An Incomplete List

Monday, November 23, 2009

Give me one hour of uninterrupted alone time, and I know exactly what I will do with it.

There are abundant things that I should do with that hour. Do the dishes, do the laundry, sweep, sleep, exercise. There are countless things I enjoy that I could also do. Paint, Photoshop, catch up on my DVR recordings, listen to music, blog.

But the one thing I choose above all others?

Read.

Since I was little, reading has been my favorite activity. In second grade, I would grab a blanket and sprawl in the sun on our back porch with novels far too advanced for my age. I didn't understand the subtleties of the plot, the emotions were often beyond the range of my own experience. But the adventure, danger, and romance swept me far away from my 8-year-old life. Any given afternoon, I was exploring tropical jungles, settling the West, or attending balls in the courts of France.

AS a teenager, I would walk around the house with my nose in a book. It was propped behind the sink as I washed dishes, it joined me at the dinner table. And often, I would sneak into the bathroom for completely uninterrupted reading, only to emerge, sometimes an hour later, and usually to frustrated siblings. I could disappear for a weekend at a time, curled up in my bed, exploring space, surviving wars, or discovering radioactivity.

I read nearly every book of the reading lists for high school. I made lists of book to read, and methodically crossed them off.

As soon as I had money, I began buying my own books. If anyone draws a blank on what to get me, they get me books.

Now I horde them. Do not ever, ever ask me to throw out a book. It does not matter that our five bookselves are overflowing and stacked every which way with tattered paperbacks from the book exchange or shiny new hardbacks from the chain store. The books are not books any longer. Each one is a character, a personality, well known and well loved.

I even love the smell of books. Open a brand new book and the smell of paper is intoxicating. I used to study on the second floor of the university library, not for the silence, but for the inviting, soothing smell of the rows upon rows of books.

It is hard for me to come up with a list of favorites. I can name my favorite people or favorite songs much easier than I can my favorite books. But I will do my best.

Some are on this list because of the story, some because of the impact they made when I read them, and others, purely from the joy I have every time I turn the first page.

A Tale of Two Cities


In my mind, this is Dickens' best book. The imagery is breathtaking. The strength of the writing and the plot development never disappoint. Not once.

Pride and Prejudice


I love Austen. Her witty, nearly sarcastic view on women's lives at the time appeals to both my feminine and feminist sides. And there is no character that I love more than Elizabeth Bennett. She is both perfect and flawed, and therefore, completely human.

Harry Potter


Yes, I am counting all 7 as one book. I have read these books more than I have any other (although Pride and Prejudice does come close.) Rowlings mastery at weaving a plot that takes twists never expected, her brilliant character development, and the sheer magic (pun both intended and not) of the books make it so they captivate me just as much the seventh time through as they did the first.

To Kill a Mockingbird


Exquisitely painful and beautiful at the same time, the range of emotions of this book nearly overwhelm me each time I read it. There are few literary characters that make you want to stand beside them as Atticus Finch.

Crime and Punishment


Dostoevsky's examination of guilt, conscience, justification, and redemption are both frightening and captivating, without letting you be sure of which emotion is stronger.

The Hobbit


I was sure at one time that I loved science fiction more than I loved fantasy. Now, I'm not so sure. The one thing I am sure of is that I can trace my shift in feelings back to when I first read a story about a hobbit stepping out of his little round door and setting of in search of gold, adventure, and self-identity.

I think I should stop at 6. Otherwise, I will be perusing my library all night, reading through books and deciding if they should be on my list or not.

This is not be any means a complete list. Not even close. Mary Shelley, Ray Bradbury, Leo Tolstoy all belong on this list as well. Nor is it even close to being a list of books I feel are must reads. I'll save that for another day.

What books are on your "favorite" list?

Let me know, so that, given enough uninterrupted alone hours, I can add them to mine.

The healing process

Saturday, November 7, 2009

Years ago, someone very close to me hurt me in such a way I thought I would never recover.

I'm not going into the details, because now, years later, the details themselves mean very little.

At the time, I felt angry, betrayed, neglected, and above all very, very sad. Heartbroken.

I know that this person never intended to hurt me. I understand that the circumstances surrounding the event may not have been possible to change. Even then, I knew that most of what happened was the perfect storm of bad events.

Knowing all that, I could have forgiven the person and moved on. However, one thing prevented me from doing this. It has prevented me for years from doing this. I have carried this hurt inside for a long time and it has severely influenced my relationship with this person.

The thing that prevented me from ever getting closure was this person's refusal to acknowledge what had happened. We both knew things probably couldn't have been different. However, in this person's mind, because he couldn't change things meant he didn't have to recognize the damage it did. Every time I tried to talk about it, all I was met with was justifications and excuses and even accusations. Why couldn't I recognize that it was the best he could do, and that should be good enough for me?

I eventually stopped talking about. I eventually stopped crying about it. I eventually stopped thinking about it all the time.

But it was always there, a giant gorilla that stood in place of our relationship.

I don't want anyone to think that I have spent the last many years carrying a grudge. It is not a grudge. It is such a big event for me that I needed to talk about it, and have only been met with resistance. And because of that, I felt I have never been able to start to heal.

My least favorite movie all all times is Love Story.


I felt it was less of a love story, and more of story of people using love as an excuse to treat each other badly.

"Love means never having to say you're sorry."

I don't believe that.

I think we are only truly sorry about hurting someone we love. And admitting a wrong and truly apologizing to a loved one is one of the most difficult things to do. Being able to say sorry, and mean it... now that is love.

Many people think that an apology is just words. That it doesn't do anything to change the action that happened. It's true that it doesn't go back and erase what happened, but it is not true that it doesn't change things. A true apology can be one of the most healing things there is.

During conversations with patients and patient families regarding bad outcomes, many of them say the same thing. They knew that things probably couldn't be different. They knew everyone did their best. But still bad things happened. The one thing many of these people wanted was an apology. Just to have their physician recognize what had happened and just say they were sorry. No defensiveness, no excuses, no justifications. Just an apology.

I had long given up on an apology.

Several days, I was on the phone with this person. We were talking, as we often do, about things that are "safe." Our families, our jobs. Then, out of no where, this person said apologized. Things have been rough for a very long time. And I'm sorry for that.

It was the first time in my life I have ever heard this person say "I'm sorry."

I'm not exactly sure what the apology was for. I'm not sure it was a recognition of the hurt I have been coping with for years.

