ch-ch-ch-changes

This blog, from the beginning, has been a journal about change. I started writing here in the year 2000 (though some of the older Homestead archives have since been eaten, believe me, they went alllll the way back, and yes, there was an Internet then) and from the beginning, it’s been a chronicle of ∆x/∆y. Medical school. Marriage. Residency. A different residency. Parenthood. Moving to the South. Every year was something big and something new and oh hell, how are we going to do this now and the constant, underlying theme through it all was change.

At the time I kind of petered out on the blog (and know that I never really intended to step away entirely, but the slow fade just kind of…happened) part of it was that the rate of change had slowed. Things were calming down, and we were settling into our lives in a way we’d never had a chance to before. Joe and I were both attendings and in stable jobs. Our kids were getting older. We bought a home and lived in it for a while. There were days with patients and nights on call and parent teacher conferences and summer camps and carpool lanes. And while things continued to be busy, they also became shockingly normal. Calm. Maybe even a little bit boring, though I mean that in the best possible way. It just felt, though, that in this journal about change, there wasn’t much left to write about.

I don’t think I feel that way anymore. There are a lot of ways to view this post-Trump ascension world we live in now, but I don’t think I can say anymore that life ceases to change. But neither can I continue to insist that it is boring, so...there's that. I think a lot of people—regular people, normal people, people like me—have a lot of energy and a renewed sense of civic responsibility in the face of this new administration, but often if feels difficult to know where to channel all that energy, you know? What do we do now? Where do I put all this? How can I help? How do you do stuff?

Look, I’m just a dumb doctor. I do what I know how to do. I work with patients. I help people individually in sometimes big but usually small, concrete ways. I speak the language of medicine and science and research and data. My campaigns are waged at the bedside, or in the operating room. I’m not a politician. I’m not a legislator. I’m not a lobbyist. I’m not a judge. I don’t know how that world works, or the avenues into it. But I want to change that. I want to learn. Then I want to do it. And I don’t want to do it alone.

I’ve done a few things since Election Day. These are just very small things, things I know how to do, in order to chip in, help shore things up, fix things, and teach my kids how to do the same. But it’s not enough. These things are important, but they are also too small. I know it takes thousands of little drops to fill a bucket, and I want to keep on adding those drops, but I’m ready to start doing more, and I just need to figure out how. So now we’re going to start, and we’re going to do it together.

Here’s a small list of some of the things my family and I have done since November 9th. It’s not a complete list (there are probably some things I don’t quite remember, I didn’t write them down or anything), but I also didn’t talk about it much on social media either, because my instinct was always that anonymous good works are the best kinds of good works. However, now I think the need for collective action and coalition building supersedes those instincts, and also, more than ever, we deserve to know that we’re not alone on this. So, an incomplete list.

• Donated money to Planned Parenthood.
• Donated money to National Public Radio and the Public Broadcasting Station.
• Donated money to the National Parks Service.
• Volunteered at Hands on Atlanta making holiday gifts for veterans at the VA. (The kids helped with that one.)
• Sponsored a needy family for the holidays through Families First Atlanta—a mom, kid, and grandparents. The dad had been deported earlier in the year.
• Signed up with the Clinician Action Network.
• Signed this petition to fight the repeal of the Affordable Care Act.
• Donated to the DNC.

But these are tiny actions, and not nearly enough. Lately it has been suggested to me that one means of political action is, quite simply, talking out loud. I mean, after a fashion. Via the Internet, on social media, ways in which ideas can be shared widely and communities built broadly. I know this is not a new idea at all—it's pretty much Twitter's entire modus operandi, at this point—but I never felt that it was as satisfying talking about doing stuff as actually just shutting your mouth and doing the stuff. But I think what I'm learning now is this. Sharing ideas is activism. Talking to people is activism. Starting the conversations and keeping them going is activism. And then we'll get to what comes next.

Anyway, this blog. I'm still just a doctor. This has always been a small platform focused on the minutiae of daily life, and will continue to be for as long as I can remember my Blogger password. (Hey, shut up, it's hard sometimes.) But the world is bigger than any one of us, and it's also up to us to take responsibility for all of it.

Now, to what you've all actually been interested in.

Cal is eleven now, and in the seventh grade. I know many of the people who have been following this blog since time immemorial remember when Cal was just born, and it's impossible for you to believe that he's in middle school. Don't worry, I feel exactly the same way.

Mack just turned eight a few weeks ago, and is in the second grade. He only recently stopped making a weird face every time I tried to take a picture of him. This photo was taken before that particular skill was mastered.

Nina, she will insist on telling you and everyone in earshot, is A Big Girl. She also insists on dressing herself sometimes, as you can clearly see, but has luckily tried to cut her own hair only once. She is four and a half years old, and in Pre-K.

Joe is 42 now and in the one millionth grade. No, but really, he's doing well. I'm not going to talk too much about his work, because that's probably pretty boring, but he's great at what he does, and it's an honor being on his team. Probably the most important thing you can do in life is choosing the right co-pilot, and somehow I lucked into a good one. I'm not a perfect person, and I have more flaws than I can reasonably enumerate. But whatever good I've done, and continue to do, is due to and in the service of these guys right here.

Anyway, this is just a brief mic check, and a post it note on the wall to say...I'm here. I hope you are too. So let's start talking. Let's get to work. Let's do this thing.

Discuss: What social or political actions you and your family taken, if any, since the election, and why? I understand that we don't all have the same political leanings, and I respect those differences. I live in the South, after all, I am accustomed at this point to having smart people disagree with my political views and having it descend into a slap fight only 50% of the time. (60% tops.) But the goal is the conversation, after all. In the end, the campaign of change has to be one of hearts and minds. So let's start here.

