your self-esteem boost for the weekend



When we first moved into this house, we noted that the previous owners had added a few design flourishes which were a little bit, shall we say, rococo for our tastes. Some of them came down immediately--the full wall mirrors in several areas, the gold-painted mirror flanked by a roulade and cherub motif in the half bathroom. But some of the others, like the gold (colored) doorknobs on the French doors throughout, while not quite my taste, seemed innocuous and certainly functional enough.

Seemed.

The problem with these doorknobs, I've found, is that I keep getting hooked on them. Not anyone else, just me. Everyone else in this house is either tall enough or short enough to avoid this particular problem, but at my height (5'2" and a half--and if you don't think that half inch is important, you much be much taller than 5'2") these doorknobs all over the house are right at waist height. Belt loop height, to be exact. I keep getting hooked on these doorknobs. And you would think that it's easy enough to unloop oneself, but look at that doorknob a little closer. The loop is a little bit spiralled, like a nautilus. Like one of those barbed fishooks. And once you get hooked, it's actually unusually difficult to extricate yourself.

Yesterday, I went to Costco to do some grocery shopping. We had a nice time in Orlando, but when we came home the food situation in the larder was a little bare-bones, and breakfast that morning was somewhat thin, which inexplicably panicked the kids. (Under normal circumstances I don't think they'd have any trouble with a breakfast of cereal and milk, but the fact that that's all there was to eat suddenly had them eyeing the USDA food pyramid and acting like we were the Joads in Dust Bowl Americana or some such thing.)  So anyway, I went to Costco and stocked up on, whatever, a coffin-sized flat of strawberries, cinder-block sized bricks of cold cuts, the like--and headed back to the house to stick the perishables in the fridge before heading out again to pick up the kids from school.

Only, as usual, I got hooked on the doorknob. One of my back belt loops. And I had turned the home security alarm on before I'd left for the store, so now that was counting down the 40 seconds or however much time I had to punch in my code until the alarm went off. I calmly laid down my drum of peanut butter and body-bag-sized sack of raisins and went about calmly disentangling myself, only to grow increasingly less calm as the second continued to tick by and I was still caught on the spiral of the doorknob hook. Looking at it straight on, it seems like it should be easy enough, but looking at it from above and behind, for some reason I couldn't get my belt loop out.

The forty seconds elapsed, and now the external security alarm started to go off with a loud whoop whoop whoop sound which, in theory, would bring the police (or at the very least, a local citizen militia) running to help defend the old homestead. I began to panic. I had to turn off that alarm, but the security pad was at least ten feet away on the far wall of the kitchen. Plan A, the straightforward plan, was not working, so I thought: my pants. If I can't get my pants out of the doorknob, I had to take off my pants instead.

So I took off my shoes. I undid my top pants button and unzipped the fly. As I started to shimmy out of my pants it occurred to me that if someone did show up to investigate the alarm, what they'd find would be a pair of beige corduroys hanging from my kitchen door, and me, pantsless, standing in a scattered pile of bulk pistachio nuts, BUT NEVER MIND ABOUT THAT NOW, JUST TURN OFF THE ALARM, DUMBASS.

It took a little while longer to realize that it's actually pretty difficult to take off your pants if you can't pull your pants down--the pants were still hooked on the doorknob at waist-level, remember--when suddenly, I was free.  Free!  I KNOW WHY THE CAGED BIRD SINGS, FUCKERS!  What happened eventually was that the beltloop broke. Thank you, Gap Incorporated, for your shoddy tailoring. I hurriedly punched in the security code, stopped the alarm, and waited for the security company to call and make sure that I was OK, just like in all those commercials where the dark-clothed, stocking capped burglar (in broad daylight, like, nice camoflage job, guy) inexplicably tries to break into that house in where the mom and her daughter are baking cookies or whatnot else wholesome and good.

The security company never checked in, by the way. And while, yes, there was no real emergency, it was just me, my pants, and an over-designed doorknob, for all they know, I COULD BE DEAD. Whether it's a good thing or a bad thing that no one in this densely populated neighborhood came around to witness my shame, I can't quite decide yet.

next stop, Madame Pomfrey's

OK, not to make this page, like, HARRY POTTER CHAT or anything like that, but do you have a kid in your life who likes Harry Potter?  Because then by all means, if you're ever in Orlando, take them to Universal Studios and go to The Wizarding World of Harry Potter.  Because oh my god you guys, HARRY POTTER.




We were in Orlando last week for the annual meeting of the American Academy of Ophthalmologists, which basically gave us a great excuse to do something that we wanted to do anyway.  Universal Studios even had a night where they kept the park open for special extended hours for Academy members and their families, and while this meant that none of my outdoor pictures turned out at all (my cell phone camera does decently with low light conditions, but there are limits, after all), you'll just have to trust me that, perhaps especially at night, this place looked really magical.

The area is set up as some sort of amalgam of Diagon Alley and Hogsmeade, and while there were a few rides and a replica of the Hogwarts Express (which puffed smoke but didn't actually go anywhere), the area basically consisted of numerous storefronts (Zonko's! Dervish and Banges!) and food vendors (Three Broomsticks, scattered Butterbeer stands) in order to move Potter-branded merchandise.  And I realize that that's sort of the cynical reality of things, and that everything was of course ridiculously overpriced and designed to prey on your love of the books or your weakness for indulging your own children--but look guys, I'm not made of stone.  Kids, hope you're in the mood to stay up late, because WE BE GETTIN' SOME CHOCOLATE FROGS AT HONEYDUKES.




