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Nov 2, 2012

Gratitude: Fodder for Stories

Halloween is arguably the most kid-centric holiday in existence (Christmas is fun for everyone, New Years is for adults, Easter is... not really that "fun" in the classic sense.) and I tragically had to miss Trick or Treating. Owing to my current nights rotation, I left for work just as the kids were getting home from school and thinking about getting dressed up. I love Halloween and was feeling pretty sorry for myself that I had to miss it, both for myself and for the kids.

But let me back up and tell this story properly.

For months, Colin has not wavered in his desires and plans to be a Digger for Halloween, specifically, a Giant Excavator. I tried to sell him on the idea of being a construction worker but he was unswayed.

"THE DIGGER, Mommy. I'm going to be THE DIGGER."

Who am I do deny someone so determined their very dearest wish?

And so, planning commenced for an elaborate, functional Digger costume. A sure to be classic, it was constructed from several cardboard boxes which were spray painted yellow and assembled over the course of a few weeks. It did indeed have a working Digger arm, at least in theory.

"MOMMY! THE DIGGER ARM IS BENDING AND MY DIGGER IS SCOOPING THE WRONG WAY!"

Drama is inherent in the creation of any good Halloween costume, and Colin is at the age where everything is spoken in CAPITAL LETTERS and WITH GREAT URGENCY, but the arm did bend a bit so I employed some resourcefulness and duct taped the hell out of that arm. Eventually I taped some chopsticks to the inner aspect of the arm, which stabilized it enough for Colin's satisfaction.

Caroline is a baby, for all intents and purposes, and so does not know what Halloween is, nor is she permitted to eat any of the candy. She does not care for costumes or any of that silliness, as she is a very serious child, prone to introspection and reading books alone. If it were up to her, she probably would have stayed home with her book pile and Beloved Purple Hippo. But it wasn't up to her, so she was dressed up as a Construction Barrel to accompany her brother.

Her costume was much simpler: dressed in all orange, including an orange tutu provided by Aunt Jenny, she was wrapped in white duct tape (This Halloween brought to you by duct tape!) and given a small toy construction barrel to hold up as an example whenever anyone asked her what she was. Her hair was styled such that she had a pony tail sticking straight out of her head. It was, truly, adorable. She was several times mistaken for Nemo, to which I replied that obviously she wasn't Nemo, since I hadn't duct taped on of her arms down to give her a lucky fin. An obvious and clear difference between a construction barrel and a cartoon fish.




We went to a Trunk or Treat on Sunday in these costumes and they went over very well. Initially Colin had some difficulty walking in his Digger costume, but then a very cute little princess with long blonde hair said, "Look at that awesome costume! He's a construction machine! Cool!" and Colin suddenly had no difficulty in walking. He stood up a little straighter and suddenly loved his costume. (I was pleased to hear this comment as well, in all honesty.) Everyone loved the Digger and sidekick Barrel/Nemo. They made a killing in candy.

Then came Wednesday, Halloween. School had a parade in which all of the kids wore their costumes and visited each other's rooms in exchange for candy. Parents were invited and since I'm working at night and only doing something useless like sleeping during the day, I was not going to miss it. I darted home after work in the morning and collected the kids and their costumes. Caroline wasn't going to be with Colin, so her costume was converted from the Barrel/Nemo to Colin's old Candy Corn.



Colin, however, could not be dissuaded from wearing the Digger to school. I tried various tactics to get him to wear some dress up clothes that would let him run around like normal (eg: train conductor, chef, santa's helper, or any of the other dozens of dress up clothes that we have on hand) but he would have none of it.

"NO, I'M A DIGGER, MOMMY. I've never wanted to be anything so much in my LIFE."

I couldn't argue with that logic, could you? 

(There is a side story here in which I discover that I am stranded at home without car seats for the kids because my neighbor, who was not at home, had them to pick the kids up after school. I ended up borrowing a friends car who has similarly aged kids to even get to school. Then I started taking pictures with my camera, only to discover that it had neither a battery nor a memory card. This day was something else, I tell you.)

