hopefully the last meta post for a while

Despite my long-held reluctance to shut down or screen the comments section--what is hell do you think this is, Au, Nazi Germany?--I realized I should have shut the thing down a while ago when, the day after I finally pulled the plug, I just felt like this huge weight was lifted off my shoulders. It wasn't so much that I couldn't take the comments myself (though of course I didn't love reading the more crack-potty of them, they did on occasion have a certain amusement value) but I did cringe at the prospect of other people, like Joe or his family reading comments critical of them, and thinking that I instigated or goaded the more extremist faction in some way. As it is, Joe has asked me more than once in the past year to not write about Cal anymore, or to change Cal's name on my blog (a subterfuge that I don't think would work at this point, after three and a half years to call him "Stan" or something), because, in his words, "there are too many fucking psychos out there." I know that taking down comments doesn't change the fact that unpleasant people exist, but it certainly projects a little distance so that it doesn't feel like I have people screaming in my front yard. I mean, if I had a yard to scream in. So anyway, for now, let's just carry on as we have, only now minus all the distracting background noise.

Oh wait, one more thing: I woke up this morning to a filled e-mail inbox, and after the initial residual oh shit, what now dread of opening up those first few messages, I found myself speechless and overwhelmed by all your kindness. I'm always afraid of seeming like I'm fishing for the nice e-mails, because that's lame and I'm sure you have better things to do than cushion my delicate flower of an ego, but man, after that last post, they really helped me feel better. So thank you all so much for taking the time to write. I'm humbled and re-energized to keep up my end of the deal.

So.

I believe now that I have fully done everything that pregnant women are supposed to do to spur on premature labor (or at least labor at term), but so far, no dice. This is truly one tenacious kid I have up in there. Working a twelve-hour day, on my feet and racewalking nearly the whole time I thought would surely get things moving. Not drinking enough water because water is only for people with time to stop by the cooler, and who has time for such frivolity? Running up to that stat intubation in the ICU earlier this week, with all those stairs and the beeping and the big fat patient not interested in the fact that oxygen is necessary for, you know, living. Nothing. Everyone at work has been so nice about this pregnancy--not letting me push the heavy stretchers or lift my patients, but honestly, at this point, I'm like, "300 pound lady needing to be positioned in lateral decub? Let me help! And then jump up and down while eating pineapple dipped in castor oil!" Anything to get this show on the road, for god's sake.

Due to the specificities of fitting in appointments that match up with my work schedule and the winter holiday season, I don't think I've seen the doctor who's supposed to be "my" OB since...oh, probably 32 weeks? Which is fine. I liked my OB in New York quite a bit, but I really haven't gotten a chance to get too close to this OB that I've been following here and I don't feel married to her by any means. Anyway, while it would be nice to feel all BFF 4-evah! with my practitioner, I largely view my OB as my facilitator to move baby from point A (inside) to point B (outside), so barring any glaring evidence of poor training or judgement, I am pretty much happy with whoever the practice throws me.

This past Monday, for instance, was my first time being examined by a male OB, and despite some initial knee-jerk qualms (not so much over the fact of the male gender itself so much as the size of his hands, if you know what I mean) I have decided that he is my favorite one of all the members of the six-person practice, and wish that, if I had known more before we moved, that I had just gotten in with him on the ground floor. He just seemed very nice and efficient and receptive, and was of the age that I could easily imagine that I would have gone to med school with him or something like that. Which, I guess would have been kind of weird, almost as weird as when I had Cal and the OB intern who did my intake exam had been one of my medical students just a few months prior. Awkward!

Anyway, we are now at 3cm, 50% effaced, and I had my membranes stripped, for what it's worth. So we'll wait and see. Ling Ling still has nine hours to make it for a 2008 tax break, which would mark the very first and probably last chance he could have to actually save his parents some money.
boundaries

I think something is wrong when you start to dread updating your own blog.

