specs

Did you know they make special-fitting glasses for Asian people? It's true. Something about the flatter nose bridge and smaller faces of my rice-eating brethren makes it that standard eyeglasses that fit well can be hard to find, which is rather inconvenient, as I don't know any Asian people who don't wear glasses.

I always thought it was just me that needed to try on five thousand pairs of glasses before I found ones that wouldn't just slide off my face (in my youth, I first wore pink plastic frames with highly unfortunate mother of pearl "accents" that would stay on purely by virtue of the fact that they were so big that they would rest on my cheekbones--I subsequently moved onto wire-frames with the wire/silicone pad nose gripper things, which fit much better, but which I try to eschew now because they make me look like Sun Yat Sen and I want to be FASHIONABLE) but now I know that I can just blame it on anthropology. Still, since "Asian fit" glasses are not widely available (Oakley makes a line of "Asian fit" sunglasses, and of course they have tons of cool eyewear in Japan, but that's this whole other country and most of it isn't available here) I still have a hell of a hard time every time I need to switch my frames.

So. I need new glasses. First off, the old pair are broke-ass. This is largely my fault. First of all, I sleep in my glasses, because how else is the obsessive-compulsive fitful myopic sleeper supposed to know what time it is each and every time she wakes up in the middle of the night? (Yes, Lasik, I know.) Secondly, my lenses are all scratched up (particularly the left, my lookin' eye) because I use the fiberoptic scope a lot at work, and a metal eyepiece on plastic lenses is not a good flavor combination. I was talking to a pathologist the other day, and asked him how he managed to protect his glasses when he was looking through a microscope all day long, and he paused about one second too long before telling me that he takes off his glasses before looking in the scope, dumbass. (That last bit was implied, not explicit.)

Yes, so anyway, frames abused, lenses scratched. Lastly, my prescription has gotten worse. I figured this out because I was driving one day and I could not read the road signs until I was right up under them. "Why do they print those signs so blurry?" I wondered. Then I realized that despite being related to two ophthalmologists (my mom and Joe--well, actually, three, my uncle is an ophthalmologist too) I have not had my eyes checked for something like five or six years.





So anyway, I got new glasses. They are coming in the mail. They are exactly the same as my old glasses, only better, because they will not be broke-ass and I will be able to see out of them. The end.

priorities


CAL
(Lofting new Christmas present, freshly received in the mail, over his head)
Presents! Presents! Christmas! Presents! (Joyous mayhem, etcetera)

MICHELLE
Wow, a new Christmas present! Want to put it under the tree?

CAL
Mom, I love Christmas!

MICHELLE(Somewhat rhetorically)
Why do you love Christmas?

CAL
Presents!

MICHELLE
Yes, presents are fun, aren't they? But the most important thing about Christmas is being together with your family.

CAL
And presents.

MICHELLE
Yes, presents are exciting. But what's most important, presents or people?

CAL
Presents!

MICHELLE
Presents are more important than people?

CAL
Oh, I mean people. People.

MICHELLE
That's right. Presents are fun, but people are the most important thing.

(Pause)

CAL
I thought you said, "What's most important, presents or pickles."

on the fifteen-second diagnosis

Often times in the OR, I am thankful that the patient is asleep. Not so much for their comfort and safety, though obviously that's the primary goal, but more so they don't have to hear the conversation in the OR.

Do doctors talk about their patients? Yes, of course we do. Do we talk about them differently to each other, behind closed doors (or at least closed eyelids) than we do to the patients and families themselves? Yes, we do. And I'm going to be honest, usually this is not a good thing. Sometimes it's more just about an honest exchange of information--a surgeon telling the anesthesiologist that despite the surgery they're performing, that the patient's cancer is most likely terminal, in a frank way they've been unable or unwilling to talk with the patients themselves. Sometimes we complain about patients for things that make our jobs harder, even if it's not really their fault. Morbidly obese patients are difficult to operate on, patients who have smoked three packs a day for the past 45 years are difficult to oxygenate, patients who have been on chronic steroids are difficult to start IVs on. And then sometimes, there are things said in the OR, unrepeatable things, that would make Hippocrates turn over in his grave. (Or sarcophagus, whatever.)

I am not saying that the way that doctors talk about patients when patients aren't around is OK. I'm just letting you know that it happens. Certainly, things are better now than, say, in the 1960's and 70's, when doctors would ogle their naked lady patients and everyone was clad in unfortunate nubbly earth-toned fabrics. People overall are much more PC, and people are certainly much more mindful of patient privacy and respect and just basic comfort than in the more paternalistic age of medicine, where the doctor's word was the word of God. But like any profession in a highly emotionally charged atmosphere where you work closely, day in and day out with people going through potentially life-changing events (see also: those in law enforcement, the armed forces, social work), the attitude of those in the medical profession might to the outside observer often seem callous or vulgar. And probably, sometimes it is.

My last post, I made a comment about how having more than three cats or more than five drug allergies was a soft sign for mental illness--though perhaps more accurately, I meant "neurosis." Though I had a twinge of conscience even as I was typing that last, I want to apologize for not listening to it and if my five allergy statement discounted the fact that behind every chart, there is an actual living, breathing human patient behind.

I think this is a problem we fall into a lot in medicine. When you first start medical school, you're so shiny and new, your skin so pearly pink and translucent, you take everything personally. The first time you witness a bad medical outcome, you cry. The first time a patient tells you something that is not completely true, it knocks you to the ground. The first time you make a mistake--the first of many, many, many times--you beat yourself up about it endlessly. You feel everything. Patients haunt you. Every experience leaves a stain.

And then, for better or for worse, you start to get a little jaded. Your skin thickens up. Things don't affect you quite as deeply. Big things start to become banal. At the end of my residency, called in for stat intubation for a patient in the ICU, I put in the breathing tube while chatting casually with a classmate about how her new baby was doing at home. The life-changing becomes the everyday. The catastrophic becomes the mundane. I'm not sure if it's a good thing or a bad thing, but it certainly helps you get through the day. If I had to feel everything as intensely and deeply the way I did when I was a third or fourth year med student, there's no way I'd still be able to work today. In fact, most likely I'd be rocking back in forth in a fetal position in some sort of sensory deprivation tank. You need to toughen up in order to help your patients, but the toughening up can also have a distancing effect, sometimes to the disservice of those you're working to help.

It has been said before that the practice of medicine is all about pattern recognition. The more patients you see and the longer you've been in practice, the better you are at recognizing the patterns, and the faster you can react. Fever, nausea, elevated white count, right lower quadrant abdominal pain? Appendicitis. Tachycardia, hyperthermia, hypercapnia, muscle rigidity? Malignant hyperthermia. My guess is that the more fast-paced and stressful the work environment (the ER and the OR come to mind as probably the prime environments), the more likely practitioners are to make snap judgements. We are taught to group and classify patients, often in knee jerk ways, and while this can usually be helpful from a diagnosis and treatment point of view, this tendency towards generalization can sometimes bite us in the ass. Not all patients are a "type." Not all patients with the same list of diagnoses are the same. It might be easier if they were, but they are not, and we shouldn't act like we know more than we do just because we as medical practitioners have privileged access to people in ways that few other people do.

This was probably an overlong tangent to spin off of the fact that many have noted--myself included--that a long list of med allergies either indicates a long chronic illness or, alternatively, a patient who is a little bit kooky. That's part of that pattern recognition again--after a certain point, you just start to see patterns in everything. But I do need to be reminded, as do all of us, that there's a story behind every patient, and there's a patient behind every ID band.

(I still think that having more than three cats means you're crazy, though.)

