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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A Little Postparty Analysis

I left a children’s halloween party in tears yesterday.

I’m aware that sounds ridiculous for a forty-two-year old physician and mother to admit. I put this out there as I’m trying to make sense of what was a truly bizarre experience.

We were invited to a kid’s costume party for early Sunday afternoon. When I RSVP’d, I didn’t realize that the party was at the same time as the football game that Hubby was going to be broadcasting. Saturday, I noticed the overlap, but I suspected these folks would have the game on, as the last time I was at a wintertime kids party at the same house, they had basketball on in the den. Also, I knew they were fans of Hubby’s. Still, I figured, if the game’s not on, we’ll survive, and the kids will likely have fun anyways. I didn’t think about it very much.

The day of the party Babyboy refused to go. He’s been decidedly anti-costume, and asked to go to Nana’s instead, to play in the yard. Specifically, to rake leaves. He has a mini-rake and he actually does a fairly good job raking, and then takes great joy in showing everyone the leaves and dead grass he’s deposited in a paper shopping bag. Nana agreed to watch him, and I went with Babygirl to the party.

We were the first people there, and when we pulled up, the little girl at the house jumped up and down, so happy to see us. The whole family was sitting out on the front stoop, and they greeted us warmly.

Babygirl wouldn’t let me put her down and wouldn’t let me put her princess fairy costume on; she only hid her face in my shoulder. I chatted with the mom, “Jane”, for awhile, about common interests, and she tried to engage Babygirl. The dad, “John”, tried as well, inviting Babygirl to say hi to their infant. Still, she clung to me.

The dad mentioned he listened to Hubby on the radio sometimes, and we chatted about that. He said he enjoyed some radio show Hubby had been on, and he asked about the game. We talked about it, and I asked him if they were going to have the game on anywhere during the party. He smiled and said, “Sure! I think that can be arranged. We were only going to have background music on the iPod anyways.”

By this time more people had arrived, and the whole crowd started to move into the house, and from there to the backyard. This mom had done a fantastic job with the decorations, really pulled out the stops. You could see that almost everything was handmade, from the funny giant’s face on the front door to the Halloween garland on the mantle. There was a great big basket of goody bags near the front door, and I could see activities and games set up in the living room. She had even watched a Youtube video and learned how to make balloon animals.

Again trying to engage Babygirl, Jane spent a little extra time with us, telling Babygirl that she was so beautiful, and complementing the costume that was still in my hand. Babygirl smiled a shy smile.

We followed the crowd out to the backyard. It was a sunny but windy day, mildly chilly. There were kids running around, climbing on the swing set, playing in the playhouse. There were streamers and balloons. Babygirl still clung to me, though she peered out at the balloon animals being passed out from a big bag.

Meantime, “John” the husband brought out a small portable radio and set it up on the food table. The iPod had been set to a genre satellite channel, sounded like electronica. He turned the iPod off, and set the radio right onto the game. There was Hubby’s voice!

“Who’s that on the radio?” I asked Babygirl. She was already smiling.

“That’s Daddy!” she exclaimed. She finally let me put her down, and went up to claim her balloon animal.

We stood near the table, chatting with people. Babygirl let me put on her costume, but she wouldn’t stray from me, and then she wanted to be picked up again. She just clung.

Of course people tend to congregate around the food, and likely, around the game, so we just hung around the table for a bit. The radio was low enough, the kids playing loud enough, and the wind high enough, that you couldn’t hear the game at all from even six feet away. You had to be right up in front of the little radio to hear it.

Then, “Jane” came up and flipped off the radio. It was so sudden I gasped.

“What’s wrong, Mommy?” asked Babygirl.

Jane had her back to me, as she fussed with the iPod. She put the electronica station back on.

“They turned off the game, honey… Let me talk to Jane…” I murmured. I thought maybe Jane would have heard this exchange, but she didn’t turn around. I moved closer and spoke to Jane: “Oh, Jane, Sorry, John had put on the game for us…”

Jane turned around, but looked right past us and walked away, brushing up against us as she did.

I was sort of stunned. Did she not hear me? Maybe my voice didn’t carry in this wind, with the kids all running around, and people talking?

Jane had stopped with her back to us to chat with another mom. I made my way over, convinced that she must not have heard me. When a break in the conversation came, I tried again:

“Hey, Jane, we had kind of wanted to listen to the game, so John put it on for us…”

Again, she looked right past me, but this time, as I was talking, she waved her hand in my face, saying, “Yeah, yeah, alright, yeah…” and she again walked away, brushed right past me as I held Babygirl. She stopped at another group of parents, with her back to me and Babygirl.

This time, it would be hard to imagine that she hadn’t heard me. I just stood there, unsure. I actually felt queasy. There was a picnic table nearby. I walked over with Babygirl, and sat down.

My thoughts were: What did I do wrong? How did I offend? Was she angry that the game was on? That seemed really odd, as these folks had had sports on the TV at a prior kid’s party, and the husband had brought up that he was a fan of Hubby’s. He had seemed pretty enthusiastic about putting the game on the radio.

And, it’s not like there was kid’s music playing when we got there, nor was it a carefully selected song list. It was a sort of odd choice of satellite station music.

Then, I wondered if I had misinterpreted. Maybe Jane was so distracted that she really hadn’t heard me or seen us, really?

Regardless, I felt entirely unnerved, and decidedly unwelcome. I leaned down and whispered in Babygirl’s ear, “Hey, do you want to grab your balloon and go back to Nana’s?”

“Yes,” she whispered back.

I picked her up and kissed her and started to make my way to the back door. Jane and John were standing together with a group of parents right in front of it.