It could just be me, but over the past year or so, I feel like the culture of the commenting readership on this blog has changed. This is a personal blog, not a craft blog or a political blog or a cooking blog or a celebrity gossip blog, so the things I write about here are selected personal details of my life--my kid, my family, my job. In opening up one's personal life to a public readership, it is (I think) only fair to be prepared half-informed analysis or attacks or judgement from people who read about that life, and over the past eight years I think I've come to expect and accept that. I don't think that the things I write about are so revealing or inappropriate or beyond the pale compared to most personal blog out there, and I can't explain why I've detected such a spike in the hostility or knee-jerk reactivism in the comments section of this blog, only to say that in that strange Venn diagram overlap between mommy-blogging and medical-blogging and working-parent blogging lies a readership with very strong opinions that they have no trouble expressing, occasionally and unfortunately in full-throated vitriolic attack-mode.

Again, I realize that in having a personal blog, I have opened myself up to this. I have said time and time again that in putting something out in public, it is only fair to allow people to respond to it. You have opinions about what I talk about, and that is OK. My life is not perfect, as I expect that yours isn't either, and I suspect that the blog of someone with absolutely no conflict in their life would not only be cloying, but boring and probably extremely unfunny. This blog started when I was a second-year medical student as a way for my friends and family to keep up with my life, but as readership grew to include people not related to me, evolved to something a little bit more. I wanted to show people honestly what it was really like. This is what it's really like to be a med student. This is what it's really like to be a resident. This is what it's really like to be a resident married to another resident while trying to raise a young child. This is what it's really like to be a working mom starting out in a new career. This is what it's really like. The problems are real problems. The people are real people.

Again, I don't know why there's been a change in the culture of the readership here over the past year or so--maybe it's my fault, that what I'm writing about that invites it, or what I write about, or maybe the internet has changed, anonimity as always granting bravery and a form of bluntness that people might not normally employ face-to-face, in person. But I think something is wrong when I feel like with the exception of the utterly superficial or banal (I LIKE TAB SODA!), that there's nothing I can write about that people don't jump all over, or when I dread checking the comments section for fear of what I'm going to find.

Despite the fracas from the last post, this isn't necessarily in response to any one thing, rather the culmination of a long line of things that I've been thinking about for a while. I'm honestly not sure what I'm going to do about this website in the long run, honestly. When a hobby stops becoming fun, is there any point in continuing to do it? When you realize that the seemingly innocuous can so viciously become hurtful to the people you love, is it right to continue to leave that door open? Sharing my life is nothing new--I've been doing it since October 2000, when I started writing online. But there are a lot of people in my life, not just me. I'm just honestly not sure that continuing to share that life in the way that I've have so is what I want to continue to do. Some of you (many anonymously) will say that what I reap in terms of public critique is my own fault, and you know, you are probably right. But it doesn't mean that there's nothing I can do about it.

The comments section is down. If you want to tell me something, e-mail me directly. I am accountable for what I write, I respect your right to dissent, you can e-mail me tirades all day if you want. But you have to be accountable too. True, commenting as "Anonymous" is at the core no different than commenting as "Dan," because really, who the hell is "Dan" or "SuperMedStudent" or "mominmichigan" but some pseudonym that reveals nothing about you except that you have access to a computer and can type (questionably) in a text box? But having a handle, or an e-mail address, at least makes you somewhat (if only very loosely) accountable for what you say. No one needs to be hassled for my blog but me. No one needs to have their feelings hurt because of a response to my blog but me. If I have misjudged the forum for talking about my life or issues that concern me, as it seems that I have, then I am surely sorry for that.

