Every mom knows that melting feeling you get in your heart when you look into your child's bright eyes and they grin from ear to ear, beaming with happiness and love. Luckily, not every mother knows the pain - of feeling the melting heart, bending forward for a kiss and getting smacked right in the face. She, or he in my case, is the "passionate child". Passionate children have the highest of highs. They are easily pleased, smile often and charm strangers at the grocery store. Passionate children also have meltdowns at the drop of a hat, express themselves loudly and always seem to find mischief.
The following tidbits are true accounts of my fourth born child:
-one night while bathing he dumped an entire bottle of son #1's Axe Body Wash into the tub, creating a very scented and slippery tubby; while I was sopping up bubbles he ran to his room in a towel and peed on the carpeted floor
-I came home from work one day and asked our child care provider if she was getting a sore on her lip. "No" she replied, "I got head butted today" - while hugging my son
-on a warm summer night I ran across the hall to get prescription diaper cream and returned moments later to find him covered from head to toe on one side of his body in Desitin (not easily washed off)
-playing in big brother's room resulted in first a highlighter scribbled all over the wall; then, when climbing the bunk ladder was mastered a red permanent marker on the crisp white ceiling
-he has been known on numerous occasions to silently (which does not even seem possible) disappear out the front door to be found in places like the front seat of my van, playing in the garage, riding on the lawn tractor
-while cleaning up the front yard my husband discovered rocks sticking out of the oil pipe leading to our furnace
-while helping me clean his sisters bedroom he threw away some trash then dumped the bathroom trash can over and floated some toys in the toilet; while I cleaned this up he launched a toy off the top of the balcony and laughed as it smashed on the landing below
This is just a handful of the battles with my "beast", as I lovingly call him, and I'm sure if you have a passionate child you can relate. If you don't have a passionate child you may want to watch the movie Dennis the Menace and decide if you're ready to go on this roller coaster ride of parenting the passionate child.
"believe in your dreams for all dreams can come true"
-dr. mom of 4
Thursday, July 30, 2009
Thursday, July 9, 2009
Pregnancy and the best day/worst day of my life
When looking at my first pregnancy, to say that I was on an emotional roller coaster is an understatement. There really is no appropriate cliche to describe my first experience with pregnancy.
Type A personality that I am, two days before starting medical school I found myself starting the most unplanned experience ever. I wasn't ignorant as to how to avoid pregnancy however an ovarian cyst and thus change of birth control pills left me more vulnerable than I expected. We had planned to have a family but had decided to see how "challenging" medical school was and get advice from others in medical school as to the "right time". I believe everything happens for a reason and this is a perfect example. Had I not gotten pregnant before medical school and the decision been left up to me to make after starting medical school I am certain that the grueling schedule would have overwhelmed me into "waiting".
I decided that very first weekend to keep my condition a secret for awhile. I truly wasn't sure how it would be received and whether or not the school would even allow me to continue classes. That plan lasted less than an hour. At our welcome breakfast we went around the table introducing ourselves and I couldn't help but reveal how excited I was to be pregnant. The immediate support I received was incredible. I was introduced right away to two other women both in the class ahead of me who had had babies the previous year. My early jitters were quickly eased as I continued to embrace the joy of expecting our first child.
Like anyone going through their first pregnancy I suffered from some nausea and was very tired. These symptoms were multiplied however by staying up late studying and gross anatomy lab. There are mental challenges as well as odor challenges to dissecting cadavers for anyone, but add in first trimester morning sickness and breathing through a respirator for hours on end and it's the formula for disaster. Formaldehyde fumes have not been proven to be harmful to a fetus but studies indicate there may be a risk with prolonged exposure thus the decision was made by myself and my instructor to wear a breathing apparatus to protect the baby.
As first trimester came to an end, my nausea began to subside and the anatomy lab course ended. Fatigue however never let up. Endless hours of studying and the natural demands of pregnancy on my body continued to drain me of any energy I thought I would regain in the second trimester. Although I had bonded with two moms from the class ahead of me, I remained the only medical student in my class to be expecting. Sometimes this had additional social challenges. While my peers had post-test parties and "socialized", I was home reading baby name books. The majority of my classmates were single and the dating scene from college, continued at a slightly higher maturity level. I would be lying to say I didn't have a few days of envy but for the most part I was very content to start my family. I wondered often how I would balance the demands of a newborn, classes, rotations, boards and motherhood. My mom was a stay-at-home mom. I had no idea how I was going to balance having a career and being there for my kids when they needed me. Luckily I didn't put a lot of thought into it because I probably would have backed out if I could. There are no quick or easy answers and it would take trial and error, hard work, tears and sleepless nights to get me through.
