorgeous: sunny, clear, and mild. And on days like this, as strange as it sounds, I often think about the opening sentence of the 9/11 commission report; how it was so much better written than a government report had any right to be, how evocative that first sentence was, and how perfectly it set the scene for what we all now know was going to happen. "Tuesday, September 11, 2001 dawned temperate and nearly cloudless in the eastern United States."

But what I was thinking about today was not September 11th, but September 12th, 2001. I was a third-year medical student on my pediatric urology rotation, and while I don't quite remember the details of what we had originally scheduled to do that morning--maybe it was clinic, maybe we were supposed to round on the patients that were all hurriedly discharged the day before--but obviously whatever plans we had were truncated or canceled. We had no patients from "Ground Zero" yet (this, of course, was well before the days that it would be referred to as "Ground Zero," most people I knew who were working on site seemed to refer to it as "The Pit"); most who survived to get to a hospital were mostly concentrated downtown. So we had almost nothing to do that day, and somehow, that was one of the worst feelings of all. So what happened that morning of September 12th was this: the two senior residents on the pediatric urology service took me and my co-medical student out for breakfast, at a shoebox-sized greasy spoon diner near the hospital.

It was really a very odd morning. I know that it must have obviously been strange the nation over, but if you lived in New York in the immediate aftermath of September 11th you will understand what I mean when I mention this particular strange disconnect of knowing that the entire world had just imploded right in front of you, feeling with equal certainty that we were all probably going to die, and yet looking out the window and seeing that everything, at least up in Washington Heights, looked exactly the same. Like: out there, on the street, where it always stood, was the bagel cart. With bagels on it. And you'd look at the bagels, and then think about what you had just seen, which was the two largest buildings in the city crumbling to dust literally as we watched, and something would just break inside your brain, because how do those two things exist in the same world? Because on one hand, September 11th happened, and then on the other hand, here we were on September 12th, alive, at a diner...eating eggs. Everything looked and felt and smelled and tasted the same as it did two days ago, but also, at every table and booth, people were reading a copy of The New York Times with the most gigantic headline that I can remember seeing in my lifetime.

It was really...very disorienting.

Now that I'm much older, I so appreciate the simple mercies of those senior residents, and the implicitly understood comfort that they knew they could convey in that small act of taking us out for breakfast. I also know, having been a resident, that even these small gestures were not so small--I know now how little money residents make and I know now how young residents really are, even though, as a third-year medical student, I felt at that time that there was something adult and comforting about them and if they said that we were going to be OK and so we should order and extra plate of hash browns for the table, well then, I guess we would be OK. I know now that they must have been as scared as I was. I know now that they were trying to help me feel better, and in doing so, help themselves feel better, because...well, that's how it works.

And that's pretty much what I came away with today, in sudden flash of memory as commonplace and pocket-sized as the events around it were explosive and consuming. That sometimes bad things happen, and you can't really fix them; but in small ways, you try to fix them anyway.

kafka-esque

I was in the kitchen cleaning up after dinner this weekend when Mack walked into the room, looked up at the ceiling, and froze.

MACK

Mom! Mom!

MICHELLE

What? What?

MACK

(Pointing)

Look!

I looked up at he ceiling, where he was pointing, and there, just hanging out upside down, was this giant cockroach. The kind that we used to call "water bugs" in New York, and that some people call "German cockroaches" or Southern regionally, "palmetto bugs." I would post an illustrative picture here, but when I did a Google image search for "giant cockroach," I basically DIED OF GROSSNESS, which is an actual fatal medical condition. Truth.

I have a phobia of roaches. I mean, I know everyone hates roaches, but I really, really hate them, mostly because I grew up in an apartment in Manhattan and roaches were just everywhere. See, in New York, it didn't matter how nice your apartment was, or on what floor you lived, or how scrupulously clean you kept your living space. If you lived in New York, you had roaches. Period. Sure, we had all sorts of traps and devices to foil them--your standard roach motel, sprays, little strange blobs of poisoned bait we would smear in various strategic locations.  My friends in school swore by this kind of crazy roach killing "chalk" that you could only buy in Chinatown (somehow the notoriety of this chalk hinged on its seemingly underground and illicit nature, like, "You need roach chalk? I know a guy...") with which you were supposed to draw with on the inside of your cupboards. The mechanism supposedly being that when the roaches crawled over the chalk lines they would die, or melt, or combust, or something. But we never got this poison roach chalk, mostly because I was worried that we'd kill first the roaches and then ourselves with what must surely be some highly toxic shit. Like a suicide pact. WITH ROACHES.

But anyway, despite the traps and bait and sprays and no chalk, we still always, always had roaches. I'd go to the kitchen at night for a glass of water, steel myself, and turn on the kitchen light. And there they were, most skittering away, but some brazenly continuing to sit on the kitchen counter looking at me, because they knew (surely they knew) that I was too horrified of their crunchy exoskeletons to kill them. Little baby roaches. Full-sized regular roaches. The occasional waterbug (I realize this is technically incorrect nomenclature, I don't think they were aquatic because if so welcome to tonight's nightmare) which were all the more horrifying for the little details writ large for anyone to see, even at a distance. I mean, they're all gross, every last part of them, but for me, somehow those big hairy legs were the worst part of all.

Anyway, I have to stop describing now, because I'm getting all sweaty. Ugh. Roaches.

In the South, it seems that the larger varieties of cockroaches predominate, and there's always a point in the year, I think because of the heat? Or because of some kind of breeding season thing? That they decide to come indoors. I don't know how, probably through the vents or something, but there's always a few weeks, usually in the summer, that we have a few roaches in the house every day. We find one on the wall of the bathroom. One in the closet. One year I found one on Mack's bed (he wasn't in it THANK GOD--at least I don't think he was, unless it was a Gregor Samsa-type situation) just feet up, dead. It's been a strange summer this year--really rainy and relatively cool--and so even though it's September now, I guess the roaches have decided that now is their time to strike.

