sink or swim

Hope you're having a good Memorial Day weekend, everyone.  As we enjoy our holiday, of course let's not forget our brave men and women in the armed forces, without whom this beautiful summer weekend with our families and loved ones would not be possible.

In the States, Memorial Day marks the official start of the summer season, and this makes me realize that the idea of summer, to someone in or recently departed from academic medicine, is very different from the idea of summer held by the rest of the population.  For most, summer means school's out.  Summer means vacation.  Summer means sunshine and barbecues and leisure.  But for the eight years that I was in academic medicine (I'm leaving out the year that I was a first-year med student, since first-years usually get their summers off, though they usually spend the time doing something unbearably earnest), summer meant one thing: new beginnings.

The Gregorian calendar begins in January, and most schools from elementary to university begin somewhere in the neighborhood of August/September.  But in medicine, the new year always begins towards the beginning of the summer.  One chapter ends, another chapter begins.

During the summer, usually on or close to July 1st, everyone in academic medicine moves up a peg.  Third year med students become Sub-Is.  Interns become residents.  Residents become new attendings.  New people come in to fill the spots vacated.  Everyone is in new roles, figuring out what they're supposed to be doing.  Want to know why the conventional wisdom is that you should never be admitted to a teaching hospital in July?  That's why.

Here's an excerpt from my book that I was thinking about today, and after the excerpt I'll tell you why.

A sub-internship, or “Sub-I” (as it is known to those of us who cannot get through a sentence without acronym or abbreviation) is basically the training bra of residency. It is a pre-requisite for graduation from medical school, consisting of a month where we assume the patient load and care responsibilities of a first-year resident (or “intern”), albeit with the increased supervision and support required by logic and law. It is a dress rehearsal for the real thing.

In one sense, being a Sub-I the logical progression from being a third year medical student. See one, do one, teach one is one oft repeated credo of academic medicine, and after a year of watching residents in action, it seems due time for us to start “doing” on our own. Sounds reasonable enough. However, the reality of the transition from third-year med student to Sub-I is more like being lifted dripping from a knee-deep wading pool in which beach balls and foam noodles lazily float, and thrown headfirst into the churning ocean, your only instructions being to keep your head above water and not die.

So.  Cal learned how to swim today.





He's going to be six in about two months, so he's definitely not, shall we say, precocious in his mastery of water survival tactics.  He had all the requisite skills to swim, but mostly he's just been kind of nervous around the water.  Didn't like to put his head in.  Didn't like to be in the pool without a flotation device.  Worried about getting water up his nose.  Worried about sinking.  I don't think he quite trusted, despite a number of increasingly scientific demonstrations about human tissue and buoyancy, that he would float.  Being a bit of a late swimmer myself, I remember that feeling well.  But I also knew from my own experience that all it would take was one moment--one leap of faith, or more accurately a second of forgetting his own doubt--for him to realize that yes, he was going to be OK in the water after all.

It's med school graduation season now, of course, and I hope it doesn't sound disingenuous (because it is quite simply the truth) that I often think about the crop of newly minted practitioners joining us in the real world.  And look, I don't have any good advice, I'm new enough at the game that I'm still trying to figure things out for myself.  But there's going to be a moment for all of you when you look up and realize that you're doing something that you didn't think you knew how to do.  That something you practiced and practiced and practiced somehow, likely while you weren't paying attention, became automatic.  That in the recesses of your brain, you actually knew something, remembered something, that will help an actual patient in your care.  It's that moment--the leap of faith, the forgetting of your doubt--that's going to make you realize something that you're only being told now and may not quite yet believe.

You're a doctor.

Welcome to the team.

these are all good questions




CAL
What is "Ribs Et-cuh?"

MICHELLE
Oh, that says "Ribs Etcetera," it's a sign for a barbecue restaurant.

CAL
Why does it have a pig on the sign?

MICHELLE
Because that's the kind of meat they serve at the restaurant, honey.

CAL
They serve pigs?

MICHELLE
Well, you know, different kinds of meat come from different animals.  Like remember,
how steak comes from cows, and how chicken comes from, uh, chicken?

CAL
Yeah.

MICHELLE
So the meat that comes from pigs is used to make a lot of things,
like bacon, and ham, and ribs, which is one of the things they serve at that restaurant.

CAL
Oh.

(There is some silence.)

CAL
So how come the pig is smiling?

MICHELLE
Uh...


more text message exchanges in the two doctor household

JOE
How's it going?

MICHELLE
Good. Finishing a case now.  You out of the OR?

JOE
Yup.

