It’s 4 a.m On A December Sunday…. Reflecting On A Long Week

Long week. There were good things: Hubby came home from ten days on the road. The kids, Nana, and I all survived his ten days on the road. We’ve all had more quality time with the kids. In the big picture, all is well.

But. Some very heavy patient interactions this week, a few of those memorably negative, complicated, or tragic cases, the kind that weigh on your soul. I’ve been uncharacteristically dragging in clinic.

And. The annoying upper respiratory virus that I’ve been seeing in clinic for weeks and weeks finally arrived in our house. Hubby’s first night home, after a red-eye flight the night prior and a full day’s work, we had both kids up coughing, crying, miserable, all night, one and then the other. The rest of the week, ditto. Every night.

Then, of course, one or the other child was home sick from school, and Thank Goodness For Nana, or we’d have been completely out of our minds.

My Thursday off, I had both kids home sick. Snuffly and coughy sick, not febrile or SICK sick, so I brought them to the animal shelter for my usual Thursday morning cat duty. The census was low and the animal officer was there to help, so we handily made it through our feeding and cleaning shift. Then, with the whole day ahead of us and snow beginning to blow, I wondered what we were going to do.

Seriously. On a snowy weekday in December, with both kids home coughing, what better place to be than the mall?

So we spent the better part of the day (and a lot of tissues and hand sanitizer) in consumerist heaven: a whole huge mall decked out for the holidays, and plenty of parking.

Babyboy was hungry, so we aimed for the food court. A kind elderly woman asked us if we were going to see Santa. Santa! I hadn’t even considered it. Usually, the line to sit on Santa’s lap is long, and there’s hoards of loud families crowding around: a potentially very autism-unfriendly scenario.

But after they ate, I asked the kids if they wanted to meet Santa, and they both said “Yes!” So, we gave it a try.

Luck! On this weekday midmorning, there was no one in line. Santa was just chilling. He he was genuinely obese, and he had a real white, fluffy beard. He didn’t “Ho Ho Ho”, he just smiled and waved. The kids were mesmerized. With all that quiet and space, there were no problems. Both kids sat next to Santa and, very earnestly, told him what they wanted for Christmas. Babygirl: a Lego pony set (I’m pretty sure this exists). Babyboy: A stamping set with an ambulance (he has this Melissa and Dough arts and crafts stamping set with vehicles, but no ambulance; I am pretty sure this does not exist). In any case, we got a great photo!

After loads of walking and gawking, a mega Target run, and perhaps a few small unnecessary treats later, we headed home. The kids were great, and I was proud. Despite feeling tired and achey, I had a nice glass of red wine with Hubby.

I welcomed Friday, except that I came down with the respiratory bug as well. After dragging though clinic, Hubby and I spent our sixth wedding anniversary eating takeout Thai with my family over at Nana’s. No dinner out; it’s just been too crazy a stretch to arrange a babysitter, and we’ve all been sick anyways… Give it to Hubby though, when we got home, there was a huge bouquet of flowers, silver earrings, and a lovely card waiting for me. Thanks hon!

Despite putting myself on the regimen I’ve put all my patients on (short of prescription cough medicine) I’ve been up at night coughing, too. This lovely night, or morning, I woke up at 3:30 a.m. coughing. Then Babygirl woke up coughing. I rocked her and rocked her, but she wouldn’t go back in her crib. Babyboy was already in our bed from his earlier respiratory difficulty. It’s a queen-size bed; perhaps feasible to fit the whole family, as we’re all on the smaller side, but, I’m coughing anyways, so I figured I’d keep myself out. I tucked Babygirl in, and constructed a pillow-and-stuffed-animal barrier to prevent her rolling out (it’s happened) and tiptoed away.

It’s not a bad thing, to be the only one awake at 4 a.m. It’s silent, completely peaceful. I’ve been woefully behind on my blogging, online Christmas shopping, and bill pay. Here’s a chance to catch up! The tree’s plugged in and the coffee’s on.

In short, it’s been a long, exhausting week; but overall, all is well. 11581920141211_0001

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Home Alone

I’m having a rare and special experience.

 

I’m home alone.

Well, almost alone. The only other occupants are our two large, emotionally needy cats.