I overthink, therefore I am

This is the day where all my social media feeds are filled with people exclaiming, with varying degrees of vulgarity, "Good riddance, 2013! What a shitty year! Hope 2014 will be better!" Is it poor form at this point to say that I thought 2013 was pretty good?

Well, anyway. Happy New Year!

*          *          *

I don't think we go too too overboard with the Christmas gifts. At least I hope we don't--there's the tendency to lament the perceived extravagance and overindulgence of the modern secular Christmas celebration, but I think this self-imposed guilt can sometimes be a little much and tend to taint our enjoyment of the holiday as much as anything else. I remember one year in particular the kids were unwrapping gifts on Christmas morning (this was pre-Nina, so just the boys, but I think the stuff they got that year was, like, some puzzles, books, stuffed animals, a kiddie microscope for Cal) and Joe was kind of making a face and saying how disgusting it all was, I guess meaning the display of excess and the consumerism and whatnot.  At which point I said SHUT YOUR MOUTH because there's a difference between appreciating what you have and your ability to give your kids nice (if not entirely extravagant) things; and beating yourself up with bleeding-heart guilt because there there are those among us with much less. My point being that the two things can co-exist. You can choose to not hate yourself for being able to have a nice Christmas, and you also can donate your money and time to a worthwhile cause to help make someone else's holiday better. Anyway, it's Christmas, just let the kids enjoy themselves, it's not like they're getting video game consoles or a sportscar in the driveway or anything like that. A few Legos and some crap from the dollar bin at Target never made anyone a Bond super-villain. (Unless they used the Legos and Target dreck to build an excruciatingly slow crotch-slicing laser, in which case--yes, fewer gifts.)

That said, the reason that it was difficult to choose gifts for Nina in particular is because she's the youngest of three children and we already have a lot of toys. Cal and Mack were easy--some books, a mess of new Legos, some superhero crap, and we were golden. But Nina--what could Nina possibly want for Christmas? She's turning 18 months at the end of the week, and to be honest, she already has all the toys for this and the next three developmental stages. Wooden blocks? Check, Cal's Christmas gift four years ago. Little ride on tricycle? Check, Cal's first birthday present, inherited by Mack until he outgrew it--a little dirty but still in great shape. Plastic animals and people? Check, Mack has amassed a mighty collection. Thomas trains, wooden and plastic train tracks, a hogshead of die cast cars? Checkcheckcheckcheckcheck.

The only thing we didn't have, really, was girly stuff.

And I mean girly stuff as in really girly stuff, like Malibu Barbie's Dream McMansion and the like. In my effort to make sure the boys don't grow us as 'roid-raged meatheads, we had a lot of girl-ish things already, even before Nina was born, and certainly most of our toys are to my mind at least gender-neutral. Mack in particular has a self-avowed fondness for pink stuffed animals so we have our share of those, and while the boys never really got very interested in the baby doll already we've had lying around since time immemorial, they also don't think it's weird to have one around.

Sidebar: a conversation with Mack last week. (We were making bracelets for his friends--have you seen these little rubber band bracelet kits they have now? Apparently they are all the rage, at least if I am to interpret the ceiling-to-floor wall of bagged rubber bands at Target correctly, but what you really need to know is that they look like those rubber bands that people wear on their braces, and if you drop the bag they will fly out EVERYWHERE.) Anyway, the conversation:

MICHELLE

So what colors do you want to chose for your friend Charlie?

MACK

Uh...yellow, pink, blue, purple.

MICHELLE

OK, so we'll do that as the pattern? Yellow-pink-blue-purple. Start picking out the rubber bands.

MACK

Why does some people say I can't like pink?

MICHELLE

What people say that?

MACK

Girls. They say that boys can't have pink.

MICHELLE

Well, that's silly. They're just colors. Everyone can like any color. Like me, I'm a girl, and I like blue. And green. And yellow. They're just colors. They're for everyone.

MACK

Yeah.

MICHELLE

Do you like pink on your bracelet?

MACK

Yeah.

MICHELLE

Well I think it looks good on you! You choose what colors you want! Even Dad wears pink sometimes, and no one's going to tell Dad that he can't wear pink because he's a boy.

MICHELLE'S INNER MONOLOGUE

So anyway, my point is I try to be mindful about such things. To be honest Nina really hasn't expressed any preference at all about liking "boy toys" or "girl toys," (or even knowing the difference between boys and girls) and will happily play with anything, particularly if it's something that Mack has a particular attachment to so as to get the maximum possible reaction. But I'd like to think that if she enters a super-girly phase (the Disney Princesses and such) that I would go with the flow on that too, and not have too much of the opposite reaction, insisting that she only play with dinosaurs and Cal's old Black and Decker toy tool kit to make a big old feminist point about it. Whatever, she'll figure out what she likes, and I'll go with the flow. But either way, I don't want to push anything on her.

Anyway, to sum, for Christmas we got her some puppets, clothes for her baby (boy and girl clothes), some toy foods with a shopping cart, and a water/sand table that we'll hopefully move outside once the weather warms up--though until then we'll play with it here, which makes it easy to fill and clean up but also somewhat defeats the purpose of having a free-standing water table, because why not just take a bath already?

Her favorite gift, by the way, has been the puppets, so I recommend them in particular. I am also glad that I decided to go for the animal puppets instead of the people puppets, because while I love the idea of having the multiethnic people puppets for the kids to play with, the temptation to quote the Franklin scenes from "Arrested Development" would likely have been too great.

Well, onward and upward. Our New Year's Eve plans involve sparkling cider, snacks from Trader Joe's, and a "Simpsons" marathon courtesy of our increasingly outdated DVD collection. (But please note: we only have the box sets for seasons 2 through 7 because why bother with anything else?) Cal in particular has requested the B-Sharps episode, specifically citing the scene where George Harrison points Homer towards the platter of brownies at that party. "Well, what a nice fella." Kid's got good taste.