(That's a lot of cats.)

good tidings

I for one believe that you should maximize the mileage out of your Christmas tree, which is why we usually put it up the day after Thanksgiving and keep it up until, oh, March or so. Ah, if only I were kidding. (As I have mentioned several times in the past, I would keep it up even longer than that if I could--call it an MLK tree, a Valentine's tree, a St. Patrick's Day tree by rotating the decorations) but after a certain point, I guess most people feel like having a Christmas tree up past January 1st is a soft sign for mental illness. (Another soft sign--having more than three cats, and having more than five drug "allergies" on your medical record. Oh, you know it's true.) Anyway, we don't have enough lighting in the house as it is, so the Christmas tree serves many purposes.

Thanksgiving was nice, in that it was low-key and my pie wasn't awful. Cal helped. Really, the work involved was minimal, especially given that I used a frozen pie crust--anyone can slice apples and pour a bunch of sugar and cinnamon on them. Yes, and a pinch of nutmeg, shut up about the nutmeg, Rachael Ray. The most nuanced touch Cal and I put into it was the egg wash and the sugar crust, but honestly, even a child could make this pie (and did).

I had to work the day after Thanksgiving (the OR schedule was extremely light, but there were still some cases) but I was relieved by a member of the call team by around noon and being at work was a great excuse to excuse me from of any errands that might entail going near a shopping center on Black Friday. I find the whole concept of a "doorbuster" sale highly unappealing, as it implies camping out the night before and forcibly streaming in the second the store opens, trampling whatever or whoever might get in your way to secure the latest in Tickle Me Elmo technology. Someone actually gave us a Tickle Me Elmo for Christmas a few years ago (it was the model that not only talked and shook, but also would throw itself on the ground flailing its limbs and screaming) and that little buddy ended up disemboweled of its batteries and at the bottom of a storage bin in due time.




We are going to visit my parents in New York for a few days next weekend, which should be fun except for the part where we have to travel with two kids. Cal will be fine--he's old enough that he can be entertained by any number of things, be it drawing or activity books or DVDs or endlessly writing strings of cramped letters and numbers on a page until the entire surface is filled. (At best, I think, great, a facility for math and reading! But sometimes it looks a little serial killer-y, like Kevin Spacey in "Seven.") Mack, however, will probably be tougher to handle, as he has neither the attention nor the inclination towards distractibility and probably spends 80% of his waking time trying to inflict bodily harm to himself. It just makes him feel so alive. You could put him in a room full of colorful toddler-appropriate toys that light up and play music and teach you Latin while giving you a massage, and the first thing he'd gravitate towards would be the single outlet in the room, so he could try to stick the box cutter into it.

(Never fear, o vigilant internet, the ornament is plastic! As well as delicious. He will be shitting glitter for days.)

I haven't been back to New York for about a year and a half, which is far and away the longest I've been away from home (as I will probably always continue to think of it, no matter how long we've been here). The only time I haven't lived in Manhattan was for college, and that was just in Boston. In those carefree, pre-9/11 days, going between Boston and New York was as easy as hopping on the subway--one time, lacking any other form of identification, I even got on the plane with my library card. It would be great to be visit New York regardless of what time of year we went, but there's something great about the city at Christmas, so I'm especially glad that we can be there close to the holidays. I can't wait to take Cal to see the tree at Rockefeller Center. I've said this before but I'll say it again, because I am old and this is what old people do. It's one thing to enjoy the holidays (and I do), but it's a whole other thing to watch your kids enjoy the holidays. Kind of reminds you what it was like to be a kid yourself.

unorthodox, but grateful nonetheless

I got my first driver's license a little more than a month ago. I KNOW. However, since then, I have driven to and from work every single day, and even though I don't really know how to go anywhere else and I get really nervous whenever I have to deviate from that home-work-home route, I'm kind of getting used to driving. This is a big step for me, as every time got behind the wheel even two or three months ago would have me shaking with white-knuckled terror. I can even change lanes on the highway now without activating my fight or flight response. I am becoming a normal person.


MICHELLE
I wouldn't say it's enjoyable, but driving is becoming...satisfying. You know, like any other repetitive, habituated behavior.

JOE
(Brightly)
Like pooping!

(Long pause)

MICHELLE
No...not like pooping.


I used to not even be able to hold a conversation while I was driving (truth be told--I still don't like to talk when I'm driving somewhere that I'm not familiar) but at least with my commute to and from work, I recently progressed to being able to listen to the radio--the soft rock station only at first, until it started to drive my slowly insane--and now I am comfortable enough that I can listen to my podcasts* again. I can actually listen to other people having a conversation, concentrate on the conversation, and not veer off the road. Do you know what a big deal this is? It is. It is a very big deal.

I AM THIRTY-ONE YEARS OLD AND I JUST GOT MY FIRST DRIVER'S LICENSE.

So anyway, I can drive now is all I have to say. And I drove my kids around (twice!) when Joe wasn't around and we had to get somewhere and I had no other choice, and we all lived! Even though I had to tell Cal don't talk to Mommy while she's driving the car


CAL
Why?

MICHELLE
Because I have to concentrate.

CAL
What's "concentrate" mean?

MICHELLE
Concentrate means when you have to think hard about something.

CAL
Why do you have to think hard?

MICHELLE
Because...shh. Shhh. I just do, just...shhh.

CAL
Mom, why did you say "Shh?"

MICHELLE
Cal, don't talk to Mommy while she's driving!

CAL
But Mom, you're not driving.

MICHELLE
Well, I'm in the car, sitting behind the steering wheel.

CAL
(Pityingly)
But it's a red light.

MICHELLE
That's it, no more talking forever.


Um...Happy Thanksgiving!


* I used to only have the "This American Life" podcast to fall back on, but as of late I am in love with "Jordan Jesse Go!" because it is funny and I don't want to be depressed about the war in Afghanistan or teenage runaway heroin addicts first thing in the morning. If you can suggest any other similar funny podcasts, please advise. (I am trying to get the comments section back online but it has been disabled for so long that I kind of don't know how to do it. Bear with me.)

just desserts

Am I supposed to feel like a loser when people ask me what we're doing for Thanksgiving and I have nothing to tell them? Nothing. We are doing nothing for Thanksgiving. We're probably going to pop over to a friend's for lunch (they live about a block down the street), but aside from that, we don't have family in town nor are we planning to cook anything elaborate, and I have to work on Friday anyway, so even the four-day weekend aspect of the holiday has lost its impact. Maybe I will make some mashed potatoes for dinner on Thursday. Maybe. But honestly, aside from the spirit of Thanksgiving--reflection, being grateful, time with family etcetera--I don't care much about the machinations of Thanksgiving, the manic preparation and ensuing frenzied cooking in particular. (Right now, somewhere out in Ohio, my mother-in-law has read that last bit and gone blind. But everyone already knows that my housewiffery is not renown, I never prevaricated otherwise.)

But anyway, as mentioned, we are going to a friend's house for Thanksgiving lunch, and as such, I felt obligated to bring something--I offered dessert. This is called "being a good guest." As opposed to showing up empty-handed, eating everything and leaving, I guess. Like I said, I really don't like to cook. In particular I loathe the cleanup but I don't really enjoy the actual cooking along the way, either, although I do it occasionally as it is a means to an end. (The end being eating.) But I have in the past made apple pie, and though the recipe is nothing special or prized (the secret ingredient is LOVE! No actually, it's extra sugar) it usually turns out pretty good and doesn't look terrible, unlike that time that I decided to make tuna casserole not via the Tuna Helper box and the results looked like something died in the pan, and something ate the carcass and then threw it up again. So, apple pie it is. I'm not going crazy or anything, I bought a frozen pie crust from Trader Joe's, but I have real apples and butter and sugar and whatnot to fill it with.