In mid January, at 24 weeks into my pregnancy I found myself having another large hurdle. I was riding in the back seat of my parents' car, on our way to a family party when we were hit by an oncoming pick-up truck. It was a snowy winter night and the young driver had lost control of his vehicle crossing over into our lane. I remember seeing the headlights coming at us and my mom yelling from beside me, to my dad (the driver) that the truck was going to hit us. The next few minutes replay in my mind in slow-motion. There was smoke and crying, strangers helping us out of the vehicle. My dad had briefly lost consciousness but overall appeared okay. Aside from some bumps and bruises everyone seemed to have made it through the accident unharmed. Before the smoke had cleared my mom and husband were asking me if the baby was okay. "Yes, I think so" "I don't know, my stomach's tight. Is that okay?" Then the ambulance arrived and I was the first to go. In the ambulance the paramedic asked if my water had broken or if I was having any contractions. I had no idea. Fear and shock made it difficult to know what I was feeling and inexperience with pregnancy made it more complicated. After an over night in the hospital and check up the following day with my obstetrician we were both cleared. I had an amazing bruise across my abdomen corresponding to the seat belt. A pregnant baby belly is never supposed to have a black and blue mark traveling across it. A little banged up but relieved that the baby was okay, I continued on with my studies at full pace.
A little less than four weeks later I found myself having more back pain than usual. I remember getting up out of my seat during biochemistry to stretch and then pacing because I couldn't get comfortable. Luckily one of the girls from the class ahead of me saw me and asked if I was okay. I told her I was fine, just more back pain than usual. She laughed and said if she didn't know better she would think I was in labor because of how I was acting, but since I was only 28 weeks I couldn't be. Then we both got to thinking and worrying. I called my doctor and headed in for him to check me. He greeted me and was very reassuring saying that everything had been perfect so far and that he was sure it would continue that way. As he checked my cervix, the look on his face changed from reassurance into one of concern. I was 2-3cm dilated and 80% effaced. I was in labor. That weekend was the first of many days I would spend in the hospital over the next six weeks.
I was given intravenous medicine to stop the labor, steroids to help the baby's lungs mature and had an ultrasound to check the baby's "viability". And so began our nightmare. Over the next six weeks I lied on my left side, the preferred position for blood flow to the baby as much as possible and coordinated going to the bathroom so that I wasn't "out of bed too much" which would stimulate contractions but didn't allow my bladder to be full because that too would stimulate contractions. I took various pills to stop the contractions, got shots of steroids in my bottom every other day and made many trips back to the hospital for IV tune-ups. On complete bed rest I wasn't able to go to classes but tried to stay caught up via email and transcribed notes. One of my professors even sent my exam to me certified mail for me to complete at home. I wasn't able to participate in labs and thus started to fall behind, just a bit.
After six long weeks of bed rest and hospital visits, studying and falling behind, I was overwhelmed. At 3cm and with the baby dropped down I had tremendous back pain and pelvic pressure. At my 34 week visit I begged the doctor to let me stop the medication and have the baby. He allowed me to stop the medication but said we couldn't encourage labor and that I should remain on bed rest. Feeling a small victory I went home and relaxed a bit, knowing that the end was one step closer. The very next day, my water broke. I was so excited to finally meet this baby growing inside me and had tremendous relief to be through with this battle of pre-term labor. Looking back I sometimes wonder if I had stayed on the medication could I have spared us all the pain of the following week.
Contractions started by the time we arrived at the hospital and things progressed smoothly for the next three and a half hours. I pushed for eighteen minutes and was rewarded with a beautiful baby boy. They showed him to me as they whisked him away to the NICU. I wanted my baby. I worried that he wasn't okay but was reassured that it was just a formality due to his pre-term age. The nurses continued to give me reports that he was doing well BUT I wanted my baby. Finally, three hours later I was wheeled to the NICU to see my baby for the first time.
When you have a baby, your supposed to hold it close to your skin, smell the newborn sweetness and began the amazing bond of motherhood. I sat in a chair while tears rolled down my cheeks staring at my baby who laid there helpless with wires attached to his chest, an IV in his hand and other monitors on his body. I wanted my baby.
Our journey through NICU is another whole chapter. We made it through. Seven long days later I held onto my baby and walked out the hospital door. When we got home, I don't think I put him down for days. A mother needs her baby. That was the first time I ever thought, "do I really want to be a doctor?"
"believe in your dreams for all dreams can come true"
-dr. mom of 4
Type A personality that I am, two days before starting medical school I found myself starting the most unplanned experience ever. I wasn't ignorant as to how to avoid pregnancy however an ovarian cyst and thus change of birth control pills left me more vulnerable than I expected. We had planned to have a family but had decided to see how "challenging" medical school was and get advice from others in medical school as to the "right time". I believe everything happens for a reason and this is a perfect example. Had I not gotten pregnant before medical school and the decision been left up to me to make after starting medical school I am certain that the grueling schedule would have overwhelmed me into "waiting".
I decided that very first weekend to keep my condition a secret for awhile. I truly wasn't sure how it would be received and whether or not the school would even allow me to continue classes. That plan lasted less than an hour. At our welcome breakfast we went around the table introducing ourselves and I couldn't help but reveal how excited I was to be pregnant. The immediate support I received was incredible. I was introduced right away to two other women both in the class ahead of me who had had babies the previous year. My early jitters were quickly eased as I continued to embrace the joy of expecting our first child.