See you next year! (She said cleverly.)

quotidian

Cal was supposed to bring a pumpkin to school on Tuesday for some sort of jack o' lantern carving activity in his class. There was an ostensibly academic twist to it (I think they were weighing and measuring the pumpkins first, converting ounces to pounds or stones to hectares, whatever antiquated non-metric systems we still insist on teaching despite the fact that they make NO SENSE) but let's get real, the true purpose of such an activity is to claw out all the pumpkin guts and show your friends the clotted mass of stringy entrails while making a variety of throw-up noises.

Cal left his pumpkin at home by accident, so when I went to drop it off at his classroom (ordinarily in such cases I leave the forgotten item at the front desk and someone from the office ferries it upstairs to the classroom so as to minimize disruption--however, in this case the pumpkin was gigantic and when I offered to carry it up myself they happily left the hoisting to me) I kind of got roped into coming back in later that afternoon to help Cal's teacher with the activity. Honestly, my first instinct when the teacher asked me if I could be an extra set of adult hands (in the setting of 26 fourth graders wielding a variety of hollowed out gourds and serrated blades) was to beg off because look man, I'm busy. But that response was a reflex, ingrained from years and years of having to say no to stuff. Because I actually wasn't busy that day. And having the time to do things like this in the kids' classroom was precisely the reason that I went part-time in the first place.

Which brings me to the topic for today, which I have deliberately been shying away from because the kind of honesty with which I want to discuss this is precisely the kind of thing that causes fistfights to break out in the comments section of The New York Times "Motherlode" blog. (Leaving aside the truly questionable decision to call a parenting series "Motherlode," because random puns aside, parenting is only for ladies, y'all!)

Joe and I agree that since I have made the move to go part-time at work, the quality of our home life has never been better. The benefits are obvious--I have more time to spend with each kid, I am more connected with what they are doing at school and at home, we can actually schedule doctors and dentist and teacher appointments, we are all eating better, acting out less...the list goes on and on. And there are moments every single day when I think, "Thank god we finally decided to do this." The mornings I spend with Nina after the boys are off at school. Time that I get to carve out to spend with Mack alone, which I hardly ever had a chance to do before. Having time for actual conversations with Cal, who for all his idiosyncrasies as a young child is actually turning out to be a pretty cool and funny kid. These are the obvious good things. These are the things that make it clear that the decision to dial back at work was worthwhile.

But of course these are the things that just make parenting in general a joy, and between these clearly treasured moments are the interstices, the webbing, the connective tissue that binds the important bits in a dense fiber of the banal. Because for every morning I spend with Nina watching the sun rise over the Chattahoochee there is of course an entire day of chasing down lost shoes and changing diapers and washing clothes, cleaning up one mess in the kitchen while Nina is creating the next mess because allowing her to create the next mess is the only way I can buy time to clean up the first mess. For every special afternoon with Mack there is the endless run of school pickups, school dropoffs, making sure that lunchboxes are packed and thermoses are not lost at school, corralling shoes and socks and sweatshirts and more socks, items which surely must walk around at night after we're asleep because otherwise there's no explanation for how they spread out and hide all over the house. And for every pumpkin carving activity I do at the kids' school, there is an hour of sweeping up sticky pumpkin seeds, picking up strips of newspaper and magazines that have glued themselves to the linoleum with bioglue, and wiping down desk after desk with antibacterial wipes and hoping to god that the janitorial staff at night come equipped with mops. (Though to be clear: I was more than happy to help, and Cal's teacher was a brave, brave man to even consider staging the mass class pumpkin carve-a-thon without a second adult around. We could have probably used another two or three adults, to be honest.)

It is in these moments, with the brooms or with the wet rags or running in and out of the supermarket or picking up the dropped (well, hurled) sippy cup again for the five hundredth time that I think: It doesn't have to be me doing this. This does not involved an advanced degree, or special training. ANYONE could do this. Or, perhaps more precisely to the point: I took a 40% pay cut in order to wash dishes and do laundry? DOES NOT COMPUTE.

(This is the part where people start polishing their pitchforks. Hey, you missed a spot!)

Look, I know that it's not the special advanced skill with which I drive to carpool or wash the dishes or make the school lunches that the time worthwhile--it's the fact that I'm doing it for my kids that makes it special. I get that. And I also get that, with parenthood, the amazing moments are not in the majority--that it is, in fact, the intermittent and punctuated nature of the awesome moments that make you get up each day and do all the non-awesome stuff over and over and over again. And that's probably true about most things in life, though I'm beginning to find that there's something different about spending a full day parenting rather than a full day being a doctor: it feels less special.

(And here is where you start jabbing the pitchforks. Jab on, gentle village people! Miss ye not the tender essential organs!)

And when I say "special," I don't mean to say that my kids aren't special, or that my parenting them isn't special. It's just that in the mundane moments, it feels like anyone could be doing this. I didn't need to go to college or medical school or spend five years in residency training to do that stuff. My educational background, or training, or the years I spent before I had kids doesn't inform my daily parenting in any meaningful way. It's just me, doing what millions and millions or other people are also doing at the exact same time--probably I'm not even doing as good a job as many of them are, because HAVE YOU SEEN PINTEREST? Just me, momming it up like a character in a Sunny Delight commercial, part of the hoarde, one of a type, a piece of a marketing demographic. And that's the part that doesn't feel special.

