Who will run the world?


Babygirl, leaping from couch to chair to ottoman: “I’m KING of the world and I have amazing superpowers! Look what I can do!”

Babyboy, absorbed with a complex Lego creation which encompasses the entire living room rug: “You can’t be king because you’re a girl. Girls have to be queen. And kings and queens don’t have superpowers. Superheroes do. And you’re not a superhero because you’re just a girl.”

Babygirl thinks, then declares: “I have a cape and that means I have superpowers and these are my rules: Girls can be queen OR king! And superheroes too!”

Babyboy, concentrating on his Legos, making adjustments: “No, they can’t. Girls can only be girls or queens. You can’t just change the rules.”

Babygirl, brandishing an abstract painting with flourish: “But I MAKE the rules! Here are my rules, they’re new ones I just made!” 

Babyboy, glancing up from his work: “That’s just your painting from the other day.”

Babygirl, frowning: “It’s MY RULES and MY STORY and I DECIDE what it is and who can be, okay? You decide your own story okay?…. And if you want to play my story then you can make some rules too. I’ll let you.”

—————-

This was today. A beautiful spontaneous exchange that pretty well illustrated the emerging personalities of these kids. I got the image and jotted down the gist of it, heart swelling with love and admiration. 

It’s been a rough stretch for us, with our recent family tragedy; plus some issues and illnesses that have required much thought/ heavy conversations/ timely action. Hubby left for upstate New York to be with family as his mother is in poor health. I’m on call for our practice and the pager’s been fairly active. 

Thus today, Sunday, was a day to hunker down and keep it simple. The kids and I stayed inside and in pajamas. In between calls, I accomplished little besides acting as chief Lego- locating assistant and indulging odd snack requests. I shredded a massive pile of junk mail, that’s about all I can say I did for housework, and it shows. 

But, no matter. Nevermind all that, and forget the horrors of the headlines, the blatant misogyny of the current administration, and any well- founded fears for the future of these kids. 

Here, I have a budding engineer with impressive powers of logic and concentration, and a precocious powerhouse of personality in the form of a five-year-old girl. 

The question is not actually “Who runs the world” but “Who will run the world”, and here they are. 

A Proper Library

A huge chunk of my better youth was productively spent in the reading rooms, at long study tables, or in hidden cubbies of a number of libraries. Mom started us young, at the orange- carpeted seventies- style children’s room of my old hometown. I was very proud of my first card. 

One of the reasons she transferred me from public to private school was the sad lack of a school library. There was a little room crowded with shelves that admitted maximum three students at a time to browse a pathetic assortment of overly worn books. Nope, sorry, not gonna work. 

The expensive country day school had a brightly colorful, sunny, open- concept area at the heart of the building. My Catholic high school had a classically decorated space with large windows and overstuffed chairs, lots of woodwork and heavy study tables. College featured every imaginable option, but somehow I always ended up in the modern common room of the sciences library, along with every other pre-med. Well I remember the day they installed a bank of computers where we could use this new thing called the internet. 

Medical school. I lived among the lower- level stacks. Aisle upon aisle of mildewy bound scientific journals going back to the 1800’s, flanked by the most uncomfortable desk cubbies ever created, lit by buzzing fluorescence. One could not fall asleep, which was the point. 

The hospital where I trained had a solid little medical library in one of their older buildings, where antique-and-portrait-laden meeting rooms inspired a group of young writers. 

Flash forward. Our town has a library with something for everyone. Usually, it’s me and the kids in the children’s room. But lately, they’ve been doing sessions with Babyboy’s behavioral therapist, and I’m free to wander. 

It’s been well over a decade since I had any reason and the liberty to explore a library. This afternoon, I plopped down into this lovely upholstered chair by the fireplace, admired the sculptures, chandelier, massive windows, mirrors, artwork… there are also areas featuring contemporary and folk art. And, of course, scads of periodicals, a well-curated book collection, and audiovisuals galore. 

Man, I love a proper library. I’ve missed this!

Lost… and sadly, found

It is with deep sadness that I write this update to my February 19th post.

A quick summary: On February 3rd, 2017, my thirty-four year old cousin John Vincent Sciaba went for a winter hike on his own land in rural Newfield, Maine. This is what he did when he needed space to clear his head, and he would often camp out for a few days, even in the cold. But when there was an overnight ice storm and he didn’t return, his common-law wife alerted his family and the police. Friends, family, neighbors and volunteers joined authorities on a massive search of the thickly forested, steep terrain, in snow several feet deep. He was a ruggedly tough guy and a highly experienced outdoorsman, but as the days and then weeks passed, the rescue mission became a recovery mission. Though he had just seemingly vanished, my aunt often sensed his presence, and that he was at peace; others did as well, which was very comforting.