The absolute best thing at Harry Potter World though (and the one thing that Cal really, really wanted to see) was Ollivander's Wand Shop.




The wand shop was set up as more of a show really, where small groups of about thirty people at a time were escorted into the store and Ollivander picks a kid out of the throng to perform what they called a "wand-pairing demonstration." The demonstration is much as was depicted in the movies--Ollivander hands various wands to the chosen, instructs him to do some kind of magical task, and the magic goes all haywire until Ollivander finally picks the correct wand, at which point a spotlight shines and aaaaaahhh! a chorus of angels sings from on high because the wand has selected the wizard, blah blah magic talk.

This bit of whimsey, of course, is followed by the cold hard reality of them shuffling you out to the storefront where you have the "option" to purchase the special, magical wand that chose you above all others. (You'll notice that I put the word option in quotes, because really, unless you're some kind of steely-willed gorgon, there is no way in hell after that little show where your kid is looking at you with the wide-eyed wonder of oh my god, this shit just got real that you're not going to buy that thing. There's just no way. In fact, if you're really determined not to shell out for a wand, do yourself a favor and don't even walk in there.  I WARNED YOU.)




I do also find it ironic that it was the annual meeting for the American Academy of Ophthalmologists that led to a night of so many kids running around pointing long tapered sticks out in each others faces, but perhaps they haven't been doing as many ruptured globe or orbital trauma repairs as usual and want to make up the shortfall before year's end. Well played, ophthalmologists. Well-played.

lumos

I was excited when Cal started making the move from reading-as-deciphering to reading-for-comprehension because finally, finally, we could do nerd stuff together.  As a child endowed with neither facility at sports nor a particularly gregarious nature, I read a lot of books as a child, many of which I remember vividly to this day.  Not that they were all quality books by any means--I do think I read both "Sweet Valley High" and "The Babysitters Club" series in their entirety well beyond the age when I should have known better--but I read a lot of other books too.  And I read constantly.  I read at dinner, with the book in my lap under the table.  I read in the shower (note: not advisible).  I read on the subway on the way to school, and I read when I was outdoors, ostensibly getting some fresh air and exercise.  I read a lot.  So when Cal started to get to the age where he could actually start read on his own, for fun, I was super-excited, both for him, and for me to finally have an excuse to re-read the full Beverly Cleary opus.

And I have to admit, it was a bit of an uphill climb at first.  Cal liked being read to (I think I'd mentioned the "Illustrated Classics" series here already, and he particularly enjoyed the science-fiction-adventure story picks of that lot--your War of the Worlds, your 20,000 Leagues Under The Sea, what have you) but I still think he viewed reading for himself as a bit of a slog.  I got him some easier chapter books (in particular he had mentioned reading some of the "Cam Jansen" books at school--basically your standard kid mystery series, Case of the Missing Dinosaur Bones, that kind of thing--and while it didn't seem like great storytelling I did particularly like that the protagonist was a girl and her best friend was a boy who was always babysitting his baby brother) and Cal worked his way through a dozen of those, mostly when I asked him to.  But it still kind of felt like that to him: work.  He'd read two or three chapters after school, mostly on assignment, and then, duty dispensed, he'd go and do something he really wanted to do, like write the definitive illustrated reference guide to prehistoric reptiles or some such thing.

I figured I wouldn't push it.  I figured he wasn't ready.  I figured (and this I kept to myself, but with growing dismay) that not every kid loves to read, and just because Cal didn't want to read in the bathtub didn't mean that he wouldn't have a rich intellectual life.  (This was a recurring theme--many of my paperbacks from childhood and adolescence were more than a little warped from water exposure.)

I got the Harry Potter series for Cal...kind of...but also just because I thought they were books that were worth owning, period.  I expected Cal would like to read them eventually, of course, but I didn't really think he'd be quite ready for them yet--some of the writing and plot are a little dense at points, and the dialogue and vernacular is a touch continental (stuff like Ron exclaiming "bloody hell!" all the time, people referring to large groups of students as "you lot"--which I guess is the British version of all y'all) but, you know, I figure we'd have them lying around for later, and maybe Cal would pick them up and leaf through them if and when he wanted to.

A couple of months ago, we started reading "The Sorcerer's Stone" to Cal at bedtime.  We watched the movie.  Cal started getting interested, pointing out that while he liked the movie because it "showed what things look like," he liked the book better because it had details and some side plots that necessarily got dropped from the film version.  (I'd argue, actually, that they weren't judicious enough in their editorial process for that first film--have you tried to re-watch that thing?  God, it's like Exposition City, and it just goes on forever.)  We got through "The Chamber of Secrets," Joe and I reading most of it aloud, Cal reading some of it himself.  First he read it aloud to us.  Then I started noticing him silently reading it alone, while I was cooking dinner, or taking care of Mack.  We finished the second book and instantly he picked up "The Prisoner of Azkaban."  He started reading in the car.  I took him to Target the other day (to buy underwear for Mack, remember), and he was reading as we made our way down the aisles.  These past few weeks, we've been seeing more of this:




He has one of the lanterns from our camping trip in the bottom bunk of his bed, and he says up late, reading Harry Potter.  He begs us to let him read for ten more minutes, to let him finish the chapter, he'll go to sleep right after, but it's the part with Quidditch, mom, just let me finish the part with the Quidditch.  Right under our noses, he's made the jump from reading for comprehension to reading for enjoyment.

