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.
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.
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.
Jul 3, 2012
Moving on Up
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.
Feb 19, 2012
Morning Drama
I had to go in to work this morning to round and, while I was glad to have the rest of the day off, it is still unhappy to wake up before dawn, pry yourself out of your warm bed, and go bother people who also don't want to be awake. This particular morning was even harder to walk out the door, as the kids woke up just as I was getting ready to leave, making my departure even more annoying and traumatic for everyone. So I rushed to work, rounded as fast as possible, and jet out of the hospital. I will admit to being less than my usual Joy of Work self, and I probably didn't give people the emotional connection the deserve. Regardless, people were cared for and I was heading out.
I rounded a turn in the hall near the main entrance and was thinking about something completely mundane, like how I wish I'd grabbed a thicker coat or planning what to have for breakfast, when I found myself walking directly between two people in a heated conversation. A man and a woman, each of them crying, talking to each other 25 feet apart.
I discovered that I had stopped, right in the middle of them, and was watching the exchange like a tennis match. And I wasn't the only one - several other people, employees, patients, random strangers - all entranced by this Hospital Soap Opera scene playing for us, the couple themselves completely oblivious to the audience. Finally, the two lovers separated, never coming any closer to each other than they had been at the start, and the crowd looked at each other. I wanted to applaud, another woman dabbed a tissue at her eye. Everyone was a little amused and touched and bewildered by the whole thing.
I personally don't think a hospital hallway is the place to break up, but I have also been in relationships and situations where that ugly, messy, raw emotional stuff just spills out and there isn't any way to stop it. Once, I had a horrible fight with my sister over the phone while I was Christmas shopping in a fancy mall. I was crying and cursing and it was completely inappropriate for public viewing and I vaguely remember people staring at me but, again, that's where it happened and there was no stopping it once it got going.
I felt guilty for blowing off my patients this morning. Stopping to watch the personal drama of two people reminded me of my own patients upstairs, having just added to or started their families, and of their stories unfolding in front of me. I was too distracted to try to connect with them this morning, sit with them and admire their babies, listen to their concerns, allay their fears. Sure, they were fine, and I heard the "important" things, like that they hadn't developed a fever or bleeding or anything bad. But I didn't listen to how their nights went, how their babies are today, how they're adjusting to this new family.
I know that I can't be everything for everyone, and that no one blames me for trying to get home to my family on my day off. But that's part of being a doctor: expecting yourself to always be a doctor to your patients, whatever that means to you. Today, I didn't do so well. I'll do better tomorrow. And try to be even better the next day.
Jan 19, 2012
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
Oct 19, 2011
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.
Oct 2, 2011
My Loves
Every night, usually between dinner and bath time, we have the following exchange.
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.
Aug 8, 2011
Trainable Idiot
Today, I started residency. I put on my long white coat, walked into several patients' rooms, and said, "Hi, there! I'm a doctor, as you can see by the length of my coat. You can tell I'm an intern by the way my hands tremble and by the sweat stains on my shirt. My goodness, is it hot in here?"
That's not entirely true. Actually, I mostly stuttered today. I tripped all over my words when I talked to patients. I clammed up when asked by an attending about anatomy. I mentally stumbled in my to-do list, resulting in several minor but annoying mistakes. And let's not even talk about the dictation that I had to do today, instead saying a prayer for the poor, poor transcriptionist.
I think that the day was largely successful and that I should go back again tomorrow. The morning rounds were the worst, either because of the early, early, OMG early hour or because I am so rusty. Regardless, it can only get better tomorrow, now that I know where the computers are and how to log into them. I am fortunate to be on an intense but incredibly supportive team, which will mean that I will learn a ton and have fun doing it. Things look good.
Today was also Caroline's first day at "school". In the future, I think, I will probably count it as a success that I only broke down into tears four times throughout the day, and then only when people directly asked how I was doing being away from her. I kept it together the rest of the time, which is something I think should be applauded. Maybe. I don't know, maybe not. I can't decide if I'm a complete puddle of mess because I weep at the mention of our separation or if I'm a callous jerk of a mother because at all other times I am happy to be at work and feel that she is well cared for. Probably, this means that I am normal, but this is not a conclusion that I can reach on my own just yet.
Colin apparently refused to leave his sister's side this morning until he had been repeatedly assured that she would be fine and loved in her new room. That kid warms my heart, y'all.