What I do know, is that now, for the first time, there is a chance to start healing.

Two Options

Wednesday, October 28, 2009

Everyone can be an optimist when things are easy.

Okay, not everyone. Hubster is proof of that. I'll comment on what a beautiful day it is, and he will respond with something about how hot it will get, or how it won't last, or something else entirely pessimistic.

But it is easier to be optimistic when things are going the way they "should." When the boys are well-behaved, the cars both work, the weather is beautiful, and work is enjoyable.

This month has been none of those things. This month has pushed my ability to be optimistic to it's very edge.

My work this month has been more demanding than anything I have done previously. The people I am working with are some of the most difficult personalities I have ever encountered. My hours have been some of the longest I have ever put in, leaving when it's dark, coming home when it's dark practically every day.

The boys have reacted to my longer hours and other changes in their schedules by fighting more with each other. Monkey has had some regression in terms of sleeping and potty training. A lot of work around the house has fallen to Hubster, including the task of coping with the unwelcome changes in the boys' behavior. So Hubster has been a little more grumpy as well.

I've been so exhausted that my temper has been shorter, my desire to help cook and clean at home as been less. I come home and fall asleep shortly after, leaving little time to play with the boys (and even less time to blog.)

I dread going to work, mostly because of the people I'm currently working with.

I feel like I have every reason to fall into a pity party. There are days when I would just like to stomp my foot, and yell, and give up.

But I haven't.

I'm not saying that I haven't been grumpy. I'm not saying I haven't cried several times on my way home from work.

But I can't give up. I have to keep plodding on. And I have two ways I can do it. I can either cry, or I can laugh.

I'm doing my best to go with option 2.

And would you like to here something good about this month?

It's almost over.

Where we come from

Thursday, October 22, 2009

I spent most of middle school and high school dreaming about attending an Ivy League school.

Of the onslaught of college recruiting material that arrived during the early fall of my senior year, the most treasured and poured over where pamphlets from Harvard, Yale, Brown, and Stanford. (Okay, I know Stanford isn't technically Ivy League. But still...it's Stanford.)

I kept those particular recruiting packets long after I accepted my full-ride scholarship to the local state university.

I graduated Summa Cum Laude from my local state university, with the highest GPA earned by a female in the college of science. And I dreamed of attending medical school at UCSF, Mayo, or John Hopkins.

I applied to one medical school, and enthusiastically accepted a spot at a state medical school.

I worked hard during medical school and graduated with honors and Alpha Omega Alpha (or AOA, the national medical school honor society.) I had spent all of medical school picturing myself attending residency at Stanford (yep, there it is again), Wake Forest, Vanderbilt, Mass General, or Mayo.

And then I matched into my top choice at a state program in the Midwest.

The decisions I made, compared to the ones I dreamed about, were made after weighing what was best for our family. There were times that I felt deeply disappointed. I had worked so hard, and had the ability to attend undergraduate, medical school, or residency at some of the biggest, most prestigious schools and programs in the country. But, for the good of my family (and ultimately even for the good of myself) I chose to attend less well known, more affordable state schools.

I wonder...does it really matter?

I attended public high school. I did not attend a rigourous, private, college prep school. But I still managed to get a full ride scholarship to a respected school. A state school, yes, but a good one.

I attended a state medical school. Many of my classmates had done their undergraduate at Stanford, MIT, Cal Tech, Yale, and Princeton. Those classmates had attended prestigious private programs while I had attended a state school. (And yes, I have on multiple occasions seen people say "state school" with a air of disgust or as a joke of mediocroty.) And yet, we had arrived at the same place in our lives.

I attended a state medical school, and now I attend residency along side individuals who trained at Brown, Hopkins, Cleveland Clinic, and UCSF. They did go to the prestigious programs. And yet, here we are, at the same point in our lives.

I never attended any of the places that filled my academic dreams as a teenager. And yet, here I am, the initials MD behind my name.

Does it really matter where we come from?

I don't want to belittle the experience of attending an Ivy League university. The culture and surrounding probably run deep and inspire.

But in the end, does it really matter?

Because in the end, where we go depends more on who we are then where we come from.

No Right Time

Wednesday, October 14, 2009

I come from a large family.

And when I say large, I mean "could have our own TLC show" type of large.

I'm the oldest of 10.

Yep, two whole handfuls of children. 12 of us all together, once you remember to count the parents.

I'll give you a while to take that it.

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There are some downsides to being in a big family. There never seems to be enough space forever one. Never quite enough money for everything. And occasionally not enough time.

But the challenges never beat out the joys of having a large family. There are always enough people for board games (just sometimes no enough pieces, and then you improvise. I'll been the top hat, you be the shoe, and you can be rubber frog.) Happy birthday sounds so much better when sung by an entire choir (except when the choir consists of a couple of teenage boys, and then you just take what you get.) And there are enough for two teams in soccer, baseball, or basketball. And with that many birthdays, most of the year is spent in celebration. I always had the largest cheering section at all three of my graduations.

Most importantly, we always had friends. I'm not implying we always got along. Some sibling rivalries were more obvious and intense than others. I had siblings I always fought with and siblings I never fought with. But we never felt lonely.

I love my huge, crowded, loud, talented, chaotic, supportive, drama-inclined family.

But one of the strange things about growing up in a large family is the mind set that starts to set in. We felt bad for children in small families that only had one or two siblings. Or, heaven forbid, no siblings!

I grew up viewing parents who had one, two, or three children as selfish. They valued their time, money, and leisure more then their children. Career or pleasure topped the priority list above family. Small families were created by horrid people who valued peace and quiet more than they valued providing siblings and friends for their children.

I was determined to never be selfish. I was going to have a half dozen of my own children and create as many happy family memories as I had growing up.

(Remember, I was young, and like many very young people was prone to black and white images and a slight inability to view things for others point of view.)

I realized very soon after Bug was born that I was never going to have a huge family. I seemed to lack the pulled togetherness, resourcefulness, and patience of my own mother.

I love my two boys with a fierce, mother tiger like love. I am intensely proud of them, and nearly worship them.

But I came to realize that I was not cut out to be a leader of a very large flock.

And this is where it gets difficult.