So:

MACK

(Pointing at the roach on the ceiling)

Argh!

MICHELLE

Argh!

MACK AND MICHELLE

Argh!

MICHELLE

Mack! Get Dad!

MACK!

Yeah! Dad! Dad will kill it! Dad will punch it! DAD!

MICHELLE

DAD! HELP! DAD!

CAL

(Walking in from the living room)

What's going on? (Looks up) Argh! DAD!

JOE

(Running in from upstairs)

What? What happened? (Looks up)

Oh. I thought there was a fire or something.

MICHELLE

I wish there was a fire so we could use it to KILL THAT ROACH.

JOE

I'll kill it. Here, give me something.

MICHELLE

If you try to kill it while it's up on the ceiling it will jump down and land on you! 

Or worse, what if it's one of those flying roaches? THEY FLY.

JOE

(Holding up a vegetable cutting board)

Here, can I use this to kill it?

MICHELLE

Why...what...you...that's a cutting board. We put our food on there.

JOE

I'll wash it off!

MICHELLE

But why of all the things in this whole house could could possibly use to kill a giant insect 

would you use a cutting board? Find something else! Something disposable!

JOE

I said I'd wash it off!

MACK

(Pointing)

Argh! It fell!

MICHELLE

It fell? Where did it go?

MACK

I don't know.

(NINA, not really sure what we're all screaming about but excited to partake, 

proceeds to walk under the ceiling where the roach had been, laughing with her mouth open.)

MICHELLE

Gah!

(Scoops up the baby)

Look, it's like in that Iron Chef America, where Bobby Flay jumped up on his work station to "raise the roof" like a douchebag, and Morimoto was pissed because Bobby Flay didn't respect his cutting board by getting his shoes all over it, and it was a chef's ultimate dishonor. So my point is: you're worse than Bobby Flay.

JOE

OK, I'll use this thing.

(Holds up one of the baby's board books)

MICHELLE

SOMETHING DISPOSABLE.

JOE

Where is the roach even?

MICHELLE

Argh! It's right there! On the smoke hood, like, two inches from your head! 

It's looking right at you!

JOE

(Shrieks girlishly, smacks the roach with a mini legal pad of scrap paper)

MICHELLE

Did...did you get it?

JOE

Yep. (Holds up a ten-inch cockroach* by one of its filamentous antennae.)

I would have washed it, you know.

MICHELLE

Well, next time why don't you kill it with your toothbrush, and wash that off.

Anyway, there is no point to this story, except to say that roaches are disgusting, and if anyone has any of that special Chinatown killing chalk I will take some of that right now. THE END.

* Only very slight exaggeration

just the two of us

I'm in a Starbucks with a pumpkin spice latte and my laptop now like some goddamn stereotype. Man, even I hate myself right now.

Starbucks always makes me think of working hard. I studied for all my board exams in Starbucks-es, from Step I at that Starbucks on 103nd and Broadway all the way up through my Anesthesia Oral Boards at the location on Monroe and 8th. The difference between Starbucks-es in New York and Atlanta, by the way? The Starbucks-es in New York serve you much, much faster.

I also wrote my entire book at the Starbucks on 29th and Park, which if you need to do work is (or at least was five years ago) an ideal Starbucks--huge, a preponderance of large tables, with a strip of power outlets around the entire outer wall. Oh, another difference between Starbucks-es in New York versus Atlanta? People bring work to Starbucks-es in Atlanta of course, but usually it's more like a rest stop, or a place to have some coffee and kill time between appointments or tasks. In New York, people set up shop. I read once in an article that Starbucks aimed to make their coffee shop locations into "virtual living rooms," places where people can kind of hang out in an armchair and meet with friends--hopefully buying large quantities of overpriced food in the process--and I think that there's likely no place where this is more true than in New York, where a lot of people frankly don't have actual full-sized living rooms in their apartments.

I mean, I brought my laptop there, and maybe my bookbag, a manuscript envelope, assorted miscellany. But there were people who brought full desktop computers (24-inch monitor AND the tower), the entire contents of their law library, extra desk lamps for those darker corners of the store. During my final year of residency when I was trying to finish my book by the July 1st deadline, I would take one day per weekend that I wasn't on call, leave Cal with Joe, set up base camp in one corner of that Starbucks and just sit there for eight, ten hours at a time. I would buy one coffee and get something cheap(er) but filling, like an egg salad sandwich. And then I would sit there and bust ass, looking up only occasionally if something interesting was happening, like the police coming in to extract homeless people that refused to get out of the bathroom--something that happened with alarming frequency. When I left, usually in the early afternoon, my hair and clothes would reek of smoke from the coffee roaster, as though I'd just smoked a billion cigarettes.

This has been Starbucks Talk. I'm your host, Michelle Au.

Anyway, the point of this post was not to talk about Starbucks (and it goes without saying that I have no affiliation with Starbucks, not only because I don't run paid ads on this blog but because this is such a small blog that STARBUCKS DON'T GIVE A SHIT WHAT I SAY), but to catch you up on Mack.

When I decided to go part-time, one of the first things that pushed me to consider scaling back at work was the fact that Cal was already halfway out the door to college, but the things that made me actually decide to make the leap was Mack. Because see, the thing with Mack is that...he's fine. He's always just fine. Cal's the oldest, so he often gets a lot of attention because of his school and activities (Cal recently joined the Lego Robotics team at school, and to say that Mack is inelegantly jealous would be kind); and of course Nina gets a lot of attention because she's a baby and needs us to do every damn thing for her. But Mack? Mack is always OK. He can do a lot of stuff for himself. He can play nicely by himself or with his siblings. A lot of the things he needs (a glass of milk, help reaching something high) Cal can often troubleshoot, and does, especially if I'm tied up doing something like cooking dinner or putting the baby down. He's happy, he's pleasant, he's not really that high-maintenance for a four year-old. And that's how I think he ends up getting ignored a lot. Classic middle-child syndrome.