Day before yesterday (March 10th) my aunt got a call from the sheriff’s office: John’s body had been found. She was surprised at her own reaction to the news: she had thought that she had prepared herself, steeled herself, to hear those words. But in the moment, she felt like she completely fell apart, and she realized how much hope she’d still had.

We all did. You had to. You couldn’t help thinking, maybe he’d gone to stay with a friend no one else know, or heck, maybe he’d hitchhiked across the country, people have done stranger things. The search effort had been monumental, with dogs and heat-seeking drones… Where could he be? Maybe… he was somewhere else entirely?

In the early days of the search, family and authorities had combed through John’s contacts, calling any friends and colleagues, desperately seeking any tidbit of information, any lead. One contact was an old friend who also had claimed psychic abilities. She hadn’t known that John was missing, but she offered to use her abilities to help. Are you sure you want to know? she asked. Yes, yes; her offer was accepted.

She called back the next day. She described that she had communicated with John, and that he had passed, but he told her that he was, truly, at peace. He had gotten cold, confused, lost. He’d been overcome with fatigue. He lay down under a tree, and curled up to sleep. That was all. He’d passed on. He didn’t suffer, she reassured.

And that is how he was found. A man hiking with his dog last Friday came upon him, and called the police. The sheriff described: it appeared that John had curled up to sleep under a tree. He was in an area where coyotes and other animals abound, but his body was completely untouched. Not a mark on him. They brought him to the medical examiner’s office, as they must, for an autopsy.

And now, family and friends have closure. It’s not a happy ending, but it’s better than not knowing. People can finally mourn, and try to make sense for themselves, to find their own peace.

Services are planned for this Saturday March 18th, in Biddeford, Maine, at the Hope Memorial Chapel Funeral Home. The time will be announced next week, as well as favorite charities for donations.

 

 

Cooking with kids: Rainbow sugar cookies

Disclaimer from the doctor: No, these are NOT healthy cookies, and I have NO suggestions on substitutions to make them so! Rather, remember, everything in moderation.

Because, hey, we all need milk and cookies sometimes.

Babygirl and I saw a version of these on a cooking website called Eugenie’s Kitchen, and we HAD to make them. Babygirl, like many five-year-olds, is particularly keen on rainbows.

But rainbow cookies are apropos for so many occasions! We made these on a Saturday and brought them to our church on Sunday: perfect for our left-wing-liberal diverse Episcopal congregation! And, of course, for St. Patrick’s Day. Or little girls who are obsessed with rainbows and hearts.

Honestly, apart from being time- consuming, these are pretty easy.

Step one: buy a rainbow of food coloring. Liquid works better than gel here. And a heart- shaped cookie cutter, if you want hearts.

Step two: buy or make plain sugar- cookie dough.

Step 3: divide your dough evenly between six or seven bowls. Why seven? Because Babygirl insists that pink be represented in the rainbow.

Step 4: squeeze a few drops of coloring into each bowl and mix. It’s much easier to be working with room temperature dough here. You will still have to squish it around with the spoon more than stir, because dough is thick.

Step 5: wrap each bit of dough in plastic wrap and let sit in the fridge for twenty minutes or so, to firm up a tad.

Step 6: Lay wax paper, parchment paper, or use a lightly floured clean surface to roll each ball of dough into a long oval shape about a half- inch or so thick. Try to make each oval roughly the same shape so they can be stacked, and as you work, stack them up on a long piece of plastic wrap (which you will use to wrap it all up).

Step 7: When all your colors are stacked, press them tightly into a log. I made mine square as below, but you can just roll it into a round log. You’ll want your log to be around the same height and width of your cookie cutter.

Step 8: Using a nice sharp smooth knife, slice the log into half-inch thick slices, and one at a time, use your heart- shape cookie cutter on each slice. We did this right on the tray, on a nonstick oven- safe silpat (I love mine!). We also rolled up any scraps to make rainbow-mish-mosh cookies, so as not to waste dough.

Step 9: Bake cookies, usually 8 minutes at 350 degrees, but follow whatever your recipe directions say.

Step 10: Enjoy!! Ours didn’t come out perfect like Eugenie’s did, but we were proud. Many people marveled at these. Very much worth the time invested!

A Working Mom Faces Monday With Mixed Feelings

It’s the Monday after school vacation week, and here I am boarding my train, bound for downtown and my clinic.