And the thing that bothers me is that I never considered myself someone who needed to feel special, or who cared about status. I don't make people call me "doctor," I don't wear my diplomas around my neck on a giant chain, and I think I've worked most of my professional life to try to put aside whatever ego may manifest in my persona because quite simply I don't think it serves any purpose. But obviously it must have mattered to me more than I thought, because while I recognize the luxury of spending more time with my children, and for all my whining I have plenty of help in keeping this family going; I still sometimes think, this is it? THIS is what I miss work two days a week to do?

Because at work, it sometimes seems like the significance of what you're doing is obvious. That the answer to the question, "What did you do today?" could be succinctly summed up by saying: I'm a doctor, I take care of patients. Boom. Instant credibility. Credibility to whom, unclear--perhaps it's just to justify things to myself. But on the days that I'm "off" with the kids...

JOE

So, what did you do today?

MICHELLE

Well, after breakfast I dropped the boys off at school, then I took Nina to the park. Then we came home, and while she took a nap I cleaned up the kitchen. Then I started to prep stuff for dinner, but then she woke up, so I gave her lunch. Then I cleaned up after lunch. After that we kind of played a little bit out back, and then it was time to pick up the boys again. So we did! And then I finished making dinner. And then everyone ate and I cleaned that up.

JOE

Sounds good.

MICHELLE

...

JOE

What?

MICHELLE

You know, when I say it all like that it sounds like I didn't do anything.
But then how come it took up the whole damn day?

Obviously this is something I'm still working out in my brain, and clearly part of it is that there are societal indicators of what is considered "important work" that I have allowed to imprint on me (despite the fact that I obviously know that raising my children is important work, therefore the need to take more time to do it right). Also obvious to me is that this probably reflects poorly on my personality in some way--some sort of egomaniacal needs that are not being met by the quotidian tasks of parenting three young children being chief among my deficiencies. But I am curious, particularly after reading this article in the Times a few months ago--does this experience of "status loss" or this sense of becoming unmoored from part of your identity ring true for anyone else who decided to take one step back from a career that has in many ways defined them?

nature vs. nature

We found ourselves with only two kids Saturday morning. This sort of makes it sound like we left one in the back of a cab but in actuality Cal got invited to his friend's lake house, which is wonderful for two reasons. First, Cal is realizing that being unendingly polite is garnering him the reputation as The Kind of Kid That Other People's Parents Like To Have Around, and has thus been on the receiving end of a lot of very nice playdate invitations. Number two, of course, is that his friend has a freaking LAKE HOUSE. Which in Georgia is apparently pretty common, but as we have no such lake house, seems as exotic and Gatsby-ish as a straw boater worn non-ironically.

Usually we take these kinds of occasions to carve out some special time with Mack, if not just for the simple reason of heading off middle-child syndrome as distracting him from the cold reality that he has not been invited to boat and fish and tube and whatnot on the resplendent banks of Lake Wanahanapeepaw (note: not a real lake), and is, in fact, missing out on some serious fun.

Anyway. It's a beautiful weekend but as I am on call we couldn't go anywhere too far. So we went here, to the Big Trees Forest Preserve in Sandy Springs.

Mack wanted to collect some leaves for a project he's planning (I don't actually know what the project is--and I don't think that he knows exactly either, though I'm fairly certain that it will involve a lot of Scotch tape) and it's such a gorgeous time of year that I figured that something outdoorsy and wholesome was just the ticket. I originally wanted to go to the Chatahoochee River Natural Recreation Area, but of course because of the government shutdown most areas run by the National Parks Department are closed. Not that I'm complaining about it--though most visible, the shuttering of the national parks and monuments may be lower on the list of Very Important Things things the government shutdown is affecting--but I'm just pointing out that maybe in a few weeks, we'll bypass the municipal nature preserve and try something on a grander scale.

Smaller scale may have been a blessing in disguise anyway, as even the maximum loop entailing a mile and a half of easy trails can start to feel awfully long when carrying a large-ish 15 month-old (Nina can walk pretty well now, but on that kind of uneven ground she tends to fall a lot) (see also: muddy) (see also: persistent fear of snakes--my preoccupation, not hers) and felt even longer during the last leg of the hike when lugging around 40+ pounds of Big Mack. By the end I was starting to get paranoid--I assumed the trail was configured in a loop, but the longer we walked the less sure of where we were going, and there were no signs indicating EXIT or TRAIL HEAD THIS WAY or 500 FEET TO THE NEAREST CHICK-FIL-A.

I also started to get concerned that it was slightly inadvisable that we went that deep into the nature preserve in the first place--I'm on backup call for the hospital, so while one of my partners was already in house and though I checked in with him before leaving the house to determine that the chances of concurrent emergent-to-the-OR catastrophe was sufficiently minuscule, I did have a vision when I thought we were maybe-lost of being stat-paged to the hospital because, OMG TWO RUPTURED TRIPLE As AT THE SAME TIME, and having to rapidly extract myself from the middle of the damn forest using only my wits and by, like, feeling which side of the tree the moss was growing on. (To be fair, the preserve area is actually quite small, so it's not like I was on call and decided to go hiking in the middle of the Moab Desert or anything. We never even fully lost audio confirmation on the loudspeaker-amplified event in the parking lot of the Ford dealership next door. But still it's more dramatic if I don't tell you that part so forget I said anything.)

Anyway, we knew we had finally made it all the way back around when we saw the bright blue port-a-potty in the parking lot. Some of the trail had apparently washed out due to the heavier than average (some might say biblical) rains the latter part of this summer, and we had to scale an erosion-melted slope to re-enter civilization. At this point we had joined forces with another family who was similarly lost (they were not outdoorsy-types either and admitted that the only reason they were doing anything even remotely wholesome was because the dad had to attend a bachelor party later in the day and felt that he should pre-atone for the damage he was about to incur on his body), and I had recanted on all my earlier sentiments about the weather and the leaves and was basically like, "Fuck nature, let's go to Taco Bell."