I would really, really like another child. Monkey is three. And I can start to feel the baby hunger set in. I haven't felt that, well, since we decided to get pregnant with Monkey. Even when Monkey was two years old, I could hold other peoples newborns, cuddle and coo at them, and not feel one twinge of envy or baby hunger. But since Monkey is now mostly done throwing fits in the grocery store, nearly sleeping through the night, and for all intents and purpose potty trained, my brain has starting letting those TV commercials with wrinkly babies get to me.


Hubster and I have started talking about what our schedules look like over the next couple years, trying to get a good idea about when would be a good time to have another baby.

But I'm looking at 50-80 hour work weeks for the next four years, laden with overnight call at the hospital. Hubster is just finishing up some last minute requirements for his application to dental school.

If we were to have another baby in the next four to five years, that baby would spend a lot of time the same way Bug and Monkey have spent the previous four years. In daycare.

And then we ask ourselves...who's being selfish now?

Is it more selfish to continue with our plans for our careers and future and be content with our two boys? Or at least postpone baby number three four years until I am done with residency, have a stable job with some control over my schedule.? (That would make Bug 12 and Monkey 8 before we had baby #3, just to do some math.)

Or is it more selfish to give into the baby hunger and the theoretical chance of a much wanted girl (who would be just as wanted if they were a boy, just to make that clear) when they would be raised 8-10 hours a day by someone else? Just because we want another baby and would love her (or him) passionately and intensely, could we provide what is best?

Bug and Monkey are turning into well adjusted little boys, who play well with each other and others. Bug does amazing in school. They love each other and know that they are loved. They have done this even with years attending daycare behind them and in front of them. So I'm not saying daycare ruins children, or damages childhood.

But is it best?

When people ask why we decided to have children while still in medical school, we always replied: There is no right time to have children. There will always be reasons to postpone, put it off, delay it. There is no right time.

But maybe there is a wrong time.

I'm not exactly sure what time it is now.

Screaming Inside

Wednesday, September 30, 2009

The last couple days have reminded me why I blog.

My thoughts have been running through my head so fast that I'm being whisked along behind them right onto the express towards crazy. They bounce around against my skull, getting louder and louder that I'm not entirely sure people around me can't hear them.

When Hubster and I were dating, I'd often ask him what he was thinking. Turns out, guys don't like to be asked this. And without fail, he would say "Nothing."

I don't ask he what he is thinking anymore. I can read his mood better than the TV menu. And as our relationship has grown, he shares more and more.

But I always wondered about the "Nothing" response. Is it the same as when someone asks me what's wrong, and I say, "Nothing." Because I don't what you to know. Or is it really "Nothing."

How could anyone be thinking "Nothing" when my mind is constantly going. When I'm not thinking about what's for dinner and did anyone get the clothes out of the dryer, and we still need to get plastic bins for the things in the garage before winter, I'm thinking do I really want to fellowship in Pain Management or should I just stick to general anesthesia, and how long would it take to tile around the fireplace, and does Monkey like his new daycare and why haven't I started saving for retirement, and it's been a long time since I've painted, maybe I should try to work in some time.

It's like this ALL THE TIME.

So I blog. I'm not always to get everything out, but at least a little. A pressure valve. At least to thin out the internal crowd.

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I'm never sure how much to share about work. Because I work in medicine. I feel that I can't just talk about my feelings and experiences, because I'm "representing my field." Can I talk about depression rates and the horrific grind of residency without you wondering if your doctor is depressed and therefore should they be taking care of you?

If I talk about doubts and mistakes I make in my training, does that make you trust medicine less? If I were to say that I felt 100% my senior was wrong about something, and so I went ahead and did what I thought was right and practically saved a patient, is that good or bad? Interns shouldn't be acting without supervision. What I did would not have hurt the patient, and definitely helped her, while doing nothing may have been devastating. But should I have acted of my own accord? Or should I have listened to my senior? Telling you this, do you trust the system less?

I believe in medicine.

I don't think we always make the right decisions. I know that people are hurt by poor decision making. Bad things happen, both due to unavoidable side effects or due to blatant over sight or negligence. It is one thing when your mail is delivered to the wrong address. It is another thing entirely when medicine is delivered to the wrong patient. Or procedures are done incorrectly.

But I still believe in medicine.

Western medicine doesn't have all the answers. I've seen more patients' pain managed with massage and acupuncture than I have with pain medicine and invasive procedures. I've seen patients defy all odds. I've seen families and patients alike get more benefit from prayer, blessings, meditation, and even withdrawal of care, than they would have from ongoing treatment.

But I still believe in medicine.

I may not agree with my training. I don't prescribe to the old school thinking of complete dedication to the exclusion of the rest of your life. I disagree with the hierarchy that's been created in the system. Training shouldn't involve humiliation, degradation, and exhaustion until mental breakdown.

But I still believe in medicine.

I've seen children walk who shouldn't have, because of surgery. I've seen women hold children they never otherwise would have had, because of medicine. I've seen people get a new lease on life after a heart transplant. I've seen infections cured, pain treated, bones set, and lives saved. Because of medicine.

I believe in medicine.

What I write is my own experience. I have bad days and heart-breaking moments. I battle egos as frequently as I do fevers and low blood pressure. I have been through bitterness, depression, and fatigue.

But none of that will change how I treat you in the hospital, with the best care I can provide.

The High Point

Friday, September 18, 2009

I'm approaching the point in residency I've been dreading.

The point where I'm constantly fatigued. I'm so tired that I can't think about doing dishes, or helping prepare meals, or managing the boys school papers. The point where I'm away from home too much, taking overnight in-hospital call every third night. The point where I feel like I will never know enough, never be able to study enough.

I've known this time was coming. I'm not sure if knowing helps me be more prepared or if it just becomes a self-fulfilling prophecy.

During intern orientation, we are shown a graph of rates of depression during intern year. The rate in June is near zero. By January, the rate is near 75%. Everyone looks at this graph and points to the high point in January. We are then given talks about how to cope during the midpoint of the year, the increasing stress, higher expectations combined with the lack of sunshine.

I am scheduled to be on Trauma service at that point.

Although impressive and terrifying, the peak in January isn't what concerned me most about the graph. The red line we were shown never went back to baseline. The rate of depression, so low among incoming residents, so happy after completing four grueling years of medical school, never returned to zero. The lowest it got was 20%.

The funny thing is that even as I approach that January peak, and boy, can I ever feel myself rushing towards it as my confidence and ability to stay awake while standing are every tried...the funny thing is that this is still better than medical school ever was.

One Year Later

Saturday, September 5, 2009

I will get back to posting about my exhausting, long drawn out home renovation. Promise.