Like anyone going through their first pregnancy I suffered from some nausea and was very tired. These symptoms were multiplied however by staying up late studying and gross anatomy lab. There are mental challenges as well as odor challenges to dissecting cadavers for anyone, but add in first trimester morning sickness and breathing through a respirator for hours on end and it's the formula for disaster. Formaldehyde fumes have not been proven to be harmful to a fetus but studies indicate there may be a risk with prolonged exposure thus the decision was made by myself and my instructor to wear a breathing apparatus to protect the baby.
As first trimester came to an end, my nausea began to subside and the anatomy lab course ended. Fatigue however never let up. Endless hours of studying and the natural demands of pregnancy on my body continued to drain me of any energy I thought I would regain in the second trimester. Although I had bonded with two moms from the class ahead of me, I remained the only medical student in my class to be expecting. Sometimes this had additional social challenges. While my peers had post-test parties and "socialized", I was home reading baby name books. The majority of my classmates were single and the dating scene from college, continued at a slightly higher maturity level. I would be lying to say I didn't have a few days of envy but for the most part I was very content to start my family. I wondered often how I would balance the demands of a newborn, classes, rotations, boards and motherhood. My mom was a stay-at-home mom. I had no idea how I was going to balance having a career and being there for my kids when they needed me. Luckily I didn't put a lot of thought into it because I probably would have backed out if I could. There are no quick or easy answers and it would take trial and error, hard work, tears and sleepless nights to get me through.
In mid January, at 24 weeks into my pregnancy I found myself having another large hurdle. I was riding in the back seat of my parents' car, on our way to a family party when we were hit by an oncoming pick-up truck. It was a snowy winter night and the young driver had lost control of his vehicle crossing over into our lane. I remember seeing the headlights coming at us and my mom yelling from beside me, to my dad (the driver) that the truck was going to hit us. The next few minutes replay in my mind in slow-motion. There was smoke and crying, strangers helping us out of the vehicle. My dad had briefly lost consciousness but overall appeared okay. Aside from some bumps and bruises everyone seemed to have made it through the accident unharmed. Before the smoke had cleared my mom and husband were asking me if the baby was okay. "Yes, I think so" "I don't know, my stomach's tight. Is that okay?" Then the ambulance arrived and I was the first to go. In the ambulance the paramedic asked if my water had broken or if I was having any contractions. I had no idea. Fear and shock made it difficult to know what I was feeling and inexperience with pregnancy made it more complicated. After an over night in the hospital and check up the following day with my obstetrician we were both cleared. I had an amazing bruise across my abdomen corresponding to the seat belt. A pregnant baby belly is never supposed to have a black and blue mark traveling across it. A little banged up but relieved that the baby was okay, I continued on with my studies at full pace.
A little less than four weeks later I found myself having more back pain than usual. I remember getting up out of my seat during biochemistry to stretch and then pacing because I couldn't get comfortable. Luckily one of the girls from the class ahead of me saw me and asked if I was okay. I told her I was fine, just more back pain than usual. She laughed and said if she didn't know better she would think I was in labor because of how I was acting, but since I was only 28 weeks I couldn't be. Then we both got to thinking and worrying. I called my doctor and headed in for him to check me. He greeted me and was very reassuring saying that everything had been perfect so far and that he was sure it would continue that way. As he checked my cervix, the look on his face changed from reassurance into one of concern. I was 2-3cm dilated and 80% effaced. I was in labor. That weekend was the first of many days I would spend in the hospital over the next six weeks.
I was given intravenous medicine to stop the labor, steroids to help the baby's lungs mature and had an ultrasound to check the baby's "viability". And so began our nightmare. Over the next six weeks I lied on my left side, the preferred position for blood flow to the baby as much as possible and coordinated going to the bathroom so that I wasn't "out of bed too much" which would stimulate contractions but didn't allow my bladder to be full because that too would stimulate contractions. I took various pills to stop the contractions, got shots of steroids in my bottom every other day and made many trips back to the hospital for IV tune-ups. On complete bed rest I wasn't able to go to classes but tried to stay caught up via email and transcribed notes. One of my professors even sent my exam to me certified mail for me to complete at home. I wasn't able to participate in labs and thus started to fall behind, just a bit.
After six long weeks of bed rest and hospital visits, studying and falling behind, I was overwhelmed. At 3cm and with the baby dropped down I had tremendous back pain and pelvic pressure. At my 34 week visit I begged the doctor to let me stop the medication and have the baby. He allowed me to stop the medication but said we couldn't encourage labor and that I should remain on bed rest. Feeling a small victory I went home and relaxed a bit, knowing that the end was one step closer. The very next day, my water broke. I was so excited to finally meet this baby growing inside me and had tremendous relief to be through with this battle of pre-term labor. Looking back I sometimes wonder if I had stayed on the medication could I have spared us all the pain of the following week.
