A New Home

We moved to a new house about a year ago, a big, old, beautiful house just north of the city. We have plenty of space, a good sized yard, and have bedrooms to spare for our friends and family. I could go on for days about our home, but I am preoccupied today because my old house is still for sale. 

The walls have a few nondescript items, but it is obvious no one lives there. There are dishes on a table in the dining room which food has never touched and a bed that I made out of cardboard boxes in the bedroom. Fake apples in a bowl in the kitchen, appliances too clean from disuse. My little house, which kept us safe and warm throughout some of the hardest days of our lives, has been abandoned. 

Does a home return to being just a house after the home owners leave? Just a building, a collection of walls and wires? It's been a year since someone slept in the house. No one has run through its hallways or cooked in its kitchen. What happens to the love that lived in that space? My children learned to crawl, then walk, then run on those floors. They built forts in the front room and dreamed big dreams in their little bedroom. We've had raucous parties and intimate dinners, we raised our voices in anger and soothed each other's tears under that roof. But now it's just quiet all the time. 

Others see flaws that I can't see because I remember the joy that caused them. The floors look to be buckling because our sweet old cat couldn't hold her bladder anymore. The walls need to be repainted after we removed all of our artwork and the kids replaced it with their own coloring. The corner where the Christmas trees lived is now full of cobwebs and the kids room is small and awkward without their toys cheering up the space. 

We had a buyer for a little while, a woman with one child and another on the way. We were so happy that there would be children back in the house! But the woman turned out to be a less than stellar person and we parted ways in very bad terms. I remain offended for my little house that someone would consider moving in and then deciding against it. How dare she insult my little house like that? How dare she reject it? 

I am homesick for that space, that little house bursting with toys and furniture and love. Our new home is gorgeous, but I can't fully move on until my little house is in good hands. It sits on a little hill, cheerful and optimistic, like a puppy at the pound. It grows older and more neglected by the day, but still remains hopeful that the right person will come by, will connect with it, and will make it a home again. 

One Free Pass

Like most mothers with sanity as a priority, I swore that my kids would not be overextended while they were young. I played basketball as a child starting at age 2, but that was once a week after age 8. There was a brief period of piano, then dance class, neither of which lasted because they were inconvenient for my family, specifically my young sisters who required an early bed time. Even as a child, this made sense to me. I much preferred to run around outside and play, read books, watch movies, torture my sisters. The last thing I wanted after a day of school was more people telling me what to do with my precious free time. 

Times have changed, though, and now the trend is to have extra-curricular activities as soon as possible and as often as possible. I tried to resist, but it is so hard when ALL the other kids in school are doing such fun things supported by their loving, well-meaning parents. I am also loving and well-meaning! I decided that it would be best to start enrolling the kids in various activities. We started with soccer. Colin has been playing since he was 5, which equates to now 3 seasons. It is finally starting to resemble an organized sport rather than a pack of hungry hippos following a ball around while their young are straggling around the edges, not paying attention and will likely be picked off and eaten.

As a side note, Caroline attempted soccer for a single season this past year, which was terrible and embarrassing for all involved. She mostly didn't pay attention or care about the game or her classmates at all - except when she did and would terrifyingly charge at the other children, visciously knocking them down and stealing their ball (or snack, she was not particular). Once, I was trying to motivate her to play and participate, that her team needed her. She callously met my eyes and said, "I'd really rather be alone, I don't even like those kids." 

So Caroline doesn't play soccer anymore. 

Colin loves it, though, and looks forward to soccer every session (twice a week!). However, he also has other things he's signed up to do. He is a Cub Scout at our church, which is three nights a month. Piano lessons are every week and he has a weekly playdate with his aunt so that Patrick and I can sing in church. He's a busy guy and busy guys sometimes need a break. 

Which is how we came up with the One Free Pass. Each kid gets One Free Pass for each activity and, when they use it, they are let out of the activity without question. They get to decide when they use it and why. Sometimes it's because they're tired, sometimes they have a better offer, sometimes they just aren't feeling it that day. I will never let my kids quit an activity (unless its unsafe, etc) but sometimes you just don't want to go. In order to build a sense of responsibility, self-awareness, and self-care, we decided to give them this control. They pick the time and can invoke the pass without explanation. 

The other night was our friend Elliot's birthday. Colin was so torn about what to do - he felt so busy and tired, but it was soccer! He loves soccer and could totally rally! But it was Elliot's birthday, and if he went to soccer he would not be able to see Elliot on his birthday. Colin does not make decisions easily or quickly, and this was a tough one. If he used his pass, he wouldn't have another one! If he didn't, he would be sad not to see Elliot and would be really tired! Ah, life is SO HARD!