But another thing has come up.

My blog is one year old today.

I actually started blogging about one month before that, one what I now call my "family blog." Because that's what it is. It is all about my boys, and Hubster, and family activities and get-togethers. It is a stereotypical mommy blog.

I started blogging because I thought it was the best way to keep my family up to date with our lives. The grandparents could see darling photos, my friends could see what we were up to.

But soon, I realized that I wanted to write, and not just about my boys, or the latest trip to the lake. Those things, while still important to share, did not fulfill my desire to share my thoughts. My opinions about books and photos I loves and the complete randomness that is my thought process sometimes felt out of place on an otherwise linear family blog.

So I created this place.


One year ago, I never could have imagined how much this blog would come to mean to me. Many times I've turned to here as a safety valve. I've been able to express, maybe not the darkest, most intimate inner working, but definitely parts of me I felt were worth sharing.

Above all, I never expected anyone to ever read it. Especially not 21 someones, and the occasional wanderer who shows up looking for someone who hated Wuthering Heights. Every single reader has meant so much. Every single comment makes my day.

So, for the little celebration I'm having for my blog, I would like to introduce myself to you. In a much more succinct way than you've been introduced in the past, which has been wandering, rambling "getting to know" process.

But in exchange, you must let me know something about you. I don't care if you are a family member I've known my entire life, a friend I've known for years, a reader who leaves comments, or someone who has just stumbled for the first time across my attempt to be optimistic. I want you to introduce yourself to me. Because it's polite.

And fun.

So here we go.

Hello. I'm Katherine. I'm a 27 year old mother of two. I spent some of the happiest years of my childhood growing up across California, tagging along with my Navy father and my ever growing family. When I was 11 years old, my family moved to Utah. I lived in Utah for most of my life. In fact, when I turned 23, Hubster told me I had to stop telling people I was from California, because I had lived in Utah for longer than I had ever lived in California. I met my husband when I was still in high school. Nearly two years and one year of college later, we got married.

In the eight years that have followed, my life has been a mixture of happiness, chaos, hard work, and magic. We have two darling boys, Bug, age 7, and Monkey, age 3. Not their real names, obviously. But for all intents and purposes, they might as well be.


During the time that Hubster and I were raising two darling boys, I also applied to medical school, got accepted, went to medical school, threatened to drop out of medical school, and then one year ago, graduated medical school.

3 months ago, my family of four packed up our 2 bedroom apartment life and moved 1200 miles away from the mountains of Utah to the corn fields of Iowa, so I could start my anesthesiology residency training.



So, if you're keeping track, I'm a 27 year old, happily married, mother of 2 boys, first time home owner, anesthesia resident-physician.

I also have a serious age complex. I haven't determined whether I'm too young to have all those titles, or too old to still experience the emotions that come with those titles. Or just crazy. A lot of days, we just go with that one.

So now it's your turn. I don't care if it is one line or an entire paragraph.

I've been here a year and I would love to get to know the landscape a little better.

Body Image

Wednesday, August 26, 2009

Have you seen this picture floating around on the internet?



I don't normally post pictures of scantily clad (or not clad) people on my blog. But I felt that this was good enough, and maybe even important enough to write about.

I have self image issues. Major ones. Maybe, reading between the lines on my Wednesday Weigh-Ins, you've already ascertained that. I've been plagued by self image issues that have made their way into self esteem issues. I've fought my battles. Someday, maybe, I'll get brave enough to talk more about those battles. Today is not that day.

This picture was originally just a 3 inch by 3 inch photo in a major fashion magazine. When I saw this picture, it was amazingly refreshing. A woman posing for a major magazine who looks like a normal woman. She has a normal looking tummy. She has normal looking thighs. Nicer ones than mine, but still normal looking. She is a size 12-14. Not a size 0, 1, or 2. A normal healthy size.

And she is beautiful.

No matter how we would like to deny it, we compare ourselves to other women. We see covers of magazines, stick thin mannequins, impossibly thin actresses, and we do compare. We tend to focus on the thin women around us and think they are the ones we are supposed to look like. We tend not to notice as much all the perfectly normal women.

I'm not talking about wanting to be a healthy weight. I am not at an ideal BMI. When I exercise and diet (which I'll eventually get to. I promise you and me that.) I'm not aiming for a dress size or pant size. I'm aiming to be healthier.

Have you see this commercial?



When I first saw this commercial during the Super Bowl many years ago, I was brought to tears.

Hopefully, the media becomes full of pictures of real, healthy, happy women. And the next generation of girls will have an easier time of it than I did.

Avoidance

Wednesday, August 19, 2009

I got an a-mail recently, asking about my diet. To be more specific, wondering what happened to those weekly posts about my weight and what I was doing to finally lose it.

There's a reason it's been months since a "Wednesday Weigh-In."

It's because I've been avoiding the scale.

Between the Big Move, the constant work on the house (pictures to come very, very soon), adjusting to a new city, and my anesthesia residency, time for me has been in short supply.

My drive to work follows the river. Next to the river is an amazing running/biking path. As I drive to work at 6 am, in the early morning grayness, the path is full of old ladies walking in groups, cyclists in yellow spandex and helmets, college girls in tanktops and headphones. And I wish I could join them. But while they are out walking, cycling, and running, I'm already headed to work. I pass them again in the evening on my way home. And I think maybe I could fit it in. But at home, there are textbooks and journal articles, and dishes, and meals, and home renovations, and the two most darling boys ever. And I don't go out. I stay put and work hard.

And I'll admit that I haven't been eating as healthy as I should. We've allowed ice cream back in the house. It was for rewards for Monkey completing potty training, but I'll admit I've had at least my fair share (if not a little more). The short evenings and heavy work load have translated into more meals of pizza and fast food. Breakfast is a bagel or English muffin. Then I get home after 12 hour days, not having eaten all day. And I'll break into a box of crackers.

During all this time, the scale has remained pushed back as far as I can get it into the back corner of my closet.

I can't bare to look. All the hard work I did earlier in the year surely is gone.

I'm not sure I foresee a time when there will be more time to take care of me. I've got more balls than I can handle in the air, burning the candle at both ends, hanging by my teeth, whatever you like.

I'd like to say I'm doing the best I can, but I know that's not true. Everyone can always to better. I could eat healthier, even when I'm stressed. I could stop blogging and pull out my stationary bike.