Contractions started by the time we arrived at the hospital and things progressed smoothly for the next three and a half hours. I pushed for eighteen minutes and was rewarded with a beautiful baby boy. They showed him to me as they whisked him away to the NICU. I wanted my baby. I worried that he wasn't okay but was reassured that it was just a formality due to his pre-term age. The nurses continued to give me reports that he was doing well BUT I wanted my baby. Finally, three hours later I was wheeled to the NICU to see my baby for the first time.
When you have a baby, your supposed to hold it close to your skin, smell the newborn sweetness and began the amazing bond of motherhood. I sat in a chair while tears rolled down my cheeks staring at my baby who laid there helpless with wires attached to his chest, an IV in his hand and other monitors on his body. I wanted my baby.
Our journey through NICU is another whole chapter. We made it through. Seven long days later I held onto my baby and walked out the hospital door. When we got home, I don't think I put him down for days. A mother needs her baby. That was the first time I ever thought, "do I really want to be a doctor?"
"believe in your dreams for all dreams can come true"
-dr. mom of 4
Tuesday, June 30, 2009
Sleepovers
Some of my fondest memories of residency are of course those that involve my children.
Internship year, the first year of residency also known as "hell year" is very demanding to say the least. During that year call comes all too often which means sleeping at the hospital. The small hospital we covered involved a rather unique situation in which our sleeping quarters where not within the hospital, due to lack of space. Instead, the hospital provided us with a house across the street from the hospital. "House" is a bit of a misleading term. Yes there was a bathroom, bedroom and kitchen. But there were lots of insects, multiple deadbolts on the doors, poor water pressure and loud neighbors. What could you expect from a house that was known to be a drug house from its previous owners? This being the case, a little cleaning and attention to personal safety the "crack house" quickly became a second home.
There were some nights when either Daddy had to be at work early in the morning, before I could get home; or Mommy had been really busy and the kids just missed me that we had family sleepovers. My husband would bring the two kids (there were only two then, I was pregnant with number three) for dinner with me. We would eat in the cafeteria together, hoping the pager would be quiet long enough for us to enjoy the hospital cuisine together and hopefully have an ice cream treat for dessert. Then the kids would go over the the house with daddy, get ready for bed and watch a little t.v. or movie. I would make rounds on patients then run across the street for good night kisses. Then back to the hospital for more work and hopefully crawl into bed sometime before midnight. Once in bed there was no predicting as to how often the pager would go off or how often I would have to go back and forth across the street but it never mattered to me. Snuggling up with my babies for five minutes was worth every lost minute of sleep and every run back and forth across that street.
In the mornings the kids would eat breakfast and sometimes sit quietly watching television while I attended morning rounds in the adjoining conference room and completed signing off my patients to the daytime resident. It was during this long hour that emergency panic buttons were pushed, donut crumbs were strewn everywhere and stern attendings who demanded perfection and respect couldn't help but crack a smile at the little faces that often wandered into the conference room.
Our sleepovers were always crazy and it often felt like that pager knew when the kids were there and would go off at the most inopportune times but we survived and we did it as a family every step of the way.
"believe in your dreams for all dreams can come true"
-dr. mom of 4
Internship year, the first year of residency also known as "hell year" is very demanding to say the least. During that year call comes all too often which means sleeping at the hospital. The small hospital we covered involved a rather unique situation in which our sleeping quarters where not within the hospital, due to lack of space. Instead, the hospital provided us with a house across the street from the hospital. "House" is a bit of a misleading term. Yes there was a bathroom, bedroom and kitchen. But there were lots of insects, multiple deadbolts on the doors, poor water pressure and loud neighbors. What could you expect from a house that was known to be a drug house from its previous owners? This being the case, a little cleaning and attention to personal safety the "crack house" quickly became a second home.
There were some nights when either Daddy had to be at work early in the morning, before I could get home; or Mommy had been really busy and the kids just missed me that we had family sleepovers. My husband would bring the two kids (there were only two then, I was pregnant with number three) for dinner with me. We would eat in the cafeteria together, hoping the pager would be quiet long enough for us to enjoy the hospital cuisine together and hopefully have an ice cream treat for dessert. Then the kids would go over the the house with daddy, get ready for bed and watch a little t.v. or movie. I would make rounds on patients then run across the street for good night kisses. Then back to the hospital for more work and hopefully crawl into bed sometime before midnight. Once in bed there was no predicting as to how often the pager would go off or how often I would have to go back and forth across the street but it never mattered to me. Snuggling up with my babies for five minutes was worth every lost minute of sleep and every run back and forth across that street.
In the mornings the kids would eat breakfast and sometimes sit quietly watching television while I attended morning rounds in the adjoining conference room and completed signing off my patients to the daytime resident. It was during this long hour that emergency panic buttons were pushed, donut crumbs were strewn everywhere and stern attendings who demanded perfection and respect couldn't help but crack a smile at the little faces that often wandered into the conference room.
Our sleepovers were always crazy and it often felt like that pager knew when the kids were there and would go off at the most inopportune times but we survived and we did it as a family every step of the way.