And the thing with Mack is that he's just so reassuring with how normal he is. Cal was by all accounts kind of a weird child (he's much better now, warm and social and adaptable in ways we could only dream of when he was Mack's age, when he was...less so those things) but Mack has always been like the textbook illustration of Boy in Early Childhood. He like sports and wrestling with dad. He plays pretend and makes up little playlets with his stuffed animals and action figures. He's sunny and affectionate and snuggly and fun. Even his drawings are textbook--every human looks like a happy scarecrow with vertigo, all stick limbs with five fingers on each hand, clubby feet, smiley face. Every house has a chimney, every flower has six petals, and there's always a sun with beams shooting out in the corner.

(The reason that I make such a big deal about the drawings is that Cal's drawings at this age were--well, they were pretty weird. He was always good at drawing inanimate objects or landscapes, but when it came to drawing people, his drawings were just odd. Even when he was five and beyond, he'd sometimes draw people missing limbs, sometimes missing heads, and when he did draw a head it would be tiny, like a pinhead, with no face on it. NO FACE. What the hell, young Cal? Anyway, long story short I started introducing Cal to comics and gave him a little key of facial expressions so that he could draw his own comics and so the reader would be able to infer the mood of each character and thus the thrust of the story. So that's not an issue anymore, but still, I will admit that there was a period of time where I was worried that this was the first sign that we were raising some kind of sociopath who was unable to read human emotion or something.)

(And yes, I also see how telling it is that I just spent a paragraph talking about Cal in a entry that I ostensibly started to talk about Mack, but see, that's the thing! Cal was so weird and attention consuming! And Mack is so normal and easy! That's exactly why it's so easy to set him on autopilot-parenting and exactly why he's going to quit his tutoring job and join a violence gang because his parents never paid attention to him! I mean, probably!)

One of my main goals now that I have more time is to spend some time with Mack, just the two of us, one-on-one. I had to take him to the dentist two weeks ago, an expedition that I billed as our "special day" (in that yes, we were going to the dentist, but he could skip school for the rest of the day and afterwards we could go the playground and then have lunch together wherever he wanted! And also: free toothbrush!) and the degree to which he was excited about his "special day" with me was unreal. He talked about it literally every day for the weeks leading up to the appointment, and he seemed to especially relish the fact that it would be just for him, that Cal would have to go to school and that Nina would have to stay home, and weren't they going to be so jealous? There really was nothing that extravagant about the day at all, so the special thing for him wasn't so much the activities or skipping school or the Chick-Fil-A for lunch, as the fact that it happened at all. For half a day, he was my only kid.

So anyway, something that I've committed to doing is to try and have a special day with Mack about once a month--or at the very least, a special morning or afternoon. We'll just do something low-key--making Rice Krispie treats, going to the playground, doing an art project--but just something that we can do alone without Cal being there asserting his own superiority in gluing pompoms ("I used to do it like that when I was four too, Mack...but you'll get better at it. I mean, probably.") or without Nina there needing all of my everything. And maybe we won't even need a dentist appointment as an excuse to do it.

Parenthood, right?

because disasters are apolitical but choices aren't

One of the things Joe and I were discussing (because we are SO ERUDITE--in between making a series of fart noises, both faked and authentic, and then blaming them on the dog) is the impact that Hurricane Sandy and its aftermath is going to have on the election. It's difficult to calculate, I think.

First, the regions hit hardest by the storm (that is to say: the Northeast) are traditionally firmly Democratic, and logistically, it may be difficult for people to turn out and vote come Tuesday. But will this actually make any difference in the electoral college, or will it just impact the popular vote?

Secondly, people inside and out of the affected regions may respond differently based on their perception of storm readiness, reaction and aftermath. I think that overall the reaction has been largely positive (at least compared to the level of preparedness for Katrina, "heckuva job Brownie" and all), but it's clearly a difficult time for everyone impacted. Will that change anything come election day? Again, difficult to say.

Campaigning for both parties has obviously been put somewhat on the back burner, or at least a burner off to the side--for the president firstly because he's busy, you know, leading the country during a crisis; and somewhat for the Romney camp as well, to (rightly) avoid politicizing and tragedy and, perhaps more importantly, avoiding the opportunity to say anything completely offensive of tone-deaf to those suffering losses. What did these two campaigns have planned for the final two weeks of the campaign? Would that have made a difference either way?

And on and on and on. Like I said, the political effects are incalculable, and though I think the post-mortems at the end of next week will pick apart this and that trying to frame whatever the outcome ends up being in the light of inevitability, but that's all Monday morning quarterbacking to me. Regardless of whichever presidential candidate wins the election, the effect of an unprecedented natural disaster of this scale is as unexpected as it is difficult to predict.

But there's one thing I do know that everyone can take away from the stories of Hurricane Sandy, and which is: you are not immune. Terrible things happen, and they can happen to any one of us. The single mom in Staten Island and the hedge fund manager in Tribeca. The elderly couple in New Jersey and the CEO in the Hamptons. Terrible things can happen, and they can happen quickly, unexpectedly, without prejudice. And all of us, whether we think we will or not, will occasionally be grateful for some help.

I think back to my own reaction to the aftermath of Hurricane Katrina in the days and weeks that followed that particular storm. I was shocked and horrified and of course I pledged my support and dollars to help the survivors, but still, even though it happened in my own country, it all still felt a little removed for me. I admit that fully. The words and the situation: Lake Pontchartrain? Levees? Superdome? It seemed so foreign from the everyday life of a dyed-in-the-wool New Yorker that my empathy, and my ability to relate, while present, still felt a little bit distant.

But this? Oh, this.

I walked here, on my way back from a late night out in med school after finals, from restaurant to dive bar to seedy club, trying to find my way back to the subway station to take me home.

