Awakening

It has been a long, long time since I've been here.

I read through my last few posts and it was like reading someone else's writing, glimpsing into a different family, reading a blog written by an acquaintance. When I last visited here, I was a new doctor, still learning how to work the computers and OR instruments. My kids were babies and, while I can feel the fatigue in the words written, the world was still sparkly and new.

And don't worry, the world is still wondrous and beautiful, but the sparkle has changed.

I finished residency a few months ago. Shortly following graduation I took the first part of the OB/GYN Board Exam, which gives the coveted "board certified" title. The push to the end of residency was on a road made of textbooks, study guides, and highlighters for this exam, which I took on a rainy Monday at the end of June.

And then it was all over and I had six weeks of vacation, during which time I relearned how to sleep and read books and hang out with friends and family like a normal person. While Patrick still worked quite a bit, the kids and I were inseparable, making messes and memories in a way we had never, ever done before. Weeks stretched on and we lounged in the luxury of time and love. It was not until the last few weeks that I finally felt awake again.

The last four years were incredibly difficult. There is no way to describe the level of exhaustion following residency. Profound, pervasive, endless exhaustion, which seeped into every aspect of my life. There is no denying that I gave my best at work and mostly left it there. What little was left was earmarked for the children to allay my fears of incompetence as a parent and that left nothing for myself or for Patrick. While I neglected friends and ignored my family along this journey, it was my marriage that suffered most. It is nothing short of a miracle that we are still married. It may be because we were too busy to bother separating.

As I recovered, my sisters said, "It's like we haven't seen you in years" and my kids remarked more than once "Mommy, you've never been this fun before", which is at once exhilarating to be BACK but also heartbreaking that I subjected everyone to this, including myself.

I have never once regretted my decision to go into medicine, but I often questioned my motives. Was it for equal respect as my husband and father? Am I trying to prove my competence, intelligence, worth? If so, to whom? With physicians in my family, I knew how hard this would be, and yet it was so much harder than I could have imagined.

Not to say that the last few years were miserable, not at all. I love my work and it makes me truly happy, which carries over into my mood at home. The joy I feel with my kids (despite tantrums and fights and the usual family drama) is relatively unaffected by my exhaustion and occasionally helped to refill my draining emotional reservoir. For this, I am eternally grateful. People often said, "I don't know how you do it, being a doctor and a mom!" but I don't think I could have made it without them.

Last week the kids started school. Colin is now 6 and in the first grade. Caroline is 4 and in preschool at the same school, one that we love. After getting them settled, my grown up job started this week. I am a licensed, credentialed, actual physician, my friends. I have my own office, an administrative assistant, and OR pick sheets. People are interested in my opinion and want my involvement in their projects.

Somehow, when I wasn't looking, I grew up.

After my summer vacation, I am ready to be who I really am again. I am obligated to be the best I can be, not just to myself but mostly to those who put up with me through this journey, who believed I could do it, who waited for me to come out the other side.

This blog has been a source of joy, confidence, and opportunity for me. Residency was too overwhelming to write about, but I am ready again. I promise ridiculous stories and lighthearted jabs and too many photos of my kids in the near future, but I needed to tell this story first to break the silence.

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.

A Tongue and Standing Photo Essay

I now present: Caroline's tongue:













And now, Standing!













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







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

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.

Dear Colin

Dear Colin,

Your life has been completely turned upside down the last six months and while I'm not going to apologize for it, I do want to applaud you and tell you that you are a peach. You handled all the turmoil and stress of a new baby as if you were expecting this all along, just waiting for her to show up. You continue to deal with your parents both working all hours of the day and night, and you and your sister floating back and forth between various friends and family members, like you scheduled this whole thing yourself. With the exception of brushing your teeth before bed, you conduct your life with such grace and poise and exuberant joy that I find myself envious. Where did you learn to be this put together? I doubt it was from me, and I know for a fact it wasn't from your father.

The reason I'm not going to apologize for doing this to you and your sister is complicated. You and I talk a lot about how important words are, and how to choose the right ones, so I'm going to try to do that now.

You and Caroline are the highlight of my day, the brightest, happiest parts of my life. Your dad feels the same way. The littlest details of your lives are of the utmost interest and importance to us, and we clamor to hear them when we convene over dinner. But even though you and Caroline are the most important things to us, your daddy and I both need other things in our lives, too. We need to work, which is a concept you are starting to play with. You often tell me, "Mommy, I'm going to work now! I'm going to have a great day at work today!" and I hope you say that because that is the impression that your daddy and I give you about our work. We work to make ourselves better, to make other people better, to make each other better. And, hopefully, to make you and Caroline better too. We work so that we can buy food and clothes and toy cars, of course, but we also love our work. We love the people at work and what we do at work and we love to be at work. That is true, but I don't want you or Caroline to ever think that because we love to be at work means that we don't love to be with you. We LOVE to be with you, too, and it's okay to love both.