"believe in your dreams for all dreams can come true"
-dr. mom of 4
Friday, June 26, 2009
Motherisms
When you're the working mother of four:
-you have 40 toenails to cut and 40 fingernails to trim
-the common cold goes through your house 4 times as long and 4 times as often
-you have 4 beds to "help make" and sheet sets to change
-one laundry load of whites yields 67 pairs of socks, to sort and match-up
-you have 4 sets of information you're supposed to know at the drop of a hat including:
----birth statistics,
----current weight,
----doctors and dentists appointments,
----clothing sizes, and
----favorites (friends, colors, foods,etc;)
-someone is always outgrowing a size and needing new clothes
-you get to budget for 4 sets of college tuition (with inflation)
-you have four schedules to balance should you dare let them participate in any activities
-you count heads continuously to be sure you have them all
-you get to read 4 different books every night
-you have 4 goodnight kisses, and I Love Yous
-chances are good someone will want a snuggle when YOU need one
-you have 4 "potential" places to go to instead of a nursing home
-you have 4 potential sources of grandchildren (if you still like children then :) )
-you have 4 times the memories to cherish
----first words
----first steps
----first day of school
----so many more
I remember someone said to me once they never wanted more than one child because you could never love multiple children as much as you do the first nor provide for the others with the undivided attention an only child receives - that person has obviously not had four children
"believe in your dreams for all dreams can come true"
-dr. mom of 4
-you have 40 toenails to cut and 40 fingernails to trim
-the common cold goes through your house 4 times as long and 4 times as often
-you have 4 beds to "help make" and sheet sets to change
-one laundry load of whites yields 67 pairs of socks, to sort and match-up
-you have 4 sets of information you're supposed to know at the drop of a hat including:
----birth statistics,
----current weight,
----doctors and dentists appointments,
----clothing sizes, and
----favorites (friends, colors, foods,etc;)
-someone is always outgrowing a size and needing new clothes
-you get to budget for 4 sets of college tuition (with inflation)
-you have four schedules to balance should you dare let them participate in any activities
-you count heads continuously to be sure you have them all
-you get to read 4 different books every night
-you have 4 goodnight kisses, and I Love Yous
-chances are good someone will want a snuggle when YOU need one
-you have 4 "potential" places to go to instead of a nursing home
-you have 4 potential sources of grandchildren (if you still like children then :) )
-you have 4 times the memories to cherish
----first words
----first steps
----first day of school
----so many more
I remember someone said to me once they never wanted more than one child because you could never love multiple children as much as you do the first nor provide for the others with the undivided attention an only child receives - that person has obviously not had four children
"believe in your dreams for all dreams can come true"
-dr. mom of 4
Tuesday, June 23, 2009
What doesn't kill you will make you stronger?
First thank-you to everyone for all the recent positive feedback regarding my blog. Your encouragement has been amazing and I hope that I can continue to hold your interest, teach you something, and create an understanding that we've all "been there". Working moms walk the road not traveled by prior generations and we do it well. (I've promised a few of you to write more often - so here is my written oath to attempt every other night as you have requested)
So....on with the blog
This past week I have found myself in tears. Although it isn't unrealistic to cry when we are loosing a loved one, sometimes crying is a hard thing to do. I spend all day long at work being strong for patients, having an open ear and a shoulder to cry on. At home I wipe noses, put band-aids on boo-boos and kiss away the tears. So when it's my turn to cry sometimes its hard to let down my guard and be human.
As I struggled with these emotions this week I remembered another time in my life when I was pushed to the max of my emotions. They say in the military, superior officers push the newly enlisted to make them stronger. In many careers people follow this mentality and the medical field is certainly not exempt. As I've mentioned before the atmosphere in the operating room is very unique to any other place I've worked or spent time in (this includes restaurants, retail, home health care, daycare, schools, town offices).
The operating room, like the military has a hierarchy. You do not speak unless spoken to. You do not move unless you can do so in an invisible fashion. As a medical student you are expected to stand on stools and reach around surgeons to hold instruments imperative in the operation even though you probably can't see what you're doing. Until you've held a retractor open for two to three hours without resting you cannot appreciate the forearm strength that is required. All the while the surgeon is likely telling you to move left, or right or up or down and I guarantee which ever way you move will be wrong.
One day while working with a "seasoned surgeon" he handed me the instruments to close the operation. I was certainly taken by surprise but knew better than to hesitate. As I took the instruments and started to proceed with the closing stitches, he said to me, " Do you think you can do this properly?" "Yes Sir". "I doubt it" he replied. No answer from me. As I finished placing the end of the stitch he leans in and pulls the stitch out, taking the instruments from me he proceeds to place a stitch into the wound explaining his reasoning behind the exact placement of stitches for optimal healing. He then hands the tools back to me for another attempt. Now smart girl that I am, I am able to see the holes he had made in his demonstration so I precisely start the suture in the exact holes he had made with the "perfect placement". Again, he pulls out my stitch. Wasn't I paying attention? Didn't I do any reading on this? Lots of degradation as I start for the third time a simple stitch in a very small operative wound. This time he doesn't pull the stitch out! "Am I making you angry?" No answer. "Are you getting frustrated with this?" No answer. "Did I hurt your feelings? Are you going to cry?" At this point I look up from my work and inform the surgeon that, "nothing you say would make me cry in front of you". Now notice I said in front of you. I finished the closure, took care of the patient and left the operating room. After retreating to the locker room, I CRIED. I cried because I take pride in myself and my work. I was certainly frustrated by the belittling and my ill attempts at achieving perfection.
