one last thing about this and i promise i will stop

I was posting this in the comments section, but it was starting to get rather long, and in any event, my browser ate it, so I thought I would just post it here as a follow-up to the post yesterday.

First off, I want to extend an invitation to those people who are reading who are anti-vaccine to talk about why they don't vaccinate. I think we are overall very civil here, and if the concern is not about the so-called link to autism (as one of our commenters noted), then what is the concern? Some vague unease about "chemicals"? Concerns about "overwhelming" baby's immune system? Seriously, I want to know, not being snotty. It is hard to have a conversation about this without coming to (virtual) blows, so I would love to be able to talk about it rationally here, not even just to try to convince one side or the other, but just to visit the other side's perspective. (Obviously this need not be said, since we are all grown-ups here, but if anyone is brave enough to present their personal concerns about vaccines in what seems to be a very pro-vaccine forum, we all should play nice.)

The second thing I wanted to address was the fact this topic never fails to make me as both a mother and physician so enraged--not annoyed, not puzzled but actually angry, like I'm taking people's anti-vaccination sentiments as a personal affront--and I wonder why. After some thought, I have come up with this: I am taking it personally. And here is why.

As someone who works in healthcare, with sick patients, I see every day the injustice and horror that is illness. Preventative healthcare is a wonderful thing, perhaps the best kind of medicine that we can practice. Along with a healthy lifestyle, protecting against preventable illness is a big part of that. As a doctor, it's quite simply the very best that we know how to do.

When I go go onto these internet parenting boards, to read this anti-vaccination literature and hear the rhetoric, we see people who are not only rejecting we have to offer, but who vilify doctors and other healthcare workers--people who have devoted decades of their lives to caring for children and families--for working their hardest and giving the very best of what modern science has to offer, it quite frankly hurts my feelings. It's not paternalism, it's not about me wanting to tell patients what to do and for them to comply mindlessly, it's about me wanting to do my job and provide the best; and then feeling like people reject my efforts and recast my motives as somehow evil, greedy, or just plain ignorant. It hurts my feelings.

So yeah, I take it personally. I respect a parent's intuition and I respect the fact that no one feels great, myself included, about bringing their baby in, making them cry by jamming them with needles filled with seemingly mysterious antigens and preservatives. I know first hand that the desire to protect your children from all real or potential harm is beyond conscious thought, it is instinct.

But I respect science, too, and I have based my life around that. In lieu of religion, I have science. And the impulse to prosthelytise is equally strong. And just like people who prosthelytise about religious faith, I am doing so not to force you to be like me, not to scorn or humiliate you for possibly being of a different faith, but because I care about you and your children and families, and I want what all best evidence I have points to being the most effective way to stay out of my hospital.

The other thing that would have enraged me, by the way, with all the fury of a mother bear protecting her cubs, would be if Mack had somehow gotten the measles from an un-immunized kid before he was old enough to get his own vaccine. Luckily we he got his first MMR last week, so at least that's one less thing to worry about.
that squishing sound

I don't usually link to other blogs (not out of high principle or anything, I think I'm just generally not very plugged into internet "communities" as a whole and also I'M SHY) but I wanted to post this link to the most recent entry on Alice Bradley's blog, "Finslippy" about the vaccine debate. (Warning: video!) The topic of the debate is: who do you trust more, doctors or other parents?

But first, full disclosure: a lot of these so-called "mommy blogs" make me insane. I love "Finslippy" (I think Alice writes incredibly well and with great humor, and she's a Wellesley alum besides) and I think that Julia from "Here Be Hippogriffs" is another blogger who writes beautifully, with humor and nuance) but generally I find myself becoming short tempered with mommy blogs where, shall we say, perspective becomes a little unhinged from reality. I will say no more about this, because when I know I am about to step into a big pile of shit, I do not need to make the shit mound any deeper.

What bothers me particularly about some of these online mommy communities, however (aside from the fact of insisting to use "mommy" as an adjective attached to everything--perhaps this speaks to my own bias, but I feel that it essentially neuters mothers by using a cute diminutive, something akin to calling Frances "Baby" in "Dirty Dancing"), in particular when it comes to debates like whether or not to vaccinate, is the fact that doctors are so often cast in the role of the bad guy. Those evil doctors! Those dumb doctors! Those greedy doctors! They don't know! They don't care! They just want to make money off the booming commercial market that is vaccine production! Anyway, no one knows anything my kid as well as I do! It may not be scientific, but my mommy intuition trumps all!