I guess the real conclusion from all this is something that no one needed me to point out, which is that J.K. Rowling is a very good writer.  That, and maybe we need to get a better reading light for Cal's room.

the underwear drawer




I can be a gunner as much as anyone else, but when it comes to my approach towards getting my kids reliably toilet-trained, my attitude can euphemistically described as...well, lackadaisical.  To be fair, that's their attitude toward the enterprise as well (toilet training is one of the few "big boy" things in which Mack has absolutely no interest--his approach towards pooping in a diaper is the same as Homer Simpsons take on littering: "It's easier.  Duh."), but we figured he's not quite ready and we're kind of lazy, so let's all kill the earth a little more and subscribe and save on Amazon Prime, shall we?  (Diapers.  I'm talking about buying diapers.)

Thankfully (?) the preschool that we're sending Mack to has a more hardline approach towards the matter, and now that he's moving up one level (from the two-and-a-half year-old classroom to the two-and-three-quarters year-old classroom, apparently) they are going full on immersion therapy.  No more diapers at school.  Only underwear.  Sink or swim.  Oh, and also, please send in four or five spare changes of clothes for the first few weeks.

We had a few pairs of underwear lying around (I had originally bought them about six months ago as an enticement towards the idea of toilet training--Mack cheerfully tugged one pair on over his diapers and and pair over his head and has continued to wear them this way ever since, so the bloom is kind of off the rose for that one) but this afternoon, in anticipation of the new, uh, addition to his curriculum, we bought a few more packs of briefs for the rotation.

I'm sure in the next few days we're going to be pretty sick of washing these things, but you have to admit--those teeny tiny underoos are pretty freaking cute.

where context is key



The season that it is cool enough to wear sweaters and scarves, but not cold enough to have to wear those big poofy winter jackets.  Since we live in Atlanta, weather like this will last until, oh, just around Thanksgiving, and resume probably by the end of January.  Not a bad deal.

(Also, if you're thinking that the only reason to have kids is to dress them up in cute little clothes for the fall, you're 75% right.  The other 25% is to legitimize buying a lot of Halloween candy.  DO IT FOR THE CHILDREN.)

Anyway, this spawned a good amount of discussion on Twitter when I first posted it, but I just wanted to open it up here in the > 140 character arena.  An article in The New York Times today detailed the growing trend of non-physician practitioners (such as, to give one example, nurse practitioners) introducing themselves as "doctors" to patients in a clinical setting.  One argument is that, as someone with a doctoral degree, they deserve the honorific, and earning these doctoral degrees (I'll quote directly from the article here) "can help them land a top administrative job at a hospital, improve their standing at a university and win them more respect from colleagues and patients."

My personal take is this: indeed, anyone who earns a doctoral degree has earned the right to be called "doctor."  No one is disputing that, or taking respect or recognition from anyone who has earned that doctorate.  But I would also point out that the term "doctor" has a very specific meaning in a clinical setting, and that the shades of grey ("I'm not a medical doctor but I do have a doctorate in nursing,") can be confusing or simply lost on a patient or their family, especially in the setting of an already complicated interaction in the hospital.

Some people argue that there is ego involved, and I don't doubt it--and might I point out there's likely a lot of ego on both sides, from the physician side for wanting to "defend" the title of doctor, and from the non-physician side in their desire to assert their own rich and well-deserved credentials.  But like with most things in medicine, context is everything, and if we can all agree that the shades of differentiation of the term "doctor" are particularly fraught in the clinical milieu (and thus confusing to patients) perhaps ego can and should be put aside in the name of transparency.

There is also the issue of responsibility.  In most situations in the hospital, the physician has the ultimate responsibility for the patient and what happens to them.  As the physician, I am the bottom line, and whatever happens "under" me (someone misinterprets my order, a medical trainee under my supervision causes patient injury, a medication error occurs not directly because of me but under my watch)--in the end that's my responsibility and no one else's.  When I introduce myself as "Doctor Au," that's part of the implicit understanding, and patients need to enter into that doctor-patient relationship where trust and the assumption of that ultimate responsibility go hand in hand.  It may not seem like more than semantics to some people, but when you present yourself to a patient as their "doctor," in a hospital, that has to mean something very specific, for the understanding and ultimately the protection of the patients under all of our care.

In my mind, if someone calls themselves "doctor" during a professional interaction in the hospital, I assume that they are a physician, and I think I'm safe to say that most patients feel the same way.  Just the same way that, if I'm in a college French class and the professor introduces him or herself "Doctor Webb," I assume that they have an academic doctoral degree and don't start, you know, taking off my clothes and showing them my rashes.  In medicine, context is everything.

(Incidentally, on the flip side, if a patient asks me to call them "Doctor So-and-so," I will absolutely oblige them, no questions asked.  But then again, I will pretty much call a patient whatever they ask me to call them, including the one patient I had who specifically requested that, when we woke up him up from anesthesia after surgery, we address him as "Big Poppa" because it was the only name he really responded to.  No problem, uh, Mr. Poppa.)

quality

Yesterday I had to take Cal for a checkup at the video-game-magical-treasure-chest-flat-screen-TV-playing-wall-to-wall-cartoons emporium, also known as the pediatric dentist's office.  Can I say, first of all, how awesome I think the culture of pediatric dentistry is?  Getting your kids--or at least my kids--into that chair is kind of a hard sell, but they sure hit that right combination of bribery and computer-animated video hypnosis to make it a much more positive experience.