JOE
Totally nailed a big cosmetic reconstructive case today.

MICHELLE
You should really use sutures, not nails.

JOE
D'oh!

hoarders

There's this stroller that Joe keeps getting after me to put on Craig's List, because all it's doing is taking up space in our house, and neither kid has used it for the purposes of transport in the past year and a half at least.  Atlanta, unlike New York, is not a real stroller-intensive city.  There is occasional use for a stroller, like at the zoo or something, but on the whole, Atlanta is so car-centric that it's not like New York, where everyone has their one-hand-fold umbrella stroller that they carry, kid and all, up and down the subway steps.  Especially now that Mack is older, he really doesn't need a stroller, unless we're doing a lot of walking, which, as I think I just noted, just doesn't happen in Atlanta, unless you're the kind of person who just walks to and from places for no reason at all.  (Yes, yes, I know, "exercise.")



I don't want to sell the stroller.  I resisted selling it before we moved, and now that we actually have moved and the stroller is just becoming more and more obsolete, I'm still resisting selling it, though I really can't come up with a real sound reason why.  It's a good stroller.  We got it when Mack was born.  It's a double stroller, the kind where you can put one bigger kid in the front and one smaller kid in the back.  It's a narrow profile, so it's good for cities or supermarkets.  It's a nice bright green color, so it's highly visible to oncoming traffic and to satellites in outer space.  But it's pretty much strictly ornamental at this point.  No one uses this stroller.  It's just sitting there by the front door, holding a pile of winter jackets.  If we sell the stroller, we could use the money we get in exchange for goods and services.

But I still don't want to sell the stroller.

See, the thing is...we have two kids.  I love my two kids.  I really can't imagine having a third kid, nor, honestly, can we really afford it at this point, time or money-wise.  But.  But.  When I think about selling this stroller, selling this perfectly good double stroller, I keep thinking, "But if we have another baby, we can put the baby in the back and Mack can sit up front!"  Are we trying to have a baby at this moment?  Not even close.  But might we, at some point, decide to have a third kid?  I think I'm more open to that option than Joe is at this point in time, but I think we'd both agree that we won't rule anything out.  But given that, given the possibility, wouldn't getting rid of this stroller, this perfectly good double stroller with an infant attachement in the back, be kind of a waste?

Yes, I know I can sell the stroller so it's not sitting in my front hallway taking up space.  I know that if and when we decide to have another baby (and by no means is this a foregone conclusion) we can just get another stroller.  Think of the stroller technology as it might be in the future!  They might have strollers that hover and steer themselves!  Also, robot nannies!  So I should just sell the old stroller we have, right?  The double stroller into which Cal can't even fit anymore.  Which Mack wouldn't even deign to sit in at this point.  I should sell this perfectly nice stroller, take the money, and use it to buy some school clothes for Mack or a new lunchbox for Cal or something that we really need.

But I still don't really want to sell the stroller.  Make of that what you will.

on dreams

The night before I return to work after having been on vacation, I always have an anxiety dream about anesthesia.  It's something that I hoped I would outgrow, and I guess I have to some degree, since for the entire first six months of my anesthesia residency, I had anxiety dreams about anesthesia every single night.  Most of these dreams had to do with the standard things that residents are anxious about--I had dreams about machine malfunctions, patients sitting up on the table in the middle of surgery, leaking canisters of volatile anesthetics that rendered me unconscious before I could reach the machine to turn it off.  But some of the dreams I had early on were completely nonsensical, like the one where I was at an airport and I was called upon emergently to resuscitate a sea lion.  Why was I in an airport?  Why a sea lion?  If this implies anything unsound about my state of mind, please also remember that I also had a young infant at the time, and the very fact that I was even able to sleep deeply enough to dream was a triumph in and of itself.

So anyway, the dream I had Sunday night was that I had to put a thoracic epidural in my own grandmother.  To what purpose it was unclear, but I do remember having to sit her up on the OR table and prep her back with Betadine while explaining to her in Cantonese what I was doing.  Aside from the construct, it was actually a very realistic dream, and when I woke up, I had to orient myself for a few minutes to decide whether or not my work day had ended or whether it was just beginning.