AND WE DID.

(Fin.)

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?

the chamber of secrets

Cal did two weeks of "Danger Camp" this summer (basically a summer day camp program based on this book) and came away with it not only with the requisite mosquito bites and tie-dye T-shirt, but also with an enduring passion for spying, ciphers, espionage, and general subterfuge. It's all highly contagious, and while Mack will deny this to his last breath he idolizes Cal beyond all measure so whatever interests Thing 1 has rapidly become the interests of Thing 2.

Separate and mostly unrelated: we currently live in a three bedroom house, which while by New York standards is an embarrassment of bedrooms (and square footage), means that under current occupancy patterns, we have neither a guest room nor a room for Nina to decamp.

THEREFORE (and this is where the two threads come together) we are working towards the goal of consolidating both boys into the same room. We already have a bunk bed in Cal's room so we're halfway there (it's even a twin over a full so that Mack will be, what, 50% less likely to end up on the floor?) but even so, it's a transition that is sure to be met with some resistance, at least initially. So we're selling the idea by billing these new shared quarters as the SUPER-DUPER BOYZ HANGOUT ROOM. Jazz hands! And one of the ways that we thought we could make the room cooler? By building a secret clubhouse inside of it.

Cal's room has three small closets, the middle closet of which has a lofted crawlspace, about two and a half feet wide, thirteen feet long, and maybe four feet high. We'd been using this space to keep a variety of larger items that we had nowhere else to store (as we have neither garage, basement nor attic space); things like our Christmas decorations, moving boxes, an old set of doors from the laundry room, what have you. We still have no place to store these things, and in fact, all these things are kind of sitting out in the family room now until we find a better place to put them. But lack of storage aside we figured screw it, let's just empty out the crawl space and turn it into a clubhouse. A SUPER SECRET RAD CLUBHOUSE FOR BOYS. No Homers allowed!

The first thing we had to do, after we emptied the closet out, was change the light fixture. Being a closet, all it had was a single bare bulb hanging from the ceiling with a pull-chain cord, which was obviously hazardous, what with the risk of anyone walking into the burning bulb with their face. So we took out the light fixture, capped it off, and put in an outlet instead. (I say "we" but when I say "we" I really mean the electricians did it and I watched, encouraging them with the thumbs up sign and offering beverages for their troubles at annoyingly frequent intervals.) After the electrical work was done, we vacuumed and washed the floors (and I apologize for the lack of any really good "before" photos because you have to understand, it's basically a railroad car-shaped space, there's really no room to get a good shot) and got to work decorating.

One thing that Joe really wanted to put in there was a full-wall panel of dry-erase board. A dry erase board that size (about four feet by six feet) would easily cost more than a hundred bucks, but we did it on the cheap by going to Home Depot and getting a panel of fiberboard with one side of white shiny coating (not sure what the coating is but it is smooth and slick, like melamine) and getting it cut to 48 inches, which was the length of the wall on one side of the clubhouse door. The whole panel of fiberboard cost something like $12.99, and after getting it cut, we ended up with two fairly large pieces of whiteboard material--I still have to find a home for the second piece, because I guess I'm too much of a cheapskate to throw it away. The only drawback to this is that the dry-erase board isn't magnetic like some of the more expensive "real" whiteboard options, but in the big scheme of things and especially given the price differential, I don't think it's a big deal.

My big contribution was the lighting. Mainly the concern was safety. Joe had wanted to install one of those recessed can lights up in the ceiling, but I just kept having visions of the kids burning their heads or their hands on the bulbs, as the ceiling really is very low in there--Cal can't even stand up straight without his head grazing the ceiling. Another issue is that as a closet, the ventilation in the clubhouse space isn't very good. We already put a fan by the door to move some air in there and I have talked to the boys about leaving the outer closet door open, because as an anesthesiologist I am somewhat paranoid about CO2 rebreathing. (That scene from "Apollo 13" where the astronauts have to make that new CO2 filter out of, like, a sock and some duct tape? THE STUFF OF NIGHTMARES.) Anyway, my point to the lights is that anything incandescent would heat up the space quickly. I originally thought about a string of low wattage Christmas lights, but then I found these:

Tape lights! (Not "tap lights". TAPE lights.) They're LED and energy efficient, bright, cool to the touch, and super-easy to affix, as they are literally backed with 3M tape so you can just stick them up wherever you want. And best of all?

They change color! They even have flashing and strobe effects, which is not my favorite setting (I kept waiting for someone to start seizing in there) but the kids certainly enjoyed pushing all the buttons. I mean, no kidding, right? THERE ARE BUTTONS? WE MUST PUSH THEM. Anyway, we got two sets of 16 feet each, which was enough to go around the entire clubhouse once with a few feet to spare. We actually like these lights so much we ordered another two sets to rim the bunkbed with, so the kids could use them as reading lights in bed. (See also: the awesome factor.)

We rounded out the room with a berber carpet remnant we had lying around from carpeting the bedrooms when we first moved in (coincidentally the one strip we had was almost exactly the dimensions of the clubhouse space--we just had to lop off a few inches in width to make it fit), two beanbags from Target, a few superhero posters, and a world map from National Geographic. Et voilà.

The name of the secret club, by the way, is SECRET CLUB MOM AND DAD NOT ALLOWED (S.C.M.D.N.A. for, uh, "short") and after surveying the finished product, Cal and Mack promptly kicked me out, which I consider a successful end-result.

Hope you're having a happy Labor Day weekend!

recalibrating

I know there's a touch of irony in adding this disclaimer given that I haven't updated this blog in, like, half a year, but: LONG ENTRY AHEAD.