Anyway, the only appointment I could get was at 10:00am, which means that Cal missed the morning at school, and when I saw what time it would be by the time I dropped him back off (after lunch, halfway through recess, with only two hours left before dismissal) I decided to just get his assignments from his teacher and keep him the rest of the day for some quality time, just him and me.  It's something we don't get to do very often.  We need to do it more.




The fact of it is, although I talk about Cal much more on this blog (first pass effect, I guess), Mack actually much more attention from me when I'm home.  The thing it is that Mack is little, and just in terms of the activities of daily living, he needs a lot more minute-to-minute maintenance, whereas Cal I can just tell to go do his homework or go read a book or please wash your hands and get ready for dinner.  He's pretty well-behaved too, which means that for the most part, he doesn't need me on top of him for every single last detail.  Which is good of course, but when you work a lot and have two kids, I think it sometimes means he gets less actual time with me outside of the purely purpose driven tasks and me prodding him to hit all the points he needs to hit before bedtime each night.

Yesterday, we went to the dentist.  Then I took him out for lunch at Five Guys Burgers and we stopped by Staples to pick up one of those plastic report covers for a school project due next week before finally heading home.  The dentist, burgers, and a plastic report cover.  But just him and me.  Cal told me later that it was one of the best days ever.

I told him we'd do it again soon.

second opinion

Yesterday after I gave my Grand Rounds (which went well by the way, at least to the extent of my experience giving it), I was in a good mood and celebrated by taking my car to the fixit shop.  Well, actually, the second thing had nothing to do with the first, it just sounds more festive that way.

All the important mechanics were fine (you know, like the wheels, the engine, the other...drive...pistons), but there was something wrong with my trunk. To be clear, the trunk was working JUST FINE up until we went camping last weekend, when:


JOE
Hmmm.

MICHELLE
What "hmmm"?

JOE
Could you open the trunk of the car before?

MICHELLE
You mean was I able to open it earlier today?

JOE
Yeah.

MICHELLE
Well, of course, that's how I crammed all those sleeping bags and blankets and camping stuff in there.

JOE
Hmmm.

MICHELLE
WHAT "HMMM"?

JOE
I think I just broke the lock on your trunk.


The trunk could no longer be opened by the car key itself, nor by pulling the lever in the driver footwell, though oddly, the remote control keychain button still worked.  I didn't think this was a big deal at all--usually I open it with the remote anyway--but Joe pointed out that if we ever lost the keychain or it malfunctioned, we would be toast.

"OK, so I'll stop locking the kids in the trunk then," I responded (I thought) quite reasonably.

Joe made me take the car in anyway.




The car fixit place (I just took this one picture there of the pretty rust pattern, though I realize this photo makes it look like a vehicular internment camp--not that far off, I guess) told me that I should expect to leave my car there for at least the rest of the day.  They would most likely have to dismantle the whole trunk, replace the lock apparatus en bloc if (IF, they emphasized portentously) they could locate the correct parts, a process that might take a day or two.  When I balked at the day or two (or two? Two days?  TWO EARTH DAYS?) they replied that they would make their best effort to at least have the car in drivable condition by nightfall, though under no circumstances (they underlined this with an eye-roll, to illustrate how crazy this would be) should I expect the trunk situation to be anywhere near fully resolved without another one or two visits for full repairs down the road.

Anyway, I thanked them for their opinion and diagnostic time, and proceeded to take my car to a Toyota dealership across town.  (Not to ruin your fancy doctor car dreams, but I drive a used Toyota Camary with a sizeable dent on the rear drivers side.  If you see me on the road, say hi, I'll be the one gripping the steering wheel in panic.)  At the dealership, the guy looked at my trunk for two seconds, clicked something over in the lock mechanism, and said, "There.  You're good to go."

Apparently we (Joe) had automatically engaged the trunk into "valet mode," which I wasn't aware existed but I guess is what you do if you are getting your car valet parked but don't want the parking people to look into your trunk and see you stash of dead bodies or whatnot in there.  The trunk wasn't broken at all.  It was such a no-brainer the people at the Toyota place didn't even charge me.

So from a multi-day, labor-intensive, thousand-dollar estimate to a problem that was fixed with a seasoned eye, some common sense, and a flick of a switch.  I guess this would be a good time to draw an analogy back to patient care, but I think you can probably take those last few steps on your own.

country roads

And...we're back!  





We spent the weekend camping at Red Top Mountain State Park, and if I can say one thing for North Georgia, it's that they do their nature up right, son.  This is the first time we've gone camping as a family, but Red Top Mountain on Lake Allatoona, less than an hour north of Atlanta, was impressive--gorgeous, seemingly remote without actually being so, and (to my inexperienced eye) incredibly well maintained.





 


The pictures kind of make it look like we trekked out to the middle of Nowheresville, but it was hardly a survivalist exercise--there were park offices and picnic shelters, bathrooms and showers, even a mini-golf course near the campground rental office.  There were a range of different sites available, but the one we got had a fire ring, a water pump, concrete picnic table, raised tent pad, and two electrical outlets.  You know, so we could plug in our Wii.  

(To be clear: we did not really bring a Wii.  It was nice to have power to pump up the air mattresses and charge our cell phones, though.)





The kids obviously had a good time, and were a little crestfallen this morning when we got ready to go home.  Given the effort of getting there and setting up our campsite just so, I can see the argument that going for just one night is a waste, but I just did not want to shower at a campgrounds, and 24 hours was basically my aseptic limit.  Maybe next time we'll stay for two nights.  Maybe.