What anxiety dreams do you have about medicine?  Have they changed over time?  I would like to think that they will, or that I might at least at some point in my life be able to go on vacation without having to count on one full night of tossing and turning and dreaming with a pulse-ox tone backbeat.  But it's been more than 15 years since I last took a math class, and I still regularly have dreams about showing up for the big calculus final having not attended a single lecture (it's always something where I forgot that I registered for the class, and didn't realize it until the Add/Drop period had ended), so I don't have real high hopes that my medicine anxiety dreams will ever fully go away.

the life aquatic

I've been a little sporadic with the updates lately, and I apologize for that.  It's just that--well, I was away from home for about a week, and even though I'm really glad that I took the time for the book tour, I had a lot of guilt about leaving my kids, as one does.  It's one thing to be away for work--especially when you work in medicine, most of those long days and late nights can at least be couched in obligation or altruism, I DID IT FOR THE GOOD OF MANKIND and all that.  But there's no way around it, leaving home for a week to do book promotion was in large part elective and as such, felt somewhat self-indulgent, so I've been trying to make it up to my kids since then.  Mostly this involves spending a lot of time with them and taking them to the pool, largely so that they could cower by the water and tell me how cold it was.




(At the end of that clip, do you know how hard it was not to start launching into some discussion about hyperventilating at an FiO2 of 100% prior to breath-holding?  Don't know what I'm talking about?  Better for you, really.)

I had my last book event (for this round of book events, anyway) this past Thursday at the Atlanta History Center, and I have to say, it was the event that I was the most nervous about, mostly because 1.) people had to buy tickets to get in, which ramps up my responsibility not to be a blithering idiot somewhat, and 2.) this particular audience, more so than any other event on my tour, had the highest percentage of people who knew me in real life, and whom (I imagined) would spend the rest of my life giving me pitying glances wrapped in dulcet words of encouragement if I really bungled my talk.  I don't like to speak from a lot of notes (there's something inorganic and stilted about being too prepared; see the last Grand Rounds I gave for evidence) so while I had a few bullet points to sort of lead me down the garden path, largely I spoke extemporaneously.  It actually went pretty well, I think.




If you look all the way to the back of the room, you can actually see Cal sitting at the table playing iPad, which I specifically told him to do not only so that he wouldn't get fidgety, but so he wouldn't be paying attention to any of the bad words I was saying during my reading excerpts.  Mack was running around in the lobby (he kept pointing and shouting "Mama! Mama!" while I was at the podium so Joe removed him expediently and they spent the entire evening looking at Atlanta History Center promotional posters), and the one other kid in the audience was, like, 4 months old, so who cares, BABIES DON'T KNOW ANYTHING.  Who knew a memoir about medicine and parenthood could be so corrupting?

Anyway, it's been a very exciting two weeks, but I'm really glad to be going back to work tomorrow.  For all its fallibility and uncertainty, there is a certain concreteness to medicine that I miss, as well as that feeling that that feeling that small everyday actions can make a large, lasting difference.  I know that's true in life overall, not just in medicine, but in a hospital at least, there's usually coffee and day-old donuts hiding somewhere.

And now I'll leave you with this.  Here is a chicken in Uganda pecking at my book.  Why?  More like WHY NOT?





That is all.  (Thanks, Veronica!)

you guys!

I flew back into Atlanta early Tuesday morning, on a 6:00am flight out of Logan.  It had been a while since I had been in Boston (I actually don't think I'd been in Boston or even anywhere near it since college, which seems like it should be that long but was, in actuality, almost twelve years ago), but aside from the weather being ridiculously cold and dreary, it was exactly as I remembered it, including the automated voice on the Red Line on the T which informed me that "Charles/MGH" was the next stop for, like, three stops in a row.

The book events, all of them, were great.  I had conferred with a few friends in the writing business beforehand about the very fact of doing any live book events, and one of them in particular (my friend from high school Deanna Fei, whose book is out in paperback now) told me that she had been told that one is not a "real author" until they have a book reading at which only two people show up, and one of those two people is the author's mom.  So I had some real fears that this might happen to me, and that I would just be crushed because, you know, I just spent six days away from my kids in order to do all this stuff.  

But you guys!  You guys really made it worthwhile.




This was the turnout at The Coop in Cambridge on Monday.  It was a great venue, and it was actually the only venue at which they set up a podium with a microphone, which was perfect, because after the other two events and doing all those radio interviews, I was kind of starting to lose my voice.  I can't help it, I'm not much of a projector when I talk, usually I'm using my dulcet tones to soothe, like Smoove B.

The book tour (short as it was; I wouldn't have minded going to more cities, and maybe in the future I will, depending on how my schedule and how things with the book are going) was so much fun.  Even the smallest event, which was in Philly, drew more than 20 people, and even if one of those people was clearly there primarily to eat cheese and drink free wine, he was at the least very attentive, and if I may say, his large beard was magnificent.