Part of me is elated! Doctoring is, weirdly, the easier half of my existence. It’s a  challenging and rewarding career for which I feel well-suited, and our clinic is a particularly working-mom-friendly environment.

But part of me is kind of depressed.

Foremost on my mind is my cousin John Vincent, who is still missing. This is a constant sobering concern, and honestly, a 27/7 reminder to appreciate our loved ones and remember what’s really important, always.

Keeping that sentiment in mind, the two-and-a-half days I took off to be with my kids last week were truly enjoyable.  Coming off of literally months of one or most of us sick sick sick, we were finally able to be out and about. We had had nothing planned because we weren’t sure we’d be healthy enough to do anything. Plus, Hubby and I had work obligations. So we stayed local.And the weather was spring in February!

Tuesday, Hubby took the kids on a morning Science museum outing, and then brought them to my practice afterwards.

I had just wrapped up my morning clinic session. Babygirl came running at me, yelling “Mommy! Mommy! I can’t believe this is your office!”

I was still wearing my long white coat and stethoscope, and I scooped her up in my arms and we hugged, me tearing up, and her giggling.  Babyboy was shy, reticent, awkward.

We did a little tour, complete with purple polyurethane glove balloons, courtesy of my medical assistant. The kids were thrilled; no need to take them anywhere else that day. We all drove home together.

Now, time to get back into a regular work and school schedule….

Missing, and missed, but also, perhaps, finally free.

The afternoon of February 3rd, 2017, my cousin John Vincent Sciaba went for a winter hike on his own land, an eleven-acre expanse of dense Maine forest. He told his longtime girlfriend and soulmate Jen that he needed to clear his head. He packed a bag with some provisions, threw on a few light layers and sturdy boots, and headed out.

That was the last time anyone has seen him.

John Vincent, thirty-four years old, has long preferred the woods to the town; animals to people; the outdoors to indoors, weather be damned. Even as a kid, he would camp out in my aunt and uncle’s backyard in the snow. Long and difficult hikes and epic winter adventures were normal. Cold didn’t bother him. He had skills and experience. He knew what he was doing, and he’d done it before.

jvsciaba

Jen was not alarmed when he left. This was why they lived where they lived, after all. The land was a long-sought refuge from the pain and difficulty that he’d experienced as a young adult. He’d been an unusually creative child, mechanically gifted, incredibly resourceful. He was famous for resurrecting broken appliances. He would build toys: from an old CD player, an automatic spinning top. His brightness and energy were noticed and commented; everyone wanted to see what new and amazing contraption he’d invented.

As a schoolchild, he made his own go-cart, a real one that ran on gas, using a repurposed old lawn mower engine. He took it out for a spin on a main road, and was pulled over by a friendly local cop who was more impressed than anything else.

And music, he’s always loved to make music, using a combination of his drums and synthesizer and sampling to make elegant electronica- inspired songs. He sent a song of his own composition to my husband and I as a wedding present. He has always been so sweet and considerate of family, and especially our grandmother.

As he went through high school, we had no doubts that John Vincent would end up at MIT or another top engineering school. It was clear that the intelligence, curiosity, creativity, and even genius were all there.

But then the hallucinations started. There was a psychotic break, followed by more intense psychosis, and then this promising young man’s twenties were consumed by great instability, on and off meds, in and out of hospitals.

The past few years have been John’s best, since he found a stabilizing force in Jen, who somehow could connect and communicate and calm him, even when he wasn’t fully in reality. Their small, wood-stove-heated home set on the raw forested expanse was a safe zone. They shared a strong love of the wilderness and wildlife. On one visit, the kids and I found a baby squirrel that had fallen out of its nest. It was John and Jen who gently fed it sugar water, and drove over an hour to drop the creature at a wild animal veterinarian and sanctuary.

There have been summer days when John Vincent joined us on family trips to Maine beaches, especially bonding with Babyboy. They would dig in the sand for hours, examining shells and sea creatures.

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But he hated the medications that kept him grounded, because they also made him sedated, numb, clouded, slow; everything that was NOT him. So he would sometimes just sort of drift off of the meds. He would gain back some of the old spark, creativity, awareness… and then also hear things, get confused, and frustrated.

It was in that state of mind he left the house, to clear his head. Yes, he had great skills, experience, and comfort with the wilderness. But it got colder. And then there was an ice storm.  He’d been wearing fleece.

We’ve been in close touch with my aunt and uncle, such good, loving people who have looked upon our kids as their grandkids, and spoiled them as such. We visit and vacation together. We know what they’ve been through over the years, but can’t even imagine what there going through now, and it breaks our hearts.