So the public comments are down. As for what comes next for the site in general, I'm still deciding that. I don't mean this as some huge dramatic gesture or as a punative measure--I'm not much for those, as I hope those of you who have stuck around for the majority of this eight-year blog run will know--I just have quite a lot of other things to keep me busy in my life these days. And stressing about a blog--a blog for chrissake--doesn't need to be one of them.
turd-fest, 2008 edition





Last night Joe and I were discussing the contingency plans in the event (wishful thinking on my part, perhaps, though I think with a second child not entirely fanciful) that Cal 2.0 decides to make his debut before his due date--let's say sometime this week. We have our respective leaves from work planned out already (six weeks for me, one week for Joe), though at the time we requested them, we thought the most prudent course of action would be to request leave starting exactly on the day that we were "supposed" to deliver (in this case January 9th, which we were told could be our planned induction date--ENDGAME, if you will), and that in the event that I delivered earlier than that, I would just return to work early at the end of my six-week leave. My question (which I have to admit was sort of posted in a rhetorical spirit), was whether or not Joe could swing it with his schedule if we delivered this week--let's say on Wednesday. Not that the prospect of a tax break for 2008 has anything to do with ANYTHING.


JOE
Well, I still have clinic on Friday afternoon, so I'd still need to go in and see patients.

MICHELLE
But if I delivered on Wednesday, we'd probably be leaving the hospital on Friday morning.

JOE
Yeah. I mean, if they baby's already out by then, I think I should go to work that day.

MICHELLE
But we would just be getting home then. You know how hospital discharges work, we'd be lucky to get out the door by 10:00am. So you're saying you'd drop us off at home, turn around, and drive to work?

JOE
Just for, like, five hours.

MICHELLE
On our first day home. Just Cal, the new baby, Cooper, and anemic, exhausted, torn-up-down-below me.

JOE
I have patients to see.

MICHELLE
I am familiar with the concept. Well, what if we were delivering on Friday? Then what?

JOE
I mean, if you were actually in labor on Friday when I was supposed to be in clinic, I probably would have to work out something. Like I would have to reschedule them for the following week.

MICHELLE
"Probably."

JOE
But I just think if nothing is going on, like the baby is already out, I have to go in to my afternoon clinic. Who else is going to see my patients?

MICHELLE
I can't imagine. Hopefully if we deliver on Friday, he'll have crowned by 11:30am so you have enough time to take a peek before hopping into the car and driving in to work.

JOE
You just don't understand.

MICHELLE
No, as a physician who is nine months pregnant and working straight up until her due date, I simply can't conceptualize the idea of feeling obligated to my job. But there are limits, after all.

JOE
That's anesthesia, it's different for you. Clinic-based medicine isn't the same.

MICHELLE
Yes, I suppose it is.
(Finding this conversation eerily familiar, and realizing after nine years
that there is no utility in arguing this point, resumes reading book.)
You do what you think you need to do. I will deal with things. As usual.

JOE
Don't be a turd.

MICHELLE
Try as I might, I don't see how I'm the one that comes off as a turd in this situation.

JOE
You're being a turd.

MICHELLE
I just feel sorry for you for the reactions you're going to get when you show up at the office that day and tell them that your kid was just born twenty-five minutes ago.


Now, while I am not disputing that his commitment to his patients is commendable, COME ON NOW. However, this is less of a call of arms to all pile on Joe (though part of me last night would have really relished this) than wonderment that, three and a half years later, we are still having THE SAME DISCUSSION. Of course, things worked out fine the last time, as I'm sure they will this time around too, but it's just more a sense of incredulity that Joe sees this as a case in which I once again am trying to prove that I'm always right (mostly, though not invariably true), so much as a situation where I can't believe I have to explain why I'm a little surprised that we're having this conversation at all.
holly jolly



Like Thanksgiving, I think this is the first Christmas that we haven't spent with family--most of our family, I think, is saving the plane fare for after Cal 2.0 emerges (and this may be wishful thinking, but it could be ANY DAY NOW, right?)--but I think we made an admirable go of it with just the three of us.



(That is to say: the four of us.)



I don't know who "MOW" is, but I hope he doesn't mind that I opened his present.