It was fantastic to meet so many readers, of course--and I was impressed because some of you guys have been reading for a long time, I had more than a few people come with their old copies of Issue #1 (and only) of Scutmonkey Comicsvery old skool.  (Fair warning: clicking that link may cause cortical blindness.  White font on a black background with hot pink accents--mistakes were made.)

But what was really amazing was to have the chance to connect with the many, many old friends that I picked up along the way.  In the course of my six days on the road, I caught up with my family, and some of my oldest friends from high school, college, med school and residency.  Guys, I had dinner in Boston with my old Orgo professor and my old pre-med advisor, and we talked about our kids, like I was a grown-up person or something.  It was like "This Is Your Life, Michelle Au"  Blew my mind.

And I think that's what I got out of the book tour most of all.  The events were a blast, and I can only hope that it's going to help the book get some buzz or traction in this busy summer market (speaking of which, my book makes a pretty awesome graduation present, if you happen to be choosing between my book and, like, Betty White's new memoir) but most of all it reminded me of how lucky I am to have so many amazing people in my life, and that where you've been is just as important as what comes next.  

OK, I've got a ton of catching up to do right now, but more soon.  And thank you again to everyone who came to my book events, it really meant a lot to me to see you all there.  Don't forget, people in the Southeast, I still do have one more book event tomorrow evening, 7:00pm at the Atlanta History Center.  Information can be found here or here, RSVP to reserve a spot, or you can buy tickets at the door.

the hometown crew

The book event in NYC last night was...well, take a look.



The event was awesome.  I was a little concerned about attendance beforehand, because it was a Wednesday, and a little early for some people getting off work, maybe a little late for others.  But the turnout was fantastic, we pretty much sold out all the books in stock, and the discussion afterwards was really good.  Thanks for coming out, New York!

(Philly, are we going to be having some fun too?  Come on then!  I'm a little anxious about Philly because it's the city that I begged to have added to the tour but also the only city where I've never actually lived or gone to school.  But Philly is such a great medical town and so close by that I just couldn't image passing up the opportunity to meet some of you in person.  So...see you tomorrow?  And bring your friends!  All 500 of them!)

Before the book event I swung up to Washington Heights to visit with some folks and visit the med school.  You know what?  It's exactly the same.  Kind of grim, kind of imposing, with a lot of people in white coats walking around.  Feels like I never left.





I would have taken more pictures but there were so many people walking around that I probably would have gotten plowed down if I tried.  Luckily, some assiduous readers helped me out with this one:




(Thanks, Valerie L.!)

Anyway, I'll be heading to Philly tomorrow, where I'll be spending some time with my old friend Tammy, who has the distinction of being the person who convinced me to switch from Peds to Anesthesia in the first place.  We're going to the famed Mutter Museum (of Medical Marvels?) before the book event that evening, and if you don't think I will live-Tweet that shit, then obviously you don't know me at all.

Finally, a few more pictures of the book out in the wild.  Thanks to everyone for sending them in, I can't fit them all in this entry, but I picked a handful that were fun.

In honor of the first scene in the book, which some of the morning radio interviewers from today laughingly said they deliberately avoided talking about in great depth (heh) in case some of their listeners were still eating breakfast.  Thanks, Sangeetha!




Here we are, atop the CN building in Toronto, which is apparently the tallest building in the Western Hemisphere.  Lofty!  By the way, reminds me of this: On Old Olympus's Tower Tops, A Finn and German Vied At Hopps.  Quick, what is this mnemonic for?  And why do I still remember it?  Ah, the sticky and sometimes random power of memory.  (To be clear, yes, I do still kind of need to know this, and the mnemonic helps.)




Monkey see one, monkey do one.  Now we just need a shot of the monkey teaching some other monkey how to suture banans.  IT'S THE CIRCLE OF LIFE.





Finally, this last one (thanks Mingle!) is for Cal and Mack, who both LOVE "Angry Birds," which Cal can play with some skill, although Mack mainly just slingshots most of his birds backwards or straight into the ground. Which is a good segue to point out that the book is available in all e-book formats now!  Instant gratification, ho!




Thanks, everyone.  See you tomorrow in Philly, and then on Monday in Cambridge.  Surely there will be some sort of yard nearby in which to park your car.

pub date

I had mixed emotions as I headed for the airport this morning to start the first leg of my book tour.  I'm happy that the official publication has finally arrived of course, and the idea of doing publicity is kind of exciting, in the way that novel things are exciting.  But another part of me is kind of sad, leaving my kids for six days.  I know six days isn't a hell of a long time, but that's all relative.  And for a two year-old that lies in bed every night clutching a hank of my hair, brushing the wisps against his cheek while murmuring, "Hair...hair..." it might seem like an awfully long time.