I dragged that thing into school and all the teachers and other parents looked at me with odd looks. I really wanted to believe it was envy: look at that awesome costume! And she's in scrubs too, wow, how does she do it? Instead, however, I'm pretty sure it was more: pitiful woman. That costume is ridiculous and she looks like she hasn't showered or slept. It's so sad when people live vicariously through their kids. And scrubs? What a dumb costume. 

Once the parade started, Caroline would have no part of the Candy Corn or any other costume. Which is fine, whatever. Right? Not according to Colin, who kept was watching for Caroline and kept running out of his room to attack Caroline from behind.

"NO, CAROLINE! You have to wear your COSTUME! It's the only way to get CANDY!"

And he would shove it back over her head, covering her face. She would flail her arms and scream in protest, and suddenly her costume and character became Haunted Zombie Candy Corn.



Colin's turn to parade around brought a new struggle. Kids everywhere were having meltdowns in the middle of the hallway, with other kids just stepping over them. A screaming Dinosaur here, a crying Elephant there, here is a Cupcake with tears the size of cherries on top. I looked over at one point to see Spiderman lying spread eagle on the floor sobbing and the teacher standing over him. He was completely unmoved by her pleas of "Spidermans don't cry!"

The halls at school are not exactly huge, and when filled with a bunch of small children in itchy, poorly sized, uncomfortable clothes, it can be hazardous for even the most careful Digger. Every time Colin turned around, he would take out some poor one year old Monkey child with his Digger arm. He would back away from the stunned kid only to run over a little Captain America. The more flustered he got, the more dangerous he became.




About ten minutes in, he looked up at me and said, "Mommy, I am SO DONE with this costume." I reminded him that he'd just told Caroline that it was the only way to get candy and he shrugged it off, marching ahead and collecting candy anyway. I trailed behind with the sad, forsaken Digger.

 After school, he sat at the counter as I readied for work and tried to talk up Trick or Treating.

"It's so fun!" I promised, "everyone's dressed up and you get to meet new people and get candy!"

He looked tired, perhaps worn out from his vast destructive Digger path at school. "Mommy, I don't want to wear my Digger. I don't like it anymore. I just want to be Normal Colin."

I should have anticipated this. I looked at the clock. 5:25pm. My shift starts at 6pm. Nothing like a deadline!

"How about a chef?" I said, waggling the dress up clothes at him. Nope.

"Fireman? Doctor? Leprechaun?"

His eyes lit up. I froze. God, what had I done? I held in my hands a green top hat with four-leaf clovers around it left over from St. Patrick's day of the days when that was a really fun night at a bar. Where had my brain come up with Leprechaun? Regardless, that's what it was going to be, by God.

"MOMMY. I have never wanted to be ANYTHING so much as a lepa... lep... what is it again?"

So, in the five remaining minutes before leaving for work, we threw together a Leprechaun outfit and he was thrilled, Best Thing Ever. Caroline went as the Candy Corn but quickly transformed into the Sleeping Orange and Yellow Rock on her daddy's shoulder. They had a blast, going out with friends. Colin made friends with two more little girls dressed as princesses, who were quite enamored with him. Caroline slept well. Patrick ate a ton of candy.



I wish I had more photographic bragging rights for this phase of Halloween than this picture of Patrick (who was costumed only in an orange fleece), but Patrick reported to me later that night as we spoke on the phone, "Sorry, we were just having too much fun to take any pictures."

And with that, I lay Halloween 2012 to rest in a dirty, dusty grave. We'll try again next year.


Oct 24, 2012

Roses Persist

There are two rose bushes that live on the east side of my house that were there when I moved in. They are beautiful and strong, they live on and grow high despite their neglectful current owner. I don't know anything about plants, sadly, but I know they are not knock-out roses. They are pure and simple, white-streaked pink blooms. I love them.

They were planted by a man who lived in my house many years ago, the second owner of the house which was built in the 1920s. Mr. Simpson was his name. Simpson was his first name, I have no idea what his last name was. He was a proper Southern Gentleman. It is his legacy that, still, everyone on the street is Mr. or Ms. First Name to all of the children. By all reports, he was a very good man. Helpful and compassionate. He had a huge car in the 1950s, apparently, and a late night parking mishap was the event prompting the larger bump out of the garage. Mr. Simpson was a well-liked man and has friends who were willing to help him with his house as he got older. These are the friends that helped to build the ridiculous kitchen that Patrick and I love/hate. It sold us on the house but is very... amateur.