The thing that drives me nuts about this debate, aside from the anti-vaccine crazies (about which a little more later--enough has been said about this without me needing to add too many words into the ocean of discourse on this topic), is this: sometimes doctors are mothers too. Sometimes doctors and mothers are the same people! Mothers that have gone to medical school! Doctors that have reproduced! The novelty of it all! I know this is hardly the main point to make about this topic, but that's something that has always irked me to no end about this Mothers vs. Doctors debate. (And Alice, thank you for trying to call attention to this, but of couse I'm not surprised that they edited it out. How can there be an "Us vs. Them" if there is no "Them"?)

And look, I'm not saying that doctors know your kid better than you do. Obviously I know my kids better than my Pediatrician does. But loving my kids does not mean that I know everything, nor does it mean that I can protect them from everything bad that could possibly happen, much as I wish I could. Loving my kids does not make me an infectious disease specialist. It does not make me a pulmonologist. It does not make me an immunologist. In the hospital, when I call a consult on a patient, I listen long and hard to what the consult is saying. It behooves me to do so. I know the patient better than they do, but they are the experts in their field while I am the expert in mine. If I am of the mindset that the consult I'm calling is an idiot and maleficent and isn't going to make the right recommendations, why do I call that consult at all?

Look, I don't meant to discredit those who are anti-vaccine by calling them "crazies." The Lancet has taken care of that for me. (Oh, snap.) All I'll say is to repeat something I heard on NPR, which is that it's very easy to scare people, and it's very difficult to un-scare them. Just look at the opinion posited in the video to which I linked, for the mother who refused the MMR vaccine because Jenny McCarthy apparently had such compelling evidence of how it clearly caused her son's autism; but who clamoured for the H1N1 vaccine because it was in the news, all SWINE FLU WILL KILL YOU AND EVERYONE YOU LOVE, OMG, TIME TO START DRINKING PURELL. Easy to scare people, almost impossible to un-scare them. Someone should do a study on that.
time to get a flowbee




The guy at the Dunkin' Donuts drive-through yesterday called Mack "little girl." He's the third person in a month to do this. But come on, his hair's not that long, is it?

(Full disclosure: it's pretty long. Also it has pretty waves in the back. He's my pretty princess.)
alert and oriented x 2

I am embarrassed to admit this, but I might as well just tell you, since it's the end of February already. When I was in New York this before Christmas and went to my publisher's office (my book is being published by Grand Central Publishing, which is part of the Hachette Book Group) they told me that my book was looking good, and on schedule for publication in March. Since it was December, I erroneously assumed that they meant this March, as in March 2010. Now, obviously, I know very little about publishing, and though I was under the impression that it took about a year from the time that a final manuscript is submitted to the time the book actually comes out, I thought--oh, I don't know what I thought. All I know is that they said March and I thought they meant this March but what they really meant (as would be obvious to anyone who has, you know, a calendar and some sense that Things take time to happen) they meant next March, as in March 2011. Which is a year from now. See, I told you it was embarrassing. Misunderstadings! Confusion! Cutely trying to cover for misunderstandings and confusion with excessive stammering and blinking! It's like a Hugh Grant movie!

Apparently we are still right on schedule, but I guess I was looking at...a different schedule. Which is why I'm still flogging through one final set of readability/clarification edits on the manuscript, after which point, hopefully I will just throw the book into the book-making machine, and I will never have to read it again. Until the copyedits.

"What's the deal with calendars?" (The preceding was to have been read in a Seinfeld voice.)


* * *


(Mandatory aside about the olympics)

I think I am the only person in the world who has not watched any of the Olympics at all. I've tried--I usually love the Olympics--but every time I turn it on, it's like, Women's Curling or some such thing--so I haven't been following the games. Usually I can be counted on to at least suss out when the figure skating is (there's something about figure skating, not just the music and the jumping and the nude netting on the costumes but something about how smooth the ice looks is just mesmerizing) but this year, I just haven't had the urge to tune in. Maybe if I knew more about the athletes, and how they PERSEVERED and OVERCAME OBSTACLES and maybe if someone's mom was LEGALLY BLIND and had to sit all up close to the TV screen to watch them perform their long program. But I don't much follow sports either, so I guess I'll just look at the pictures on The New York Times and wish I were able to stay upright on a pair of skis.


* * *


And finally, a picture of Mack playing in a patch of sun like a damn kitten:




His first word besides "Mama" and "Dada" (which, according to the Denver Developmental Chart, do not count as words, though any parent would beg to differ) is "STOP." This is what he shouts all day long, mostly when you're trying to remove him from grievous harm (chokey toy, step stool, open manhole cover, shark tank, etcetera.) "STOP." We are in big trouble with this one.
my feelings on the matter




If you like to watch a bunch of guys making funny faces while pretending to be glittery mummies, then by all means, watch men's figure skating in the Olympics.
take a look, it's in a book, a reading rainbow





Cal has suddenly expressed a Great Interest in reading. To be fair, he is very proud when he can read things on his own, but he still prefers being read to, because why should he have to put in all that effort when he can just lay back and let Momanddad mangle the more rickety portions of The Lorax for him? Reminds me of that Simpsons where Homer is in the hospital and sees that guy on the ventilator. "And here I am, breathing on my own like a sucker." (I paraphrase.)