(Does that sound creepy?  He's a baby.  Not creepy.  But if he was a grown-ass person, yes, kind of weird.)

Even as a resident, I never spent more than 36 hours away from my kids (well, singular "kid" at the time), and the first time I spent even more time away than that was a few weeks ago when I went to Iowa City for 48 hours.  So this is...a longer trip.  Six days.

But I really wanted to do this and I think it's important (or at least, I hope it is) to do some in person events in big medical cities and at least start to thank some of the many, many readers that are generating good word of mouth for the book and making sure that it's going to be a success.  So let's make it count!  Come on out to the book events, tell your friends, drag along your relatives, whatever.  Or else I'm going to have to tell my kids that I spent six days away from home in order to sit on a series of folding chairs in various bookstores while pretending to check my email.





See you guys at the Columbia University bookstore (116th and Broadway, thereabouts) at 6:00pm tonight, and for a drink and some giant haggis-looking burritos at The Heights afterwards.  And if you're in Philly, join us for the event this Friday the 13th at the Penn Book Center.  FRIDAY THE 13th.  Like I said before, I can't promise that the reading won't prevent you from being crushed by a falling piano, but IT MIGHT.  Not worth the risk either way--just go to cover all your bases.

Oh, and you know the book has finally gone live for the Kindle and the Nook, right?  Oh good.  Also, the bookmarks giveaway is officially closed, thanks to everyone who e-mailed me and who pre-ordered the book before today.  I'm working on getting those bookmarks out in a timely way, but there are a lot of you guys, and that's a lot of notes to write and envelopes to lick.  But never fear, I'll get them all to the post office eventually.

radiolucent

Hey everyone, hope your Mother's Day was swell.  And thanks again for all the great photos you've been sending me--I have them all saved, but I'm going to preempt them for this series, which I received from Bea, Eve, Jess and Tony, some of my old friends from med school.  They got quite into the spirit of things, as you can see.  AND I LOVE IT.


Here is my book getting a mammogram.  Or rather, my book as a boob.


And here Natalie, a patient care assistant, demonstrates that reading my book can make getting a mammogram a slightly less unpleasant experience.


Tony, my old med school classmate, poses in the CT scanner with his copy.


And Bea, who's actually in the book (she's the one who compares med school to being in the army) gets a brain MRI while reading.  Now if only it was a functional MRI, so we could see which areas of the brain light up.  (My guess: the hippocampus, and the amygdala.  Neuroanatomy humor, hey-ooooo!)


This one I thought was super-cool: my book in the MRI coil.  See how the suture needles are attracted to the MRI field, and are getting dragged into the coil?  I get really paranoid about that every time I have to administer anesthesia in the MRI scanner--I keep having this vision that my pen or something is going to shoot out of my pocket into the coil and stab someone.



Hello, other authors.  Have you had your books examined under fluoroscopy?  Pity.  IT IS AWESOME.




Luckily, the scan came out clean.  Radiolucent as the driven snow, baby.

Bea was right, by the way.  Med school is like the army.  I mean, there's no actual warfare (for the most part), but you're working hard and going through some physically and psychological hardships with the same group of people for four years, all while charged with a greater sense of purpose.  And it really affects the quality of the relationships you form with people during those four years.  I met my best friend in med school--later, I married him.  There are friends I have from med school that I know I'll keep in touch with my entire life.  Because we've been through the fire together and emerged intact.  We did it together.  And most importantly, we had fun.  




Anyway, that's something I want to convey to people who are pre-med right now, or in med school, or going through residency.  It's hard, but you have people around you, and you're doing it together.  Don't forget to have fun.  Because that sense of fun is what's going to carry you through, and it's what's going to meet you on the other side.

Thanks, Bea, Jess, Eve and Tony!  I admit, getting that photo montage from you guys made me tear up a little bit, and I am not a person who habitually tears up at stuff, with the exception of "Toy Story 3," because good lord, I'm human after all.

*          *          *

Hey, do you have a radio?  Do you live in the Southeast?  Well then, listen to me on the radio tomorrow!  I will try not to embarrass anyone!  First at 8:20am on KFRU-AM out of Columbia, MO on the David Lile Show, and then at 9:35am on WRVC-AM out of Huntington, West VA.  (The website for WRVC-AM does not seem to be displaying correctly on my browser, but maybe it's just me?)  It's live radio for both shows, so watch it in the same spirit that you watched that live episode of "30 Rock," 50% out of actual interest for the topic, and 50% for the bread and circus and the excitement of me slipping up and saying something irrevocably dumb.  I LIVE TO ENTERTAIN YOU.