The hobo stew was a great success, to the point that I'm thinking I might just make up similar packets to stick in the oven for the kids' dinners on nights that I'm working late.  Someone in the previous entry's comment section pointed out that I had folded my packets wrong, but I'm pretty sure that there's not that much nuance to the fold--the main goal of a hobo stew packet is just making sure that your ingredients stay in and that the ashes stay out, and that you you a thick enough foil (or enough layers) to make sure that the packets don't rip when you flip them.  I put precooked chicken-herb sausage, peppers, roasted corn, potatoes, and butter in our packets--there was a little sear on the sausage in the end, but unsure of the timing of the cooking process (in particular the potatoes, which were raw and take longer than anything else), I leaned towards going a little over on time.




The night was fitful at best.  Joe an Mack both snore (I'm aware that a two year-old probably shouldn't snore, but he's had a stuffy nose so I blame that--I also would like to throw it out there that I don't know a single anesthesia provider with a family member that snores who has not tried to do a chin lift/jaw thrust on them at some point) and Cal, while silent, sleeps with the ponderous and deliberate pinwheeling motions of one doing somnambulist Tai Chi.  So there was the snoring and the kicking and the air mattress adjustments and the crickets and then the more snoring, until finally, at some point, it became morning.




All in all, camping was actually pretty fun.  Things I'll remember for next time:




1.) Bring a change of shoes for everyone.  It would have been nice to have slip-on shoes at the campsite for getting in and out of the tent, and besides, Mack walked through so much water and mud that his shoes were completely soaked through.




2.) Christmas lights!  Once it started getting dark it got, like, really dark, and I saw that some of the more experienced campers around us had strings of Christmas lights that they used to ring their tent sites.  Not only did it provide great ambient light, but it looked a hell of a lot more festive and warm than our two puny LED lanterns and Cal's tiny headlight.

3.) Less food, more drinks.  I brought a lot of food (thinking, perhaps, of the Donner Party), but knowing that there was water on site, I only brought a mess of juice boxes and some milk for the kids.  The water that came out of the pump at the campsite looked clear and smelled fine, but last I checked you can't see Giardia (colloquially known as...snerk..."Bever Fever") with the naked eye, so we boiled all our water before drinking any, and the kids were not really wild about drinking warm water.




4.) Our own stash of firewood.  Joe made a last minute trip to the hardware store to get a couple of cords of wood, which was lucky because it had been raining the few days leading up to our trip and though it was sunny all weekend, everything on the ground was damp.  We brought three bags, but we used it all up and we were only there one night.  Add to that point: more kindling and an extra one of those Bic firestarter sticks probably would have been a good idea too.




Anyway, it was a nice weekend.  Now that we have a little more of a system down (not to mention most of the gear), we'll definitely be back to camp by Lake Allatoona again--and maybe next time, we'll get there early enough to get a campsite directly on the water.

outward bound

Against what I consider to be one of my better instincts (and I would classify most of such instincts to be related to maintaining integrity of the integumentary system and related parts), Joe and I decided that we're going to take the kids on a camping trip this weekend.  I have nothing against wholesome family fun per se, and despite my bookish and wan appearance have even been on a camping trip or two in my own youth, but here, in no particular order, is a list of some things I hate, and which make spending a night in the woods a bit of a hard sell:
  • Being dirty.
  • Being cold.
  • Bugs.
  • Not being able to take a shower.  
  • Sleeping on the floor.

(Is hate too strong a word?  Maybe.  And yet...you've seen bugs, right?)

Anyway, I dislike many of the elements of camping, but be that as it may, we're going camping this weekend because it seems nutritious and cleansing somehow, the spiritual equivalent of a high-fiber cereal, and besides the kids have been begging us to go camping for almost a year now.  Who am I to cruelly deny them the simple pleasures of getting a billion bug bites and then tracking dirt clods and sweat into the sleeping bag, where I will spend a fitful night tossing and turning, maintaining a state of cat-like readiness in the event of bear attack or chainsaw massacre?  Only their mother who loves them, THAT'S WHO.

(Did I also mention that there's no Wi-Fi in the woods?)

Anyway, I exaggerate my low tolerance for All Things Nature, but to be fair, I like looking at fall leaves and verdant vistas just as much as any of my other vaguely geriatric pastimes, so we're all actually pretty excited about our camping trip.  So excited that, in the spirit of the proceedings, I even made four servings of "hobo stew" to bring with us and bury in the coals for dinner.





(If you are guessing that I was mainly swayed by the appending of the descriptor "hobo" to anything, you are correct, but our hobo stew contains chicken herb sausage with garlic and shallots garnished with a not insignificant amount of butter, therefore promising to be, if not tasty, then at least filling.)

We're leaving tomorrow morning.  Real-time Twitter updates for your fish-out-of-water amusement as iPhone connectivity allows, otherwise have a good weekend and we'll catch up when (and if) we return.

warning

I've got to say, once I finally figured out how to make a mouse-over image change (and granted, it wasn't that hard to do but you'd never be able to tell from how long it took me to figure out how to get it right), I just want to make a mouse-over image change for everything.  EVERYTHING.




But I guess I'll just quit while I'm ahead.

break Joe's website

So as you all know, Joe recently switched jobs, so for the past week or so I've been trying to help him build a professional website (professional meaning for work, not as in designed by a professional) because how else are patients ever going to find him and know how awesome he is?  My proposal went like this.


MICHELLE
You need a professional website.