Ever since I mentioned that I am going to make this apple pie, Joe has been after me to pick up a cake from the local bakery to bring with us to Thanksgiving lunch. As this lunch is a rather small affair (it's just going to be our family and their family, and our family will only account for about 25% of the food consumed, as one member is still mostly in the soft solids phase of mastication and the other refuses to eat anything that doesn't taste like breaded chicken with ketchup) I brought up the point that we were already bringing a pie, why would we bring cake and pie? It's like stripes and polka dots, one or the other, am I right? But Joe was weirdly insistent on the cake point, reminding me again and again that we had to go get a cake, bring a cake, buy a cake. After mentioning it for, oh, the tenth time, I began to suspect that possibly the reason that he kept wanting to pick up a cake in addition is because he thought that my apple pie was going to turn out shitty, and that he wanted to have a backup dessert option so that in the event of a last-minute pie fiasco on Thanksgiving Day when everything was closed, we'd have something to bring to lunch aside from a six pack of beer and a half-empty bag of Cheetos.

Well, it didn't matter anyone since neither of us got out of work early enough to get to the bakery before it closed for the holidays. But! I got a festive box (perhaps this is overstating it's decorative value somewhat--but there is a picture of a reindeer on it at least) from Target and have filled it with cookies. I did not make the cookies, but hey, don't ask, don't tell, right? At first I was making an effort to choose cookies that weren't so obviously out of a package (for example, ix-nay on the int ilanos-may) but then as I was unboxing the cookies and fluffing them in their decorative container I noticed that the more fancy chocolate coated of the selection had the words PEPPERIDGE FARM embossed rather vulgarly all over the back end of them, so I guess the gig is up. Anyway, it's not like anyone cares if the treats are from a box or not. Cookies are cookies, and everyone likes cookies. Especially Squanto.

I'm not really sure what my point was when I started writing this entry, except that it was maybe that I am terrible at the mechanics of a traditional American Thanksgiving. The sentiment, however, I am pretty OK at.

the solution to having no time is just to type very fast

When we moved into this new house the first week of October (cripes, almost two months ago--the fact that we appear to live in a shantytown of cardboard boxing is getting harder and harder to explain away) I could see that the backyard was once beautiful. Certainly it had some stately old growth, two stunning Japanese maples in particular, but no one had really lived here for at least a year before we moved in, so you could see the sort of soft slide into decay--the overgrown ivy, the lawn in need of raking, the decrepit-looking swing set in the back that I have declared off-limits as it appears to to not only consist solely of sharp snapped-off pieces of wood, it also plays host to a good percentage of the yard's wildlife. The backyard, it's looking a little wild, like someone's going to plant a sign in the middle of some of a deeper overgrowth inscribed, "NATURE WINS." But it has potential, you know? And someday, maybe someone (possibly us, though unclear--we're just renting, after all) will get in there, plant some stuff, pull up some other stuff, put in a new playground set, clear off the stone path, and it will be a pretty great backyard.

That's kind of how I feel about this website.

Unlike a yard, though, I actually sort of know how to upkeep a website. I know it's not really obvious, since I haven't really had the time to do much with this space as of late (see: two kids, myocarditis spouse, big move, book revisions), but I have some ideas in my mind of some new content that I might start to feature, which will take this blog back a little more in the medical direction. There may be some video. There may be some special guests. We will see the return of open reader comments. I still have to work on fleshing it out, but there is stuff in the works, and I hope you're going to like it. In any event, and in the meantime, here are some pictures of from Halloween and this past weekend. See you again soon.













(Full disclosure: I Photoshopped a booger out of Mack's nose in that last photo. You're welcome.)

as seen on the MARTA during my afternoon commute





No words can appropriately communicate the sheer wrongness of these shoes.

60 posts in 60 non-consecutive days: the stink of failure

So...I failed my road test. But it wasn't totally my fault.

Wait, let me rephrase that. It was my fault. Nobody failed my road test for me. But the nature of the failure wasn't (in my opinion) related to skill or disobeying traffic rules or running over granny or anything like that. Well, let me get to that part.

First of all, yesterday (the day I took my road test) was maybe one of the rainiest days I've seen since moving to Atlanta. This was not rain as you or I understand it, this was monsoon season on the Ganges. This was, "I can barely see out of my front windshield with the wipers going at full speed, giant lakes of water on either side, can't hear what anyone is saying because of the volume of water beating down on the roof" typhoon level rain. It was also the first time I had ever driven in the rain. Ever. Not making excuses, just saying. There was a note on the DMV website that said that driving tests would be cancelled under unsafe weather conditions, but I guess they were talking about, I don't know, tornadoes or something. I know I'm going to have to learn to drive in the rain at some point, since, you know, it does rain sometimes, but probably trying to do it for the first time the day of the road test would not be the way I would want to break into the practice of inclement weather driving. Anyway, again, not an excuse, but non-ideal conditions they were.

We waited at the DMV for about two hours. It was a little annoying since we actually made a 9:00am appointment for the test (in the end, it turns out there was some sort of problem with the light-up board that calls your number, hence us waiting an hour past the appointment time for our ticket to get called), but at least it allowed us to play sociologist in the fascinating and occasionally grim world of the DMV. Like, for example, noting this conversation next to me, between a a mom and a teenage girl filling out an application for her learner's permit.


TEENAGE GIRL
(going through checkboxes on form)
"Do you want to be listed as an organ donor on your license?" What does that mean?

MOM
It means if you're in an accident and they have the choice between saving you or saving your organs, which one should they save? If you say you're an organ donor, they'll just take your organs and let you die.

TEENAGE GIRL
Oh. I don't want that.
(Checks "NO" on the form)

MICHELLE
Sigh.


When it finally came time for the test, we had to run out from the rear doors of the DMV to this tin metal shed, where "the licensed driver" (Joe) was instructed to pull up the car. The rain on the tin roof was deafening. The road test instructor was kind of a small lady, clad in a full-length (and I mean full-length, down to her ankles) yellow rain slicker with a gigantic hood. With the hood up, she looked like that killer with a hook for a hand in "I Know What You Did Last Summer," except, you know, yellow. I know that instructors aren't supposed to give a lot of feedback or show emotion or whatever, but she was also rather sphinxlike. Meaning that she was unusually stoic and stony-faced, not that she had the body of a lion or anything. (Though, under that rain slicker, who knows?)

"Get in the car and (blum blur blar) so I can check your (inaudible)," she mumbled grimly.

"Excuse me?" I moved closer to her so that I could hear. "Sorry, I didn't catch that, the rain is really loud."

She looked at me about a beat too long. "I need to check your TURN SIGNALS and your BRAKELIGHTS," she said, as though to someone of questionable intelligence.

"Oh. Yes. Right away." I duly fired the signals, and she neither conformed nor denied that everything was OK, just got into the car.

"Cool raincoat," I noted. I wasn't trying to kiss up, though the second those words were out of my mouth, I wish I hadn't said them, because--complimenting your road test instructor's attire? How could that not be perceived as kissing up? In any event, she didn't respond, just telling me to pull out into the driving course in the back lot.

The driving course part went OK, I think (again, I didn't get any feedback, so who knows. It was fairly hard to see out of any of the windows despite the windshield wipers going full blast and the defrosters going front and back, but I think I parallel parked OK, and I think I managed to do what she was telling me. ("Yes ma'am." Southern people seem to have this innate ability to say "Yes sir" or "Yes ma'am" sounding totally sincere, but for some reason, when I say it, it sounds sarcastic, even if I mean it. But no matter.)

The real trouble came when we had to start the "road" portion of the road test. Now, let me just say this first: I had been told by several people (including one of our OR techs, whose daughter just took her road test at this same DMV location a few months ago) that this would consist of "driving around the block." I also heard from one of the other parents standing under the tin shed (I guess they were there for a repeat road test too) that the instructor would take us "in a circle." So I was all geared up for that. We pulled out of the parking lot, turned right, and started going down this long, straight road which ran parallel along a larger street.