Also, let me point out that I added a meet-up for after the NYC event this Wednesday at the Columbia University bookstore.  So after the reading, let's say around 8:00pm, we'll meet at The Heights, which is about a five minute walk away.  It's a nice place and they have a nice rooftop bar, and yes, yes, I know, it's a Wednesday and you have to get home to study (or whatever)...but have have to eat anyway, and it's not like we're going to keep you out all night and get you wasted or anything, just stop by and relax with some harmless pleasant nerds.  It'll be pleasant and I guarantee that taking a few hours off on one night will do more for good for your brain than studying all the rest of the entire week.

I'm shipping out bookmarks in the middle of next week.  Even though the book is widely available at this point, I did say originally that the bookmark giveaway was for all orders prior to May 11th (which is the "official" publication date), so that offer still stands as is.  You still have a couple of days to get your free bookmarks and a personal note from me, so if you were waiting for some reason, go ahead an order the book and then e-mail me  to let me know you did!  I will mail you one bookmark for each book you order prior to Wednesday, so yes, if you order ten books, I will mail you ten bookmarks.  Need I also point out that it makes a wonderful graduation gift?  Much better than a polyester stuffed bear wearing a mortarboard, I can tell you that right now.

mother's day 2011

Hey everyone!  Happy Mother's Day!


Cal made me a card this card at school.


Here's what was inside.


At first I thought he wrote that I was "3D," but then realized that he wrote that I am "32."  Well, both are technically correct.


This was a little off.  I'm not sure if he wrote that I weigh 15.5 or 155, but just for the record, the latter puts my BMI at almost 150.  Time to lay off the donuts, shorty.



Mother's Day is a little forced for my taste, and I would never mandate that anyone celebrate it, especially for my own sake, but since it is almost Mother's Day and the occasion presents itself, I would like to say that there's no better present than these two boys.


And if only I had some arms, I'd hug them both.

but when I'm on microfiche, that's when I'll know I've hit the big time

I don't mind telling you that I feel like I'm stretched a little tight these days.  At this point, I'm used to balancing the working thing and the parenting thing, and up until this point, the book had always been something that I'd had on the back burner at a low simmer--a thing that required some low-grade attention but not a lot of constant energy.  But as the publication date approaches and the book has actually become available, that has changed.  Publicizing a book takes a lot of time and effort, and I'm lucky enough that I have a team of awesome people at my publisher to help me with some of the nitty gritty elements of it all.  But even so, it takes a lot of work.  

Publicity and self-promotion is not something that comes naturally to me, and it's honestly something that I've had to work on.  But obviously, it's important.  Some might argue (not me, though I understand it in concept) that the publicity element is almost more important that the book itself--you could write the greatest book in the world and it doesn't matter a bit if no one ever reads it.  So I've kept at it.  It's hard to tell how much traction I'm getting or how far I'm actually moving the boulder, but...you just keep at it, you know?  If there's one thing you learn in medicine, it's that--just keep working on it, and even if you don't end up quite where you thought you would be, at least you'll get somewhere.  And you don't spend three years writing and editing a book only to throw up your hands and say, "not my department" when it comes to marketing the thing.  Sometimes it feels like I'm a little tiny bird pecking away at the world's largest seed bell, but...I've got a sharp beak, and given enough time, I could eat a lot of seeds.

(That tinkling sound is my labored metaphor falling apart.)

Thank you so much to everyone who has been helping out with the effort, by the way.  The tweets and the Facebook mentions and the pictures and book reviews all really help, and it's tremendously heartening for me to look up once in a while and see that I've become part of a community, and that that community is growing.  I hope to be able to meet many of you in the next two weeks and be able to thank you guys in person.

OK, so speaking of publicity, a couple of quick notes:

1.) Angela over at "Authors and Appetizers" very kindly hosted me and my book on her site today, and featured my recipe for Painless Chick Pea Vegetable Soup with Parmesan and Rosemary.  If nothing else, just at least try making this soup--aside from the dicing, lemon zesting and the efforts of popping open a few cans of chicken broth, it takes nearly no effort, and is a healthy, family-friendly recipe that will yield a lot of tasty leftovers.  (As a rule, I exclusively cook things that are leftover-friendly and involve as little cleanup as possible--this usually means one-pot-wonders.)  Enjoy!