JOE
I do?

MICHELLE
It has to have your credentials on it, and all the information about the surgeries you do,
with, like, "Before" and "After" photos and contact information and post-op instructions
and such, because blah blah blah online presence marketing Internet searches social media blah.

JOE
What is an "Internet"?

MICHELLE
Let me...just do it for you.


So we made this:



I designed and built the site, while Joe provided the content.  It's still a work in progress, but I think it's starting to look...pretty decent.  I personally have a bias when it comes to doctors' work sites--many many of the plastic surgeon websites I've seen I think come off a little too glitzy (and I realize that this is somewhat dictated by the nature of the work and clientele, but there comes a point where patients may have a hard time telling if they're researching a doctor or reading US Weekly).  For Joe's site, though, I wanted a simple, clean interface with all the medical information and professional credentials easily available. Joe does such good surgery and his professional pedigree speaks for itself, I thought it would only be distracting at best and cheapening at worst to gild the lily with, like, animated lens flare effects and an Enya soundtrack.

But anyway, do me a favor and look at the site. Look around on all the pages and see if they read well, click on the links to make sure they all work. I know some of this is a matter of personal taste, but does the website flow well for you?  Is there anything not on the page that, as a patient, you would want to see? Click around a lot, roll around, try to break it, think of it as a couch at Ikea that you're trying to decide to buy for your family room, then e-mail me or leave a comment to let me know what needs to be fixed.  Remember, this is still a work in progress (in particular, I have an "FAQ" section and a "Patient Testimonial" section that we're still working on) but in general, how does it look?

As for the subject of trying to build a website with your spouse looking over your shoulder, I will add this conversation from this morning.


MICHELLE
(Painstakingly editing HTML to adjust photo alignment and spacing, because the Blogger 
"compose" interface is a piece of doo and has already taken years off my life.)

JOE
Hey, you should try to use HTML!  Or something!  For the website!

MICHELLE
(Pause)
Have you ever seen that site, "Clients from Hell"?

JOE
Yeah, you showed me that once.  Hey...why are you bringing that up now?

MICHELLE
No reason.


Thanks guys!

(By the way, I've test-driven the site on Google Chrome, Safari and Firefox and it renders decently on all of them so far as I can tell--however, if you're using some kind of antiquated browser, NO PROMISES.)

as time goes by

I don't really know what this says about me--probably nothing good--but I'm glad that September 11th doesn't fall during the work week this year.  Something about the idea of having the day, in all its past, present and future incarnations, commentated on relentlessly on the TV in the anesthesia lounge (I was going to say CNN but to be honest it seems that the default setting is usually Fox News) is more than I really have the stomach for.  As a native New Yorker who was in the city on the day of the attacks, I, like many, still feel that it's a little bit of a tender spot.  And I think I've talked in the past about how much doctors dislike having feelings.

Ten years later, the events of September 11th have arrived at their final resting place in history, though it's hard for me to put my finger on exactly where that is.  More often then not now, when I see it referenced (and granted, I no longer live in New York), it's held up as an emblem more than anything, or used as a supporting argument for this that or the other thing.  It's the stuff of decals, of commemorative plates, of tattoos and of posters.  And it makes it feel important but distant, like something horrible you'd read about in a book but hadn't actually lived through yourself.  The distance is inevitable.  Time makes everything less raw, a little less messy, and filters our memories through experience.

We even have a whole other language for it now.  September 11th is now "nine eleven."  I remember on the day of the attacks one of the doctors in the OR was speculating whether or not there was any significance to the fact that the date spelled out "9-1-1," as sort of a wink to the emergency response system that would surely be activated.  We didn't know to call it "nine eleven" then, the date itself at that time was nothing special.  In the weeks to follow, the smoking craters where the Twin Towers stood and where remains and debris were being excavated were still being referred to as "The Pit."  Not until later did the language of "Ground Zero" take hold, though now, you say "Ground Zero" in reference to Lower Manhattan and everyone knows what you're talking about.  Why do I bring this up?  I don't know.  Maybe because it's midnight and I'm on call and too wired to go to sleep.  Or maybe because, as strange as it sounds, I miss there being a time where that whole other language didn't yet exist.

Joe and I broke up shortly before September 11th, 2001, did I ever tell you that?  I probably didn't, it even in those early days of my blog I didn't exactly consider it grist for the mill, and I can't even remember why it was that we had broken up at the beginning of our third year of medical school, shortly after our OB rotation in Stamford, CT.  (I blame OB, personally.  Or maybe Stamford.  Probably both.)  Anyway, we'd broken up for some reason, and it was weird and awkward, because we were still in the same clerkship rotation group after all, and we still had to see each other every single second and act all normal and professional, which if you don't think was torture you've obviously never dated anyone before.  On September 11th, we were on one of our Surgical Subspecialty rotations, which I thought was a blessing because we got split up into smaller groups--I was rotating on Pediatric Urology, whereas Joe was, I think, rotating on ENT (Otolaryngology for your purists out there) in an entirely different part of the hospital.  It was a relief to be away from him, so I thought.  But after those planes hit that day, Joe was basically the only person I wanted to be with.  Six months later, we were engaged.