Someday, I'll get brave enough to pull out the scale. And then someday I'll stand on it. And someday, I may even look down and read the number between my feet.

But for now, I'm just going to keep plowing along.

Monkey

Saturday, August 8, 2009

I'm just going to come right out and say it.

Monkey has been a difficult child.

It nearly kills me to say it. Because he is so ridiculously cute. But nearly everyday, Hubster and I look as him after he has finally fallen asleep, and just stare at the occasionally still dirt-smudged pile of smooth blond hair, little nose, and dimpled elbows and knees, and wonder. How can he possibly be so darling, but so exhausting and frustrating at the same time?

From the moment he was born, the personality differences between him and Bug were apparent. He was always awake, more social, and grinned at every object within view.

Little did we know, that was just the beginning.

Bug, now 7, was always content to just read, draw, or do nearly anything that would allow him to be busy, but by himself. He was usually quiet. And although occasionally moody, he was usually quite well behaved.

This, of course, allowed Hubster and I to clap ourselves on the back, foolishly thinking it was our exemplary parenting skills that had lead to such a wonderful child.

Monkey, on the other hand. Well, we thought our house our house was child proof...

The minute he could crawl, he would go to the cupboards and try to open them. Of course, he couldn't get past the child locks, but this did not stop him from trying everyday. Just like a velociraptor on Jurassic Park, he would daily try the locks on the off chance that one day, he would get around them.

He would follow his older brother every second, and destroy anything Bug tried to do. Block towers, beware. Train tracks, doomed. Puzzles, not a chance. He even enjoys a little independent destroying. There are only a handful of toy cars that still have ownership of their tires, the rest having been chewed and pried off. Books that made it by Bug unscathed met their untimely demise during the moments we suddenly realized we hadn't heard Monkey making any noise for 2 minutes.

We have an ottoman that no longer resembles a piece of furniture, after being used as a chew toy by Monkey.

Once, when he was about 18 months old, I was cooking dinner. I turned around to see Monkey holding a huge ball of dryer lint that he had fished out of our (covered) kitchen garbage bin. He was chewing and shuddering. In the half second that I had been frozen with the horror of it all, he took another bite. I immediately became unfrozen and extracted the fuzzy gray mass from his chubby hands, and held his still lint covered hands under the facet. And the whole time, despite the screaming I was being met with, wondering why, WHY, did he take a second bite?

The terrible twos have been especially terrible. We haven't escaped a store without a display being knocked over, the shopping cart being pushed into some unsuspecting shopper, a fit in the middle of an aisle (all for unknown reasons, as he never asks for candy or marshmallow laden cereal), or some content of our cart being chucked out and occasionally hitting an innocent passer-by. We've even contemplated giving up food shopping and living off the grass in the backyard. (Of course, we've tried just not taking him, but sometimes circumstances just don't allow it. And leaving your two year old child in the car like a golden retriever is frowned upon.)

I've been asked to leave a shoe store after Monkey was discovered licking the entire front window of the store that was within his reach. All within the time limit it took me to turn my back on him to look at a cute pair of red pumps and think, just think, about trying them on.

Not everything is difficult. He is a better sleeper than Bug was (or is.) He's not a picky eater. He is happy 90% of the time. And we try to focus on these (and his overwhelming cuteness) anytime we start feeling our nerves being stretched a little too far.

We've had months of frustration, wondering if any of us would survive this time period. But then, he curls up on my lap, smelling of sunshine and grass and stuffed animals, asking for a story, and my heart just crumples inside. He looks up at me with his amazingly wide blue eyes and tells me I'm his best friend and I wonder how I ever get mad at him. I walk in the door after a 13 hour day and he runs up, grabs my legs, and says "I missed you and I've been good!" And I get an ache in my chest from the love I feel towards him.

Monkey turns three in a few weeks. We're not sure if we will be leaving the terrible twos behind or just entering the terrible threes.

What we do know, without a doubt, is that we are in for an adventure.

Confidence

Sunday, July 26, 2009

Even after four years of medical school, I feel like I know very little.

And I've forgotten at least half of what I used to know.

That's what residency is for. To re-establish and build up the knowledge base that eventually will become second nature.

But everyday, I feel overwhelmed. I feel that I just don't know enough. I'm not always sure how to approach a patient's problem.

It probably doesn't help that this under current of anxiety is coupled to my personality. I'm not a very outgoing person. When I'm with a group of people and someone else is willing to lead (or even dominate) the conversation, I'm more than willing to let them. I'm not a person who will chime in with a thought or opinion. (Note: this is referring to public settings, not interactions with my family, since in those cases I'm more than willing to blurt out my opinion at any time.)

I'm worried that this combination often comes across as a lack in confidence.

I watch my fellow residents (and as much as I hate to admit it, the medical students working with me.)

Everyone acts so much more confident than I feel. So much more sure to make suggestions or even act on decisions.

However, I know for a fact that most of them do not know more than I do.

When we undergo "pimping" sessions, I am able to answer more questions than most. (For the lay person, to "pimp" has no sexual connotation in the medical field. It refers to attendings or senior residents asking questions with the sole purpose to show a junior resident's or medical student's weaknesses in their medical knowledge. It is a very unpleasant experience.)

I did extremely well in medical school and received very high board scores. I spend a lot of time studying.

So, by my calculations, I know at least as much as most the people around me.

So why does everyone else appear so much more confident? Even the medical student who can't come up with a decent differential diagnosis?

My conclusion...

They're faking it.

Back of my mind

Saturday, July 11, 2009

When I was an undergrad, and then again when I was a medical student, I spent most of my times thinking about my children. Nearly every second was spent wondering if they were okay. How long Monkey continued to cry after he was dropped off at daycare? Were the other kids being nice to Bug? How did Bug's spelling test go? Did Monkey get his nap on time? What time was Hubster able to pick them up? Did they get dinner on time? It's bath night, did Hubster remember? Did they get read to before bed?

I resented every minute that medical school kept me away from my children and my husband.

Even when I took several months off and was home with the boys, I would think about Hubster a great deal. Wondering how his day was going, when he would be home, how that project or meeting went.

Since residency starts (a whole 11 days ago) I found myself realizing that I wasn't thinking of them as much.

I would have a quiet moment to sit down and get a drink of water and work on a patient's note, and suddenly realize that I hadn't thought about Bug or Monkey for several hours. Or nearly my entire shift.

And that realization bothered me.