2.) So I guess I'm going to be on the radio.  I know.  I KNOW.  This upcoming Monday, you can tune in: 
  1. LIVE (!) at 8:20am (EST) on KFRU-AM out of Columbia, MO on the David Lile Show
  2. LIVE AGAIN (!!) at 9:35am (EST) on WRVC-AM in Huntington, West VA
Is this my first time on live radio?  Hardly.  There was that one time when I was invited to be a guest, along with, like, four other people in varying stages of inebriation, onto a friend's show on WZLY, Wellesley's college radio station.  Mostly we just listened to music and hooted "Woo!" a lot.  So this is going to be practically the same thing, right?  Also, where are my beta blockers?


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OK, let's move on to more book sightings in the wild, shall we?

Here first: from Nicole's carry-on luggage, going on a trip to New York after finals.  First of all, congratulations on finishing finals.  Second of all, congratulations on that handsome bound volume of Shakespeare's Great Works.  Wait, it's not Shakespeare?  George Bernard Shaw's collected plays then, no doubt.  Good old beard-face.  Wait, what is it?  A medical memoir called what?  Written by who?  Never heard of it, but clearly, from the looks of its simple but handsome hardback cover, it is A Very Important Work.  


(And that's why I love hardcover books.  They look so serious without the dust covers--it's like the opposite of hiding a Spiderman comic on the inside of your Chemistry textbook.)

This one, from Flora's bookshelf, where she tells me is where the book will live after she finishes reading it.  Here, very fittingly, it is pictured resting between the following titles:



"Pregnancy Day by Day"
"Writing Your Life Story"
"Time Management"
"Preparing for Marriage"
"Help Your Man Get Healthy" (If by "Your Man" you mean "Your Patient Who Is A Man")

It's like distilling all the major themes out of the book and putting them on the bookcase alongside!  Nice work, Flora.  I think that new book is going to fit in juuuuuust fine.

Dogs!  Cute kids!  They all love the book!  And so should you!  Unless, you know, you're a bad person or something.  It's OK if you are, it takes all kinds to make the world go round.




I just want to point out that the last little boy is named "Mendel," which is a simply adorable and medically-themed name.  Mendel, you simply have to grow up to be a geneticist, or else it's such a waste.  This from Dr. Ow, the anesthesiologist.  NEVER PASS UP THE OPPORTUNITY FOR A MEMORABLE AND APPROPRIATE NAME-JOKE, MENDEL.  (Thanks to Jackie, Sam, Stephanie, Mendel and Leah for those last three.)

OK, this one really got me excited, because I'm a nerd.  First sighting of the book in a library!  With library binding!  The shine off that cover is intoxicating!




To have my own Dewey Decimal number.  Dreams DO come true!




Here it is, our very first picture from outside of these United States, courtesy of Murray in Montreal!  The book is very fittingly sitting next to a giant flagon of coffee, without which the manuscript wouldn't--nay, couldn't--have been written.



Oh, and finally, this one was not sighted in the while, rather online, but I had to post it because...well, look:


This is from Grand Central Publishing's website of books they are promoting for Mother's Day.  Should you buy my book for your mom for Mother's Day?  Only if you love your mom.  WHAT, YOU DON'T LOVE YOU MOM?  (This is called "a guilt trip." Jargon!)  I also think it is a particularly fitting graduation present, particularly for the medically-oriented student in your life--hey, it's going to be their life, they deserve to know about it.  But the real reason I posted it, the real reason that made me take this screen capture and sleep with it under my pillow (as one does--what, you don't have a computer under your pillow?) is because in this display, my book is diagonally next to Tina Fey's "Bossypants."  Our books are almost touching corners.  Which means that WE ARE IN LOVE.

(Yes it does.  Yes it does.)

Thanks again to everyone for supporting the book, and keep the fun pictures coming!  Email, Twitter, Facebook, I accept them all.  I am also told that shipments to our international readers, including from some of the smaller online retailers, have shipped or are shipping within the next few days, so I look forward to seeing some of those.  My book atop the colored spires of the Kremlin in Moscow?  An elaborate feat of balance and/or glue, but you guys are very industrious.  It can be done.

school daze

Sarah asked me in the interview that ran yesterday about the three words I would use to describe my two kids.  I wish I had found this picture before I answered that question, because all you need to know about their personalities is laid bare by their expressions in this photo:




(Look, I'm going to talk about preschool stuff right now, even though I know this is one of the topics that inexplicably makes people irrationally angry, but hey.  I'm reckless like that.)

Mack's starting nursery school in June.  He's ready.  Frankly, he was ready months ago, but nursery school is expensive, and we needed Cal to be a little closer to finishing up his stint at private school (he'll be starting first grade at our local public school next year) before we started sending Thing Two into the money-vacuum that is pre-primary education.