There's a snippet of a cartoon I remember from my childhood--I can't remember if it was "Tom and Jerry" but if it wasn't it was in a similar vein--where a mouse is reclining in a hot tub. He's sitting back with his arms along the rim of the tub, maxing and relaxing as cartoon mice do, wearing that look of smug satisfaction he was prone to. (As an aside: I never liked Jerry. I always thought he was a real jerk to Tom, a cat who was just fulfilling his evolutionary imperative after all. Ditto Road Runner. Ditto those capering harpy kids that keep taking the Trix away from the rabbit. JUST GIVE HIM A BOWL, YOU ASSHOLES.)

So anyway, the mouse. He's enjoying the hot tub. He's relishing the water, the heat. But the water starts to get a little bit hotter. And a little bit hotter still. Suddenly it's not so comfortable anymore. Not hot enough that he wants to get out of the tub or anything, but just...hotter. He starts sweating. His fur starts getting a little frizzy (from the humidity, you understand). Then, finally, he turns around and notices the cat behind him, slicing onions and carrots to add into the now boiling water. (My memory of this part is not quite as clear, but the cat may have been wearing a chef's toque.)

I've thought of that cartoon clip a lot in the last year.

But let me back up for a second.

If you've ever followed this blog with regularity in the past (though I'm sure with my sporadic updates I've winnowed that number down to only the die-hardest of die-hards) you've probably noticed that I haven't had the time to write much of substance since I went back to work after my maternity leave last September, and that I haven't updated basically at all since December. The reasons are all those that you could probably expect: busy job, three kids, and the responsibilities and duties associated therein. The explanations are always boring because everyone's reasons for being busy are pretty much the same, but to put it in medical terms: it's just a matter of triage.

It's hard to know where the tipping point was--though I have to presume that it was at least in part associated with the addition of our much-beloved third child into the mix--but at some point in the last year, things started getting hard. Not impossible, not un-doable, but subtly, Joe and I started to notice just how tight things were getting. Time was tight, at home, with the kids, with each other. Emotional resources were tight. Patience was less of a resource we could reliably depend on. The days and weeks started becoming these things that we were enduring, rather than living, let alone enjoying. Again, the imagery from an old movie comes to mind--inmates in a prison, grimly notching off yet another day on the wall of their cell.

I don't mean to imply that our life is a joyless dirge--far from it. We love our family, we love our jobs. Even working the hours that we do, we try carve out quality time when we can--long weekends, holidays, family vacations where they fit in. We bolus our family time because our basal infusion rate is so parsimonious, but we do make an effort to compensate. And we liked to tell ourselves that this bolus dosing was sufficient, and it worked...not well, but well enough.

But it didn't change the fact that over the past few years, and over the last year in particular, the feeling of our everyday lives becoming something that we were tolerating started to feel more an more pervasive. When you only see your kids for an hour or two at the very tail-end of each day, only to perform the most basic of maintenance for them (bath! brush teeth! yell at them for not taking their baths and brushing their teeth quickly enough because I'm tired and they're tired and everyone's tired so LET'S ALL GO TO BED AS SOON AS POSSIBLE) you start to feel like you're consisting on a diet of discarded crusts in an otherwise empty pizza box. Maybe you can piece together a life in these scraps of the day, but split between three kids, it's simply not enough time.

Joe and I have been discussing for years our long-term outlook for modifying (read: decreasing) the work hours for at least one of us to have more time with the kids, and for the longest time, our party line has been: soon. We're going to do it soon. "Maybe in a few years or so," was the stock phrase. But there was always the next thing. We'll think about it when I finish my fellowship. We'll figure it out it when I get more settled in my job. We'll do it if I make partner in my group. Later. We'll do it. But later. Meanwhile, time marches on.

Then: I was talking with one of my partners at work a few months ago. He has four kids, the oldest of whom had just turned eight. "I just realized," he said as we were chatting in the front hall of the OR, sidestepping a stretcher careening down the hallway from the PACU, "that he's eight. In another eight years, he's going to be in high school, driving, getting ready to go to college. Half my time with him is already done. I mean, they come home after they go to college and all, but you know what that's like. It's not the same. Half my time of having my son in my house is over already."

There feeling that I had after having that conversation was not unlike being wrapped in a piece of wet burlap and gently asphyxiated. Because Cal was turning eight too. Half our time raising our oldest son in our home was done, and not only had this particular calculus not ever occurred to me, but looking back, I can't say I really know where those eight years went.

Because see, we've always lived like this. Cal was born when we were residents. His entire life--and thus of course, Mack and Nina's entire life too--we've worked. Both Joe and I have worked our tails off. We're not residents anymore of course, and some of the specifics of our jobs have changed from year to year, but the fact of it is that we each work on average 50-60 hours a week, more if we're taking weekend call, and although we've been saying for years that we were going to try to get more control of our work schedules to put some more time into our family life, it hadn't happened yet. The decision point was always pushed off down the road. Later. Soon. Not yet. Someday. And now Cal was turning eight and I have no idea how time passed so fast.

If I'm going to be completely honest with myself I'm sure some of this particular grim inertia was also linked to a perverse macho pride. I've always spoken a lot about work-life balance in medicine and how these antiquated notions, about doctors functioning as around-the-clock automatons sacrificing their personal lives for the greater good, would have to evolve along with the rest of the world. But I think that in some ways I felt safe championing the choice for others to go part-time because I myself chose to work full-time. You do what works for your family, everyone's definition of work-life balance is different. But saying it from the vantage point of someone with three kids and still worked full-time herself felt like a secure platform from which to proselytize, like I was somehow above reproach from people who might accuse all part-time doctors of being lazy or uncommitted. DO WHAT YOU NEED TO DO; BUT AS FOR MYSELF, I AM DOING ALL THE THINGS.

