shelf exam

I've only ever watched, like, two episodes of "Hoarders," but it's enough to make me feel 

1.) Vaguely reassured, that, despite my packrat tendencies, I'm not that bad (did you see the one with the lady that had two dried up dead cats under her rubble heap of trash?  Like cat jerky they were, good lord).  Also

2.) Slightly uneasy about my own clutter, to the point that, after I watched the last episode, I just started throwing things away to make myself feel better.

One thing that I've never been able to get rid of--even though we've moved five times (yes) since I started med school--is my books.  I am unnaturally attached to the books.  I have purged many of our other possessions, some of which would seem to have more sentimental value (Cal and Mack's old baby clothes went to Goodwill with the last move, for example--they were adorable and teeming with cuddly memories, but there's only so many outgrown onesies flopping around in boxes that I can abide) thought when it comes to my books, I have repeatedly put my foot down against giving any away.  Because you can tell a lot about people by their books.

We used to have them somewhat categorized on separate shelves (all our medical books were clustered together in our workspace, for example), but at this point the fact of unpacking them seemed like feat enough, so everything is all jumbled together in a hodgepodge.  Highbrow, lowbrow, and everything in between. 

Evidence that I don't just recommend books willy-nilly.  My own copy of Michael Ruhlman's "Walk on Water" has damn near been read to tatters, obviously.  (I used to have the unfortunate habit of reading in the bathtub, which no doubt accelerated the process.)  So you can see why I basically had to resuscitate myself when I heard he wrote a blurb for my book.

I went through I period in college where I read a lot of plays.  I also went through a period in college where I got used texts from the college bookstore for classes that I wasn't taking because I thought it would broaden my horizons or whatever.  (Nerd.)

And then when I was in med school I got a book of pictures of 1000 olde timey tattoos, just the right size to keep in the bathroom on top of the toilet.  Highbrow, lowbrow.

Ophthalmologists have the best words for Scrabble.

These EC comics were a Christmas gift from my parents.  Somewhere, possibly still in a box, is a complete box set of "Crime Suspense Stories," "Weird Science," and "Weird Science Fantasy."  A healthy proportion of the books on my bookshelf are actually comics or graphic novels, a fact that perplexes my mother-in-law a great deal.

I still have a handful of author copies for my own book lying around.  It seems weird to have them out but I literally don't have anywhere else good to put them.  But they're on a very low shelf, at least, so less visible, thereby making me a little bit less like Richard Dreyfus in "What About Bob?".





(I said a little bit.)

joyeux anniversaire a toi

So the party on Saturday went well!  Though here's a little before and after of the cake.  So...before:

After:

Apparently there's nothing that ten six year-olds find more funny than smooshing Spiderman into a cake and creating a little playlet like he's drowning in a vat of quicksand.  DELICIOUS QUICKSAND.

Cal's birthday is obviously over summer vacation, so we've always had to have these hodgepodge birthday parties where half of his friends are out of town, on vacation or visiting grandma.  But now that Mack is school-aged and seems to be developing a rudimentary understanding what birthdays are (it's the thing where you eat cake, duh), I'm looking forward to his birthday next year, as it'll be the first time where we'll actually be able to have a traditional classroom birthday party.  Mack already has it all planned out.

MICHELLE

Mack, when it's your birthday in January, would you like Mommy to bring cupcakes to school for you?

MACK

Yeah!

MICHELLE

And we'll have a birthday party for you and your friends and teachers at school?

MACK

Yeah!

MICHELLE

And we'll light three candles and you'll blow them out?

MACK

Yeah!  Three!

MICHELLE

And we'll all sing "Happy Birthday to Mack"?

MACK

(Glowering)

No want you sing.

Anyway. We saw friends and ate cupcakes and the aforementioned wad of pizza, and that evening we had cheeseburgers and watched "Harry Potter and the Sorcerer's Stone," I seemingly having forgotten how plodding and dense the exposition in the first movie is, like, GET TO THE MAGIC PARTS ALREADY.  (Should have skipped straight to "The Chamber of Secrets," except then I would have missed how adorable little Rupert Grint was before time and testosterone had their unfortunate way with him.)