Hubster and I have talked about this before. I would tell him that I thought about him and the boys practically all day long. And he said that he didn't. It wasn't anything against us or mean that he didn't love us or care about us. He just...didn't think us at work.

He thought about work.

I used to chalk this up as one of the many differences between men and women. That men were able to compartmentalize their lives easier than women were. That women worried more. That women were more attached to the people they loved.

And suddenly, I'm faced with the reality that that might not be true.

I've been trying to figure out why. Why, after I've spent years being angry about being gone and worrying about my children with every passing breath, am I suddenly not constantly fixated on how they are doing.

Hubster and I talked about this as well.

For the first time in my professional career, I'm actually responsible. I'm actually making decisions that can affect patients.

I'm also very busy. I've only had the chance to go eat lunch (or breakfast, depending on the shift) once out of my 10 shifts. I see 6-12 very sick, complicated patients a shift. And then there are the consults to call, the labs to order and review, the prescriptions to order, and the notes to write.

And, for the first time, I am the one responsible for providing financially for our family. It really makes a difference when you know that you are being paid for the time you put in. And not paying for it with student loans. There is a lot less resentment there when you are being reimbursed. (And I know, I know...I signed up to be a medical student, I asked for it, it was what I wanted. But that doesn't mean that it is a very difficult, degrading, humiliating, exhausting process.)

It could be any of those things. Maybe just one of them, maybe all of them.

Hubster agreed. He said that when he was doing his job, that's what he was doing.

But I thought of another thing. In the first time in 6 years, our children are being taken care of, at home, by someone who is truely invested in them.

I think that knowing Hubster is home with Bug and Monkey has taken some of the worry that constantly nagged at the back of my mind. He knows that Bug likes only peanut butter and not jam on his sandwich. That Monkey needs to take a 2 hour nap at 1:30. That Bug has a special shirt he likes to wear on Saturdays. That Monkey needs his stuffed dog to fall asleep.

To know that my children are safe and loved and happy takes a lot of weight off my shoulders. Weight that I didn't even recognize I was carrying until I noticed, suddenly, that it had disappeared sometime over that last 11 days.

I don't think this means I'm a bad mother.

I need to be focused at my job. I need to learn everything I can to be a better physician.

My children may not be in the front of my thoughts constantly like they used to be.

But they are always with me.

Scared Stiff

Thursday, June 25, 2009

In a world where people live and die from decisions people make, where 80 hour work weeks are considered merciful, and you are asked to give up sleep and family time without a blink, we're supposed to be tough.

But I'm feeling anything but.

I am scared. Probably more scared than I have ever been in my whole life.

I realize now that all those other times I thought I was scared, I was just nervous. (Well, except before Bug was born. I was actually scared then. But completely different.)

This time, I'm so scared it is difficult to swallow. I walk around with this strange feeling in my stomach that alternates between a dead weight and a hole. I find myself looking at the ceiling when I thought I was sleeping.

Starting July 1st, I am actually going to be taking care of patients. Not medical student patient care. Not "go see this patient, write a note, tell me what you think, and then I'll take care of the rest" type patient care.

This is the real thing.

Obviously (and probably a huge source of relief to all you reading this) I am supervised. Closely.
There are people very invested, for my sake, their sake, the hospital's sake, and mostly the patient's sake, very invested in making sure I don't screw up.

But for the first time, I can sign my name with an MD behind it. And if I write an order in a patient's chart, it will happen. For the first time in my professional life, I have real responsibility that has real consequences. Never will the transition be so enormous.

As a medical student, we can interject our opinions or thoughts, but in the end, we are not responsible. Now, I carry the title "Intern." And that means I am responsible.

I love patients. I love the feeling that I am in a field where someone, voluntary or not, puts their trust in me to take care of them. To treat them. To ease their pain and their worries.

Only in parenthood do we see that some type of trust.

And the thought that I might hurt someone, unintentionally of course, but still hurt someone none the less, scares me.

During medical school, we study nearly endlessly. We take exam after exam. We sacrifice for that opportunity.

To have the trust of a patient.

And I don't want to do anything to lose it.

Just before the drop

Thursday, June 4, 2009

I love roller coasters.

I wait in line excited, watching the people riding before me envious that they have already made it through the line and onto the ride.

But every time I'm in my seat, harness clicked in place, and moving slowly, slowly up the hill, I start to get a little panicky. I know the ride will be fun, but the slow clanking ride upward makes me nervous. Right at that moment I want off.

I'm getting that feeling now.

We pick up the moving truck in the morning. We hit the road the day after. I don't think I've been this excited about something in a long time.

But tonight has the feel of the chain clanking under my feet as I reach the summit.

And I'm scared.

...

...

I tried to think of a nice tie in to this next part, but couldn't. So here it goes. This is less of a confession and more of a...confidence. I don't know. You read, and then you tell me.

I don't really have any friends.

(Okay, don't sit there reading this and say "Oh, the poor girl." Or "Great. I smell a pity party.")

It's not like I've never had any.

I had a lot of friends during high school. But as high school friends, we lost touch as we went our separate ways.

I was friends with my roommates during undergrad. But I was a science major living with three music majors and we all had such different personalities, I think we were glad to let things slip when we moved out.

Out of my group of childhood friends, I was the only one who went to college. I think that decision put a little distance between us. Not purposefully of course. A few of them talked about going to college.

There was always a lot of talk.

It was medical school that really put the nail in the coffin of many of my childhood friendships. Some of my friends were not that subtle about that fact that they were not interested in continuing our relationship.

At first I just thought it was because between raising two boys and working on my medical degree, my schedule just didn't allow for as much time together as it once had.

But after a few obvious snubs, I began to think it might be more.

I blamed myself mostly. I wasn't there enough. I wasn't trying hard enough. I just wasn't a good friend.

Hubster has always been of a different mindset. He thinks that most of my friends were intimidated by what I was doing. That suddenly all their talk couldn't hold up to my actions.

I had always dismissed this.

Until recently. I read an article that female physicians have a hard time making friends in general. Some of it is self-induced seclusion. But not all. Women have talked about negative reactions they have gotten once other women have found out that they are doctors. Soon, they just stop telling people what they do for a living. They try to avoid conversation about work so they won't be asked the question that will stop all future conversation. Many have guessed at possible reasons. The other women are intimidated by the title. Others don't think they are "worthy" (huh) of physician friends. Whatever the problem is, apparently I'm not alone in it.