"Up ahead," the instructor droned, "there's a left turn coming up. Go left, straight."

"Left, got it." I approached the turn and saw a couple of signs indicating that I could make a left turn to double back at this point. Figuring that this was the part of the circle where we turned around, I signaled, pulled up to the intersection, and turned left, heading straight down the road back the way we came. Only as I was completing my turn (visibility not so good, remember), did I see a small, side street a little off to the right from the left turn, across another lane of traffic, which went straight down into kind of a warehouse-y type neighborhood. And I probably wouldn't have thought much about that, except that for the first time, the road test instructor showed a human emotion, a barely perceptible moue of annoyance and displeasure.

"Oh wait," I said, trying to salvage the situation. "Did you want me to go into that side street? When you said 'left, straight,' I thought you wanted me to turn left and head straight down this road. Sorry, I didn't understand what you meant. Do you want me to go back?"

"Pull back into the center," she said. And that's when I knew that I'd failed.

Anyway, after I made the Drive of Shame back to the shed, she told me that I "didn't make it today" and that I "needed to learn to follow instructions." I remembered that not following instructions was one of the automatic fail criteria of the road test, lumped in with trying to bribe the instructor or driving on the wrong side of the street into oncoming traffic. I would argue (not that I did, NEVER ARGUE WITH THE DMV) that "not following instructions" is different than "not understanding instructions" (for example, if she had said, "turn left here, across the lane of traffic slightly off to the right is another road, I want you to go straight down there" we might not have had this issue), and I exhibited no unsafe driving or violation of traffic laws...but whatever. You can't semantically debate your way out of a DMV fail. I will make another appointment for as soon as I can and hopefully, it won't be hurricane conditions that day.

(And I definitely didn't say this part, but saying that a former medical resident needs to learn to follow instructions? Until last year, following instructions was all I ever did. Medical training is like the army, but with worse food.)

60 posts in 60 days, day 12: this old house




So we stopped by the new house today to finalize some last minute details before assuming the lease, including signing some papers and asking the landlord stuff like "what do we do with our trashbags?" and "what do all these light switches turn on?" Oh, also, we had to pay them the money. Our lease starts this Tuesday, at which point we can start our staged operation of moving select items in before the big move date on October 4th.

And for those security-minded who are going to e-mail me that I shouldn't put a picture of our house on the internet because that's how They find you and kill you in your sleep, maybe it will make you feel better to know that every single house in this entire neighborhood looks exactly like this. I guess Tudor architecture was all the rage in the 1920's, when the majority of this housing stock was built, but it makes the area look like some kind of Hobbit village.

60 posts in 60 days: I never specified that they were consecutive days

(First of all, let me say that there would have been a post up yesterday afternoon, had Blogger not decided to ingest it. RIP, post that never was. Someday it will turn up tucked into the archive, all dessicated and mutated looking, like when one twin absorbs the other in utero. Yes, well...)

First off, more pictorial evidence of why we are moving in a few weeks:




(Fortunately, not our car.)

I wish I could tell you I had to look and look and look for a car with a broken window, but the fact of it is that a few cars get broken into every week around here. Also, the assaults and the stabbings and the fact that when we left the house last weekend there was a police squad slapping cuffs on some guy right outside our door. Nice. So long, wrong side of the tracks. Three more weeks to go.

(Here is the part where I try to regenerate the post that got vaporized.)

I love having kids and I would not trade the two I have for all the tea in India, because what would I do with all that tea? No, but seriously, sometimes I envy my friends who don't have kids, not so much for their disposable income (well, a little) or their fancy travels (again, a little) but the very fact of how much time they have for themselves. I don't make a real effort to have "me time," (that started to sound hopelessly indulgent right around the time that I started my intern year) but I do get the feeling between work and home that my whole life consists of careening from the service of one set of needs to the other. Imagine what people do when they don't have kids! I can barely even remember. This is all somehow sounding very pathetic but you have to understand that I wake up for work at 5:00am and spend the few hours after getting home from work packing lunchboxes and giving baths and putting people to bed, until it's finally time for my own bedtime, usually around 8:30pm.

(Actually, I'm going to abort this post regeneration. Reading it again makes me realize how utterly boring it is to read about the minutiae of the ostensibly SO BUSY! SO HECTIC! life of the working mother. Wah wah, tell it to Joy Behar. Followed by some canned banter and Whoopi Goldberg drawling something borderline off-color.)

All of us have been a little sick this week, except for Joe, unless you count the myocarditis. Cal had some sort of flu (whether swine or otherwise I know not, nor does it really matter I guess, it's not like we would have been rubbing him on babies and the immunocompromised regardless) and Mack had one of those mysterious baby illnesses that manifests purely as a high fever with no other symptoms whatsoever. Is there anything worse than waking up in the middle of the night with a glowing hot baby beside you? His little hands and feet felt like mini grill pans, and his head felt like a giant light bulb.

I used to feel guilty every time Cal got sick as a baby, so certain that he was sick because I had brought something unsavory home from the hospital, clinging to my clothes or my hair like some miasma of infection. But now that Cal is in school I think that he can claim his share of the blame for bringing things home. As for me, I haven't had a fever or any specific symptoms, but I've just been feeling a little punky (Pediatricians would have you know that this is a clinical term) and have one giant lymph node blown up on the side of my neck. Nothing else. I'm not even sure if the three of us had the same thing or if we just happened to all catch three separate illnesses at the same time. Oh epidemiology, you mystify and intrigue me. Maybe we need a blackboard so we can draw lots of circles connected by dashes and lines. TV tells me that this is how medical mysteries are solved.

OK, have to put the kids to bed. Alcohol-based hand sanitizer, people. Buy yourself a bottle today.

60 posts in 60 days, day 10: the heart, el corazon



A Post-it note I found on the sidewalk out in front of the hospital.

60 posts in 60 days, day 9: road test

September 19th, I'm going to take my road test for my Georgia driver's license. I've been able to hold off for more than a year (a fact that defies credulity), since we live near a subway station at present and I don't go anywhere during the week except between home and work. However, once we move, I won't be able to take the train to work anymore, and if I can't drive I won't be able to get to work, which basically means that, as the primary breadwinner of this family, our entire livelihood is resting on the fact that I will pass this road test and get my driver's license.

(No pressure, though.)

Not wanting to shell out any more money for Driver's Ed, I'm relying on Joe to get me up to speed (as it were) for this test. Luckily, he is already on beta blockers. Since driving is such a reflexive, intuitive thing for most people by adulthood, it's proving harder to teach in a constructive manner than one would think. Though he is overall a fairly calm, patient person, I think there's something about teaching your spouse to drive that reduces all your constructive instruction to: quit driving so crappy. Yesterday, we were practicing parallel parking.


JOE
Now back in straight. Straight. Now cut it hard. Are you cutting it all the way?

MICHELLE
Yes, I'm doing it. God.

JOE
You're never going to make it in now.

MICHELLE
Thanks, fatalist. Well, once I get in the spot, I can try to get in closer to the curb.

JOE
Just start again. Cut it hard when you clear the cone.

(Reattempt)

JOE
Now you're going in too steep!

MICHELLE
You told me to!

JOE
But look at you, you're going in sideways!

MICHELLE
Well, if you'd just let me do it the way I was doing it, I'd be fine!

JOE
You're not getting close enough to the curb! The manual says you have to be 18 inches from the curb.

MICHELLE
Well, but those cones are in the way. Do you think you can get 18 inches from the curb with those cones there?

JOE
Oh, easily.

MICHELLE
OK, show me then.

(JOE parallel parks. Opens the door to check. Car is two feet from the curb.)