The kids are at school and Hubby is traveling for work. Errands and chores are done: We’re stocked up on essential groceries. I already went to the animal shelter and the gym. I logged into work and answered a very few messages. Laundry happened early this morning. Even the bird feeders are full.  The Christmas tree is up and decorated, me and the kids did that over the weekend. The outside lights are up, ditto. I even made a respectable start with the Christmas shopping with a cyber- spree last week; packages should start rolling in any day.

Essentially, I am in my house alone, and without anything pressing to attend to.

Sure, there’s boards study. I actually cracked open the first workbook a few nights ago, and at the suggestion of my expert test-taker brother, I dove right into the practice questions. Each is written like a little medical mystery to be solved. They’re actually FUN. Last night, I found myself looking forward to the kids’ bedtime so that I could work through a few cardiovascular self-assessment questions. That will be my nighttime post-kids-ritual from now until April.

Christmas cards have to be addressed and sent, but it seems a crime to use precious daylight hours for that. The photo cards, address labels and stamps are all ready to go… that will wait.

I texted a few friends, asking, “Hey, are you working?” and, so far, everyone is, or, at least, they’re not answering. Haven’t made it all the way through the list though.

So, I find myself writing a little blog post, with the plan to take a nice long shower, and maybe even paint my nails! Because I have to pick up the kids at 2:30…. and who knows when I’ll be home alone ever again.

 

 

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The Everyday Things I’m Thankful For….

Okay, I’m a couple of days late on the thankful post. But today I was inspired by a colleague’s post on the Mothers In Medicine blog: I’m Thankful For A Bridge . In this piece, she describes that when a bridge she barely noticed had to be closed, it affected her life in a big way. At the end, she asks the reader to think about what mundane things they are thankful for.

This is a good question. Of course I’m thankful for my husband and kids, my family and friends, my job and home. But there’s so much else to be thankful for, things that we barely think about.

We got a reminder on that last month. I had peeled a couple of pounds of potatoes, and I stuffed the peels down the kitchen garbage disposal. Awhile later, we had a backup in the sink. Okay, no biggie, we plunged, we pushed, we fussed. When that didn’t work, we poured baking soda and vinegar down and waited overnight. When that didn’t work, and we realized water was pouring out of the motor casing of the garbage disposal, we called the plumber.

It was the plumber who noticed we had a flood in the basement. He also realized the job was bigger than he could handle.

The clog was in one of the pipelines beyond our house. We couldn’t use any of the plumbing in the kitchen, or the washer. It was four days of snaking and roto-rootering by two different specialists (and over a thousand dollars) before we could wash dishes or clothes.

It was a pain, but not the end of the world. We put a basin in the sink to catch water so we could wash our hands, then we would toss the used water out the back door. The dirty clothes piled up and up. We adjusted.

It reminded me… Years and years ago, I did a few stints of medical volunteer work in Central America. Twice I stayed in villages without reliable electricity, and no running water. The homes I stayed in had wells; they also collected rainwater. Water for washing and bathing was kept in big barrels. When these were running low, someone had to haul water from the well. A bath was whatever water you could carry to the plain concrete room, and dump over yourself. If drinking water wasn’t bought or delivered, we had to boil well or rainwater.

Once, when the rainwater we used to wash our hands in the clinic smelled funny, someone went up to the catchbasin on the roof with a net on a long pole, and came down with a bucket of dead rat and frog carcasses. It was apparently not uncommon for thirsty animals to fall in and drown…

At the end of one six week trip, on the plane ride home from Managua to Miami, I turned the water spigot in the tiny odorous lavatory, and clear water poured out for me to wash my hands. I almost cried. I marveled that on a plane trip of two hours, there was running water. In a village of a thousand people, there was no running water.

Though our plumbing ordeal was annoying and expensive, it wasn’t a big deal in the face of the fact that most of the world doesn’t have reliable access to clean water. Our experience actually made great fodder for funny stories (think about it before you stuff vegetable peels down the garbage disposal), and we now have the low-down on all the local plumbers. Need a plumber? Let me tell you who to call and who not to call…

We had a second mini-Thanksgiving today, and I just finished washing loads and loads of pots, pans and dishes. The dishwasher is humming and churning. The kids are going up to take their bath. Yes, we are quite thankful for clean, running water. Something we don’t often think about, but so, so important.

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When Am I Going To Study For The Boards???

I graduated from residency in 2005, and took the boards. I did a Med/Peds combined program, so I took both the pediatric and medicine boards back-to-back. Somehow, I managed to pass both.