I'm not sure if this made me a better doctor which is what that surgeon would say to you in justification for his behavior. I don't think it has changed or improved the kind of physician I am today but maybe it helped me to control my emotions, to be able to stay tough when I needed to be. It was certainly one of my most challenging training rotations.
So today when I cry over the loss of an amazing physician, mentor and friend of mine I do so without guilt. Somewhere during my journey as a physician and a mom I have learned its okay to be human even if its hard for some of us some days.
"believe in your dreams for all dreams can come true"
-dr. mom of 4
So....on with the blog
This past week I have found myself in tears. Although it isn't unrealistic to cry when we are loosing a loved one, sometimes crying is a hard thing to do. I spend all day long at work being strong for patients, having an open ear and a shoulder to cry on. At home I wipe noses, put band-aids on boo-boos and kiss away the tears. So when it's my turn to cry sometimes its hard to let down my guard and be human.
As I struggled with these emotions this week I remembered another time in my life when I was pushed to the max of my emotions. They say in the military, superior officers push the newly enlisted to make them stronger. In many careers people follow this mentality and the medical field is certainly not exempt. As I've mentioned before the atmosphere in the operating room is very unique to any other place I've worked or spent time in (this includes restaurants, retail, home health care, daycare, schools, town offices).
The operating room, like the military has a hierarchy. You do not speak unless spoken to. You do not move unless you can do so in an invisible fashion. As a medical student you are expected to stand on stools and reach around surgeons to hold instruments imperative in the operation even though you probably can't see what you're doing. Until you've held a retractor open for two to three hours without resting you cannot appreciate the forearm strength that is required. All the while the surgeon is likely telling you to move left, or right or up or down and I guarantee which ever way you move will be wrong.
One day while working with a "seasoned surgeon" he handed me the instruments to close the operation. I was certainly taken by surprise but knew better than to hesitate. As I took the instruments and started to proceed with the closing stitches, he said to me, " Do you think you can do this properly?" "Yes Sir". "I doubt it" he replied. No answer from me. As I finished placing the end of the stitch he leans in and pulls the stitch out, taking the instruments from me he proceeds to place a stitch into the wound explaining his reasoning behind the exact placement of stitches for optimal healing. He then hands the tools back to me for another attempt. Now smart girl that I am, I am able to see the holes he had made in his demonstration so I precisely start the suture in the exact holes he had made with the "perfect placement". Again, he pulls out my stitch. Wasn't I paying attention? Didn't I do any reading on this? Lots of degradation as I start for the third time a simple stitch in a very small operative wound. This time he doesn't pull the stitch out! "Am I making you angry?" No answer. "Are you getting frustrated with this?" No answer. "Did I hurt your feelings? Are you going to cry?" At this point I look up from my work and inform the surgeon that, "nothing you say would make me cry in front of you". Now notice I said in front of you. I finished the closure, took care of the patient and left the operating room. After retreating to the locker room, I CRIED. I cried because I take pride in myself and my work. I was certainly frustrated by the belittling and my ill attempts at achieving perfection.
I'm not sure if this made me a better doctor which is what that surgeon would say to you in justification for his behavior. I don't think it has changed or improved the kind of physician I am today but maybe it helped me to control my emotions, to be able to stay tough when I needed to be. It was certainly one of my most challenging training rotations.
So today when I cry over the loss of an amazing physician, mentor and friend of mine I do so without guilt. Somewhere during my journey as a physician and a mom I have learned its okay to be human even if its hard for some of us some days.
"believe in your dreams for all dreams can come true"
-dr. mom of 4
Monday, June 15, 2009
Layperson versus Physician
At a recent family get-together one of my relatives commented that its my personality that has pushed me to become a doctor and not "being a doctor" that has made me the way I am. I had never really thought about it that way but it's so very true.
Like most physicians I am a perfectionist. I am obsessive about doing things correctly and a bit of a control freak. It's not that I don't appreciate help sometimes, but it easier for me to do things myself, my way, instead of watching them get done at a lower standard. Think about it - its these qualities that serve my patients well. I call my patients personally with their results. I follow-through with things to the final degree. Helping others is what comes natural for me and what truly makes me a happy person.
Unlike other young physicians, my mom and dad were not physicians. They were not professionals of any sort, nor did they pay for my education. Dad worked in the middle class labor field and mom stayed at home the first half of my childhood then worked at my school the next half. My clothes came from low end department stores and I never had the "in" toys or clothes but we were happy and loved. I think this upbringing is what separates me from many of my colleagues. I understand what its like to worry about paying the bills and grocery shopping on a small budget.
