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