Most days, you are excited to go to school. Your friends are there and you know your way around the games and the books. You have a routine that makes you comfortable and a chair with your name on the back. "C O L I N," you tell me proudly and you point out the letters. You have learned so much there, and you feel like you belong. I hope you can always find a place that pushes you to grow, to learn, to become more than what you were when you got there. A place where you feel you belong. I want you to have that away from our home and family, and then to leave that place, come home and embrace your family, eager to share what you've learned and to love each other in your home.

It isn't always easy, and sometimes things fall apart a little bit. The last few weeks have been really busy for our family. While I've tried to keep things as relaxed and joyful at home as usual, I don't think it was successful, and you started having accidents at school. I took this as a personal, secret message that I needed to pay attention, to step it up, to make sure you and Caroline knew how much you are adored around here. I don't know if that is really what's going on, but thanks for the reminder anyway. It won't be that last time you'll have to set me straight in all likelihood, but know that I'll be listening when you do.

Today I dropped you off at school and reminded you to use the potty. You wrapped your not-so-little arms around my neck and said, "I will, Mommy. I'm going to make you so happy!" Having no words, I buried my face in your hair and squeezed you until you complained and wriggled away from me to build a tower out of blocks and change the world.

You make my heart sing, little man.

With love,
Mommy

New Year

Happy New Year! Guess what one of my resolutions is this year?

Residency is trucking along relentlessly and so does everything else. The kids are getting older by the second, holidays have come and gone, and I am living and breathing work. I can't believe how different I feel in just a few months, though I don't know if my confidence is premature and based only on blind hope that I am doing the right thing (likely). Tomorrow starts my first off-service rotation (emergency room medicine), which means that it's unlikely I'll see a pregnant patient again for more than a month. I am thrilled at how sad this makes me. I worried that I would tire of obstetrics, but I just find it more and more fascinating and challenging as I get deeper into it.

That being said, ER should be fun. If nothing else, there are shifts that are 7am-4pm. SEVEN TO FOUR. I've usually seen ten patients by 7am, and leaving at 4pm seems like a crime, no matter what time you start the day. It's going to be great.

I was so lucky to have a few days off for the holidays, and even more lucky that those days included Christmas. We did a good bit of local traveling, but saw family and friends that, during a busy month in residency, might as well live on the moon. We are still paying for how hard we pushed the kids - poor things, we tried to convince them to nap in the car everyday, since we were constantly running from one place to another. They made up for it in the tremendous love they encountered at every turn (not to mention loot, spoiled rotten children).

COLIN

Have I told you? HE POOPS IN THE POTTY. Thank the stars, he just up and decided to do it one day and has never looked back. Not an accident, sleeping in Big Kid Underwear, the whole deal, can you believe it? It's the best Christmas gift ever. He did it first at school, a day I happened to pick him up. Normally, when I ask how his day was, he tosses a "Fine" over his shoulder and I have to tackle him to the ground to get anything out of him. This day, however, he says, still nonchalantly, "I pooped in the potty today." In fact I thought I had misheard, that my wildest hope had manifested as hearing things. But then he sent up to me the proudest, most quietly excited look, his eyes squinty with the breadth of his smile. I made a complete scene, I'll have you know. The whole building knew what had happened that day.



Interestingly, all the bribes I offered in my desperation were not at all lost on him, and he reminded me of his promised winnings as we walked to the car that night. "I get my MaiMai back, and a giant truck, and a cupcake, and a pack of stickers..." It was a good lesson about bribery (for both of us, unfortunately).



Colin was thoroughly confused by Santa this year. He was completely into the idea of getting presents, but many of the details were lost on him. At one point, I was informed that Santa rides flying dogs to people's houses, as well as that Santa would come every day until Colin's birthday came around again. This confusion was likely not aided by Patrick, who was equally puzzled. One day, in front of our children as well as our two nephews, said, "Wait, who does the stockings? Us or Santa?" He's lucky to be alive, I think. The Baby Mama is a fierce defender of Santa. Anyway, I don't know what I'll do with the two of them.