Moreover, Mr. Simpson was a well-loved man. There were two Mrs. Simpsons of the house and he outlived each of them. He loved those women, my neighbor says. He took care of each of the women as their bodies became ill and their spirits drifted away from him. He planted a rose bush for each one after she died and tended them as carefully as he tended to his beloved Mrs. Simpsons. I think that the roses live so well now because they had such a loving start, watered by Mr. Simpson's sweat and perhaps his tears, thinking of his wives.


Aug 6, 2012

Gray

When I was younger I loved to dye my hair, but my hair never really took to the color. I tried to go blonde, but it turned out just slightly lighter brown. I went red and kept it that way for a long time, but it was really just reddish-brown. Even when I dyed it purple, you could only tell if you looked really closely that it wasn't just an unfortunate color of brown. Brown is where my hair stays, and that is just that.

Except recently, my hair has been switching gears and going gray. I noticed the first gray hair almost four years ago on Colin's first birthday, just before his party. Predictably, I cried out in agony and ripped it from my head. The grays keep coming, and now there are more than just one. Still only a few, and difficult to see (it still just all looks pretty brown), but they're there.

This is in no way surprising: both my parents and all my grandparents are gray. My younger sister has grays all over, has for a long time. I truly expected them much earlier. But now they're here, so what's to be done?

It is not feasible to rip them all out. Aside from ouch, there is the inevitable thinning that would result. As someone with fine hair to begin with, this is not a good strategy. I stopped dying my hair about six years ago because I recognized the futility in trying to deviate from brown. Brown Brown Brown. But now gray.

Those grays are part of me, I suppose, and it's a waste of time to try to convince myself otherwise. Just like my nose that's turned up but is my father's and my ears that stick out a bit too much but are my mothers and her father's before that, they connect me to my family. It may not make me more beautiful, but it is from them and that's enough. The grays are from delivering my babies and now mothering them. They are from my patients keeping me up at night, worrying over their problems and lives and futures. They represent the painful, frazzled, wonderful life of a mother, a doctor, a person in the world.

I think the Olympics have given me some grays, too, both because of the suspense of some of these competitions and also because I have been choosing to forgo sleep to watch. Hopefully I'll get some more grays in the near future that represent the maturity I develop when I get myself to bed on time. We'll see.

I think that I will leave them for now. Live and let... grow gray.

Jul 3, 2012

Moving on Up

Shortly after I wrote my last post, I started on my nights rotation, a six week block of time during which I worked 14 hour shifts five days a week overnight. It was an incredible experience; since I did this rotation last of the year, I was the most prepared, the most confident I could have been. I knew what I was doing a lot of the time, which is not a feeling an intern experiences all that often. I felt comfortable with my hands and knowledge, familiar with the patients, and I became friends with and earned the trust of the nurses. It was lovely and I felt like I rocked it. During this block alone, I performed 76 vaginal deliveries, more than doubling my total for the year.

Simultaneously, I didn't check my email for approximately six weeks, nor did I see the sun, brush my hair, or speak to my mother (sorry, mom! I'm alive!). I saw my children for minutes at a time, and only then when I was either waking from a too-short sleep during the day or just before they hurried off to school and I collapsed into bed. Also during this time frame was my seven year wedding anniversary, father's day, and Patrick's birthday. I am ashamed thinking about how little attention I paid to these, and to the man who cared for me and my children during this block.

Caroline had a birthday too, can you believe that? She turned one. ONE, fortheloveofpete. She's huge, she's almost walking (three steps at a time!), she's signing her preferences, and she love love loves her brother. She's beautiful and wonderful and while I was on nights I missed her so much it hurt.