MICHELLE
"Oh, easily."

JOE
Shut up.


It's not so much the road test that I'm worried about, though, it's the actual driving myself to work. It shouldn't be that bad in the morning, since I'll be on the road before 6:00am, but it's the commute back home during rush hour. When I started my anesthesia residency, it took me a good month of being in my own room to feel at least slightly more comfortable at the helm, so I expect it will be the same thing with the car. The difference is, the anesthesia machine isn't moving at 60 miles an hour on the highway. Hold me.

60 posts in 60 days, day 8: teeth!

60 posts in 60 days, day 7: sensitive new age man




Sometimes I worry that Cal is just too sensitive for his own good. Not to hide behind the excuse of him being "too sensitive" to gloss over all flaws--I've certainly seen some parents describe their little Damien as "so sensitive" while meanwhile, Damien is beating the pulp out of some other kid and will undoubtedly grow up to be the kind of thug who pushes smaller bespectacled classmates into lockers--but really, Cal is sensitive. And I mean that he is too sensitive in the same way that I was probably too sensitive as a kid, and ended up crying every day at school for the first six months of first grade for reasons obvious only to me.

Like...OK, so I let Cal watch "WALL-E" a couple of nights ago. I'm not big on watching movies on school nights, but the fact of it was that we had finished bath early and Joe was working late again and I had to put Mack to bed, so hell, if "WALL-E" will keep Cal safely tethered to the living room for a while instead of exploring the gas range on the stove, I'm all for that. I had only watched "WALL-E" one other time myself a few months ago, but it seemed fine--cute and largely non-violent at the surface, with a level of melancholia and dystopic sentiment that was probably above the heads of most preschoolers anyway.

(On an unrelated note, part of me really, really wants to get the DVD of "Pee-Wee's Big Adventure" for Cal, because there are parts of it that I think he'd really love--mostly the first 30 minutes of the movie, I guess. But I also think that sequence near the ends with the clown bicycle hospital would terrify him in into the next century, so I guess it will have to wait. "Is this something you can share with the rest of us, Amazing Larry?")

So anyway, I come back downstairs after Mack has fallen asleep, to find the TV off and Cal subdued.


MICHELLE
Did the movie finish, Cal?

CAL
Yeah.

MICHELLE
Did you like "WALL-E?"

CAL
(Quietly)
Yeah.

MICHELLE
...

CAL
(Mumbling)
I don't really like "WALL-E."

MICHELLE
Really? Why don't you like it?

CAL
(Tearing up)
I don't like that "WALL-E" movie, Mom.


So I assume that something scary or sad must have happened in the movie to upset him, and I'm trying to figure out what in the movie may have set him off, made all the more difficult by the fact that I've only watched the movie once before myself. (In my memory, the entire movie consists of one robot shouting "WALL-E!" and another robot shouting, "EVE-A!" Repeat ad nauseum. Then, let the Oscar nominations roll in!) So I'm asking Cal, "Was it too sad when WALL-E got broken? Was that sad? Did that make you sad? Was something scary? Was it too scary? Was it scary when the spaceship was all tilted and the babies were spilling into space? Babies in outer space? Too scary for you?" Cal isn't saying much. Then, like, half an hour later, he finally spills it.


CAL(Almost inaudibly)
I don't like that trash.

MICHELLE
The...what?

CAL
The trash on the Earth. How come there was so much trash on the Earth?

MICHELLE
Oh. Oh! Because people didn't take good care of the Earth, and there was too much garbage, and so then they had to leave the Earth and live on the spaceship.

CAL
(Tearful)
I don't like the Earth full of trash.

MICHELLE
Well, that's just pretend, sweetie. And you know, if we keep taking good care of the Earth [blah blah blah insert moralistic environmentalist pinko babblings here, recycling, energy conservation etcetera] then that will never happen. You and and your friends at school are doing a good job already. Like turning off the lights and not wasting water and stuff.

CAL
(Darkly)
But not everyone takes care of the Earth.

MICHELLE
Really? Like who doesn't?

CAL
Like that time we went to Chuck E. Cheese and there was a man in front of us and he threw a can on the floor.
(More tears)


Damn you, cartoons with a social message, you're depressing my child. From now on, we're only watching movies with no morals at all. Or where the moral is: even if you let some fat rich kid steal your bike, at worst you will be launched into a cross-country journey, meet a number of colorful characters along the way, and end up with a bit role in the Hollywood treatment of your own story. And also, that there is no basement in the Alamo.

(Full bubble blowing picture set here.)

60 posts in 60 days, day 6: unclean




How many times a day do I wash my hands? One million times, plus or minus five thousand. In fact, thinking about handwashing makes me feel like washing my hands again. Kind of like when you see someone yawning and yawn yourself.

60 posts in 60 days, day 5: milk of amnesia




I guess I have Michael Jackson to thank, but suddenly, everyone and their 85 year-old grandmother knows what propofol is. Now if only cisatracurium would get this kind of press.

60 posts in 60 days, day 4: 3 sixty 5




Because of my essentially reclusive and misanthropic ways I am not much of a joiner both online or off, but I recently joined a pool on flickr called 3 sixty 5 that basically challenges its members to post a single photo every single day for a year. The year started today, September 1st, so there's one down, 364 photos to go. This group appealed to me the same way that 100 steps challenge appealed to me, which was to force myself to stop and look at things and not be in such a rush all the time. It's not much of a challenge to take pictures I guess, but it will be challenging for me to find new things to look at, in that I really don't go anywhere particularly photogenic day to day-- my Monday through Friday existence is basically walking from my home to the train to work and then reverse order again. But who knows, we are moving to a new neighborhood, maybe there will be all manner of exotic fauna to look at there.

Speaking of which, on a completely unrelated topic, on my way to work this morning I passed by a gigantic dead possum in the road. I think it was a possum. OK, tell me if this was a possum: it kind of looked like a big raccoon, but it was greyish (I think, it was dark) with kind of a pointy snout, and it had that kind of thin, bald rat tail. It was truly horrifying, and lying in the middle of the road down this semi-side street/dark alleyway that I walk through at 5:45am to get to work because clearly I want to die. Seriously though, I don't much get worried about being mugged walking down the street, but walking by that dead possum (opossum? Not really dead, just playing possum?) I was honestly freaking out that the thing was going to jump up and start chasing me around as I passed. Because that tail is disgusting.

Above, my submission for 3 sixty 5 today. (It is a drain pipe on the curb outside my building.) Below, some other photos that didn't make the cut. It is tempting to save them to post another day, but I think the spirit of the thing is actually to post new pictures every day. They are, in order, 1.) the Georgia Tech shuttle waiting outside the subway station, 2.) the leaf-strewn hood of a pickup truck on my block, and 3.) some vines spilling over the fence lining Dead Possum Alley. (The possum carcass had thankfully been cleared away by the time I walked home.)

60 posts in 60 days, day 3: nomadic

So we're going to move again. The first weekend of October. It's all set up, movers are coming and everything. We are just moving to another neighborhood five minutes away, Cal will be going to the same school and no one has to switch jobs and we are likely still going to be going to the same supermarkets and everything because it's that close by--but still, it's light years away.

We're moving to a house. A real house, not a townhouse. It has four bedrooms. (It's listed as a five bedroom, but the fifth "bedroom" is in the basement and it's barely habitable, I wouldn't stick anyone down there, except for maybe Cooper or possibly my in-laws) (HA! Just kidding in-laws! If you're reading, you know I love you guys and would not incarcerate you in the basement) (No, seriously, I was really kidding) (Don't kill me). It also has a backyard and a garage and something called a "bonus room" (???) and it's in a neighborhood with trees everywhere and lots of other houses with backyards garages, and if you kind of squint and look at it out of one eye, you might think that you were in the suburbs. I never thought that I would live in the suburbs. Except, apparently, I sort of will be now.