Luckily, Santa did visit our house, and left all kinds of goodies for everyone. Colin cleaned up the most, but he was most helpful in opening everyone else's presents as well. Caroline especially, given that she is mostly unable to coordinate tearing the paper off the package. The natural disaster left behind Christmas  morning reminded me of so many Christmas mornings growing up, when my sisters and I raced down the steps and dove into a pile of presents. Colin barely stopped to look at his gifts, there were so many to get to. There were a few that stopped him in his tracks, though. 





After Christmas at our house, we traveled south to a cabin on a farm to celebrate with my mother, sisters, and our nephews. Food, games, snuggles, and love. Exploring in the chilly weather and back in for hot chocolate and a nap. What else could you ask for, really.







However the real scene stealer was Angry Birds. All the  kids are obsessed with it and play at every opportunity. In fact, Colin insisted on getting an Angry Birds dog toy set for the pups for Christmas, which, incidentally, look a lot like the set that we gave to our nephew. Hm.



CAROLINE

Caroline is beautiful and sweet and serious, very observant and curious. She cracks up at anything her brother does to get her attention, but anyone else has to work for a smile. She has this incredible intensity about her, still playful but with a more reserved sense than Colin ever did. I love the closeness she demands, though it does get a little claustrophobic at 3am.



Christmas for Caroline was mostly about the wrapping paper. She did flips over it, reaching and scooting and screaming for wrapping, mostly unconcerned with the actual gift. Typical 6 month old, am I right? The paper was the gift for her, which makes her a really cheap date on Christmas.









v







It was a very Merry Christmas indeed. I hope you can say the same.

Bad Mommy

We've been told by Colin's teachers that he is an exceptionally bright boy, eager to learn and quick to master new challenges. He demonstrates, we are further informed, a love of learning that "makes teaching him a joy", a quality that makes my heart sing with pride.

This eagerness and quick mastery, however, has not yet extended to potty training. The joy certainly does not.

We were pretty close before Caroline was born, but that event threw a large, awkwardly-shaped wrench into our collective potty training efforts. Not so unexpected, we sighed, he'll catch on when he's ready. And along we went, gently encouraging him, loudly praising and quietly correcting, operating under the assumption that it is unlikely that he will have to attend his high school graduation in a pull up. And it largely worked, for the peeing part anyway. He picked it up just before his birthday and has been relatively reliable since then. We still celebrate and offer treats for his good "choice" to pee in the potty, but it is completely expected behavior now.

We have never, ever, not once managed to get him to poo in the potty. Not once, in the many months we've been at this, have we even come close. The only mild success was the other day when he announced in an alarmed voice, "Mommy! I'm pooping! I'll try to hold it in!" and then proceeded to visibly suck in everything he could. He didn't quite make it and the event still necessitated a complete costume change, but it was the best attempt he's had so far. Every other day is as follows:

Colin do you need to poo? No, Mommy. Colin how about now? Any poo for the potty? No, Mommy. Colin how are you doing? Any poo? NO MOMMY!

What's that smell?

Mommy, I pooped in my pants! 

We have tried everything. We've tried incentives, you wouldn't believe the things we've promised him. Candy and cupcakes and trips to the park and new trains. We've tried the Ick Factor, forcing him to clean himself up afterwards, which has thus far only resulted in delighted squeals from the bathtub. Peer pressure, shame, sticker charts, and throwing away treasured Big Boy Underwear - nothing has even made him blink. He is impervious to my bribes and pleas and threats and promises.

Until last night, when I did the unthinkable.

I took away his MaiMai.

I immediately regretted it, truly. What was I thinking? It's his comfort source, his beloved ball of knotted yarn (formerly a blanket), that to which he clings and snuggles and seeks out when he is upset. And so we proceeded through our evening. Three straight hours of screaming for the MaiMai. If it wasn't about that it was something else ("I need a bear! I'm thirsty! MY BELLY HURTS!") but it was all really about the MaiMai because he'd lost his ability to deal with things, to take a step back and breathe while snuggling with something treasured and safe. Awful, awful, awful.

The worst part is that I have now doomed anyone taking care of him to the same fate, since I clearly told him that he can't have it back until he poos in the potty. So Patrick, poor post call Patrick, will have to deal with him tonight. Our beloved neighbors this weekend. Of course, maybe this will be enough, this will be it, this will work. Maybe. Or maybe he'll go to high school in pull ups and be in therapy forever because his mother stole away his MaiMai. Too early to tell.

I am such a mean, mean mommy.

 

Distance

About a week ago, I got home while it was still daylight and got out of my car to find the kids at my neighbor's house. Colin was running joyfully around the backyard, in a furious lightsaber battle with the older boys. Caroline was carrying on a very deep conversation with my neighbor, telling all about her day. I sat down and scooped Caroline up into my arms, breathing in her sweet baby smell. She smiled and laughed before spitting up all over me.