Eventually, Colin decided to use his One Free Pass. We took homemade birthday cards and cookies to Elliot and then went to bed early. As we snuggled into bed, Colin said, "I'm glad I used my One Free Pass, Mommy. It was important to see Elliot and take care of myself today." 

From the mouth of babes. 

Buried

As is usual when a person graduates to the next level of the heirarchy, I had NO EARTHLY IDEA how much paperwork and general minutia would be a part of my everyday life as an attending. My first schedule had a few half days with no clinical activity assigned and I thought WOO HOO! This attending life is amazing! Little did I know that those times are built in not only for professional development or meeting with mentors/mentees or going to the dentist but that they are there so you can finish your damn charts.

I've only been a grown up for a few weeks now and already feel so overwhelmed by the amount of paperwork. And, of course, it is not actually on paper but just a thousand little clicks. I wonder what my click-per-hour rate is... If I were a website and getting this many clicks I'd be rolling in gold dubloons.

This is not a new question, but I don't understand how medicine go to be this way. Why is the emphasis on clicking instead of talking? On sitting in front a computer as a data-entry clerk instead of making medical decisions and taking care of people? It is an evolution of necessity for insurance companies and law firms, but both the doctors and the patient suffer.

My father, an old timey country doc, has been complaining about this for years, but it is a sharp contrast for me. As a resident, my job was to take care of people, learn from them, and write down what I saw and did. I thought this was a lot of busywork at the time, but I had no idea how much worse the billing component makes it. I spend more time on the billing and charting than I do with any patient, and it makes me so, so sad. I don't think physicians go into medicine to be data entry clerks, but I think it is why a lot of physicians get out of medicine.

A good friend of mine and I were recently talking and she said how burned out she feels. Exhausted and drained, feeling like nothing she does makes any difference. She says that these phases happen sometimes to everyone and that this one will fade like the others have, but it is disheartening to know that someone who views her purpose in life is to help other people, one patient at a time, feels like she is failing. And drowning. I wanted to lift her up, to assure her that she is making a difference, but that was not the point. It doesn't matter what I see, it's what she feels. And she feels exhausted and tapped out.

How do we protect physicians from feeling this way? How do we bolster and encourage those who sacrifice so much for the betterment of others? Money and bonuses and vacation time help, but in these times of dwindling reimbursements and corporate owned practices, we are unlikely to see an increase in that benefit. And we know from "the good old days" when doctors were better paid that they still were burned out and disenfranchised. In this and all things, financial returns are not the way to happiness.

The answer is to find meaning in the work and value in the care of others and ourselves. Though self-care is largely beaten out of us in our training, we are our most important patient and serve as an example to others. Support among the physician and health care community is critical but clearly deficient. As a new faculty, I need mentoring and support, but it is hard to find because EVERYONE needs those things. But we're all too busy and buried in our charts to help each other.

Surely there is a better way! Being new around here, I don't know what it is yet, but I'm still young and rested enough to want to find it. Because I don't want to feel burned out. I'm so excited to be here, a part of something so big and amazing and yet intimately personal. Being excited is not the same as feeling valued, but I am determined to maintain both.

(image credit: doctordocs.com)

Volun-Told

Colin, being a bad ass first grader now, has joined Cub Scouts. The pack is brand new, this is the first year. We're trying to get things off the ground and Colin loves being a part of it. He looks forward to it every week and was obscenely quick at learning the Oath, handshake, laws, Pledge of Allegiance, and the other required learning. It is a neat group of kids and provides fun, adventure, companionship, blah blah blah.

It's yet another after school activity that requires me to drive the kids somewhere and sit to the side, bored out of my mind, while my kids have fun and be enriched.

It's not that I don't want them to be enriched, obviously I do. That's why I sign them up and pay for all this stuff. But I get bitter that, after all this time and hard work to be a grown up and earn enough money to afford to enrich my kids, why don't I get to be enriched too?

Not that I don't appreciate the friendships I make with the other parents, but it's hard to maintain those relationships. Everyone is busy with their own families and lives, so often it is a temporary friendship out of convenience that quickly dissolves once the activity has ended. At least that's how it is for us. Every time.

It used to be that the kids needed me to watch them for encouragement or discipline, but now they mostly take care of themselves and, often, will behave worse if I'm paying attention. So I think that there should be some Away From the Action activity for parents of these kids. Let the kids have fun and be enriched/exercised/educated/etc and let the parents grow a little too.

Which brings me back to Cub Scouts.

As I said, the pack is in its infancy and, as a result, all the parents who showed up to the first meeting were forced to volunteer (what?) in order for the group to actually form. I am never availble to go to anything, ever. Except that one day. THAT ONE DAY when everyone present had to pick a volunteer assignment. And so I am honored to tell you that I am the new Advancement Chair for Pack 72.