Over the course of high school I got off at this subway station hundreds and hundreds of times.  We'd take the 6 train one stop down and switch here to catch the express, or maybe venture above ground to get something to eat, or browse through the new CDs at HMV (remember when we used to do that?), or just walk around and people watch.  Do you know how vast, and how deep those tunnels are?  Do you know how much water it must take to fill them up?  I don't.  I can't even imagine.

The cutoff for power outages on Manhattan was at 25th street and south.  I used to live on 25th Street and Second Avenue, on the 19th floor of our building.  Most likely we would not have had power.  Now, with three kids, in the chill of November, it's difficult to imagine how we would have handled it, though I can say for sure we would not have done it with the grace of those in New York the even more seriously affected outlying communities.  Probably I would have just cried.  Well, cried and eaten all the ice cream, like we did after that big power outage in 2003.  (IT WAS GOING TO MELT ANYWAY YOU GUYS.)

We lived just a few blocks away from NYU Medical Center (it is, in fact, the hospital at which I was born), which of course was evacuated after the storm when the power went out and the backup generators failed.  I can't even imagine what it must have been like for those staff working that night.  I read accounts of patients, fresh CABG post-ops and others, being walked down 10 flights of stairs or more to evacuate after the elevators failed, NICU babies being carried out one by one, nurses and housestaff and techs and everyone forming lines up the stairs passing buckets of fuel up the fire escape to the emergency generators after the fuel tanks in the basement of the hospital became overwhelmed with water.  I think: what if I had been in the OR at that time with a patient when all the power went out?  What would I have done?  I see myself reaching for the ambu-bag, sending someone to run for more IV induction meds, and holding up the flashlight we keep in the bottom drawer of our anesthesia cart so that the surgeon could see enough to sew faster.  I can kind of imagine it.  But also, of course, I totally can't.  Not really.

In the final days before the election it's hard to conceive of people who are still undecided about who to vote for, but I know they must be out there because the news and the polls say its true.  And I ask these people to think not just about jobs or the economy or foreign policy (though these are, of course, also crucially important issues) but to also think about the role of government in the face of crisis.  In the face of bad things happening, indiscriminately and free of political bias.  And think not just of how the candidates are reacting now, but of what they've said in the past.  About the role of government.  About "dependency" and "entitlements."  About the size of government and how some might propose both a smaller government with a diminished role and ability in providing help to its citizens in deep trouble, but also concurrently one that paradoxically insists of legislating and restricting our personal lives.  Think about these things.  And then go vote.

It's easy to accuse and tell people what they should have done or what you would have done when bad things don't tend to happen to you, but Hurricane Sandy reminds us in the most explosive and shocking way possible: bad things can happen to us all.  And everyone needs help sometimes, and sometimes the help we need is bigger than that which individuals or private institutions are able to provide.  And it's a credit to our civilization when we as people, and yes indeed as a government, are able to help those least among us.  Because next time, it could be you, too.  And where do you want to be living, and under what kind of leadership, do you want the next time something does?

My family are all OK, thankfully.  Much love to my friends in New York and the surrounding areas devastated by the storm--I'm with you in spirit if not in person.  If you need help, just ask.  And if you're looking for ways to help, two good starts are here and here.

as time goes by

I don't really know what this says about me--probably nothing good--but I'm glad that September 11th doesn't fall during the work week this year.  Something about the idea of having the day, in all its past, present and future incarnations, commentated on relentlessly on the TV in the anesthesia lounge (I was going to say CNN but to be honest it seems that the default setting is usually Fox News) is more than I really have the stomach for.  As a native New Yorker who was in the city on the day of the attacks, I, like many, still feel that it's a little bit of a tender spot.  And I think I've talked in the past about how much doctors dislike having feelings.

Ten years later, the events of September 11th have arrived at their final resting place in history, though it's hard for me to put my finger on exactly where that is.  More often then not now, when I see it referenced (and granted, I no longer live in New York), it's held up as an emblem more than anything, or used as a supporting argument for this that or the other thing.  It's the stuff of decals, of commemorative plates, of tattoos and of posters.  And it makes it feel important but distant, like something horrible you'd read about in a book but hadn't actually lived through yourself.  The distance is inevitable.  Time makes everything less raw, a little less messy, and filters our memories through experience.

We even have a whole other language for it now.  September 11th is now "nine eleven."  I remember on the day of the attacks one of the doctors in the OR was speculating whether or not there was any significance to the fact that the date spelled out "9-1-1," as sort of a wink to the emergency response system that would surely be activated.  We didn't know to call it "nine eleven" then, the date itself at that time was nothing special.  In the weeks to follow, the smoking craters where the Twin Towers stood and where remains and debris were being excavated were still being referred to as "The Pit."  Not until later did the language of "Ground Zero" take hold, though now, you say "Ground Zero" in reference to Lower Manhattan and everyone knows what you're talking about.  Why do I bring this up?  I don't know.  Maybe because it's midnight and I'm on call and too wired to go to sleep.  Or maybe because, as strange as it sounds, I miss there being a time where that whole other language didn't yet exist.

Joe and I broke up shortly before September 11th, 2001, did I ever tell you that?  I probably didn't, it even in those early days of my blog I didn't exactly consider it grist for the mill, and I can't even remember why it was that we had broken up at the beginning of our third year of medical school, shortly after our OB rotation in Stamford, CT.  (I blame OB, personally.  Or maybe Stamford.  Probably both.)  Anyway, we'd broken up for some reason, and it was weird and awkward, because we were still in the same clerkship rotation group after all, and we still had to see each other every single second and act all normal and professional, which if you don't think was torture you've obviously never dated anyone before.  On September 11th, we were on one of our Surgical Subspecialty rotations, which I thought was a blessing because we got split up into smaller groups--I was rotating on Pediatric Urology, whereas Joe was, I think, rotating on ENT (Otolaryngology for your purists out there) in an entirely different part of the hospital.  It was a relief to be away from him, so I thought.  But after those planes hit that day, Joe was basically the only person I wanted to be with.  Six months later, we were engaged.