Because of Joe's HEART CONDITION (I have to say it like that, like it's in caps--partially to make it sound funny because to the casual observer he looks fine, but partially to disguise the fact that I was scared out of my everloving wits when he was ensconced in the ICU) he's not allowed to lift anything, and between that and our work schedule and all these damn kids underfoot it's a little difficult to pack up everything in this house in order to move it to the other house. And thus was a dream fulfilled, and that was to have movers come into our home and pack everything up for us and move it to our new place, just like on that final episode of "The West Wing," where the second the outgoing president left for the inauguration, about fifty professional White House staffers swooped in and packed up every single item of furniture and clothing and all the Americana knicknacks off the desk in the Oval office, presumably (this was not shown on the show) unpacking it for him at wherever Martin Sheen was going to go live post-presidency. Well, our movers aren't going to unpack for us, and we have to pay them many dollars to help us pack the day before the actual move, but miracle of miracles! To have someone pack for us! And to have it all done over one day! Truly, this is what makes our country great. That, and baseball.

(Really, I don't care about baseball. I just threw that in there. But I do hate packing.)

It's not even going to be as big a deal packing this time as the last time we moved. Well, first of all, we've only been living at our current place a little more than a year. Second of all, most of my clothes have never been unpacked in the first place. When we moved down from New York to Atlanta, I was pregnant, so most of my clothes I couldn't wear anyway, and therefore never bothered to unbox. And then I had the baby, but then it started to get warmer here, so I didn't need to wear my sweaters. Or my winter coat. Also, I never wear anything except scrubs and the most slovenly of weekend clothes, so I'm pretty sure I have several boxes of dresses and smart work-type clothes (from college and med school and my Peds resident days) that I have not looked at since I hermetically sealed them up in cardboard all those months ago when we were preparing for our interstate move. So good deal for these movers now. Just take those same boxes and throw them on the truck.

The real question is, if all those boxes are filled with clothes that I haven't found it vital to unpack and wear in more than a year, and probably didn't wear for a considerable amount of time prior to that, why am I even moving them with us this time? Have they not necessarily proved their obsolecense? This is Joe's argument. And while I see his point, part of me also thinks, they're fine clothes, and they still fit me, isn't it at least possible that I might still wear them at some point? Yes, I can no longer readily think of a venue in which to wear those black leather pants or those horribly uncomfortable stacked heel platform loafers circa 1996, but if the fashions of the 80's are back in vogue now, I only have to wait another ten years before 90's-wear is once again cutting edge. That's how it works, right?

60 posts in 60 days, day 2: going viral

So, Joe's heart. What happened was this.

About three weeks ago, Joe had a cold. All of us, of course, ignored it, because the fact of it is that Joe always has a cold. I'm not sure why, whether or not this is a testament to his delicate constitution or to my insurmountable immune defenses, but while we both work at hospitals and both live with two preschool-aged kids, he catches everything, and I catch nothing. So Joe had a cold, sniffling and coughing and what have you, and there was nothing much more to say about it than that.

Though, apparently, there was.

Three days into his cold, Joe started noticing some palpitations. He describes them as feeling weird, occurring first at night as he was trying to fall asleep, like strange jolts to his body that shook the bed. He tried to ignore them, but they were getting more frequent and he was feeling shitty, and after his surgical cases one Wednesday afternoon, he asked one of the anesthesiologists to run an EKG on him and hook him up to some monitors, just to see what was going on. This was in a series of cryptic and alarming texts I got from him while at work:


Getting an EKG.

Pulse ox reading 95% on nasal cannula.

Having lots of PVCs, P waves look funny.*

(* If those letters and words mean nothing to you, don't worry about it, the long and the short of it is that all indications pointed to the fact that something with his heart was fucked up.)

I texted him back, basically telling him that he needed to go to the ER postehaste and force them to get an echocardiogram, because it sounded like he might have a viral myocarditis. So he did, and they did, and...he did. ("I knew it!" I crowed triumphantly over the phone when Joe confirmed the diagnosis, after telling me how others in the ER were pooh-poohing his concern, with some sentiment that an echo might be overkill. But then I kind of realized that this wasn't an academic discussion and this wasn't "guess the diagnosis" on rounds, this was my husband, and the ridiculous knee-jerk triumph of being right kind of gave way to dread.) So anyway, they admitted him to the cardiac "progressive care unit," put him on telemetry, and that is how Joe ended up in the worst place in the entire universe: an ICU in an academic hospital at the beginning of August.

I know I'm going to get such shit for saying this, since I was a resident, like, yesterday, but the intern who rounded on us? Was probably fourteen years old. She was lovely though, and adorably flustered. I remember that feeling so vividly, how much as a medical student or a junior resident we would all just hate having a patient was was a doctor. There was that dread, that sense of embarrassment that I was never quite able to hide. I might be able to fool my other patients into thinking that I knew what I was doing, but the patients who were medical professionals? They knew how inexperienced I was. They knew that I was an impostor.

This is probably also a good point to make note of the fact that as patients, we were exceptionally privileged in terms of the kind of care that we received. As a two MD household, one of whom actually worked at the hospital where he was admitted as a patient, we know that people treated us a little nicer, checked in on us a little more often. We had a little more access to information. When it came to the issue of visiting hours, people looked the other way. When it was time for us to go home, the discharge protocol was accomplished with probably the most expediency I've seen in an academic hospital. But the fact of it is that regardless, being a patient is just a terrible, terrible experience. No matter how much you know, you will feel helpless. No matter how much you can do, you will feel powerless. And no matter how much you try to reassure yourself, there is that lurking dread in the back of your mind that the worse case scenario could and may occur. In this sense, being an overly knowledgeable patient may actually be worse. And as much as being a doctor helped to understand what was going on, there were moments when I would have gladly put out of my head the patients I'd had with a history of myocarditis who were on the UNOS list for a heart transplant. Ignorance can be bliss.

Joe, luckily, was never that bad off, and our hopes are that the odds are on his side and that in the next few months he will get better and better, his myocardium remodeling and his cardiac function returning close to his baseline. But until then, he's taking a handful of meds--some of which aren't a terrible idea for him to be taking anyway (hard to find a thirty-something year-old cardiologist these days who isn't already on a statin) and some others which we hope he can wean off eventually. And not to be hopelessly glass-half-full about things, but this may be something of a blessing in disguise, forcing us to take a good hard look at ourselves and make some lifestyle changes that have been long overdue anyway. We're trying to cook more, eat healthier, and while Joe is still restricted from any major physical exertion (I've been doing most of the heavy lifting around here, which is even more hilarious than it even sounds), I'm sure at the end of the six month convalescence period, he will be more than happy to step it up on that front too. Sometimes it can take something like this--frightening and vivid, but hopefully with no long-term implications--to scare you straight.

But that aside, what I learned from this experience is that the line between ourselves and our patients is a very, very thin one. Curiously, being exposed to sick people day in and day out has something of a distancing effect. I take care of patients in some degree of heart failure every day, but I never think of it in terms of my own life. The more I take care of patients with myriad medical problems, the more it can seem like heart disease and lung disease and freak accidents are things that happen to other people. But they're not. It can happen to us. It can happen to our spouses, our parents, our friends, our kids. We like to think there is a line dividing us and our patients, but one day when you wake up and find that you are the patient, you realize that line is just wishful thinking, a protective measure that exists only in your own mind.