But. It’s now fast approaching 2015, and board re-certification looms. Granted, this time around it’s “only” the Medicine boards. But.

Given how much I already have to cram into a day, when the hell am I going to study???

I had this plan that I would purchase the most popular board review materials in the online as well as print versions, and work in about a chapter a week, which would bring me to completion around March, with the boards being in April.

And I had definitely planned to take a whole week off from work in March, and attend an in-person boards review course, to freshen up.

Well, it took me several months to simply find the time to get online and order the damn review materials in the first place. I blew almost 1000$ on those. They arrived, a box of books weighing about fifty pounds, that sits, unopened, on my floor.

I managed to sign up for the refresher course. I hit click and spent 1500$ just like that.

At least these expenses are tax-deductible…

So far, I have found ZERO minutes to pull out the books or log in online to start studying. Where does my time go?

I work four half-days a week. or, more accurately, I see patients four half days a week. Then I spend several hours documenting/ billing/ reviewing and reporting results/ calling patients/ visiting inpatients. I’m usually running to get home at a decent hour by the end of the day.

I know my priorities differ from most. I put eating and sleeping well and exercise at the waaaaay top of the list, well behind cleaning house, running errands… studying for the boards.

And we try, really try, to prioritize our family and community involvement.

This past two weeks, we’ve been invited to or hosted several events; family, church, community. Warm, healthy, fun events. Nurturing our connections to our extended family, our church, and our community, is as important to us as nurturing our children. After all, regardless of your politics, it does take a village. We try to give, and we hope to get back. Our children will benefit.

But we often miss events. A few weeks ago, I absolutely killed myself to rush out of work a few hours earlier than usual and high-tail it over to my daughter’s school for a Parent- Teacher Organization Meeting. Then, the whole meeting was about setting up more meetings, in order to plan a whole series of school events. I realized, as I sat there cry, very quietly, that I would never be able to make it to even half of the events, never mind the meetings to plan the events. I bowed out of that committee.

So, we pick and choose. Or, take turns. Hubby goes to some school things, Nana others, and I step in when I can. I was the one who made it to our son’s Parent-Teacher Conference night last week. But for the most part, I think we aren’t going to be the parents that get all involved with the schools.

We try to make it to church things and family things… We try.

So already we can’t manage to be fully engaged. How do I fit in boards study?

How, indeed… Most nights, realistically, I have about twenty to thirty minutes of down-time after the kids go to sleep, before I am totally incoherent. That’s usually the time I reserve to write a quick blog post, or read a Parent’s magazine article or leaf through Cook’s Illustrated. My brain is usually a bit fried by that hour.

But I think that’s going to have to become Boards Study time. I’ll pile all the magazines in the bathroom, and set those books right up here on the bedside table.

Occasionally, I get in a blog post at work. I feel terribly guilty when colleagues walk by my workstation and see NOT the electronic medical record, but rather, WordPress or Blogger, and me typing away like my life depended on it, because I know I’ve got exactly twenty minutes before I have to run out the door.

Blogging may have to take a backseat for awhile. Of course, there is the consideration that blogging is somewhat therapeutic for me. And, very good suggestions come my way through this blog.

I guess we’ll have to see what works… And pray that I pass the boards, because it cost a pretty penny to register for the test, as well….

 

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MiM post on Unruly Kids

Great comments from other mothers in medicine, in response to my post asking for advice: How Do You Discipline Your Kids- In Public?

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Parenting Advice From A Patient

Last month, I met a lovely patient for the first time.* On taking her social history, she mentioned that she had four grown children. I asked her how they were doing and what they were doing. She matter-of-factly and succinctly described four extraordinary citizens. All four children had earned degrees and were working in various service professions, things like teaching, nursing, public service. Three were partnered and raising families nearby.

I’m fascinated by this. I always want to ask, How did you do it, raise all of your children to do so well? 

And, I often do ask. Asking benefits me, yes; but many patients enjoy reflecting on this and discussing their lives and their families at a deeper level.

In this case, the woman smiled and said: That’s so interesting. It’s so true, though. Sometimes I look at them and wonder, How on earth did these creatures come from me? Just, that they’re all happy and thriving, it’s the answer to so many nights of prayer. 

She thought for a moment. We- my husband and I- always tried to treat each other, and all of them, the way we’d expect  them to treat others. We definitely had our moments; Oh, definitely, my husband and I have had our share of troubles, even needing couples counseling; but by and large, there was no sarcasm, no yelling, and no disrespect between us. We treated each other kindly, and lovingly, as much as possible. 