I don't really know what my point is with all this, and I know it sounds incredibly short-sighted or even mean-spirited to begrudge the way that the events of that day have become more totemic than real.  It's just that I can't help but to think that way.  It wasn't a T-shirt.  It wasn't a bumper sticker.  It wasn't a picture on a TV.  It was real.  The little things make it real, and each year that passes, the edges of those little things becomes increasingly softer.  But I still remember.  The blaring radio at the bagel store across the street from the hospital.  The smell of that fall morning walking into work.  The jungle animal print cap the anesthesiologist was wearing in the OR when we heard the news.  The way the smoke looked rising up to the sky, thick and billowing at the base, then spreading out into a blanketing haze.

It was real.  It happened.  We were there.  And you can print as many banners and lawn signs as you want, but New Yorkers don't need to be told to "Never Forget."  Because we never will.

the hometown crew

The book event in NYC last night was...well, take a look.

The event was awesome.  I was a little concerned about attendance beforehand, because it was a Wednesday, and a little early for some people getting off work, maybe a little late for others.  But the turnout was fantastic, we pretty much sold out all the books in stock, and the discussion afterwards was really good.  Thanks for coming out, New York!

(Philly, are we going to be having some fun too?  Come on then!  I'm a little anxious about Philly because it's the city that I begged to have added to the tour but also the only city where I've never actually lived or gone to school.  But Philly is such a great medical town and so close by that I just couldn't image passing up the opportunity to meet some of you in person.  So...see you tomorrow?  And bring your friends!  All 500 of them!)

Before the book event I swung up to Washington Heights to visit with some folks and visit the med school.  You know what?  It's exactly the same.  Kind of grim, kind of imposing, with a lot of people in white coats walking around.  Feels like I never left.

I would have taken more pictures but there were so many people walking around that I probably would have gotten plowed down if I tried.  Luckily, some assiduous readers helped me out with this one:

(Thanks, Valerie L.!)

Anyway, I'll be heading to Philly tomorrow, where I'll be spending some time with my old friend Tammy, who has the distinction of being the person who convinced me to switch from Peds to Anesthesia in the first place.  We're going to the famed Mutter Museum (of Medical Marvels?) before the book event that evening, and if you don't think I will live-Tweet that shit, then obviously you don't know me at all.

Finally, a few more pictures of the book out in the wild.  Thanks to everyone for sending them in, I can't fit them all in this entry, but I picked a handful that were fun.

In honor of the first scene in the book, which some of the morning radio interviewers from today laughingly said they deliberately avoided talking about in great depth (heh) in case some of their listeners were still eating breakfast.  Thanks, Sangeetha!

Here we are, atop the CN building in Toronto, which is apparently the tallest building in the Western Hemisphere.  Lofty!  By the way, reminds me of this: On Old Olympus's Tower Tops, A Finn and German Vied At Hopps.  Quick, what is this mnemonic for?  And why do I still remember it?  Ah, the sticky and sometimes random power of memory.  (To be clear, yes, I do still kind of need to know this, and the mnemonic helps.)

Monkey see one, monkey do one.  Now we just need a shot of the monkey teaching some other monkey how to suture banans.  IT'S THE CIRCLE OF LIFE.

Finally, this last one (thanks Mingle!) is for Cal and Mack, who both LOVE "Angry Birds," which Cal can play with some skill, although Mack mainly just slingshots most of his birds backwards or straight into the ground. Which is a good segue to point out that the book is available in all e-book formats now!  Instant gratification, ho!

Thanks, everyone.  See you tomorrow in Philly, and then on Monday in Cambridge.  Surely there will be some sort of yard nearby in which to park your car.

pub date

I had mixed emotions as I headed for the airport this morning to start the first leg of my book tour.  I'm happy that the official publication has finally arrived of course, and the idea of doing publicity is kind of exciting, in the way that novel things are exciting.  But another part of me is kind of sad, leaving my kids for six days.  I know six days isn't a hell of a long time, but that's all relative.  And for a two year-old that lies in bed every night clutching a hank of my hair, brushing the wisps against his cheek while murmuring, "Hair...hair..." it might seem like an awfully long time.

(Does that sound creepy?  He's a baby.  Not creepy.  But if he was a grown-ass person, yes, kind of weird.)

Even as a resident, I never spent more than 36 hours away from my kids (well, singular "kid" at the time), and the first time I spent even more time away than that was a few weeks ago when I went to Iowa City for 48 hours.  So this is...a longer trip.  Six days.

But I really wanted to do this and I think it's important (or at least, I hope it is) to do some in person events in big medical cities and at least start to thank some of the many, many readers that are generating good word of mouth for the book and making sure that it's going to be a success.  So let's make it count!  Come on out to the book events, tell your friends, drag along your relatives, whatever.  Or else I'm going to have to tell my kids that I spent six days away from home in order to sit on a series of folding chairs in various bookstores while pretending to check my email.

See you guys at the Columbia University bookstore (116th and Broadway, thereabouts) at 6:00pm tonight, and for a drink and some giant haggis-looking burritos at The Heights afterwards.  And if you're in Philly, join us for the event this Friday the 13th at the Penn Book Center.  FRIDAY THE 13th.  Like I said before, I can't promise that the reading won't prevent you from being crushed by a falling piano, but IT MIGHT.  Not worth the risk either way--just go to cover all your bases.