Tomorrow, I get to go to the OR! Scrub-a-dub-dub!
May 18, 2009
Alone and Loving It
Today was an absolute disaster at work - I'll spare you the details, but there were definitely threats to chuck my computer out of the nearest window (which is not that near, sadly) - and gave up around 2 this afternoon, a good three hours early. I decided that what I needed was to start over. Everything I was working on could be done anywhere there was a computer and internet connection, so I brought a folder or two and a jump drive home in my purse, made myself a PB&J and spent the rest of the afternoon in my pajamas in bed. And I got more done in those three hours than I have in a week at work.
There was a decidedly rebel feeling about just leaving work to forge out on my own, and I relished the freedom that my bold choice gave me. If I were a true rebel, of course, I would have gone shopping or gone to the park or gone and smoked a cigarette behind a tobacco shop or something. But I am an honest person, generally, and so I worked diligently at home and finished several looming projects. What can I say. Even when I'm a rebel I'm still a goody-two-shoes.
The biggest adventure of the day, however, was a total surprise to me. I cannot adequately describe the thrill, the downright novelty of being home alone. As in, all by myself. I cannot remember the last time that happened! Patrick and I try to allow each other some "alone time" and alternate who runs the errands after the baby goes to bed (we live such exciting lives), so I have been all by myself recently, but not at home. This is subtle, but important. I was AT HOME. ALONE!
I cranked up my music and lounged in my bed without worrying that I would wake the baby or that he would discover electrical outlets or that Patrick would make fun of me for listening to my "coffeehouse mix" music. (I can only take so much Bruckner before I need a little teeny-bopper music to even my brain out.) It was just me and I could do as I pleased. And I did. And I was very pleased.
Feb 17, 2009
Office Crazy
I have kind of a lot to write about. From the stand-in babysitter debacle of yesterday to the shocking realization that I miss being pregnant and am considering having another Turnip someday to the movie that I saw the other night that I thought was hilarious. But now that I’m working and spending all day sitting at a desk in front of a computer, I just can’t bring myself to write anything when I get home. In fact, I get home and play with the baby and, when he goes to bed, I just want to hook myself up to one of those Chinese Stretch-Torture things and re-align myself after being stationary and slouched all day long. Now that I think about it, though, I suppose a chiropractor or a good massage could accomplish the same thing and without the messy quartering business.
I keep a little notebook with me all day and am constantly jotting things down to write about, but ARRGG I’m getting carpal tunnel after six days of a desk job and – this is serious now – I’ve got my eye twitch back. Usually, I only get the eye twitch when I’m really stressed (see: Boards) or really, really tired (see: newborns). But I am neither of those things. Maybe it’s eye strain from the constant computer action. Maybe it’s out of sheer annoyance that I still don’t have a god forsaken DESK at work yet and have to move two or three times a day. Maybe it’s that Colin has taken to screeching as his new favorite pastime and, while cute, it is slightly unbearable.
Regardless of the reason for the eye twitch, it’s back and I just simply can’t go on like this.
I need ice cream and a hot bath. NOW.
And so I’m off.
Feb 13, 2009
It's on the Internets
Today was my fourth day on the job. I am still painfully enthusiastic, way too friendly, and am generally really annoying. This afternoon, I was called into a meeting about a project that I am only peripherally involved with but know the details of well. Present were four other women, ranging from mid-30s to around 50 years old, all PhDs and all completely brilliant. As we discussed different aspects of the project, I took notes furiously, nodded in agreement with everything anyone said, and tried not to be in the way. Then something happened that made me giggle uncontrollably.
One of the project's aims is to study the social networks of high school kids. As you can easily guess, facebook was mentioned. Except:
We can contact the students on the computer because they all have email through the schools for FacePage.
KATIE
(chokes on tea)
BOSS #2
Is that what it's called? My kid calls it Facebook.
BOSS #3
Oh, that's it. I don't get it, though. What is it?
BOSS#1
It's a web page that lets people know who your friends are. Except my son thinks it's a conspiracy to spy on them.
BOSS #2
He's probably right. Have you heard that the word "friend" is actually a verb now? You "friend" someone or they "friend" you. What is that about?
KATIE
(snorts with barely contained hysterics)
BOSS #3
I think that's the networking. These kids ask each other to be friends and then look and see who else people are friends with so they can be friends with them too.
KATIE
(speaking in a small, trembling voice for fear of laughing out loud and getting fired)
Maybe I can help? I have a facebook account...