It's true that doctors make the worst patients, but in another way, we also make the best patients. Having seen the good, the bad and the ugly, and having more of a sense now how fine the divisions are between, we will do what it takes to get things right. Having walked through the trenches for years among those who have not been so lucky, we appreciate what we have, and we temper our attitude towards the sick people in our care accordingly, from those days and weeks and months that the word "patient" were not a them, but an us.

let no one say this has not been an eventful year

OK, OK, but before you get all piqued at me about not posting, quick pop quiz. Which of the following things happened in the four months since my last substantial post?

1.) Random stray gunfire came in through our window one night
2.) I took the Anesthesia written boards
3.) Joe was hospitalized for three days in the cardiac ICU
4.) We found a new rental in a less bullet-y neighborhood and are moving in five weeks

All of the above, my friends. All of the above.

First thing: I reposted those two entries I redacted a few months ago, here and here. There, now everyone knows what I was cryptically referring to in my penultimate post before that video with Cal and the driving dogs. We got a bullet through our window. No one was hurt, but really, a bullet through our window? That is excessive drama by any standards, and I am a decidedly undramatic person. Despite the sweeps season-like air that the incident lent this blog, I took down my posts about the bullet shortly after posting it because Joe didn't want his parents (read: Mom) to know about what happened until we were out of our current living situation (lest she worry unduly), and I found that since I couldn't talk about the bullet and I couldn't really talk too much about work and since I couldn't talk about XYZ other topics for a wide variety of reasons (ranging from general discretion to topics just too boring to write about), I realized I couldn't think of anything to blog about. One week became two, became a month, etcetera etcetera. The more you stay away, the more you stay away. Anyway, barring any further upheaval to cap off the year (perhaps alien abduction would be a fitting coup de grace), I will resolve to do better. Perhaps I will do what I did last year after I fell off the wagon for an overlong period of time. 30 posts in 30 days, that kind of thing. Anyway, we'll see.

Oh yes, Joe in the ICU. That was about two weeks ago. Short answer: viral myocarditis. Long answer: I will try and get a blog entry up about it sometime soon, both about the general experience and about the dual advantage/terror of being a healthcare professional hospitalized for a potentially serious condition. He's out now and doing better of course, or I wouldn't be talking about it at all. Call me superstitious, but I'm a firm believer that talking about bad things makes them come true.




Cal and Mack are both doing well. Cal started school a few weeks ago. He is in Pre-K this year--after some stunning-to-the-teachers (though not stunning to us) gains in the social arena during the Spring semester, his teachers decided not to pursue the issue of retention, and though he still is the youngest kid in his class this year, he's basically normalized himself amongst his peers and is just acting like a regular kid--talking and playing and laughing and running around, as opposed to sitting on the sidelines with the teachers chatting about numbers and scowling evilly about this kid or that kid breaking the rules. (Among other things little-old-manly, Cal loves pointing out and imposing rules on others, sometimes in less than adorable ways. My little mid-level manager.)

And Mack?




Mack is delicious.

So let's jump back into it, shall we? Or hell, I'll do you one better. Forget 30 posts in 30 days. It's 60 posts in 60 days this time around, baby. This is called "penance." And lord knows we have enough to catch up on.

cal explains...why dogs can't drive

redacted

Had to take down the last two blog entries (if you read them, I'm sure you'd recall, they were somewhat memorable) at Joe's request, because he didn't want certain people who read this page to worry. And worry they would. So poof. Ignorance is bliss.

Anyway, that's that. Don't worry, you're not crazy, they really were up there, and you really did read them, I just removed them. Maybe we can talk about it more later when the dust settles. I have some strong opinions about this matter, as you may have guessed, and have been angrily shaking my fist at Charlton Heston since.

commence freaking

While I was certainly concerned last night, it was dark, I didn't ever see for myself the bullet hole, nor its proximity to where we were sleeping with the baby. Then, when I got home from work this afternoon, I took a look.

Now I am freaking out.

"he hates these cans!"

At 11:58 last night--I know the time exactly because I looked at the clock when I heard the sound--there was a small, tinkling crash in our bedroom. It sounded like a light bulb had exploded, or that a Christmas tree ornament had shattered, both sounds which were somewhat improbable, as light bulbs are not in the habit of exploding spontaneously, and even we've had our Christmas tree down since...uh, March. "Did something break?" I asked, looking around. Joe got up to investigate, telling me to stay in bed with the baby, because I didn't have any shoes on and he didn't want me to step on any glass.

He looked around the room, picked up something off the floor. Then he went downstairs for what seemed like a long time. I figured he was looking for the broom. When he finally came back into the bedroom, broom-less, he came up to me and pressed something small and cold and metallic into the upper part of my arm, so I could feel it. "I found this on the floor."

"What is that," I asked. "A penny?" I couldn't see, it was dark.

"It's a bullet," he answered.

There are these moments, few and far between, thankfully, where the cognitive dissonance between what someone is telling you and what you are seeing are so different that you just can't understand quite what's happening. There I was, in bed, holding the baby, who was nursing contentedly and making little snuffly sleep sounds. And there was Joe, holding up the bullet that had just been fired through our bedroom window.

"I've called 911," Joe said. Cal was fine, sleeping in his room. His little toddler bed is up next to the window, just in the room next to ours, but thankfully, due to his truly acrobatic sleeping habits, he had since relocated to the bigger, queen-sized mattress that we also keep in his room for guests, which is set farther back by the door.

"Where did the bullet come in?" I asked. I was still confused. Were we really talking about a bullet being shot through our window? Like, from a gun?

"I don't know, but I'm not exactly going to go up to the window and start looking around now," answered Joe. "Stay up here with the baby. Don't get up. I'm going downstairs to wait for the police."

I will tell you, I lived in New York for 30 years, and never once had I been near gunfire, nor had I called 911 once. (Well, there was that one time in med school, but that was an accident.) I've been in Atlanta for less than one year, and already we've called 911 twice, and had a bullet come through our bedroom window. What gives, Atlanta?

Anyway, the police came, looked around, and Joe brought them up to the bedroom, where they found a small bullet hole through both the outer screen and one of the bedroom windows. The angle of the bullet holes lined up such that it seems that the bullet was traveling on a downward trajectory when it entered the room, and was moving at such a low velocity afterwards that it bounced off our squishy upholstered rocking chair and ended up on the floor, next to the changing table. So likely some idiot was shooting his gun in the air, probably even at some distance from our house, given that neither of us remember hearing an actual gunshot. Clearly some people don't believe in the axiom that what goes up, must come down. Maybe they think that bullets travel up so high that they burn up in the stratosphere on re-entry, like some damn meteoroid. Or maybe they're not thinking very much at all.

Mack and Cal thankfully slept through the whole thing (the police were very nice about being quiet, even when they were upstairs), and Joe and I eventually went back to bed after cleaning up the glass and changing our sheets, which had some shattered glass strewn about. But I still can't shake that feeling of cognitive dissonance. A bullet landed in our bedroom. Where our baby was sleeping. Next to the room where our other baby was sleeping. And the person who shot it likely has no idea, nor is he in the least bit sorry.

Anyway, we're all a little tired this morning.

i totally knew that this would happen

I had been thinking for years (YEARS!) that I might want to get back into print photography, perhaps of the lomo variety, just because while digital photography is great for instant gratification, there's nothing like holding that print in your hand. And let's face it, we never make prints of our digital photos, because dude, that's what Flickr is for. But also with respect to print photography, there's sort of that fun guesswork and the economy that the medium forces on you. I will easily fire off thirty shots of basically the same shot digitally (see: my roughly five million shots of Mack lying on a pillow staring blankly at the ceiling), but when I have to actually pay for the film? Well, let's make sure the light and composition and setting are right and DON'T YOU DARE BLINK, KID. Yes, I know, I am making this hobby sound like an absolute blast.