Oh, and you know the book has finally gone live for the Kindle and the Nook, right?  Oh good.  Also, the bookmarks giveaway is officially closed, thanks to everyone who e-mailed me and who pre-ordered the book before today.  I'm working on getting those bookmarks out in a timely way, but there are a lot of you guys, and that's a lot of notes to write and envelopes to lick.  But never fear, I'll get them all to the post office eventually.

live, from new york

Inexact science though it may have been, there clearly was enough interest in and around New York City to justify a book event there in May.  So we're on!  It will be held at the Columbia University bookstore on the Morningside Campus (or, as we used to call it in med school, "The Undergrad Campus," though every single other grad school of the university was on that same campus but us, the red-headed stepchild in Washington Heights) on Wednesday, May 11th.  WEDNSEDAY MAY 11th.  Burn it into your brain!  Or, you know, just remember it the normal way!

More details to follow, including the time of the event (I still have to find out the fine details myself), but I'm presuming it will be in the evening.  And perhaps afterward, if we're feeling good, we will all nip out to Coronet Pizza, the pizza that only tastes good when you're drunk (TM).

On a somewhat related topic, I have am taking the week of the book publication and the week afterwards as vacation time off work, in order to avail myself to do any and all publicity-type stuff related to bookery.  However, the more I read and learn about it, the more I realize that actual physical travel may only play a very small role in all this.  I'm doing book events in Atlanta (because I live here) and New York (because I lived there before I lived here, and also, I can stay at my parents house, which is FREE), but from all my research on the topic, actual physical appearances do very little to sell books, especially when you take the time and expense of the travel into account.  Also, to be honest, I am pretty busy at work and I have two little kids--if I'm leaving town for any reason, I have to maximize efficiency--for example, when I'm in Iowa City next weekend I have two talks, a book reading, and (hopefully) a reader meet-up scheduled for the two days I'll be there.  If I was younger or less encumbered, the idea of traveling for the sake of traveling might kind of fun (I distinctly remember relishing the seemingly jet-set adventure involved with med school interviews the first two or three times around--after that it just got very tiresome) but to be honest, I need to have a really compelling reason to leave my kids and go somewhere these days.  Actually, this trip to Iowa City is the first time I've traveled without either kid, ever.  I may weep.

I'm not saying that I don't want to travel for the book, of course.  I am completely committed, and as such, I will do whatever the occasion requires me to to.  DO YOU WANT ME TO BE ON YOUR SHOW, ELLEN DEGENERES?  I WILL TOTALLY BE ON YOUR SHOW BECAUSE I LOVE YOU AND YOUR BLAZERS AND ALSO YOU ARE ADORABLE.  (You too, Meredith Viera.)  But I am also acutely aware that the publishing industry is changing (this is just what I hear--changing relative to what I have no idea because I know nothing about publishing but I'm told it is in the middle of an evolution, like in the pre-Cambrian seas) and that a lot of book publicity now takes on the form of "virtual" book tours, where authors are interviewed or guest post or are somehow featured on various like-minded blogs around the internet.  And then we all put on goggled helmets and tactile-sense gloves and go around and shoot aliens with our space lasers!  (Oh wait, that's "virtual reality.")

Anyway, my point is, do join me in New York if you're in the area and not too busy (ooh!  I made these super cute little bookmarks that I'm going to give out!  Remind me to show you later, they are the greatest) but if you can't, why not help me with my virtual book tour?  Do you have a website that seems like we might have a like-minded readership?  It doesn't have to be medical, I read lots of news, academic, craft, photography, design, food, and parenting websites too.  I can come visit your blog!  Do you want to review my book?  Chat with me?  Have me do a guest post?  These are things I can do, and there are presents I can get you!  E-mail me, or contact my publicist!  And, by the way, if you're close personal friends with Ira Glass, tell him that if he could feature this excerpt as part of a cold open for "This American Life," I would die of happiness.  The theme of the show could be, "Places I Never Thought I'd Be," and the rest of the show could be about, you know, the war in Iraq or whatever.

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Special coupon section!

This will only apply to people who live in or around Atlanta, so if you don't live near here, don't bother to read this next part.

OK, are they all gone?  Great.  Let's talk mosquitoes again.  Regarding the last entry, Chuck wanted to offer any readers of this blog a special discount if they are interested in getting a mosquito system installed for their homes.  The discount will entitle you to one free refill of mosquito spray stuff free--a $200 value.  (The bucket of the stuff is 50 gallons, I think ours is supposed to last three months before it needs to be refilled.)  The coupon code is 7214H, so go ahead and give Chuck a call if you're interested, he does free evaluations of your home and whatnot, so there's not really that much to lose just to have him come by and give you advice.  Also, he looks a little like Alan Alda, though I'm sure that resemblance probably doesn't play as well down here as it might up north.

NYC book event this May: let's make it happen!

OK guys, sorry to bother you about this, and I've never run a poll on this site before so forgive me if I'm not doing it right, but the thing is this: we would like to do a book event in New York around the time that the book comes out on May 11th. I grew up in New York, went to med school and did one and two-thirds of a residency in New York, the book is set in New York, everyone I know is in New York--it makes sense.

But I have no idea how many people would actually, physically show up to a New York event if we did plan one, and I'm sure that my publisher would want to make sure we'd have a reasonable showing before deciding whether or not to have an event at all.

I don't mind telling you that I really, really want this event to happen. First of all, my parents would be able to attend, and they would be proud. Second of all, so I would get to finally meet many of you--I know that a good number of people are based in or around New York. So, see: the poll.




This is not a poll so much as a headcount, I guess. It's not final or binding obviously, I don't know who's voting though I do get a breakdown of what state you're voting from, because, you know, something something IP addresses. Also, if you can't be there, don't bother to click "no" (after all, not everyone will be in the NY/NJ/CT/PA area in May, so it's entirely expected that most of my readers actually won't be able to come)--what I'm really interested in is how many "yes" votes there are. So please, please, if you think you'd like to hang out with me at a book event in New York in May (again, my goal is around the second weekend in May, since the book comes out May 11th), go to the poll either above or at the top of the sidebar on the right and click "yes." I will try as much as I have power over such things to make it an event that's in the evening, towards the end of the week, so as to work with people's busy schedules. But before any event can be planned at all, my publisher needs to know that there is interest, and that it'll be worth their while.