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Colin is ENORMOUS. He has these new shoes that he says make him jump better but I think he is just using that as an excuse to show off how coordinated and grown up he is. He has a new bike with training wheels that he rides up and down the street with the big kids, no problem at all keeping up.  During the time I was working overnight, Patrick took them to visit his parents and he took Colin to a car show. They participated in a pinewood derby and Colin won a (participant) trophy which he loves passionately and sleeps with every night.

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Patrick started his fellowship in renal (kidneys, blech but yay for him!), I moved up in the academic world and am now a second year, and we are all feeling a little beat up. But happy, which, in the end, is the goal. It's just so hard when you get to happy by slogging through such exhaustion and guilt and pain and loneliness. It's hard work to be happy, did you know?

I hope you're happy. I've missed writing here and hearing from you. Let me know how you are.

May 17, 2012

Cancer

Disclosing someone's diagnosis of cancer is a morbid privledge. There is tension that hangs in the air as you sit with the patient and their family, all gathered to hear what news you have, waiting for you to confirm their fears. And you will, but not yet. First, as you've been taught, you ask them what they understand about the situation, what they are worried about, how they are feeling. Then, in an unfailingly abrupt change of focus, you tell them that the news you have is not what you'd hoped. You look around the room and notice how everyone is acting differently, some meeting your eye, some avoiding your gaze, some still, some restless. But no one is breathing, not until you're finished.

"I'm sorry to say that you have cancer."

The news hangs in the air and only then does everyone breathe it in. The news becomes impregnated into their cells and starts changing, altering the person, invading the known and making a new space for itself in the minds and hearts of each. The patient looks down, tries not to cry, tries to be strong. You can hear thoughts steeling for the battle ahead, promising to be victorious but doubting even now. The family moves closer to the patient, maybe asks a few questions but doesn't listen to your answers. Your role here is ceremonial now, you serve no real purpose. You have delivered your message. Now you just sit in the presence of the family and offer mumbles and soft touches of support.

Once, I told a man he had cancer. He held my gaze for a moment before looking away. His cancer affected his brain and I saw him fighting to understand what my words meant. He was surrounded by family, but his 18 year old daughter was not present. He looked for her, reached for her, forgetting that she hadn't been able to get off work tonight.

Seeing her absence, he turned back to me. "When can I go back to work?"

The answer was never, sir, and in fact you may not ever leave the hospital, this room, this bed. But that was not his concern and I missed the meaning in his question.

"When can I talk to the work people? I need money."

The tumors prevented his thoughts from forming words and his words from expressing his meaning. Finally we heard him. He didn't need money. He needed life insurance.

"What about...? What is she going to do...? She.... needs me... needs money..."

His head rested in his hands as he tried but failed to remember his daughter's name. 

"You know who I mean?"

He cradled his arms and rocked them back and forth, slowly, gently, with love. He looked down at the place where his baby's head once laid and tears fell onto his arms.

"What about her?"

The privledge in taking care of people during these moments is in seeing their hearts exposed, raw and bare. When given their death sentence, people always think of others. Their children, usually, and spouses. They mourn the sorrow that they will cause and the pain that will be their legacy. They look to you to heal them, but not always to cure. Sometimes it is enough to acknowledge the pain and recognize the suffering, to comfort the families as much as the patient. I sit on their beds and look in their eyes and hear them, each time leaving a little of my life with them to quiet the disease, each time taking away a little of the impact of illness away with me.

Mar 26, 2012

A Tongue and Standing Photo Essay

I now present: Caroline's tongue:

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And now, Standing!

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There aren't many good photos of Colin these days, because all I ever see of him looks like this: 

Best Buddies

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But still, there's this. (Still with some tongue.)

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Mar 24, 2012

Update from the Front

Caroline crawls now. She pulls herself along with the strength of a woman with a mission and gets herself into fabulously perplexing situations. Nothing makes her happier than getting herself stuck under the table or smashed behind the couch. Squeals and peals and laughter, which all inevitably evolve into shrieks and screams and pleas for rescue. Once rescued, she returns to her previous adventures, scouring the floor for things that might be lethal so that she may shove them in her mouth before someone stops her.