I don't really know what my point is with all this, and I know it sounds incredibly short-sighted or even mean-spirited to begrudge the way that the events of that day have become more totemic than real.  It's just that I can't help but to think that way.  It wasn't a T-shirt.  It wasn't a bumper sticker.  It wasn't a picture on a TV.  It was real.  The little things make it real, and each year that passes, the edges of those little things becomes increasingly softer.  But I still remember.  The blaring radio at the bagel store across the street from the hospital.  The smell of that fall morning walking into work.  The jungle animal print cap the anesthesiologist was wearing in the OR when we heard the news.  The way the smoke looked rising up to the sky, thick and billowing at the base, then spreading out into a blanketing haze.

It was real.  It happened.  We were there.  And you can print as many banners and lawn signs as you want, but New Yorkers don't need to be told to "Never Forget."  Because we never will.

ch-ch-ch-changes

When I'm not trying to work or sleep or keep my fool kids from killing each other (it's sweet actually how much they love each other--they hug and kiss and everything, which if you don't think is adorable I have some concern for the cold black granite that is YOUR HEART--but hand-in-hand with this adorable snugglefest is the fact that they fight like puppies crammed into a wicker basket only given one very small squeak toy to share) sometimes I try to update this blog. Clearly I have failed these past two weeks. But that Virgina Apgar thing was still pretty cool, wasn't it?

(Crickets.)




The big news these past few weeks is that Joe has left the world of academia and has now joined Paces Plastic Surgery, an excellent and highly respected plastic surgery group in Atlanta. It was tough to leave the university setting, but we're all very proud of him and excited for his prospects. To be totally honest, Joe is one of the very best doctors I know, and he cares about people and families more than just about any practitioner I've ever met. His patients are very lucky.  So here's to new beginnings for him, and for us.




Cal has been...well, Cal has been great.  You probably remember that I had some reservations prior to the start of this school year (we just switched schools, after all, so I had some concerns about the, shall we say, elasticity of the curriculum) but we've been pleased and actually delighted at how attentive and responsive his teachers have been, especially given that we'd actually not said anything to them at all.

"Maybe we should tell them to give him some harder math problems," Joe said near the beginning of the year, as we looked at Cal's homework (which was a giant worksheet of, essentially, counting problems).

After I duct taped him to his chair and stuck a sock in his mouth, I hissed at him don't you dare say anything, because it was the first week of the school year and the last thing I wanted to do was position us as the insane pushy Tiger Parents who don't know when to shut up.  I wanted to trust the teacher to make that assessment on her own.  Cal had a long history (particularly in preschool) of being perfectly able to do things well, but being too stubborn to show anyone that he could.  It led to talk of remediation a few years ago, for chrissake.  So I figured, just let it be for now.  Cal would either show what he could do, or he wouldn't.  And the teacher would make an assessment of what he should be doing, or she wouldn't.  But the first two weeks of school was way, way too early to start inserting ourselves and insisting that, HEY, MY KID CAN READ HARRY POTTER AND DO MULTIPLICATION, ARE YOU DOING HARRY POTTER AND MULTIPLICATION IN SCHOOL YET?  There's a fine line between advocacy and just being a pain in the ass.

So we didn't say anything.  Cal has been having fun at his new school.  He loves his teacher.  He is making new friends. These are the big things.  But also, on the other end of things, his teacher has told us that she's going to start pulling him out of their regular math class and that the "Enrichment" teacher is going to design some special extended projects for him to do during that time so that he doesn't get bored.  This really makes me happy, because the worst thing that could happen to Cal would be for him to become disenchanted with school--already he's asked me why, if school is so easy, does he have to go every day.  (Because of THE LAW, son.)

Anyway, I'm really impressed with the school's flexibility, it's certainly beyond what I had expected, and I'm even more glad that they came to that decision outside of me or Joe pushing anything.  Or perhaps it was Cal doing the pushing, as he'll regularly finish up his homework, and then, on the blank page on the back, write himself an entire new worksheet of more difficult math problems, and then finish those too.

I'm proud of my boy, is all.

(ASIDE FROM MEMORY LANE: When I was in fifth grade, I remember the teacher letting me and this other boy, Frances, do our own writing activities during the phonics curriculum, because phonics was, well...pretty ridiculous.  So what Frances and I decided to do was a booklet of political cartoons centered around the 1988 presidential elections, where we lampooned each candidate, as well as the sitting president at the time, Ronald Reagan.  I believe there were a couple of comic strips featuring Mikhail Gorbachev as well, and I remember studying his nevus flammeus very carefully so I could draw it just right.  And that, friends, is what you call a Baby Nerd.)






It's probably been observed to the point of stereotype that after a bringing into the world a particularly bookish, adult-oriented child, your second child is bound to be the human equivalent of a monster-truck rally, and that is most definitely the case at our house.  Mack is like...well, he's like a Mogwai.  Starts off real cute, ultimately destructive, and should not be fed after midnight.  (If it turns out he starts multiplying in number after he gets wet, however, we're in big trouble.)




The weather has finally started getting cooler here, and after four straight months of 90+ degree weather, I could not be more ready.  It's been a long summer, but autumn smells like beginnings.

"my dear Doctor Whipple..."

I was doing some internet research today when I happened upon some copies of the original letters written by Virginia Apgar (yes, that Apgar) to Allen Whipple (yes, that Whipple) concerning the formalization of medical training for perioperative care, into what would eventually become the Department of Anesthesiology at Columbia Presbyterian Hospital.




Now I don't know if it's just because I'm a dork (certainly) or because the players were such medical legends that getting a chance to read their correspondence (along with handwritten notes jotted in the body and along the margins!) feels like watching history unfold in real time.  Or perhaps it's just seeing that familiar address on that old letterhead--the correspondence below detailing the formation of a department where, seventy years later, I myself would train--that got me all goose-bumpley.   But certainly, there's a reason that these were called The Days of the Giants, and Virginia Apgar no doubt stood tall among them.