So please vote! Tell your friends who also want to come to vote! I mean, vote with numbers grounded in reality, don't just click "yes" a thousand times, but do click it multiply if you're indicating the number of people that you might bring along to such an event, like, say, you and your twenty highly literate best friends. Thanks so much, and with any luck (and your help) I'll see you in May in New York!

next I suppose you'll want me to explain calzones

So as today was Doctor's Day, NOT ONLY did we have free bacon for breakfast in the doctor's dining room (they love us to the extent that they want to keep us in business, I guess?) we also had a special lunch, which consisted, somewhat eclectically, of some kind of heat-lamp-incubated meat log, tilapia with mango (I know), and a falafel bar. So obviously--the falafel, right?

(Full-disclosure, I also did chip off a piece of the meat log. Come on, I'm not made of stone. MEAT. LOG.)

So I'm assembling my falafel when one of the radiologists I'm friendly with came up and pointed at the chick pea patties sitting in one of the steamer trays. "What's that?"

"Oh, I think that's for the falafal." And then, as some further explanation seemed to be required, I added, "For Doctor's Day."

"What's a falafel?" He replied innocently. And then he said something else, but I couldn't hear him because my head exploded.

"WHAT'S A FALAFEL?!" I repeated, after I had collected all my head pieces and reassembled in roughly the correct configuration with bioglue and an Kling wrap. "It's THAT. THAT is falafel. Fried chick pea patties. Cucumber tomato salad. Tahini. Pita bread. Please tell me you know what a falafel is." And then, like a very bad Pictionary player whose teammate clearly has no idea what is being represented, I just emphatically pointed to the food again. And maybe I screamed the word "FALAFEL!" a couple more times, just in case he hadn't heard me properly.

"I think...I'll get some of this fish," the radiologist finally said, which, I'm sorry to say, was not the correct response.

After this, I informally polled a handful of people in the anesthesia department, all natives of the South. None of them had ever even heard the word falafel before. So tell me, am I crazy? I know I grew up in New York and what's commonplace in New York is not commonplace in most other places, but I had always figured that falafel was just a ubiquitous American-adopted ethnic food, like pizza, or tacos. You know, when you walk down a street in New York, it goes like this: coffee cart, hot dog/pretzel cart, falafel cart, and that vendor that sells three dollar cell phone cases from Hong Kong. I didn't know people didn't eat falafels in the South! Which makes it all the more mystifying that they chose to serve it to us for Doctor's Day. Maybe it was the vegetarian option, and they figured no one would touch it anyway?

Now I also know not to go out clubbing really late and end up with a case of the 3:00am munchies, because where there is no falafel, there is certainly no schawarma, and if there's no schawarma at 3:00am when you're drunk, there is no tomorrow.

Uh...Happy Doctor's Day!

(For the record: I don't think we as doctors need a "Day," but I appreciate the sentiment--I will continue trying to earn it.)

midnight snack

Look, first let's make it clear that Atlanta has really grown on me, OK?  First off, the weather is pretty nice here.  Second off, people are charming and say cute things.  Third off--well, today I was taking care of a patient who just so happened to be an "ambassador" (his word) for Chick-Fil-A, and he had such a nice time talking to me that he gave me a personal business card which could be redeemed for one free chicken sandwich.  Free Chick-Fil-A!  How was your day?

But one thing that drives me crazy about Atlanta is the restaurant hours.

OK, so forget the fact that no non-fast-food restaurants open before 10:00am, like, ever.*  I like to get an early start on my day but whatever, I can deal with having to stand outside a self-proclaimed brunch establishment at 9:00am on a Sunday morning waiting for them to wake up.  But what really kills me, especially in my line of work, is the fact that no restaurants stay open past 10:00pm.  It's ungodly.  Don't people get hungry at night down here?  More importantly, don't people want to make money selling food to people like me?

Back in New York (oh, not this again) I would often get off work late.  Obviously.  Being a resident means working weird hours, and by "weird hours" I mean all the hours.  Many days I'd get in before the sun rose and leave work at 10:00pm, midnight, sometimes 2:00am, knowing I'd have to be back in to work the next day.

After a certain point of the night (I'd put that cutoff at around 9:00pm I guess) there was really no point in me hurrying home anymore, since I knew everyone there was already asleep and therefore there was no one to see.  So sometimes, on my way back downtown, I'd stop for a very late dinner by myself.  And if this sounds pathetic, it absolutely is not--eating alone in restaurants is awesome.  You get to order whatever you want and you don't have to share it with (or feed it to) anyone, and you can eat your whole meal while reading a book or listening to "This American Life" on your iPod.  And for someone who always felt like she was at the beck an call for other people (kid, patients, attendings, spouse), these occasional late night dinners were the ultimate indulgence.

I don't know how your tastes run, but when I'm up late at night, especially after a long night at work with limited sustenance, my appetite runs towards the hot, the brothy, the spicy, the comforting.  Korean food was always a good default--relatively inexpensive, lots of food, and restaurants in Koreatown (the only redeeming feature of the Herald Square area, in my opinion--please don't counter with "Macy's," you'll just depress me) are open all night long.  And everyone goes there.  There were many nights that I'd be grabbing a quick late-night meal on my way home, past midnight at some Korean restaurant that I didn't even know the name of because nothing in the restaurant was written in English, and the restaurant would just be packed with people.  Old couples grimly gumming down their hot pots, not speaking to each other.  Masses of young teenagers oozing booze and karaoke.  Single people like myself at many of the smaller tables, sitting alone but looking utterly contented.  It was so busy and alive, even at that hour.  And that made the food taste really good.

You'll forgive me this lament because obviously we're happy in Atlanta and we love the people here, but that last part is the key to why I miss New York so much.  And it's not just because I'm a creature of habit, or because everyone I've ever known in my life up until this point is in New York.  No, it's because in New York, you don't ever feel like you're just you.  You always feel like you're part of something bigger.  And that's fun.