Before we moved to Atlanta, we probably toured five or six preschools for Cal, mostly because we had no idea which schools were good or where the schools were or even where we would be living.  Also, Cal was our first child, and we were coming from Manhattan, where there is this curious notion that picking that one, perfect preschool will either make or break your child's entire future forevermore amen.  We picked the school we thought was the best, and Cal's been there for the past three years, though, as I said before, he'll be switching schools in the fall to the local public school that, among its other benefits (FREE), is only about five minutes away from our new house.

Because see, that's the main thing that we learned about sending your kids to school.  Obviously there are good schools and some schools are worth the sacrifice and commute (I had friends in high school that commuted up to two and a half hours each way just to get there every morning--it made my 45 minute single subway train commute look like nothing) but preschools?  Let's face it, most preschools are pretty much the same.  So if you don't have to drive a million hours each way to drop your kid off there, all the better.  I toured two schools for Mack before we picked one, and both were right close by.  One was closer.  That's the one Mack will be attending in May.

This is not to say that it's not a good school.  This place?  Is ridiculous.  They have computer class and foreign language and dance and they have this crazy water playground in the back that's just--well.  Mack may never want to leave.  But the best part of it?  The very best part?  They provide breakfast and dinner and all snacks at the school for all the kids.  Meaning they make the food.  Should I say that again?  WE DO NOT NEED TO PACK ANY FOOD FOR MACK TO TAKE TO SCHOOL.  Do you know how many hundreds of hours of my life I have spent cutting up grapes and packing little cheese squares and making sandwiches for Cal to take to school?  Do you know how many hours I will save by not having to do that for Mack?  "All meals and snacks provided" may be the sweetest words in the English language.

So that's Mack's nursery school in a nutshell.  It's three minutes from our house.  There's a ton of stuff for him to do there.  And we will never, ever need to pack him a lunch box.  If there's anything else we need to know about this place, I can't think of it right now.





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More sightings of my book from around the country (and hopefully, soon, around the world):

Jamie from the VCU School of Medicine in Richmond, VA sent me this one.  She wrote, "I'm sure Hippocrates would give your book two thumbs up... if he had thumbs." Well played, doctor. Well played.




This one comes from Henry, my first Aussie reader (that I know of) to get his hands on a copy of the book.  Of course, he did have to fly into New York to buy it, but be that as it may, it's a proud day for Australo-American relations.  This shrimp's on the barbie for you, Henry.  (I SPEAK AUSTRALIAN, YES.)




This one's from Roxanna, who told me that she burned 2500 calories while reading my book on the elliptical.  2500 CALORIES.  Does this book give you super-powers?  Is it so utterly absorbing that while you're reading it, you can no longer feel pain?  Who can say, really, why not read it yourself and find out?  (Short answer: YES.)




Also, here is Roxanna's daughter, because she is adorable.  (Hopefully she's not reading the gross parts or any of the bad words.  Cal has read some of the book too, but mostly he just like the chapters that are about him. Egoiste!)




This cat right here in Corona, CA is so pissed that she can't read right now.  Pissed, and hungry.  Is my book a good present for cats?  Depends how many cats you have.  Each cat must have her own copy, though, or else they get jealous, and the resentments will tear your home apart.  (Thanks, Jenn!)




And this one, my favorite of the day, comes from Professor Miwa in Wellesley, MA, who has photographed my book with her Organic Chemistry students in the Wellesley College Science Center.  Oh, I learned so many important things in the Science Center.  And then I graduated and forgot all of it instantly.




Now, if I remember things approximately, probably at least 75% of this organic chemistry class are premeds or pre-medical professionals in one form or another.  Ladies, study well and work hard, and five or six years from now you too may be eating cold refried beans out of an emesis basin at 2:00am next to the hospital supply room!  REACH FOR THE STARS!  (And good luck on finals!  By the way, is it true that the answers to the Orgo 2 final exam are actually fiendishly encoded in the pages of the book like the damn DaVinci Code?  I can't confirm it...but I won't deny it either.)




Keep your photo submissions coming, either to my e-mail or on Facebook or Twitter.  And hopefully I will see some of you guys at the book events in the Northeast starting next week.  Did I mention that the reading at the Atlanta History Center will also have light refreshments and a cash bar?  A BAR IS THE THING WITH THE BOOZES ON IT.  Enough of that business and I'll hardly need to be funny and insightful at all!  Delightfully potted attendees--the pressure is off!