BOSS #1
Yes! Perhaps you can give us a tutorial?
BOSS #2
Can we look at my kid's page? He's always on there and I'm not allowed to see.
BOSS #3
Maybe we could all sign up and be friends with each other!
KATIE
Er...
Upon showing them the wonders of facebook, they had a slew of new ideas, including setting up groups and events and all kinds of things to encourage networking that we could track. I tried to explain that facebook exists for the sole purpose of, shall we say, "friend whoring", and that people, especially kids, are amazingly indiscriminate when it comes to who they "friend". The bosses disregarded this advice, as they were sure no one would be friends with someone they didn't know, like, and trust. Again, I tried to explain the difference between a friend and a Facebook "friend", but I was overruled by those wiser than I. They all signed up for accounts and began to write up the procedure in their fancy-pants grants and papers. I'll have to fix their language later. They'll never get published - or friended - if they call it FacePage.
Feb 10, 2009
Productive Member of Society
I started work today! Woo!
Well, truthfully, it was a little less than Woo. I arrived this morning to find that no one had considered where I was to be housed or how exactly I was to accomplish any of the numerous tasks that had been assigned to me. In other words, there was no space for me, no computer for me to use, and I had to specifically ask to borrow a pen and paper to make notes. I camped out in a conference room for today, though I had to share it with the lunch-breakers, and borrowed a laptop that kept melting down and losing all of my work. Then, no one could find a pen. It was a little odd.
That was the worst of it, though. Happily, there is much for me to do and I got a good start on it today. I worked consistently and was challenged but not overwhelmed. It was nice to read all those big medical words again and engage my brain for the first time in many months. (Though I will say that I nailed the House diagnosis in the one about the cancer researcher. That show is utterly ridiculous, but I was still proud of myself.) I am excited about these projects and about my role in them. Already I learned enough to answer questions that one of my bosses had about her own project! This is where the Woo! comes in. Woo!
Tomorrow, however, there will be changes. For one, Patrick and I cannot ride together. This morning was like a tornado and the cold war wrapped into one awful caffeine-free experience. Last night I specifically said what time I needed to be at work and what time we would need to leave in order to get Colin to day care in order for me to be on time. 7:55am. That was the latest I wanted to leave the house. I was very clear about this, and Patrick knows how much I lose my head when I am late. So perhaps you can image that this morning at 8:20am, when Patrick was standing in the kitchen without a shirt on, having lost his glasses, and fussing with the espresso machine, that I was NOT PLEASED. I was not pleased AT ALL. It was a rather unpleasant exchange and, though we still kissed goodbye when he dropped me off in front of the hospital, there might have been a foot or two between our lips. So. We have agreed that we will ride separately until I settle into a routine, though it is completely stupid to take two cars to the same place. It will avoid allowing the stress to take years off of our lives, thus giving us that much longer to drive each other absolutely crazy. Maybe later we can re-attempt the carpooling. I am not holding my breath, to be honest with you.
A second change will hopefully be a little preparedness on the part of my employers. Now that I've shown up, been in the way for an entire workday, and bothered them for things like a pen and a computer, I am confident that they will find me a workspace and provide the materials necessary for me to keep to myself and stay out of their lunchroom. I know I would if I were in their shoes. Who like to hear the tappity-tap of keys when trying to gossip about the girl in the next cubicle? I know I certainly don't.
Feb 9, 2009
Job
Hold everything! I might, maybe, hopefully, keep your fingers crossed, am planning to start work tomorrow.
I know, you probably thought that I have been working all this time. I was supposed to start at the beginning of January, but things got postponed and delayed. Then I was supposed to start at the end of January when, lo! my appendix decided to stage a mutiny and had to be surgically thrown overboard. Finally, three months after I initially made contact with these people and five weeks after my original start date, I am finally showing up to work tomorrow with the expectation of doing stuff and being paid. I will drop Colin off tomorrow morning and instead of coming back home to mope and pace, I will go out into the world and be a productive member of society. Tomorrow is the start of a new era! I will be a working mother, able to pay for day care and diapers! I would open a bottle of wine to celebrate, but I wouldn't want to show up for my first day all bleary eyed and dumb (though it would be easy to blame the baby), so I will refrain. Instead, I am going to go shower and curl my hair, lay out an outfit for tomorrow, and pack a lunch.
Adulthood, ho!