There's a Vietnamese pho place up the street from where we live now in Atlanta that has some decent food.  But when I drove past it tonight, at 10:00pm, it had long since closed.  The lights were off, the parking lot was empty.  So instead I came home and made some instant noodles and sat in my dark house eating them by myself.

It wasn't the best late-night dinner I've ever had.  But it was all right.

* I already know what you're going to say.  "Something something The Flying Biscuit."  Right?

transitory

Every visit to New York seems too short, which I guess is the name of the game when you visit a place where you kind of still wished you lived. We're still missing Mack and Joe like crazy, of course. However, Joe very kindly e-mailed me this little home movie last night that mitigated our homesickness somewhat.





Yesterday, as those who follow my Twitter are aware, we went to the New York Transit Museum in Brooklyn Heights, where I exercised my penchant for making Cal pose alternately as an abandoned child or a talentless stripper on a variety of vintage subway trains. We had a good time.





Cal, hanging tough with some TNT. 'Sup, fool.




Also, this comparison from the last time we took Cal to the same museum about three years ago. Sunrise, sunset.





I did not dress him in the same colors on purpose, but I guess I just have a penchant for orange jackets and turquoise neckwear. (Actually, the orange jackets is kind of on purpose--I like to make sure my kids are easy to spot in crowded places. And putting a road cone on their heads seems excessive.)

(View full photo set here.)


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Thank you to all that people who LIKED my book page and who friended me on Facebook. I had my Twitter and my Facebook linked for a little while (hence all the links to TwitPic a few days ago) but then it kind of stopped linking, which was perhaps a blessing in disguise as it's possible that could have been annoying for some people. MODERN DAY PROBLEMS, am I right, people? And what's the deal with answering machines, anyway? All those little cassette tapes!

Anyway, I have some ideas for some new content coming up in advance for the book release (it's all just sweet dreams in my head right now, but early hints: it involves video) so I appreciate having the maximum number of ways to reach everyone, even if I'm still working out the kinks in straddling accessibility and annoying ubiquity. Needless to say, watch this space.

having fun, wish they were here

You don't know what an achievement this is, updating my blog from my parents house. Guys...they don't have wireless internet here! It's, like, dial-up modem, with the beeps and boops! Not quite, but still kinda bad. They use AOL to get their e-mail! Like in the 1990s! All this I could have worked around, except that my laptop is a MacBook Air, which does not even have an Ethernet jack, as I guess that would have been like putting pockets on a cocktail dress. Also, because it is the year 2011. There used to be people in surrounding apartments from whom we used to steal internet, but they either moved away or realized that they needed to password protect their networks, so...yeah. Luckily, I am borrowing some weak-ish coverage from some nice guy named WLAN, so I'm going to do this quick while I'm still getting a signal.

(Yes, I know WLAN is not a guy. GOD, guys, it was a JOKE. Nerds.)

So we got into New York yesterday afternoon. On the way in from Laguardia, we stopped by my grandmother's house in Flushing (Flushing: Official Home of the Chinese Grandmother!) and then I had to hustle to my parents' house for a quick shower and change of clothes to say hi to some people at my publisher.




Look, I know that to some degree it must be a job, just like any other job, but can I just tell you that it looks incredibly fun to work in book publishing? Because there are books everywhere! Like, books falling out of the sky! And you can just pick up and read any of them! Also, they had a lot of high-end office supplies; obviously this is the world of the gigantic professional printer in the kingdom of the extra-large padded mailing envelope, and I don't know why I love that so much but I DO. So anyway, I stopped by, we chatted a bit, and then I walked through Midtown to the West Side to meet up with everyone else for dinner.




I won't say too much about the meal because I basically live-Tweeted the thing last night, and probably some of you are going to kill me over that, because some people get very persnickety about their feeds. Sincere apologies for those who don't like me clogging up their tweet stream, but my reasons for live-tweeting were two-fold. First is that one of my partners at work (hi Kim!) told me to take pictures of the meal, SO I DID. Secondly, I had some scheme that I was going to Twitter Guilt executive chef Eric Ripert to come out into the dining room to say hi to us. (Unfortunately, he did not, because he is important. Also, it's possible he wasn't there last night, because from his Twitter feed, it sounded like he went skiing. Either way.)




Today dawned sunny but cold, so we scrapped our plans for riding bikes in the park and just went straight off to the Natural History Museum, where we looked at some dead stuff. Cal was suitably impressed. I always like to seek out the older, unrenovated wings because they look exactly the same as they did when I was a kid and therefore exercise upon me some kind of memory vortex, but mostly we just looked at the whale and the dinosaurs and they were pretty neat.






Cal was still pretty creeped out by the whale and the squid, by the way. He didn't want to go near it at first, though he warmed to it eventually. I tried to get a picture of that exhibit, but it really was still pretty dark and the picture didn't turn out. So instead, just picture some kind of deep-sea horror tableau that will haunt your dreams. There you go.

If I were making this trip with Joe, without the kids, undoubtedly we'd be spending all our time downtown, eating every two hours, window-shopping and people-watching until we passed out from sheer exhaustion. Well, except for maybe one day, which we'd spend all the way up up uptown in Washington Heights, where we could revisit old haunts and eat at Malecon, home of the garlic dipping sauce and on-call 2:00am regret. Being here with a kid sort of pulls the center of gravity towards Central Park, which is fine, but maybe we'll find some time over the next day or two to go below 14th Street. (I know, I know, there's tons of kids stuff down there too, but it's different when you live here versus when you're only in town for two or three days. We have to cluster our activities a little more is all.)




We're having fun, but we really miss Mack and Joe. That's the problem with everyone in our lives being so spread out--wherever you are, you always end up missing someone. When we get home, I'm going to grab Mack and just squeeze the snot out of him.