In a moment of weakness, and perhaps against my better judgement, I got Cal these "Yo Gabba Gabba" figurines. So now he will grow up to do drugs and join a violence gang.



The obligatory cookies, milk, and letter for Santa. Cal wants Santa to know: "DLDHDILLDLLHL."



Which apparently means, "I took the liberty of pre-sampling the Nilla for you, and don't worry, they're NOT POISONED. So enjoy!"



We had nothing else to do today (see above: no family in town) so we ended up going to the Georgia Aquarium, which was actually open early on Christmas Day. Those godless fish have no respect for the baby Jesus. We all had a good time, and Cal managed to hold out for almost two hours, which is pretty much the longest we've managed to stay at the aquarium before starting to get bored and cranky--probably due in no small part to his NEW CHRISTMAS CAMERA, which we got him (under advisement from another classmate's parents, who also recently had a new baby) as a bribe "gift" from his little brother. They have online shopping in the womb now, apparently. Also, maybe it will encourage him to keep his mitts off my camera, which is evidently not made of indestructible rubberized parts.



Hoping you had a happy holiday with people you love too. And also hoping that my next update will herald some sort of news of imminent new-baby-ness, at least, because I am getting pretty sick of this pregnancy thing. Come on out, Biggie Smalls, and join us out here, where things are merry and bright.




(Full Christmas photo set here.)
37 weeks

I know this is a bad time to be too busy for frequent updates, but believe me, if I'd had the baby already, YOU'D KNOW. I'm looking forward to my maternity leave like a kid looks forward to summer vacation, not just because of, you know, the baby and everything, but because dude, I'M GOING TO HAVE SO MUCH FREE TIME. So until then, you can interpret no news as a sign that Ling Ling is still percolating, though, having reached 37 weeks this weekend, I am at kind of the ticking time bomb stage of things. I should have also explained to those childless/non-medical among us that being dilated to 2cm and 50% effaced (as I was at my last OB exam) doesn't actually give any temporal indication of the immediacy of labor, but it certainly is not a bad sign that if, at worst, I need to be induced, we will not be starting from scratch.




Earlier this weekend, I saw a frontal view of myself in the bathroom mirror, and thought, despite my ungainly waddle and the (new! fun!) shooting lumbar plexus pain originating, I assume, from the HUMAN BEING inside me who insists on rolling around luxuriously on my bed of nerve fibers, I didn't look that huge, really. And then I turned to the side...




...and realized that I looked like the world's most un-subtle thief trying to casually shoplift a volleyball from Modell's. Here is another view:





Biology in action! Though the real question I have is: where did all those veins on my stomach come from, and could I start an IV in one of them if I needed to?

Things around here are going well. Cal is now officially on The World's Longest Christmas Break, the length of which was only compounded by the fact that he was out sick from school for two days the week beforehand with some mysterious though apparently completely asymptomatic fever. How dare he get sick? Doesn't he know he's using up all our child-entertainment strategies? HOW MANY GINGERBREAD HOUSE-MAKING KITS DOES HE THINK WE HAVE?

Anyhoo, not much new to report here, as you can clearly tell from the utter lack of content, but rest assured that when there is, you will definitely, definitely know. And look forward (or dread, whichever) an increase in frequency and substance of updates once I am actually on maternity leave, and have a chance to, you know, breathe.
why i can now never leave this job




Before I started working at [Private Hospital], my only knowledge of Tab soda was from that scene in "Back to the Future" where Marty, newly transplanted to the year 1955, orders a Tab at the diner and the wise-cracking diner owner tells him that he can't give him the tab, he hasn't ordered anything yet. I figured that Tab, much like Max Headroom and Ms. Pac Man (Pac Woman?), was an artifact of the '80s that no longer existed outside of the vaults of collectors and connoisseurs of rare discontinued sodas.