The Newfield sheriff’s team and everyone have been wonderful. They held a massive search with K-9 units, even a heat-seeking drone. But as the days have gone on, and with several more storms, they have gently, kindly, moved from rescue to recovery mode.

My aunt offered the best hope when she explained how at times, many times, she has had a deep, real sense that John Vincent is near, trying to tell them that he’s OK, he didn’t suffer, and he’s happy. Once, early on, she felt that he was sitting right next to her on the living room couch. So intensely natural was the feeling that she had to turn her head and look, speak, say Hi, honey. She was a little shy to share that story, because she was worried what some people might think, but truly, her experience has also been comforting to us. Those times, she has believed he is at peace, which gives us all peace, as well.

Maybe he is nearby, a light and loving soul reaching out to comfort the living. Maybe it’s true that he was always meant to be in the spirit realm, not earth-tied-and-bound, and he’s finally free.

But I’ve delayed this post for days and days, because I was waiting, hoping, thinking maybe, maybe he’ll still turn up, walk in saying he’d hiked out to a different area, found a cabin in the woods… Who knows. You wonder.

They’re still out looking: my uncle and others, the sheriff’s men in their spare time, volunteer snowmobile teams, friends and colleagues, because, of course. You keep looking. As my aunt described, it would be fantastic if he walked through the front door. It would be awesome. It’s all been unreal, too much. To have him back, just like that, of course.

But she knew when the sheriff and team came in, hats in hands, that that wasn’t as likely an outcome, and she is, at times, accepting of that.

And when she feels John Vincent is nearby, in spirit but also warm and safe, she is at peace.

 

When the doctor really f—– needs to see the doctor

That f — can mean many things… freaking, finally, or… other things.

I showed up at my primary care’s office yesterday waving the white flag. It was two weekends ago that Babygirl woke up with 102 degrees temp and exploding snot; it’s been ten days since Babyboy and I got it; it’s been ten days that I’ve been wheezing and coughing like an eighty-year-old-lifetime-four-pack-a-day-smoker.

I’ve continued to see patients in clinic, fever be damned. I’ve been escalating my own treatment to ridiculous levels.

Why?

Hey, this is what doctors are EXPECTED to do, what we are pushed to do throughout training, what we are admired and congratulated for as tough-as-nails, badass attendings.

No one wants us to cancel. Not the patients who will be massively inconvenienced, not the staff who will have to make all the calls to reschedule, not the department who will lose out on revenue, not me who will have to make up ALL those visits.

So last week, when I was feverish, chilled, woozy, congested, and COUGHING ALOT, naturally, as per normal ingrained doctor culture, I sucked it up and did my clinic.

I wore a mask some of the time, but not all the time… I made it through the week, and I saw ALL my patients.

But by last Friday, my breathing was so bad, I couldn’t make it through an encounter without leaving the room to use my Albuterol. My patients were reaching into their purses to give ME cough drops, and offering ME sips of their water. My nurse set me up with a neb mid-clinic, and that bought me some time; I got through the day and got home.

All weekend I was using my puffer waaaay too much: three, four puffs every two, three hours, including multiple awakenings overnight.

By Sunday my chest felt packed tight with steel wool. It HURT to breathe. And of course Hubby was traveling, at a conference, and it was storming snowing out, to boot. I was alone with the kids and I realized I needed a higher level of care.

So naturally, as per normal ingrained doctor AND MOTHER culture, I called my friend and colleague who very kindly called me in a course of oral steroids.

I took more than she prescribed (of course) and went to bed. Monday dawned and I felt 75% better.

But it started creeping back, the steel wool in the chest, the coughing spasms, the nighttime awakenings and desperate puffing…

So yesterday, I showed up at my Primary care’s office waving the white flag, and she put me through my paces. She pointed out several things: I had a fever. My oxygen saturation was abnormally low. I was using accessory muscle of breathing. I was wheezing. My peak flow was lower than normal.

I got a chest xray. A flu swab. A neb.

The flu swab came up positive. Influenza A.

We realized: I’d been seeing patients (and taking the train… and going to church…) while infected with Influenza A and coughing all over the place, spewing viral particles.

It’s been a bit of an Occupational Health disaster. We had to notify all the staff. They’re going to notify the patients. I had to notify my church. If people develop a febrile illness, they need to know that it might be flu. They can get tested, and can get Tamiflu. Or, they may want to take prophylactic Tamiflu.

What a mess.

Me? I’m on mega-high-dose steroids, nebs, inhalers, et cetera, and I feel great.

Dumb, and guilty, but great. Because I f—- f—- saw the f—- doctor.

Lesson learned.