One day when I was on a surgical rotation my attending stopped me in the middle of the ICU and asked me what a particular marking was on a random x-ray hanging on the wall. Not knowing the patient or case I looked at the x-ray and tried my hardest to anticipate what he was trying to get at. I answered him, and was immediately chastised with his yell, "what are you a dumb ass layperson or a doctor". Now I'm not good with quotes, but this one was burned in my mind forever. I didn't acknowledge his statement and then listened dismally as he explained that as a physician I would be held to a higher standard in life and that I needed to have higher expectations of myself. Every ounce of my being wanted to yell back at him that the blood running through my veins was one hundred percent dumb ass layperson and always would be.
There's a difference in your inner character when you grow up knowing the value of a dollar. I still don't want a BMW, nor do I have plans to become extravagant when the student loans are paid off. I struggle with balancing giving my children more than I had and making sure they too appreciate the value of a dollar. It was this past year that my son (who has a PS3, wii, digital camera and Nintendo DS) was crying about wanting a PSP that made me take action. I arranged for all of us to volunteer in a local food pantry. It was so heartening to watch my ten year old son pitch the "great taste of rice cheese" to an elderly woman as he helped her bag some groceries. I know I am succeeding when each month my son and daughter proudly carry large boxes and bags of groceries to people's cars with a smile that warms every one's heart.
So for now I know that a hard working middle class girl from a small town can do anything she dreams of and hopefully those roots will help to grow a compassionate physician who is able to be an integral part of her patients' lives. As for my children, I hope that the values and morals I teach them will far out value any object they may own.
"believe in your dreams for all dreams can come true"
-dr. mom of 4
Like most physicians I am a perfectionist. I am obsessive about doing things correctly and a bit of a control freak. It's not that I don't appreciate help sometimes, but it easier for me to do things myself, my way, instead of watching them get done at a lower standard. Think about it - its these qualities that serve my patients well. I call my patients personally with their results. I follow-through with things to the final degree. Helping others is what comes natural for me and what truly makes me a happy person.
Unlike other young physicians, my mom and dad were not physicians. They were not professionals of any sort, nor did they pay for my education. Dad worked in the middle class labor field and mom stayed at home the first half of my childhood then worked at my school the next half. My clothes came from low end department stores and I never had the "in" toys or clothes but we were happy and loved. I think this upbringing is what separates me from many of my colleagues. I understand what its like to worry about paying the bills and grocery shopping on a small budget.
One day when I was on a surgical rotation my attending stopped me in the middle of the ICU and asked me what a particular marking was on a random x-ray hanging on the wall. Not knowing the patient or case I looked at the x-ray and tried my hardest to anticipate what he was trying to get at. I answered him, and was immediately chastised with his yell, "what are you a dumb ass layperson or a doctor". Now I'm not good with quotes, but this one was burned in my mind forever. I didn't acknowledge his statement and then listened dismally as he explained that as a physician I would be held to a higher standard in life and that I needed to have higher expectations of myself. Every ounce of my being wanted to yell back at him that the blood running through my veins was one hundred percent dumb ass layperson and always would be.
There's a difference in your inner character when you grow up knowing the value of a dollar. I still don't want a BMW, nor do I have plans to become extravagant when the student loans are paid off. I struggle with balancing giving my children more than I had and making sure they too appreciate the value of a dollar. It was this past year that my son (who has a PS3, wii, digital camera and Nintendo DS) was crying about wanting a PSP that made me take action. I arranged for all of us to volunteer in a local food pantry. It was so heartening to watch my ten year old son pitch the "great taste of rice cheese" to an elderly woman as he helped her bag some groceries. I know I am succeeding when each month my son and daughter proudly carry large boxes and bags of groceries to people's cars with a smile that warms every one's heart.
So for now I know that a hard working middle class girl from a small town can do anything she dreams of and hopefully those roots will help to grow a compassionate physician who is able to be an integral part of her patients' lives. As for my children, I hope that the values and morals I teach them will far out value any object they may own.
"believe in your dreams for all dreams can come true"
-dr. mom of 4
Tuesday, June 9, 2009
Housecleaning for Working Moms
I remember how it used to be:
When I was in medical school and people would ask, "Do you have a house cleaner? Does your husband do most of the housework?" No and No. My husband, like most husbands, enjoys mowing the lawn and is great at handy-man tasks. Although he has attempted most everything; dishes, laundry, dusting, vacuuming, grocery shopping, and cleaning toilets have never been on his regular chore list.
I remember when Alexandra was about one and I was in my third year of medical school which meant that every six weeks my schedule changed. Life was crazy and we were getting ready for a family event at our house. I was on a rotation where I had to be there at 5am to see all the patients before 7am rounds with the attending, and had to stay til every last order was signed usually 5 or 6pm. I was venting to my mother-in-law about trying to get ready for the party with such little time and she shared with me these words, "Just remember when people come to your house they'll never leave it saying Andy's a bad house keeper. They'll always say geez that Su sure has a messy house". Somehow, not the support I needed. So as usual, the house was clean before the party (probably not every closet, but at least the main house).