And to be honest, we were getting by. It wasn't wonderful, but it was OK. We were surviving. Maybe we weren't "living our best life" to invoke an Oprah-ism (and I don't even know how I know that since I never even watched Oprah) but...day to day, we were getting by.

And then, the week before Memorial Day, our nanny of five years quit. With no warning, and giving zero notice. She just left one day and mentioned on her way out the door that she wasn't coming back.

Boom. Game-changer.

I'm not going to talk too much about the nanny thing because frankly, after probably the most stressful two months of our lives, I'm just over it. It wasn't even so much the issue of finding a new nanny--though that, obviously, was a huge part of solving our problems, at least in the short term.  But the larger and more important part was having to honestly evaluate our life, our choices, and just how much time we did indeed spend at work, away from our children. It was like turning the stark, faintly buzzing fluorescent exam light onto the fish-white underbelly of what kept things functioning at a level that passed as "OK" for the past five years. And what we realized was that: it really isn't OK. Having to outsource this much of our children's care--of our children's lives--to someone else, particularly someone who after five years could walk out on them without so much as a backwards glance...is not OK.

(This is putting aside the obvious logistical difficulty of finding a non-live-in person to work 50-60 hours a week. It's a tough sell to say the least. One suggestion, perhaps less helpful than most, was that we should just hire two nannies. To which my reaction was, if you have to hire two people to take care of your kids while you're at work, it's possible you're not spending enough time with your kids.)

So. Joe and I discussed and agonized and number crunched and evaluated. We talked to a lot of people. We agonized some more. And what's going to happen now is this: as of September 1st, I will be going part-time at my job. Joe and I would have been fine with either one of us working less, but because of the ways our jobs are structured, it makes more sense right now for the part-time working parent to be me. My new schedule will have me working three days a week, mixed in with my share of nights, weekend and holiday call. And my main goal for the other two days of the week? To do some of the things that I've never been able to do with my kids because I've haven't had the time. Simply to be around more.

I know this all seems unnecessarily melodramatic of an announcement to some, because plenty of people in a multitude of fields choose to work part-time. But for me, it is a big deal, because to be honest, when you're accustomed to following a prescribed path, swimming against the current for a change can be scary. And there are a lot of issues--job guilt, fear of resentment from co-workers or being perceived as less than fully committed to medicine, concerns about crippling my career potential--that I'm working through having finally made this decision. There's a fear of not wanting to let people down.

But that's it on the other side too, isn't it? I don't want to let people down. I want to do my job well. All my jobs. And I think that right now, I need to spend more time with my kids. Nothing's broken, I still love being an anesthesiologist, and the fact that I've worked full-time for the first eight years of parenthood wasn't the wrong call nor has it damaged our family. It's just that our choices then are not the same as our choices now, and when we have better options we owe it to ourselves to take them. We could be making more of this life. We could be doing better.

I'm not going to be there hovering in the periphery for every single second of my kids' lives, nor frankly should I be. But I'm looking forward to just being around more.

So that's what's going on with us. In most ways, it's really no big thing. But in other ways, it's the biggest thing.

costume drama

He's my firstborn and so I say this with all possible love and bemusement, but Cal is a weird child when it comes to dressing up for Halloween. It's not so much like he has sensory issues--he doesn't have problems with the costumes being itchy or bulky or too hot, he just thinks they're dumb or something. I think in reality he just gets self-conscious. Like the act of wearing a costume garners too much attention, and he doesn't like the fuss. At all.

Above is, unfortunately, the only surviving photo of his first Halloween costume that I can find (there must be more out there, but I didn't use iPhoto during Cal's first year so many of those digital image files are archived somewhere unreachable). It also showcases Joe's unfortunate predilection for grafting cheesy beyond belief titles and borders onto photography--just be grateful we're spared a wreath of pumpkins around Cal's face or something similarly Printshop circa 1988. Anyway, I just show you this picture because this, taken at the time that Cal was about Nina's current age (they were both born in July), is the last time that we were able to cram Cal into a Halloween costume without him complaining.

Here the following year. You can't see most of the costume since he's you know, running away from Joe (I think I was actually on call that particular Halloween so I wasn't even there) but he's supposed to be a monkey. See how happy he looks? SEE THE LOOK OF CHILDLIKE WONDER WHILE TRAIPSING THROUGH THE MAGICAL WORLD OF MAKE-BELIEVE?

Above, the following year, when he was two years old. We, thinking ourselves terribly clever, dressed him as a medical resident. Cal quickly stripped himself of the accessorizing accoutrement (the scrub cap, the pager, the stethoscope which had been doused in alcohol and Clorox to eliminate all traces of Enterococcus fecalis--it's the small touches that really make the costume, after all) and just barely tolerated the rest of it, mostly once he realized there was candy involved. This was back when we still lived in New York by the way, so his exposure in costume was minimal--mostly we just walked down the hallway, trick-or-treated one apartment, and then walked back. (Some of the candy he got may have been from our own bowl.)

I had some high hopes the following year, as in September Cal specifically requested a pink butterfly costume. Yes, a pink butterfly. So I got the costume (OK, so maybe I got a red and orange butterfly costume--I am as open-minded as the next parent but maybe it's my own bias that led me to apply some well-meaning edits to his original intent), but by the time it came Cal decided that he didn't want to wear any costume, butterfly or otherwise. "I just want to wear regular clothes," he said, a refrain that would dog us again and again subsequent Halloweens. We went to his nursery school Halloween party that year wearing khakis and a grey cardigan (I begged him to let me put some baby powder in his hair so that we could at least pass his costume off as "old man," but he was not having it) and had no further costume planned as of October 30th.