Not until I started work at [Private Hospital] and opened the fridge in the physician's dining room for the first time did I ever see a real can of Tab. It was there, amidst the Cokes and Sprites and little cartons of milk. The Tab cans were packaged in a long box of a dozen. The box was open. And it was half empty. People were drinking Tab. In the year 2008.

I figured that the hospital must just have a monstrous stash of Tab, stacked in some basement vault, amassed sometime in the mid-80s and which they were bringing up box by box until all the Tab was gone and they could buy some more normal soda, like, I don't know, ginger ale or something. But the Tab kept coming up. Every time the box would near empty, another would appear, sometimes even two boxes at a time. And people kept drinking it. I saw it with my own eyes. They would bypass the Diet Coke and go for the Tab. What the hell? I THOUGHT DOCTORS WERE SUPPOSED TO BE SMART.

The first time I tried Tab--purely out of curiosity, mind you--I hated it. It had a cloying, strangely chemical taste. I know that all diet sodas are chemical-y and it's not like I think Diet Coke is some kind of ambrosial brew, it's just that I am used to the chemicals in Diet Coke, and to me, Tab tasted, well, weird. But then, a few weeks later, I had another one, because that day at lunch, all the other sodas were either not restocked, or warm. And then another one a week after that, because there was a line in front of the fridge and it was the only can I could easily reach. And another a few days after that--I hardly even know the reason.

And now I like Tab.

So this is why I can now never stop working at this hospital. Because so far as I know, it is the only place on Earth where Tab still exists.

(And yes, I know that Tab contains caffeine, but despite the fact that I am pregnant, I have not totally cut out caffeine, even though yes, I read that article in the American Journal of Obstetrics and Gynecology too. One, because I believe that caffeine, especially in the latter half of one's pregnancy, and in moderation, is not going to kill anyone. Also, the fact that when I was a Peds resident, the fact that we actually used to directly administer caffeine IV to our preemies as a treatment for apnea and bradys has probably removed some of the stigma of deadly baby-killing caffeine for me. This is all very logical and sounds like the reasoning of a rational mind, but the real reason is--I already had to cut out a shitload of things from my diet in the interest of a healthy pregnancy. If I cut out all caffeine too, I WOULD HAVE NOTHING. So let me drink my weirdly retro Tab.)
benign neglect

Sometime last week our nanny asked me if it would be OK for her to keep an overnight bag at our house, in the event that the baby suddenly and precipitously decides to make an appearance and she needs to stay overnight with Cal while Joe and I were at the hospital. I told her that the overnight bag was a great idea, but it took me a full few days afterwards to realize that huh, with all this thinking ahead that other people are doing on my behalf, I should probably pack an overnight bag of my own at some point. Not really overly prepared for this baby, me.




I noticed while getting dressed for work this morning that Ling Ling's position seems to have dropped somewhat, which is good news for the old breathing (increasing FRC is one of my favorite things, how about you?) but which might explain why I had to go to the bathroom three times overnight. At 35 weeks, I'm sure (or at least I'm hoping) that this shift in position doesn't mean that anything is imminent, but certainly things are looking like they're moving in the right direction. That direction being down and out.

We did do some baby laundry this weekend (consisting mostly of Cal-era hand-me-downs--swaddling cloths and blankets and the like), unboxed some of the comically small newborn diapers that we finally got around to ordering, and setting up our upstairs-downstairs diaper changing stations. But we're probably still underprepared for the baby. This is largely my own fault. At this point, I'm just like, "What, the baby? What's the big deal? Babies are easy. I'll just stick him in a sling and carry on." Honestly, I'm more focused on how I'm going to juggle taking care of Cal with a baby strapped to my chest than I am about the baby himself. I may be practicing a little selective memory here, but compared to a three year-old (what with their talking and questions and desire to have you ooh and aah over the wonder of each bowel movement bearing a passing resemblance to some letter of the alphabet), aren't babies kind of...low maintenance? Portable? Essentially lumpish and inert? I'd better be right on this, or I'm screwed.