I’ve been reflecting alot lately on this. Our kids are so, so young. We have the power, now, to raise them well, or to totally screw up.

What I would give to see two educated, empathetic, and happy adults come out of this household.

How crushing it would be to raise a mean kid.

There’s alot of media attention nowadays on the concept of mean girls. If you do a Google search on “How not to raise a mean girl”, you get 30,000,000 hits. The first few pages are articles basically titled “How Not To Raise A Mean Girl”. I know this, because I searched it.

It makes so much sense to me that the most powerful tool we have available to craft emotionally healthy good citizens out of our preschoolers is… ourselves. We have to model what we want to see.

I’d like to think that we’re well on our way. Sarcasm makes me sick to my stomach. Neither Hubby nor I are well-suited to passive-aggressive behaviors: We wear our hearts on our sleeves. Hell, I post mine on the internet. Our rare arguments are recalled with humor, even when they involved inanimate objects being thrown: The Cookie Dough Incident; The Eggplant Incident.

And for me, any confrontation with suburban cattiness is generally enough to send me fleeing, literally and figuratively.  Physically out the door, and emotionally back into 1985, and from there to self-analyze the heck out of whatever silliness it was (see the “Postparty Analysis” post from two weeks ago…).

But, we are far from perfect. I know we both need to work on our discipline skills. Stay calm and in charge, do not get emotional, do not punish our of anger.  Sigh; alot of work to do there.

I was going to provide links to some of the How Not To Raise Mean Kids articles, but honestly, most echo the experience and advice of my lovely patient:

Be the people you want your kids to be. Your partnership is their first and best model for all the relationships that they will ever have. 

 

(*As always, this is not a specific person, but rather a composite of a few similar patients.)

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We Finally Surrendered… Or, At Least, I Did

Yesterday morning, I woke up with a backache. And it was raining hard. And I was on call.

There was a flurry of pages in the late morning, all “real” calls, with sick patients. I was talking on the phone and working on the computer for a few hours. The kids were getting progressively more stir-crazy. If one wasn’t poking/ tackling/ beating the other, the other was. Hubby was trying to do research, and keep order. I kept apologizing to patients on the phone: Sorry about the racket in the background! Apologies for the ruckus over here! The usual cheap distractions weren’t working: Curious George, Caillou, cooking shows.

Out of desperation, I grabbed the controls and announced, “We need something mesmerizing. Now. “

Hubby froze. “You’re putting Frozen on, aren’t you?”

We’ve been making a concerted effort to avoid Frozen. And despite the facts that the songs are on everywhere, their friends have the little figurines, and that 75% of little girls were in blue princess gowns for Halloween, we’ve managed to NOT watch that movie.

Our kids are pretty little, and basically watch what we put on for them. Since we avoid most movies in general, it’s not too hard.

At a ladies’ brunch recently, somehow it came up that neither I nor my kids had seen this movie.

“But how?” asked one shocked mom. “It’s so… mesmerizing!”

That statement resonated with me. And yesterday morning was the perfect setting for… mesmerizing.

As soon as the Disney intro came on, the kids were transfixed. But, as soon as girl characters came on, Babyboy was outta there. “I don’t LIKE this show,” he announced, and fled to do arts and crafts in the other room.

Babygirl, on the other hand, was quite taken with the show, at least for a half an hour or so.

At least they had stopped poking/ tackling/ beating each other.

The funny thing was, as Hubby pointed out, the one person in the house most mesmerized by Frozen was…. me.

I only got to see the very beginning, the medley where, of course, the parents are eliminated. I even got a little teary-eyed. So touching! So beautiful! But… what happens?

The rest of the cold, rainy, shut-in day, I kept trying to interest Babygirl in watching the rest of the movie. “Hey, want to see what happens to the two princesses?” or, “I bet the rest of the  Princess movie is really good! Want to watch?”

Finally I got her to say “Okay,” and I got to watch the rest of the movie. It IS a really good movie. Catchy songs. Well-done. I was glad to have seen it.

Then, this morning, we awoke to even MORE rain, and even snow. The dreaded Wintry Mix. And, Babyboy has a fever, he’s back in bed, hugging a bucket. And Hubby left for the game. And I’m on call…..

“Hey Honey, want to see that princess movie again?”

 

 

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