Anyhoo, I hope everyone had a good weekend, and remembered to finish all their homework.  Sunday nights always feel so laden with obligation and foreboding, don't they?

one of our own

I got this e-mail today from the chairman of the Emergency Department of St. Joseph's Hospital where I work, and which I will share here, lightly edited for privacy purposes.

Dear Colleague:

On July 4th, after working the night shift in the Emergency Department, Dr. D.G. had a right ventricular hemorrhage with subcortical ischemic changes. He is currently in [the medical ICU] awaiting transfer to [a prominent local rehab center].

Mrs. G was recently informed that D’s insurance does not include benefits for inpatient rehabilitative services. This news follows a difficult financial year for the G family; D has also been supporting his brother’s family due to metastatic disease as a result of stomach cancer. His brother died three months ago.

Because D is now considered uninsured, [the rehab center] is requiring $60,000 prior to D’s transfer. We have requested donations from numerous sources including Saint Joseph’s Mercy Foundation, but no one source has the availability of the entire amount.

We would like to ask for your help in the form of a donation as soon as possible. The sooner D can begin rehabilitation the better chance he has for a positive outcome.

I talked about this a bit in an entry a few weeks ago, but again, when you're working in a hospital with sick people every day, mortality is all at once distant and immediate.  Morbidity and human frailty are all around us, but at the same time, the very fact of its constancy makes it fade into the background.  It's just the scene that you're in, but seemingly, it's never you.

But it could be.  It could be you.  It could be me.  It could be your co-worker, your friends, you family.  I've met this doctor several times (the Emergency Department and the Anesthesia Department, as you can imagine, have more than just a glancing interface) and this doctor is not old, maybe just ten years older than I.  The day of his stroke, he wasn't feeling well.  But he came in to do his job anyway.  See the letter above: "...after working the night shift in the Emergency Department..."  He came in to do his job anyway.  Maybe he shouldn't have, but was the job he was trained to do, the duty he was called on to provide, which was to take care of sick people.

Now let's help take care of him.

Here's how.

(I apologize that this is so cumbersome as I'm not the one who set this up, but I'm told you're to click "Donate Online" --> "General Donation" --> "Other Fund" --> "Physicians in Need of Medical Care" and help however you can.  And please pass this link around to anyone who you think may be interested.)

Thanks everyone.  And have a good weekend.

why my post-call day off is equally exhausting as the call itself

Scene: This morning, post-call, at the crack of dawn.

MACK

(Speaking very, very close, directly into MICHELLE's face)

Mom, want to get up.  Want yogurt and toast.  Get breakfast.

MICHELLE
Hmm?  Snrg?  Mrpgh? (Shakes self awake)
Mack, Mom is sleeping. She worked very late last night.  

Go see if Dad will help you get breakfast.

MACK

No, you.  Want you to get me breakfast.

MICHELLE

Dad can do it.

MACK

No, want Mama.  Need you.  You.  YOU.

MICHELLE

OK, just give me a second...

(Long pause)

(Snoring)

MACK

Mom, get these blankets off!  Off!  Off!  (Pushing blankets off my body.)  

Don't cover your legs!  Don't cover foot!  Get up!

MICHELLE

Mack, Mommy's tired.

MACK

(Insistent)

NO NO NO YOU NOT TIRED.

MICHELLE

Groan.  Fine.  Fine.  I'm up.  I'm... (struggling into sitting position) OK, now I'm up.  

Don't you know Mommy was working late last night?  That Mommy needs to rest, like, occasionally?  

Fine, now what do you want for breakfast?  Toast?  Yogurt?

MACK

Yes.  Also need you change my diaper.

MICHELLE

You're pushing it, kid.

(Fin.)

favoritism

So it's Cal's birthday party this Saturday.  We're going to do exactly what we've done for the past two years, which is to go to the local municipal pool, get a wad of pizza (appetizing to refer to it as a "wad," I know), and let the kids go crazy.  Do you want to see what I got for party favors?  Yes you do.  YES YOU DO.  