"Katie! You didn't tell me that Caroline could roll over already!" My neighbor looked at me expectantly, but was visibly shocked when my eyes welled up and tears spilled over.

"I didn't know, actually."

I just finished an incredibly demanding rotation. The hours were greuling and the work was constant. It was incredible learning and the people I worked with were wonderful, but I never saw my kids. I left hours before they woke up and came home only in time to put them to bed (on a good day). Patrick did 90% of the parenting for more than a month. The other night, when Colin woke up a feverish, sweaty mess, he cried for his Daddy. I put him in our bed and he and Patrick snuggled, Colin with his thumb and his MaiMai, while I laid in Colin's bed, trying to get Caroline back to sleep after all the wailing.

This morning, I happened to have a late day, and I took the kids to school. As I walked in, I realized that I had never taken Caroline to school. Ever, in her now eleven weeks of attending school. Colin has changed classrooms since the last time I was there, and I didn't even know which one was his. I didn't know where his coat hung, how to sign him in for the day. He looked at me curiously and said, "It's okay for you to go now, Mommy."

It was the first time I questioned my choices.

Why was I even in medicine? It wasn't what I started out to do, so how did I end up here? Why am I a mother to two perfect children if I'm not going to be with them? Who am I to give advice to pregnant women about being a mother when my own son calls for someone else when he's sick?

This post is not going to end with a shocker about how I'm dropping out of residency. Not even close. I love this work and look forward to coming to the hospital every day. I am unbelievably grateful for the opportunities I have been given to participate in the care of women.

But this post also isn't going to end with a happy story about how we all snuggled on the couch and giggled until we fell asleep. I didn't know Caroline was rolling over because I never put her down once I get home, instead holding her close to me and breathing in her sweetness like a drug. I quiz Colin incessantly about his day and his new classroom. Who are your friends? What color is Your Spot? Do you like the potties there? How awesome is your new, big playground?

By the time the kids are fed, washed, and asleep, I have nothing left. Patrick gets the absolute worst of me, the part that is left over after everything else has been taken during the day. If we're lucky, we  will swap stories from the day and pow-wow about the plan for the next day while we pass out in bed, but most nights I am asleep within an hour of putting the kids down.

I haven't figured this out yet. I don't want to wish away my life, live for tomorrow. My kids and my husband and my life is here now, and that deserves my attention and so much more. I give everything I have left to them and tell them a thousand times in that hour or two how much I adore them, cherish their every breath. I kiss them enough times to make their skin red and chapped, but it still feels inadequate, too distant. I expect that this pain will dull, but I can't imagine that this ever gets easier.

My Loves

Every night, usually between dinner and bath time, we have the following exchange.

COLIN

Okay! It's time for me to go to work!

KATIE!

Colin, we just finished dinner! Let's play for a bit and take a bath.

COLIN

I'm sorry, Mommy I have to work! I love you though! Can you help me find my keys?

He tools around searching for his plastic Lightning McQueen keys, puts his shoes on, and then makes the rounds, kissing everyone, spending an extra moment with Baby Caroline, and heads out the door.

"Bye, Mommy and Daddy! Bye Baby Caroline! I'm going to work!"

Friends, residency is HARD. Yesterday was Colin's third birthday and also my first day off in a while. We threw together a fun party at the last minute, with our family and neighbors (aka extended family), but no long planned shindig like we have done before. I just couldn't swing it. I can't swing much of anything these days. It's a miracle my kids even still respond to me at all.

In fact, Colin calls for his Daddy when he wakes up or when he is hurt. Caroline smiles indiscriminately, but she lights up for Patrick and is merely politely cheerful for me. The dogs greet me like a stranger, and I sometimes feel like a stranger coming home. The kids have already eaten, having had a full day and ready for bed. I'm watching from the outside, wanting desperately to be a part of their day but only catching the very last bit.

Patrick and I are nothing more than ships passing in the night, quite literally. He's been working evening and night shifts, where I have to be asleep by 9:30 to be functional and at work before 5am. He drops off and picks up the kids, I try to remember to pick out clothes for them the night before. He does all the shopping, cooking, and laundry, I try to pick up the house before passing out in bed. He asks about my day and listens and I stumble through my stories, trying to stay awake long enough to connect with him, and mostly failing.

Work itself is going well, I love my job and I feel so honored to be involved in the care of women at one of the most memorable times in their lives. I am learning so much so fast, and I am so grateful to be able to do this work. But I miss my people. I miss my own life and the lives of my kids so much that it hurts.