Medical school was the most emotionally demanding, physically exhausting thing I have ever done (and that is including surviving two newborn phases of 1 am-3am-4am-6am feedings). However it offered a respite from the loneliness that I had felt before that time. I had the most amazing friends in medical school. People that were working towards the same goal I was. People that were coping with the same challenges. People that weren't offended if you didn't make it to a party, because well, they didn't make it either, because they were home studying for the same exam.

But medical school ended and my friends are scattered across the country. We still talk occasionally. But, obviously, it is not the same.

Blogging has helped. I get to have conversations. I've reconnected with people I hadn't talked to in years. Some have even gotten to see that I haven't turned into the emotionless controlling "stereotypical" doctor. And I've made bloggy friends.

Which I get to take with me regardless of where I live.

I've been asked if I'm sad about moving. Scared? Yes. Sad? Not really. Yes I will miss my mom only being an hour away.

But I'm not really leaving anyone else.

I think being lonely in Iowa will be about the same as being lonely in Utah.

Maybe I shouldn't, but I do

Friday, May 29, 2009

I'll admit it.

I get a lot of inspiration for writing from other people's blogs. I don't think this is cheating by any means. It just that people have ideas that get my mind going light speed, and then I need to write.

I read in several blogs lately about regrets.

Mostly, about how people were claiming that they didn't have any.

Not that they thought their lives were perfect or mistake free. But that they couldn't regret anything because it had made them the person they were today.

What's wrong with me?

I've finally gotten to a place in my life where I'm pretty happy with nearly everything.

But I still have regrets.

I've made it through medical school, and I think that I finally have stopped regretting going in the first place. But I will always regret how difficult I made the process for my family. I spent so much of medical school being completely miserable. And it didn't make it so I had to work less, or that people were nicer to me at work. All it did was make it difficult for my family.

I have a wonderful relationship with my boys. But I regret every time that I've lost my patience with them. There is never really a good excuse for it. And I know it didn't ever make me a better person.

I regret losing so many friends along the way. I could have done a better job keeping in touch, trying to be there for people, or just showing up.

I regret nearly every doughnut I have eaten on call nights and morning rounds. I might not have to work so hard to have something to report on Wednesdays if I had just eaten a few less of those glazed temptations.

I regret being so hard with myself when I was "younger." (It feels stranger to say younger when I'm only 27 and already young, but yeah, you know what I mean.) I beat myself up over how much I studied, about what I looked like, about how much I could get done in a single day. If I had just learned to relax and accept me for me, I would have not lost so much time being unhappy.

Maybe I'm over-reacting. Maybe none of these things are worth regretting. Maybe I need to work on letting go of these regrets and accepting that they have made me the person I am now.

But I don't think that any of those things benefited me. Just made me and those around me miserable.

And the regrets keep my eyes open to how to prevent those mistakes in the future.

Like my goal for residency.

My goal is to just suck it up. Yes it will be horrible. It will be much more miserable than third year or my fourth year sub-I could ever be. Will I want to quit? Yes. Will I probably cry? Yes (no probably about it.)

But I'm going to try to not be miserable. Because I have to do it. And being miserable won't make it so I have to work less, or my senior residents be nicer to me. And it won't make the process easier for my family.

I guess this is just a reiteration of my thoughts on guilt.

I don't dwell on my regrets. But I don't deny that they are there.

For Better or For Worse

Tuesday, May 26, 2009

Today is day that Hubster and I have been married for eight years.

Those years have flown by. Hopefully by saying that, you can tell how happy I've been during these eight years.

It is no secret that we are blissfully happy.

I've very lucky. I'm sure that there is no other person in the world like Hubster. No one else would have put up with me this long. He makes me happy every. single. day.

The way things started out, you might not have guess it.

And when I say started out, I don't mean how things were when we were dating, or when we were engaged, or when we were first married. We were just as blissfully happy during those times as we are now.

When I start "started out," I mean just that.

The wedding day.

Hubster and I don't go to a single wedding or reception without thinking of our own. And what a complete disaster it was.

Oh, my handmade dress was wonderful, the flowers divine, the flower girls darling, Hubster dashing in his tux, the cake delicious, the location beautiful.

I know, it sounds great, right?

Well, let me set the stage.

My parents filled for bankruptcy around the same time. Both Hubster and I were in college. There was no money for this whole affair. We briefly talked about postponing the wedding, but decided there was no real benefit for us in doing that.

So we did the wedding on a shoe string. As in, so little, I can't really mention it here (you would die of shock.)

And we did it mostly by ourselves. Make the food, set up the ceremony and reception location.

Which resulted in us walking down the aisle an hour late. After many of my friends had given up and left. In 100 degree weather.

The guy doing the ceremony talked about making up after fights and forgot the rings.

My dear mother in law had invited some of Hubster's relatives to sing (unknown to either of us.)

When we were going around greeting guests, people kept complaining about the weather.

Do I wish that things could have gone better? Yes. Do I regret some of the decisions and circumstances around the wedding? Absolutely. Do I feel sad every time I go to someone else's exquisite reception? Yeah.

After all, the wedding day is the one that nearly every girl plans for the moment she is five years old.

Would I trade what I have with Hubster, trust, support, and love, for the most amazing wedding of all time?

Not a chance!

Something's Gotta Give

Wednesday, May 20, 2009

I'm going to write about something different this Wednesday. Because honestly, you can only hear about someone's weight loss (or lack there of, or gain, etc...) so much before you want to completely skip the whole thing.

(And this isn't because I've given up on the diet, or I'm not having success. I'm still working at it. And I've lost 1 1/2 more pounds. Putting my total at 11 1/2 pounds so far. )

(But that's it. That doesn't make much of a post.)

So, this week, I'll talk about other things somewhat related to health.

And I'll start with a confession.

I shop at Wal-Mart.

This is either met with "So? I do to." Or "Gasp...How could you!?"

A little background.

A friend in medical school was married to an economist who studied the effects of Wal-Mart on small communities. He found a lot of evidence that after a Wal-Mart moved into a small community, mom-and-pop shops shut down at extraordinary rates, unemployment rose dramatically, and quality of life decreased slightly.

I also disagree with a lot of Wal-Mart's business practices. (Although this is not the time to get into all the details. There are plenty of links if you're interested: read here and here and here.)