Finally, we just ended up putting him in his beloved "regular clothes" (black long-sleeved t-shirt, long pants), gussied it all up with his rain boots and a two-tone bolt of electricity that I cut out from construction paper and taped on his chest. Enter "Captain Lightning Bolt."  He was OK with this for some time, but then had a little potty accident after hitting three or four houses (three year olds never feel like they have to go to the bathroom until all of a sudden OMG THEY TOTALLY DO) so trick-or-treating was cut short and the costume issue was put to rest for another year.

At age four, Cal finally acceded, after weeks of cajoling to think of a Halloween idea, any idea; to go as "a builder man." Again, a costume involving his everyday clothing and some accessories from the toy bin.  The hat, tool belt and goggles were, of course, instantly shed the second after the pictures were taken, and he ran around his school Halloween party somewhat incongruously dressed in jeans and a blue oxford shirt.

And then, the year he was five, Cal refused to wear anything even approximating a costume. In fact, we didn't even go trick-or-treating that year because he just flat-out refused to do anything and Mack was too young to know any better. At the 11th hour (that is to say: 6:00pm on Halloween night) we thought maybe we had convinced him to go as Steve from "Blues Clues" just by wearing stuff out of his closet (green striped rugby shirt, khakis, blue dog stuffed animal--boom, instant Steve) but then at 6:05 he decided with finality that costumes were BOGUS and trick-or-treating was DUMB and a horribly humiliating ordeal for LOSERS. Also maybe he whined and cried and acted like we were asking him to eat not but burning hot coals and drink not but burning hot cola.

"But if you go out and wear a costume, people will give you candy!" I told him, playing what I thought was my trump card.

"We have candy at home," he said, quite reasonably.

So after that debacle, we decided last year, when he was six, that he was going to find a costume that he would tolerate and we were going to go trick-or-treating whether he liked it or not. I don't think we're of the type necessarily to force our kids to do stuff that they hate, only it seemed like he was getting himself all worked up over nothing, and that if only he would stop being so rigid and just relax about "looking dumb" and allow himself have fun, that maybe he could actually have fun and we could be like a normal family going trick-or-treating. And then maybe I finally get some candy runoff at long last. IS IT SO MUCH TO ASK?

We decided, after brief discussion, that he would be Harry Potter, which was cool because he already had a Harry Potter wand, and anyway, Harry Potter wears regular clothes, he could even skip the glasses, all he'd have to do is let me draw on the forehead scar and wear this Gryffindor scarf that he got just so it looked like he was trying a little.

After a lot of discussion (and more whining, and more crying), he finally let us tie the scarf on him. But he was not real happy about it. "You know, Cal," I told him, "most kids actually really like Halloween. They think it's fun to dress up, and go around, and they like going door to door to get candy. It's kind of a really big holiday for kids, you know?  Some kids look forward to this all year!"

He just grunted.

(Though eventually he did get into it.)

This year, we didn't even have a discussion. We were going to do this thing. After polling Cal to see if he had any costume ideas (to which he responded, "I don't know. I have to consider it.") I just decided, boy, you're going to dress up as a Star Wars character, and I don't want to hear any more about it. Originally I bought a whole pile of cream and brown fleece and was going to sew all the kids matching Jedi costumes (pause for laughter), but reality testing eventually intervened and I ended up buying the chintziest of chintzy drugstore Jedi outfits for both boys, coupled with these foam colored light up rods that I highly recommend to anyone who has kids that are into Star Wars.

And when we went to the third grade Halloween party this Friday, he put it on without any discussion.

Cal!

Put on an actual non-regular clothing costume!

WITHOUT DISCUSSION!

(High fiving a million angels)

I know it's not a big deal (and believe me, I'm trying not to make it into one, especially in front of him), but it's been seven years and eight Halloweens to get to this point so...yeah, it is kind of a majorly big deal.

Both of the boys, by the way, decided to be Obi-Wan Kenobi for Halloween.  Originally Cal wanted to be Obi-Wan and Mack was going to be Anakin Skywalker (which I found actually quite fitting), but then Mack decided that he wanted to be Obi-Wan too, and Cal got mad because what are you nuts, there can't be two Obi-Wans, haven't you even seen the movie?  Like, a couple hundred times? And there was much squabbling, and I came in and decided, perhaps at a slightly higher volume than strictly necessary, YOU KIDS SHUT UP EVERYONE'S GOING TO BE OBI-WAN.

Ah, Mack.  Mack, on the other hand...

The only problem we have with Mack is getting him out of costume.


* * *


I'm kind of hustling to write this while the kids are asleep so I don't really have time to reflect on this fact or get overly introspective/profound/lachrymose about this fact, but: this weekend marks the twelfth anniversary of this blog.

Twelve years. That's a lot of years, boy. Twelve years ago I was starting my second year of medical school and decided, on a whim, to start an online journal in lieu of memorizing the complement pathway to have even a faint hope of passing my immunology midterm. And now I am an attending anesthesiologist, married to my med school classmate (who, not to knock my own clinical skills, but I often think is a better doctor than me, or at least good at different things), a mother of three, living in the South.

Aside from the part where I now have a medical degree, at the moment I started this blog I had no idea where I would end up ten-plus years down the line.  I can't say that everything that has happened to me since has been expected. But as much as we Type A personalities like to control things, the unexpected can be exciting, and what's more, the unexpected can be quite good. And really, I don't think that this blog anniversary requires much more reflection than that, only to say that life now is busy and full and, most importantly, fun. I think I've reached a point in balancing my life and obligations where I feel that if something extracurricular ceases to be fun, it's probably not worth doing anymore. But keeping this blog, even after twelve years, continues to be fun, and that's why I keep writing. So thank you for sticking around with me.

And yes, if the finer details of the CXCR4 signaling pathway are indeed important to my clinical practice, I am pretty much screwed, because I don't think I ever really learned it in the first place.