Finger lights!  They're like little tiny flashlights that you can put on your finger.  Why?  What is this for? I don't know, ask a kid!  (Maybe they want to don their earth-colored hemp robes and re-enact that underground Zion rave scene from the "Matrix" sequel.)

Also, these lollipops that no one actually eats because they're too big to cram into your mouth and also don't actually taste that good, but that kids go nuts for because they are gigantic and rainbow, LIKE MY SOUL.  (OK, I don't know what that means.)

Also, Whoopee Cushions, which I found a great deal on last night, after which I tweeted abundantly on flatulence related humor.  I particularly like the helpful diagram (one presumes for prudes who have never seen a Whoopee Cushion) including the little word bubble that insists: "POO."  

See, the thing with party favors is: I know they're kind of a waste.  Kids play with them for two seconds and then they end up in the footwell of your car or at the bottom of the toy chest or soggy after a rain in the front lawn.  I have plenty of post-other-kids-party detritus cluttering up my own house, so every year I think: I just shouldn't do favors this year.  But then every year when I give out favors anyway (last year it was pencils and stickers and handfuls of leftover candy--I can't remember from which holiday, I'd like to think it wasn't Halloween but it well may have been) and it just makes the little guys so damn happy.  So what's a couple more dollars thrown in the direction of your local party crap store for that kind of joy?  It may well be just a gimmick, or at best a brief thrill, but at any rate the joy is full-bodied and genuine, and that's something we all need more of in our lives.  

So...pass the Whoopee Cushions, and viva los farts.

while we're talking about it

So some of you may have seen it already, but this AP article ran in The New York Times today, about a huge scandal that has embroiled that Atlanta public school system.

Atlanta Schools Created Culture of Cheating, Fear
By THE ASSOCIATED PRESS
Published: July 16, 2011 at 10:20 AM ET


ATLANTA (AP) — Teachers spent nights huddled in a back room, erasing wrong answers on students' test sheets and filling in the correct bubbles. At another school, struggling students were seated next to higher-performing classmates so they could copy answers.

Those and other confessions are contained in a new state report that reveals how far some Atlanta public schools went to raise test scores in the nation's largest-ever cheating scandal. Investigators concluded that nearly half the city's schools allowed the cheating to go unchecked for as long as a decade, beginning in 2001.

Administrators — pressured to maintain high scores under the federal No Child Left Behind law — punished or fired those who reported anything amiss and created a culture of "fear, intimidation and retaliation," according to the report released earlier this month, two years after officials noticed a suspicious spike in some scores.

The report names 178 teachers and principals, and 82 of those confessed. Tens of thousands of children at the 44 schools, most in the city's poorest neighborhoods, were allowed to advance to higher grades, even though they didn't know basic concepts.

One teacher told investigators the district was "run like the mob."

"Everybody was in fear," another teacher said in the report. "It is not that the teachers are bad people and want to do it. It is that they are scared."

For teachers and their bosses, the stakes were high: Schools that perform poorly and fail to meet certain benchmarks under the federal law can face sharp sanctions. They may be forced to offer extra tutoring, allow parents to transfer children to better schools, or fire teachers and administrators who don't pass muster.

(Read the full article.)

So...that.  This is not a new story, by the way--it's been in the local papers for the past few months--but it's one that I've been following with more than a little interest.  Because in a few weeks, we're going to be part of the Atlanta Public School system, when Cal starts first grade.

I would first like to point out that both Joe and I attended public schools up until we went to college, and Joe's dad is actually a retired public school principal.  And of course, I'd also like to think that if reputation and historical data count for anything, the school Cal (and maybe Mack in a few years) will be attending is actually supposed to be excellent--that school is, in fact, the reason we moved into this particular neighborhood in the first place.  But do these things make me feel better?  I little, I guess.  But not totally.