But anyway, it puts a song in my heart to be a nerd and have my child express these budding nerdistic qualities (some of my most cozy memories of childhood are lying on the couch with a giant pile of books next to me--no, I was not very good at sports, nor did I have any friends, why do you ask?) so of course when Cal started talking about reading, I immediately pounced onto Amazon and ordered him a kings ransom of "I Can Read!" titles, Uncle Elephant, Frog and Toad are Friends, Bread and Jam for Frances etcetera. Oh, and Amelia Bedelia. It remains to be seen if the somewhat more nuanced fumblings of Amelia Bedelia will be above a four year-old's head (this is a kid who says that his favorite part of "Monsters Inc." is when Mike Wizowsky burps up the microphone) but whatever, we'll see.

I worked him into a fine frenzy rolling yesterday when I kept telling him that the books were set to be delivered that afternoon, that evening at the latest (creating the saddest possible tableau of him sitting next to the door looking for the mail truck) until I realized that it was President's Day and thus no mail delivery. And so it goes. But for sure they will come today, and frankly I am just as excited as he is. My little old man is becoming old for real!
voices that care

Was reading the New York Times article about the new version of "We Are The World" (to benefit Haiti, you know), when I remembered this other celebrity pastiche piece from the early 90's, "Voices that Care," which was made to support the troops during the first Gulf War--a simpler time in our nation's history when, if I recall correctly, they actually sold Operation Desert Storm trading cards (with gum and everything) at newsstands in my neighborhood. Laudably earnest sentiment of the song aside, you have to watch this video, because quite simply, it is awesome. The Nelson Brothers! Michael Bolton! Will Smith with a sideways baseball cap! Strange interlude in the middle with squiggly colored lines! Kenny G on his little weiner sax! FRED SAVAGE SINGING NEXT TO ALYSSA MILANO! Also, Dudley Moore for some reason. We're sending our love down the well (down that well)!





Awesome. I think I still have this cassingle in a shoebox somewhere at my parent's house. And so would you if you, like me, are a relic of an earlier time.
the life of an attending (as imagined by residents), complete comic




(Click on comic to embiggen)
the life of an attending (as imagined by residents), part 6


the life of an attending (as imagined by residents), part 5


the life of an attending (as imagined by residents), part 4




(The above was inspired by Dr. Glenda Garvey, who I still want to be when I grow up.)
the life of an attending (as imagined by residents), part 3


the life of an attending (as imagined by residents), part 2


the life of an attending (as imagined by residents), part 1


scut i have done, medical school edition (complete comic)




(Click on comic to embiggen)

You know, in retrospect, all of these little incidents occurred in two of the ten rotations I went through my third year of med school. Panels 1, 4 and 6: General Surgery. Panels 2, 3 and 5: OB-Gyn. So take from that what you will.
scut i have done, medical school edition, part 6




(Have your own stories of scut? Share them with us in the comments section!)
scut i have done, medical school edition, part 5




(Have your own stories of scut? Share them with us in the comments section!)
scut i have done, medical school edition, part 4




One of the commenters remarked that I must not have had a very good experience on my OB/Gyn rotation. Bingo. (Not to offend our colleagues in OB/Gyn, who I'm sure are all very nice. You understand that while everything depicted is true--SO VERY TRUE!--obviously I have selected and amplified for comic effect.)

Have your own stories of scut? Share them with us in the comments section! It is very cathartic, you'll see.
scut i have done, medical school edition, part 3




When I tried to pick the particular scutwork to depict in this comic, I tried to be as selective as I could, because I'm sure most of you will agree that not all scut is created equal. Some is related to patient care, and therefore somehow justifiable (even if occasionally disgusting/demeaning/mind-numbingly boring), whereas some scut is just kind of like hazing--humiliation for humiliation's sake. At least she didn't make me clean the stool with a toothbrush.

Have your own stories of scut? Share them with us in the comments section!
scut i have done, medical school edition, part 2




(Have your own stories of scut? Share them with us in the comments section! And thank you for those who have already shared. Reading about other people's degradation is very normalizing.)
scut i have done, medical school edition, part 1




(Have your own stories of scut? Share them with us in the comments section!)