Turns out it is exactly what I needed. Last night we met for our first committee meeting to plan out the first few months. We met at a new start up place and planned, schemed, and laughed over beers. We talked about the kids but also about the parents. We talked about the families and how they could all be involved, not just the elementary school boys. Topics for meetings were discussed and included safety, religion, culture, exploration, adventure, and self-awareness, all for the whole family.

I know part of this is the actual structure of the Cub Scouts, something I had no idea about. But a lot of it is also the small, fun group of parents who appreciated the opportunity to get out of the house, away from the kids, act like an adult, but put forth effort to contribute to and better the activity for their children.

Turns out, I love this extra-curricular activity and can't wait for this year! The kids will love it, but, if all goes as planned, so will the families and so will I.

All Grown Up

The best part about being an attending physician is being able to act like a grown up. 

I get to make my own schedule! I get to say when I need a day off or want to work more. They ask me what kind of patients I want to see, and then they schedule those patients. I have some actual control over my life. I don't really know what to do with that kind of power. 

Studies show that a lack of control over one's schedule is the leading cause of burnout for physicians and I am starting to understand why. The sheer joy I feel at being able to click a button and be off, without much in the way of having to explain myself or why I need time away, is unspeakable. After years and years AND YEARS of being told exactly when and where to be without my input or personal life considered, this is a breath of fresh air. It's a hurricane of fresh air and I love it. 

I know that I will get busier and feel much more pressured. I understand that this euphoria I am rolling around in will become mundane and that I will grumble like everyone else. So when that happens, I hope to reflect back on the freedom I feel now and remember how much I wanted to be where I am, how hard I worked to get this much control, and the sacrifices I made to have these privileges. 

But most importantly, I never want to lose sight of how incredibly lucky I am to be here. 

Adult-ing

Just recently - like, REALLY recently - I started my first attending position and started seeing patients.

Do you know what that means? Do you understand the gravity of that statement? I'm sure you do, but let me just highlight a few things.

First, I am officially, no question about it, a grown up now. I have my grown up job, I live in a grown up house, I regularly attempt to parent growing up children, and people expect me to adult on a regular basis.

Which brings me to point #2: patients are now trusting me to be their real life doctor. They ask me questions and want advice

Re-introductions

It has been four years since you've seen my kids and you would NOT EVEN BELIEVE how big and old and grown up they are. Let me re-introduce you! Have a seat friends, the flood gate of kid stories is opening.

Colin, who was once The Turnip.

Colin is now 6, almost 7, and in the first grade. He reads and writes, loves to be outside, and makes friends easily. Already he is an impressively loyal and trustworthy kid and his friends love him. Even older kids want to be with him because he is genuinely happy, positive, creative, and fun.

The kid is one of the most sensitive people I have ever known. When he started kindergarten, he was so upset by being separated from Caroline that he asked his teacher to call the day care several times a day to check on her. It was almost debilitating, so we switched Caroline to the preschool at Colin's school. Since then, he has flourished and it's incredible to watch.

He rides a gigantic bike, he begs for bike rides daily, and can ride circles around the rest of us. It is somewhat embarrassing, actually.

If I had to predict his future, I would guess a social worker. He likes to take care of people and make sure everyone's okay. Constantly checking on people and bringing them stuff to make them comfortable. When he's not absolutely losing his marbles because of how sensitive he is, the kid is an absolute joy of a human being.

Caroline, who was once The Secret Child.

Now 4, Caroline is, by all accounts of anyone who meets her, awesome. Truly, in the same way that masses adore celebrities even when they're poorly behaved and make incredibly bad decisions. Caroline has this way of attracting a crowd, wooing them into her graces, and then terrifically abusing her power.

She is smarter than I know what to do with and more clever than is fair. Once, when she asked about where the rain came from, I told her about evaporation and precipitation, getting all science geeky about it. She took it all in, paused to consider it, and then told me, "Mommy, I don't think you know what you're talking about."

I remember worrying about how I would teach a baby girl to respect herself, to stand up for herself in this world, but it turns out I didn't need to worry about it. The girl could teach a course on self-respect and self-defense. I would pay to go. Recently she was sent home from school with a report of getting into a fight. Apparently she and a little friend (a boy) got into an argument. The boy got angry and started yelling at Caroline, getting right up in her face. According to the teacher, Caroline got a terrifying look on her face, said "You are not being respectful to me and I don't appreciate it."

If that were it, I would throw her a party. However, she then grabbed a Mason jar full of water and clocked him.

If I had to predict her future, I am going to guess either President of the United States or assassin. Not sure which yet, and not sure which is worse, but either way, we are in trouble with this one.

We are different than the last time you saw us, but I can't wait for you to get to know us again!