Colin is endlessly fascinated by Caroline. He wants to be as close as humanly possible at all times. Closer. He bends over her and grins right into her face, giggling and saying in a sing-song voice "Caroline-y!" She loves it, and grabs his face to pull his nose into her still toothless mouth. He protests, "Yuck, Caroline-y! That's my nose!" but he doesn't mean it. What he means is "You're the best thing ever" and she laughs and drools and shuts her eyes tight, which, of course, means "No, you are."

**

It recently occurred to us that we are in our 14th year of togetherness. Fourteen years of tolerating each other, even seeking each other out, putting up with all the ridiculous things that people do to each other. The last few years have been more difficult to keep up with the ins and outs of a relationship, what with the careers and the kids and the, I don't know, life, so we decided to make an effort to spend more time together, away from the children. We spent a night away, bought tickets to see an opera, and stayed in a hotel. We got take out Thai food and went back to the hotel after the show instead of going out for drinks (what? they had free cookies in the lobby.). It may not have been the most adventurous weekend away, but it was well deserved, much appreciated, and so, so fun. The opera was good, too, as an added bonus.

**

Work. Work Work Work. Work times a million.

When I took my maternity leave at the beginning of this academic year, I did so knowing that it would eat up all of my vacation. That even included any time off at Christmas or New Year's. I took unpaid leave then so that I could have a short time with my family, but aside from those few days, I haven't had more than two days off in a row since July, and I won't until probably September. That is a LOOOOOOONG time, for anyone in any place in their life, but to do that your intern year? It's crazy, completely insane. It's painful and horrible and awful.

What I'm saying is: I could really use a vacation.

I'm rotating on Internal Medicine right now and realizing that I really, really made the right choice in what to do with my life. Every day I go to work and try to fix people's problems. I try to fix their blood pressure or their diabetes or their bad back or their bad heart. I try to talk them into quitting smoking or eating better or taking their medicines. I slave over the computer and write novels into people's electronic medical records, only to have the consulting services ignore my notes and sign off on complex patients, leaving me to fend for myself - and the patient - alone. The problem is that you can't fix anything! You can't deliver their baby that's making their blood pressure high - there is no baby! It's a dude, first, and second, his blood pressure is from years and years of poor diet and no exercise, not a placenta that doesn't work. You can't simply take the patient to the OR to fix their heart that doesn't work as well as it should. You can't do a quick note, you can't make rounds quickly, you can't just stop in and talk to a patient. Everything is inordinately complicated and has to involve seven different services not to mention the patient's grandmother and cousin and neighbor two doors down. NOTHING EVER HAPPENS OR GETS BETTER.

I can't wait to get back to the OR and Labor and Delivery and my relatively healthy young women.

**

I've started running. I went one day on a whim and something clicked in my brain and I haven't been able to stop running since. I've always hated running, hated it. But it was nice outside one day and the kids were out with Patrick and this idea popped into my head. It's a nice day for a run, my brain mentioned, and I thought, Hmm. Yes, it is, isn't it. And so I strapped on some old tennies and went for a run. I did run-walk intervals so I didn't die, which was clever on my part but was in no way my idea, and afterward I had lots of energy and didn't need to collapse on the grass. My brain said, Well, that was just lovely, wasn't it? So refreshing. I took a mental tour of my body and noticed that I felt great, completely fantastic. And so, after a few more runs, I thought, My goodness, I'm turning into one of those odd people who run. For fun. Then I bought new shoes and now I love it even more. I think about when I'm going to run next during the day. When I get home from a run, I think through it in my head: how was my form, where does my body hurt or feel sore, what was challenging about that run or route, what was good about it?

I miss yoga still and try to stretch and stay flexible, but at this moment in my life, I need the fresh air, the movement, the wind. It is inexplicably restorative to go move outside, alone. Just me and my shoes and sometimes some music. There is this lightness I feel when I'm about halfway through a run that I never feel elsewhere, a lightness in my chest that lifts me up out of the frustrations of the day and lets me see the miracles of my life. I see that even just a dose or two of caring is good for these medicine patients. I see the joy in my children - a joy that comes from each other and makes my stomach burn with love. I see myself growing up and falling in love with my life again every day.