For more on Dr. Apgar, they have quite a trove of biographical information, pictures, and letters in the "Profiles in Science" section in the National Library of Medicine.  Definitely worth checking out if you're a medical history wonk.  Or just look at this picture of C. Everett Koop and wonder why people don't grow beards like this anymore.

mack cheats at air hockey


AND NOW THE WHOLE WORLD KNOWS IT.

the taller it grows, the lower it bends

I know I haven't posted a lot this last week, but here, just because it looks so darn mystical, are some pictures of my kids in a bamboo forest.




 




It looks like the freaking mountains of China in those pictures (and frankly, in real-life as well), but it's actually just the back edge of a cluster of homes just a block or two off a major road here in metro Atlanta, right near hospitals and malls and giant highrises.  Atlanta, you are one weird city.

(I'm just going to put this part here because, next to medical stuff, photography is quite possibly the thing I get e-mailed the most frequently about: the square pictures I post on this blog (but more frequently here) are taken with my iPhone using the Hipstamatic app, with the lens and film combo that come with the app itself--John S lens, Ina 69 film.  I've tried many, many other photo apps, and this app, with this combo, is still my default, because in my opinion it produces the best quality pictures in the right lighting conditions--ideally natural light in partial shade.  On a broader note, the advent of digital photography overall has turned the hobby from a fairly expensive one to one that, minus startup costs, is essentially free, and one that more than ever can be both personal and public.  As much as I like my "real" camera, until digital cameras start adopting some of the smartphone features that allow you to instantly share photos online, my smartphone camera is the one I'm using basically 95% of the time.  Because the best camera is the one you have with you when you want to take photos, right?)

Apologies again for the lack of updates.  To be honest, we are going through a little bit of professional upheaval at the moment--nothing catastrophic, but also nothing that I can talk about here very much here, so I'll just leave it at that for now.  I hope you're all doing well and that you're enjoying the tail end of your summer.

** Residents of Los Angeles!  Tomorrow at 11:00am your time (2:00pm my time) I will be doing a 50-minute live interview with Allen Cardoza and Dr. Melody Foxx on LA Talk Radio on their show "Answers for the Family," about the book and issues related to families and whatnot.  I don't actually know what we're going to talk about actually, so tune in, find out with me.  It's a live interview, right? THOSE ARE ALWAYS EXCITING, in that Christians and lions kind of way.  (It also looks like they post the audio for their shows afterwards as well, so for non-Californians, I'll get the link up here after it's done.  Unless the interview is terrible, in which case I'll just bury the evidence.)

up the creek, no paddle

On call at the hospital yesterday, I had a beautiful grand scheme: finish rounding on my service first, then afterwards, reward myself with cup of coffee and some breakfast.  I was just in the middle of talking to the last patient on my list and trying to decide whether I should get bacon or cheese grits (to be honest, probably both) when then announced a code overhead in the ICU.  Ten hours later, I had my first meal of the day, which was a handful of Twizzler nibs crammed into my gaping maw as I waited for the water to heat up for my ramen noodles.  I only tell you that because the old adage they tell people in medical school is true.  Eat when you can, because you never know when your next meal will be.

Anyway.  That was yesterday.

One of the things that I find wonderful about Atlanta (and while my heart will always be in New York I am not immune to the charms of the South) is how much public green space there is everywhere, even within the city proper.  Joe and I were trying to figure out what to do with the kids this morning--I'm still on "backup" call today and didn't want to stray too far, but Cal and Mack were acting like one of those nature shows where hatchlings turn on each other and eventually cannibalize the runt.  (Unclear who is the runt and who is the Alpha in this equation, I guess if I was interested in finding out I could have just let their youthful exuberance play out to its eventual gruesome conclusion, but I just cleaned the floor last week.)

Anyway, Mack has been talking and talking and talking about going fishing for weeks now, and barring the freedom to go to any actual fishing spots, I pointed out that we did, in fact, have a nature preserve about a block away from our house.  To call it a "nature preserve" is, in fact, a little grandiose--it really just amounts to a creek that runs a few miles behind a stretch of residential housing and listlessly spreads into a nearby duck-and-turtle pond--but it's close and there's water in it, so off we went.

There was a sign at the trail head with notations on various animal tracks (Bobcats? Really?) which I was inclined to breeze by, but of which Cal made very careful notation.





When we got to the creek bed, the water level was very, very low--I guess we've been a little minus on rain lately, and what little water there was amounted to a trickle of ankle-deep runoff with a few minnows in it.  No matter.  A stick with some twine and a pinecone tied to the end was all Mack needed to amuse himself for the next hour.







I think Mack was fully expecting to catch a fish, and I'm just glad that he didn't pitch a fit when his dangling pinecone failed to attract anything more than assorted natural detritus from the creek bed.  Cal did a little "fishing" too, but spent most of his time amusing himself by skipping stones on the water and playing with a tire swing that someone had fixed up down near the water's edge.  I think it would have been a little more thrilling had the water level actually been higher, but I think he had fun all the same.





Mack, looking admiring, then apprehensive.





So actually, that was pretty fun.  What I always tell people about New York is that there's so much to see and so much to do that you'll never get bored, and that much is, of course, true.  But to live in the metro area and yet have a nature trail and a creek a three minute walk from our front door?  For my kids, I'll take that too.