I knew it was strange to be leaving not even thirty minutes into a party, and I still wondered if I had misunderstood the whole thing. So, I stopped in front of them and said, “Hey guys, I think we’re going to be leaving now….” and I started to say to John, “It meant alot to us that you put Daddy’s voice on the radio” but Jane drowned me out, again waving her hand in my face, saying, “Yeah, yeah. Thanks for coming, Bye.” She then turned to another parents and started talking to them.

If her behavior and tone hadn’t been clear before, they were now. It was a viciously sarcastic dismissal.

The sounds of the children laughing and playing and the party chitchat and the weird electronic music all blurred together, and I knew that I was about to burst into tears. I didn’t see or hear what John’s reaction was, because I fairly ran to the back door.

The house with all its decorations was empty. I found my diaper bag and we showed ourselves out, walked right past the basket of treats, no goody bag for Babygirl.

Once I was in the car with the doors shut, I felt better. It was quiet, warm, and when I turned on the car, there was daddy’s voice on the radio again.

“It’s Daddy!” said Babygirl.

“Yes, honey, it is,” and I started to cry.

When interactions upset me like that, I try to figure out why. Why is this triggering me?

In this case, Jane’s behavior triggered traumatic memories from school days. The ignoring, then the brush-off, and finally, the derisive send-off, were all too reminiscent of events from almost thirty years ago. Who didn’t suffer from some Mean Girl attack or another in junior high and high school? I could almost hear my own insecure, wavering voice from decades ago, asking, “Why aren’t you guys talking to me?” 

The tears and self-pity didn’t last long. I came to my senses, remembering that I’m a forty-two-year old physician and mother. Composure came, and by the time we got to Nana’s house, Babygirl was asleep in the back seat, still hugging her balloon.

Our whole family was gathered in the living room, watching the game as we always do, with the TV on mute and the radio on. Home, sweet home, safe and sound.

I carried Babygirl to the couch and she stayed asleep for two hours.

So, what happened? Looking back at it, I suspect that I wandered unknowingly into a husband/wife battle. I bet “John” had wanted to put the game on, that they argued about it, and she won with the music. So when he put the game on for us, it likely triggered her fury, which she directed at me. That’s my guess, anyways.

Regardless, Babygirl and I were treated poorly, even cruelly. My dilemma now it, what do I do when I see the perpetrator socially? My instinct is to say nothing, and never respond again to any invites.

Any advice welcomed!

 

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“Too Busy”

What does “I’m too busy” mean? Usually, I don’t have much patience with this excuse, because it really means “That’s not my priority.”

But, as you can see, for the past two weeks, I haven’t blogged on this site. Why? Uhhh….I’ve been too busy. Clinic days have been long and difficult (more posts on that to come), family was visiting, we had more events than usual, I’ve been exhausted. Et cetera.

Every day for the past week, I’ve had guilt over not writing on here, and I’ve reflected about what it means to say you’re “too busy”.

I hate hearing from others that they’re too busy to be healthy. So much of my workday is spent explaining, encouraging, even begging patients to make small lifestyle changes towards better health. It’s safe to say that the majority of folks I see are overweight or obese. If there is also low back pain, asthma, reflux, high blood pressure, high cholesterol, high blood sugars, heart disease (or family tendencies towards those last four), then it’s part of my job to explore the weight issue.

Usually I’ll end up making suggestions for tiny changes: Give up soda…Walk more…check our a low-carb diet plan…do some core strengthening. Some patients get very excited, and we end up going over our allotted time, brainstorming about how they can drink green tea or water with lemon; team up with that neighbor for early morning walks; join Weight Watchers; check out a ten-minute Pilates DVD.

Sometimes, albeit rarely, a patient runs with this, and next time I see them, they’ve lost weight, and usually, their blood pressure, cholesterol, and blood sugars are down. They’ll have a glow, that inexplicable aura of success, of pride.

But, more typically, no significant changes have occurred, and, without my even asking, I’ll hear about how they were just Too Busy.

I sit there and think that it’s all about priorities. I think about how I’ve lost and maintained lost fifty pounds of post-baby weight over three years. I remember how hard it was to get going, with an eight-week old infant and a two-year old special needs child at home, working four days a week, with a husband whose work takes him on the road often. I was really busy, and it was very hard.

Yes, there has been tons of family support, and I’m lucky I don’t work full-time, and lucky that we don’t need to stress about basic necessities. I get that and I am appreciative. But I’m often sitting with patients in similar positions, and they’re Too Busy. It’s an excuse, it’s lame, and it’s really hard to get past or around that mental block.

But, I need to remember that there’s al lot the things that I’m Too Busy for. Keeping in touch with old friends; organizing photo books; cleaning up my desk; anything in a salon. Then, when I get the text or Facebook message or email from someone, How the heck are you? Haven’t heard from you in ages! I have to make my own lame excuses. Sorry! Things have been so hectic around here, We’ve been just so busy. 

I’ve started two great blogs posts in the past week, but they both involve looking things up, and things have been so hectic around here, I’ve been just so busy, and I haven’t had any time to do a good job with those posts.

So, this morning, I got up before the kids and started this post. Of course, they both woke up before I could get very far. Determined not to feel guilty another day, and also not to make any more excuses, I’ve chipped this out in small increments over the last three hours.

The kids hate it when I’m on the computer. Babygirl keeps grabbing my legs and saying Pick Me Up! Pick Me Up! and Babyboy wants me to build Legos with him. They’re had to have breakfast, which involved cutting up melon, oranges and kiwi for fruit salad, and then pouring Rice Krispies for them anyways. I tried putting on Curious George, but bugging me when I’m typing is much more fun.

But, I did it. The post may be lame, but it’s better than the excuse that I’ve been Too Busy.

 

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Latest MiM post, on Ebola

Some good input from other doctor-moms on my post: Would You Care For A Patient With Ebola?

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