Ideologically, I think that every child should have the right to a good education, that we need to direct more resources to public schools, that the public school system in the United States should, by all rights, be one of the best in the world.  I don't believe that getting a quality education should solely be the purview of those who can afford private school.  The fact that an education is state-funded doesn't make it a bad one, just as much as paying a lot for an education doesn't make it a good one.

But at the same time, want to know my first, knee-jerk response?  It was: If this doesn't work out, there is no amount of money that I wouldn't spend to make sure my kid gets a good education.

It isn't about the money.  Or is it?  How do you separate out resources from environment?  Why is it that the best public schools are usually in the most affluent neighborhoods?  And wherein do other, non-monetary resources come into play?  There was an example in the article of a parent who talks about how she was just blindsided that her child, despite passing all standardized testing indicators, was actually performing way under grade level, and the first thing I thought was: how could you not have known that?  How can you not know what your kid is doing?  How would you be surprised to find out that your kid can't read?  Can't do math?  Isn't performing at grade level?  I wouldn't think you'd be blindsided by that; I'd think you, as the parent, would be the first to know.

So in this case, as is the case with just about everything in the world, it is about money, but also...it isn't.  It's about the rest of the picture.  My kid spends seven hours a day at school, ten hours a night sleeping.  It's what one does with the other seven hours that make the difference.

(And before people get upset, let's not equate emphasizing academic success with a joyless childhood.  I have two little boys and I know kids have to unwind and have fun in order to grow up happy, so I'm by no means promoting seven straight hours of grim academic drills, cram school-style.  I'm just saying is that as their parents, we have more perspective than anyone else the extent to which our kids can achieve, and also as their parents, it is our responsibility to help them get there.)

Anyway, Cal's starting first grade in a few weeks.  And Joe and I are going to be right there.  We'll see what kind of work he's doing, see what kind of homework he's bringing home, see what kind of progress he's making.  We're going to work at home, and then we're going to work a little more.  And I think that'll be just as important--probably more so--than what school he goes to or what teacher he has or whatever summer reading list they're sending home.

And make no mistake, I think all schools most certainly have a tremendous responsibility to their students.  They should, and they must.  But along with that, let's not let institutional reputation, test scores and a grades give any false reassurances, or absolve us as parents from the responsibility of picking up the slack.

miscellaneous etcetera

I was trying to figure out why this week felt so interminable, when I remembered that I was on call this weekend, so instead of two separate weeks, I'm living through one endless mega-week.  Like a monobrow, there was no line of demarcation.  And since I didn't have a weekend to take care of all my odds and ends, I started off my week behind, so now I am tired.

But first things first.  The winner of the guerilla marketing campaign (and the pack of awesome ultra-fine-tipped gel pens, along with a signed copy of my book) is Julia Blue, who's ingenious book cross-promotion on Facebook impressed both me and my editor.  Julia, e-mail me your address, and I'll send those out.

(Speaking of mailing things out, if you have not received your pre-order bookmark yet, don't worry, you're going to receive your bookmarks, and many of you have already.  It's just that I actually got, like, ten times the number of e-mails than I had initially anticipated, so I'm just very, very slowly hand-writing the notes and addressing the envelopes and mailing them all out in between other pressing tasks I have to do, like going to work and raising my kids.  International pre-orders will probably ship out last, just because those are the only ones I actually have to take into the post office for air mail.  Everyone else, be patient, they'll all get shipped eventually, even if it kills me.  THANK YOU.  Unless it really does kill me, in which case: avenge my death.)

Uh, where was I?

Oh yes, it's been a long week.

*          *         *

OK, so tell me what you think about this.  Cal's starting a new school this year for first grade.  We just found a copy of the summer reading list for rising first graders.  I'll just put part of it up here, see what you think.