I vacuumed in my kids rooms while they slept. I commonly would be doing dishes with the Letterman show on in the background. For parties frosting cakes at 1am is common for working moms. When my kids took baths I cleaned the bathroom (still do). So much of what we do is multi-tasking. These days my hours are better but the number of kids to clean up after has increased. I still multi-task as much as possible. It's easy for me to play a board game and cook dinner or help with craft projects while doing dishes.
On days off when I'm trying to tackle larger projects I try to include the kids on my "fun". Last weekend on one of these endeavors I carried a bucket with soapy water into the living room armed with three rags. One for me, one for the four year old and one for the two year old (whom I thought could handle this). For the mother of four I was seriously unrealistic. What started as controlled cleaning quickly turned into puddles of water on the couch (I had just scrubbed and vacuumed), water on the hardwood floor and a two year old slipping and sliding as though he were on Funniest Home Videos. He thought it was a great game, I feared the hardwood floors would get water marks and Daddy would not take that well. Not yet entirely discouraged, we moved on. I placed the bucket out of reach and ventured forward with the vacuum and dusting cloths. Four year olds dust well with a little cloth pre-sprayed with furniture polish, and two year olds love to use the central vacuum. He was great at first vacuuming areas I pointed out while I washed windows and Morgan dusted. Then the giggling started. Luke figured out if he got the end of the vacuum near Morgan's socks it would pull at them. Ahhh the discovery of suction. In a mother-like split second I dashed for the vacuum in time to watch him suck up the dusting cloth. He laughed so hard I couldn't help but laugh too. It was also easier to laugh at after I had gone to the basement and found the green cloth at the bottom of the central vacuum canister, confirming that it had made its way through and not damaged the system. That was the final end of our attempt to clean the living room. I was defeated into a round of puzzles in the play room.
I'll have to admit although I was annoyed by my mother-in-law's comment six years ago, I know its the truth and still find myself cleaning at 1am after a long day at work, long evening at home, and house to keep clean.
"believe in your dreams for all dreams can come true"
-dr. mom of 4
When I was in medical school and people would ask, "Do you have a house cleaner? Does your husband do most of the housework?" No and No. My husband, like most husbands, enjoys mowing the lawn and is great at handy-man tasks. Although he has attempted most everything; dishes, laundry, dusting, vacuuming, grocery shopping, and cleaning toilets have never been on his regular chore list.
I remember when Alexandra was about one and I was in my third year of medical school which meant that every six weeks my schedule changed. Life was crazy and we were getting ready for a family event at our house. I was on a rotation where I had to be there at 5am to see all the patients before 7am rounds with the attending, and had to stay til every last order was signed usually 5 or 6pm. I was venting to my mother-in-law about trying to get ready for the party with such little time and she shared with me these words, "Just remember when people come to your house they'll never leave it saying Andy's a bad house keeper. They'll always say geez that Su sure has a messy house". Somehow, not the support I needed. So as usual, the house was clean before the party (probably not every closet, but at least the main house).
I vacuumed in my kids rooms while they slept. I commonly would be doing dishes with the Letterman show on in the background. For parties frosting cakes at 1am is common for working moms. When my kids took baths I cleaned the bathroom (still do). So much of what we do is multi-tasking. These days my hours are better but the number of kids to clean up after has increased. I still multi-task as much as possible. It's easy for me to play a board game and cook dinner or help with craft projects while doing dishes.
On days off when I'm trying to tackle larger projects I try to include the kids on my "fun". Last weekend on one of these endeavors I carried a bucket with soapy water into the living room armed with three rags. One for me, one for the four year old and one for the two year old (whom I thought could handle this). For the mother of four I was seriously unrealistic. What started as controlled cleaning quickly turned into puddles of water on the couch (I had just scrubbed and vacuumed), water on the hardwood floor and a two year old slipping and sliding as though he were on Funniest Home Videos. He thought it was a great game, I feared the hardwood floors would get water marks and Daddy would not take that well. Not yet entirely discouraged, we moved on. I placed the bucket out of reach and ventured forward with the vacuum and dusting cloths. Four year olds dust well with a little cloth pre-sprayed with furniture polish, and two year olds love to use the central vacuum. He was great at first vacuuming areas I pointed out while I washed windows and Morgan dusted. Then the giggling started. Luke figured out if he got the end of the vacuum near Morgan's socks it would pull at them. Ahhh the discovery of suction. In a mother-like split second I dashed for the vacuum in time to watch him suck up the dusting cloth. He laughed so hard I couldn't help but laugh too. It was also easier to laugh at after I had gone to the basement and found the green cloth at the bottom of the central vacuum canister, confirming that it had made its way through and not damaged the system. That was the final end of our attempt to clean the living room. I was defeated into a round of puzzles in the play room.
I'll have to admit although I was annoyed by my mother-in-law's comment six years ago, I know its the truth and still find myself cleaning at 1am after a long day at work, long evening at home, and house to keep clean.
"believe in your dreams for all dreams can come true"
-dr. mom of 4
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