About two years ago, I was this close to buying a Holga, but decided not to, because I was a resident (read: no money) and I didn't want to buy film AND pay for developing AND find out, like, two weeks later that I had made some stupid mistake with the manual settings and ended up with a roll full of completely blacked out shots anyway. But then a while ago, I started thinking, why not Polaroid? True, the film is more expensive, but I am impatient, and spoiled by digital besides, so I liked the idea of seeing how I screwed up one minute later, not, like, a month later, when I can't even remember what I did when I took the picture. I ended up (in a pique of righteousness, after I, though my own incompetence, didn't win a bid on some cheapy old Polaroid on eBay despite the fact that no one else bid on the item) thinking that Polaroid film was defunct anyway, why buy into a dying medium, and getting this hilariously bulky Fuji Instax 200 instead as my gateway drug. But who am I kidding, I'm probably going to end up getting a cheapy old Polaroid on eBay anyway and thus squandering away the rest of my already ill-spent youth trying to figure out the dying art of instant film photography while all the kids look at me strangely as they glide by on their hoverboards and jet packs. (It will be THE FUTURE, you see.)

Anyway, here was my first roll. Please excuse the lack of a scanner, our old one decided to go all Skynet on us and started making strange sentient human-killing noises, so we unplugged the thing and are deciding if it is a lost cause to try and fix it (likely) or if we will end up needing to get a new scanner. Anyway, I already spent all my money on film, what else do you want from me, people? (Note to Joe: Not really! Don't worry, we still have money! Anyway, Cal probably won't want to go to college anyway.)

What you can determine from this first roll is that I do not know how to use this camera indoors. It cannot focus worth a damn closer than oh, say, 4-6 feet, and I cannot figure out how to turn off the flash, which accounts for the three completely dark photos that I tried to take in the subway station, as well as the two obligatory shots of myself in the mirror. But the outdoor shots worked rather better, and I do like how the camera renders blues.

Second roll. Getting better. OK, so the other thing that you need to know about this camera is that it looks freaking ridiculous. Seriously, like people may laugh at you when you whip it out. I looks like Cal's toy camera, only even more huge. Also, the photo shoots out the top instead of the bottom, which is like--what? Problems I have been troubleshooting include how to get the shot centered (I am used to using SLR so I'm not used to the viewfinder not lining up with the lens--see the totally off-center picture of the Yo Gabba Gabba dolls on the bottom left), what settings to use in different lighting conditions, and remembering to set my focus distance from near to far when I'm shooting different things. (Not that it really shoots anything that near. No macro setting on this thing, that's for sure.)

It's surely not as retro-cool as shooting with some of the old Polaroid cameras, which would make me feel like I was on "Mad Men," chain smoking and wearing high-wasted skirts and living in a state of quiet despair and whatnot. But it was a good start, especially since I knew (know) nothing about instant film photography and at least I didn't have to figure out how to use a second-hard camera from the 1960's with a discontinued battery and no instruction booklet, not even knowing if the camera was functioning or not. However, I fear that I will be there soon. Perhaps adopting this hobby was unwise.

i already used up all the brainpower i might have otherwise used to think of a title for this post

I've decided that to study for my written anesthesia Boards (which I will be taking the first week of August) I will start reviewing 10 practice questions a day, every day, up until the week before the exam, at which point I might step up my game somewhat and start some sort of a cram-a-thon. Ten questions a day is certainly not too onerous, but the only time I have to do it is at home, after both kids are asleep and before I go to sleep, usually a window of about five minutes, seven if I decide to brush my teeth. And this amount of time does not exactly allow for careful review of the source material.

So I guess I have to start going to bed a little bit later. This should not be a big deal--after all, didn't I stay up late every night in college, back when I was a weenie little premed and could only dream of the glamourous life that I lead now? (See: today, I got a free bagel! With cream cheese! BEHOLD, THE POWER OF THE MEDICAL DEGREE.) But the thing is, I've started seeing sleep as sort of an investment for work. As in: if I don't get enough sleep, I cannot think quickly and perform my job well, and this is not good for my patients. And therefore, I have to be in bed by 9pm or else PEOPLE WILL DIE. I know this makes very little sense--I didn't get enough sleep as a resident and I was taking care of patients then--but somehow being the one who is ultimately responsible makes me take everything a little more seriously. And if treating what little is left of my brain to the minor pampering it requires to function well, then by all means, put me in bed before it's dark outside.

Anyway, I did my ten questions for the day. And now I updated my blog, albeit nonsensically. And now I'm going to bed.

almost makes my eyes hurt

Ridiculously neon pink flowers growing outside the hospital.

so...that happened

I love having kids and all that, but one thing that I don't think I'm going to stop being jealous of childless people for anytime soon is their ability to travel. Because no matter how cool you are and how well-behaved and flexible your spawn are, once you have kids, your days of traveling as you once knew them are over. When you have kids, your travel is not dictated so much by concerns such as where you would like to go or what you would like to do when you get there, rather how long the flight is, what kind of kid-friendly activities are available, and whether or not chicken tenders and french fries will be on the menu as a backup plan in case your kid decides to eschew the seared ahi tuna on a bed of wasabi-infused slaw. Before Joe and I had kids, Joe and I traveled. Not as exotically as some of our friends, and not as often as we would have liked, but we traveled, you know? We went to Japan, Hawaii, Europe. And after Cal was born? Florida, Florida, and Florida. Oh, and Atlanta.

The real shame of it is, even if you dump your kids on someone and take a grown-ups only vacation (something that we talked about but probably will not do anytime soon) it's still not the same as before. Because while you can then fly to Prague or Chile or wherever, in all probability we'd just spend our whole vacation missing those kids. And that would just ruin everything. Therefore, whether or not your kids are physically present or not, travel after kids is never quite the same.

So while I know that the hipster thing to do would be to hate on Disneyworld--the commercialism! The artifice! The cloying "Disney Princess" empire (which, with one minor exception, as parents of two boys we have luckily not yet had to accept into our household)--I have to say this: I LOVE DISNEYWORLD. Do you hear that, cool kids? I love Disneyworld. I don't know anything about its corporate policies or unfair hiring practices or creepy communist-leaning history, all I know is that it's one of the few places in the world where you can take a kid and almost everything--EVERYTHING--you can do will be enjoyable and appropriate for them. And that makes it fun for me. Because while I would love to take a trip to South Africa without having to worry about how many sticker books and Play Doh containers and Pixar DVDs worth of cartoons to pack for the flight, I love seeing my kid have fun even more than that.

The nine hours we spent on the road each way were no fun, of course. Cal actually did fine--we packed enough amusements to keep him busy, and at the end of it all, there was the "Cars" DVD on my computer, so why wouldn't he be fine? But Mack--Mack was not happy. At baseline, he is a baby that likes to be held, so being crunched up in the carseat for that long, regardless of how many rest stops we made...well, let's just say that it made me rethink our decision not to fly this year. And even after we got there, poor Mack still had to suffer through being dragged around everywhere like some kind of teddy bear, napping in the stroller, eating on the run, propped up on the nearest convenient lap while his brother went on one ride or another. Oh, the woes of the second-born.

Cal, on the other hand, had probably the best time of his life. Because did I mention that there was a ride wherein he got to drive a CAR on a RACETRACK by HIMSELF? Well, there was! And he thought he was the man! (Don't tell him: it was on rails. Shhh!) And there were fireworks EVERY NIGHT. And ice cream! And he tried a roller coaster for the very first time and didn't die! Oh, but good times were had.

So anyway, we had a good week. Thanks to everyone who e-mailed me road trip entertainment strategies, they were well-appreciated and employed. And now we're all settling back in--back to work, back to school, back to...whatever it is that Mack does during the day when I'm not here. But that's not all bad. It was a nice time, and a fun trip, but it's good to be home, too.

(See full collection of photos here.)