Everyone knows that Wal-Mart sells a lower quality product than other chains. I would rather buy things for my home at Target than Wal-Mart any day.

And don't even get me started on their produce. I hate the commercials that say how wonderful Wal-Mart's produce is. Have you ever actually looked at the poor fruits and vegetables? Good luck finding a ripe avacodo. Or a non-soft cucumber.

Once I sent Hubster to grab some canteloupe for a party. He came back with canteloupe from Albertson's. When I asked why he had gone all the way to Albertson's when Wal-Mart is 2 minutes away, he said this.

"You know how grapes turn into raisins, and plums turn into prunes? Whatever canteloupe turn into, they're selling at Wal-Mart."

So despite all this, I shop at Wal-Mart.

Why?

After Monkey was born, I was lucky enough to stay home for six months with him. During this time, I decided that I was going to work on getting my family healthier. No more eating out. No more junk food. I was going to cook every meal. We were going to eat all organic, and local when we could. Everything was going to be whole foods.

I started shopping at this local grocer that sells primarily organic food and local products when there are available. The food was beautiful. Local corn, local heirloom tomatoes, organic onions, free-range chicken, certified hormone-free milk, wild fish.

In two weeks I had spent what we normally spent in two months.

It was not sustainable.

Our family budget is tight. There is not often room for luxury, and never room for extravagances. We just couldn't keep it up. I tried buying cheaper, not top-of-the-line organic. Still our budget wouldn't allow it.

So back to Wal-Mart we went. Back to where onions are 47 cents/pound instead of $1.75/pound. Back to where milk is $2.00/gallon and not $3.50/gallon. Back to where chicken is $5.00 for four boneless, skinless chicken breasts and not $8.00 for the same product at the beautiful store.

Do I miss it? Yes. I would rather feed my family the healthiest, most natural version of food that I can. (Even though Hubster is still a sceptic when it comes to organic food. He hears organic and he thinks carbon containing molecules and not pesticide-free food.)

I still try to cook at home every chance I get. I try to use fresh ingredients as often as possible. They don't say organic on them very often. And a lot are Wal-Mart brand. But we can afford them.

I guess this means that I'm a hypocrit. I put my budget before my ideals.

But sometimes, something's gotta give. And it's not going to be dinner.

Writing for Real

Tuesday, May 19, 2009

I know that every blogger, wait, every writer, has the same problem. Do you write what you really want to? Or do you edit yourself from what seems most popular?

In blogging, where the number of followers and comments you have often speak to your blogging "status" it is easy to feel the pressure to write what is popular, even though none of us are being paid for this. We don't really have anything to lose, except followers.

(Which, by the way, this isn't saying that I don't appreciate those of you who do read. It means a lot to me, and gives nearly every day a pick-me-up.)

But thinking about the blogs that are popular, although they vary dramatically in content, have striking similarities. The people who write them are either funny or sarcastic (which can also be funny.)

I'm not really that funny.

I try. But usually my funny lands on its face while people stare.

And I don't want to be sarcastic.

Although this is becoming more and more prominent a trait. Part of it I blame on Hubster, who is the most sarcastic person I know. It has worn off a little.

But the other source of sarcasm has been my training.

In medicine, idealism, optimism, and daydreams are quickly checked at the door for better survival skills. Namely, cynicism and sarcasm.

We see a lot of bad things. Things don't often turn out the way I would like them. Children don't always go home with their parents and families don't always get time to say goodbye. Inequalities and poor decision making become glaringly obvious. Bottom-lines replace ideals.

Five years ago, I would have described myself as idealistic, optimitic, and hopeful. Now, I am just clutching at those in an attempt to not let more warped characteristics completely swallow me.

Another thing that most bloggers seem to avoid is politics. I'm pretty sure that we all have strong opinions about one aspect or another. I've avoided politics on my blog, despite down right passionate feelings. And I think I do this from example.

If you avoid politics on your blog, why?

I started this blog to hopefully reconnect with traits that seemed to be slipping through my fingers as I progressed through my training. I'm not sure I always do a good job. But I'm going to here and now make a re-commitment to write what I came here to write.

A better introduction

Sunday, May 17, 2009

Residency is just a little over a month away.

I've been trying not to think about it. I've been so happy during my time off. Playing with my boys, picking Bug up from school, reading to Monkey every night, catching up on my own reading.

I knew that it, like all vacations, wouldn't last. But it is so easy to pretend.

My first year, or intern year, contains a variety of clinical experiences. So that I have a broad variety of experiences on which to draw when I start dedicated anesthesia training during my second year.

I start in the emergency room.

I think my biggest fear about starting residency is being taken seriously. It never really happened during medical school. No matter how often I introduced myself as "Katherine, the medical student on the team," I was consistently called something else by patients.

Nurse.

Now, I'm not trying to belittle nurses or say that I'm better. Because without nurses, there could be no doctors. But the point is, I'm not a nurse. I'm a doctor.

Many school makes their medical students wear short, hip length white coats. This was to help differentiate medical students from residents and attendings. My school didn't do this. I wore a long white coat like everyone else. But despite this, I was never once "accidentally" called doctor.

Only nurse.

When people would ask what I was in school for, I would respond, "I'm in medical school." I got the same reaction from acquaintances, relatives, and strangers on the bus. "Oh, you're going to be a nurse!"

No. I'm not.

Once when I was admitting a patient from the emergency room, his cell phone rang. He answered it, talked for a moment, and then said, "Sorry. I need to go. There's a really pretty nurse here asking me some questions."

I know which emotion was stronger. I was flattered that he had referred to me as "very pretty" and not "nurse who looks like she hasn't slept in days, had time to comb her hair, and has the biggest, darkest circles under her eyes I've ever seen." But I was frustrated that he just assumed I was a nurse, despite my careful introduction.

It's not just my gender that have worked against me being taken seriously. It's my age. Or more accurately, my perceived age.

I think I can sum up this problem accurately with a single patient encounter. I had entered a room to place an I.V and take a patient back to the operating room. The patient turned to me before I had time to introduce myself and patted my arm.

"It's so nice they let high school students volunteer here."

Aww, thanks.

In the past, being seen as something other than I was and younger than I was made me timid. No one took me seriously, so I stopped seeing myself seriously. It wasn't until the end of medical school that I started to get a little confidence back.

This time around, I'm going to try to not let this past experiences hinder my confidence in anyway.

And this time, I can actually introduce myself as "Doctor Katherine." Maybe that will help.