On-Grade Level:
1. Arthur Series
2. Biscuit Finds A Friend, Alyssa Capucilli
3. Brown Bear, Brown Bear, What do you see?, Eric Carle
4. Dr. Seuss Beginning Reader Books
5. Franklin Series
6. Frog and Toad All Year, Arnold Label
7. Frog and Toad Are Friends, Arnold Label
8. Sheep in a Ship or Sheep in a Jeep, Nancy Shaw

A little more challenging:
1. Alex and the Terrible, Horrible, No Good, Very Bad Day, Judith Viorist
2. Berenstain Bears Series, Stan and Jan Berenstain
3. Click, Clack, Moo: Cows That Type, Doreen
4. If You Give A Mouse A Cookie, Laura Joffe Numeroff
5. Little Bear’s Visit, Else Holmelund Minarik
6. Sheila Race the Brave, Kevin Henkes
7. Strega Nona Series
8. The Best Nest, P.D. Eastman
9. The Very Hungry Caterpillar, Eric Carle

OK, so look.  I like these books too.  I'm not saying my kid is some kind of super-brain, because he's not.  But really, these are the books that he's supposed to be reading for first grade?  "The Very Hungry Caterpillar" is a nice story, don't get me wrong, but is it really considered "a little more challenging" for a class of six and seven year-old kids?

Am I nuts?  Am I going Tiger Mom on this list?  Or do you think these books are too easy too?  Seriously, be honest, because I can't even tell.  I'm trying to figure out how much of it is just the fact that there's a range of books for all kids in the class, and how much of it is the fact that it seems like the expectations for our first graders is--look, I'm going to get flak for this, but I'm just going to say it--sadly low.

I'm not saying that I expect school to take the place of parents pushing (that word is so loaded, let's say "encouraging," because it sounds nicer although my meaning is the same) their kids to reach their full potential.  But I guess my fear is that if this reading list is a preview of the expectations for our first graders, school's going to be combination of mind-numbing boredom and then hours of meaningless busy work in the form of infinite homework assignments designed not to reinforce any actual learning, rather to fulfill some kind of meaningless quota.

I mean...OK.  Frog and Toad are very cute, and I love the fact that they are friends.  But people, really.  I mean, "THE VERY HUNGRY CATERPILLAR," for chrissake?

*          *          *

Mack's enjoying school so far, even though the transition of actually being dropped off at school all day, coupled with a week of Extreme Togetherness (my new reality show) while we were on vacation for a week has turned him into some kind of Momma's Boy monster.  (MOMMA'S BOY MONSTER is the working title of my horror film screenplay.  Alternate title: THE CLINGER.)  The biggest problem with him right now is quite simply that he's two years old, and while Cal waited until he turned three for the worst of his behavioral tics, Mack has apparently been reading all the child development books and has seized upon the terrible twos with gusto.

I know it's a developmental phase, and that he's right on schedule, but seriously, watching him and his 720 degree changes of heart in under 30 seconds is vertiginous to say the least.  And it's just hard to keep up with exactly what phase of the I love you / I'm angry at you / I need you Mom, every second of every day, I must only breathe your exhaled air / NO MOM GO AWAY I DO IT MYSELF cycle he's on at any particular moment.

Kid's lucky he's cute is all I'm saying.

*          *          * 

Oh, and I'm not going to plug every last public thing I do excessively, because it's all on this page and you can just look at it at your leisure (or not), but I just wanted to share this one interview I did with Greg Berg on WGTD-FM, because Greg is a great interviewer who listens as much as he talks, and whose reading voice made the excerpts of the book sound much, much better than if I had read them myself.  Is there some NPR master class that teaches people how to talk good?  Because I'd sign up for that in a second.  And then I would narrate Ken Burns documentaries all freaking day.

Hope everyone's having a good week.

colonoscopy face

I tweeted today that someday, I want to make a video of all the faces that doctors make while they're doing colonoscopies.  Our GI colleagues are as talented as they are brilliant, but as we all do, they sometimes make some funny faces while they're working.  And since I'm almost always standing directly across from them, I get to see the full spectrum.  Here are a few favorites.

We love our GI colleagues, and I hope that I look as cute when I'm making my "concentration" face as they do.  (However, as I know I likely do not, it's a lucky thing that I'm wearing a surgical mask 75% of the time.)

pecking order, level 2

So I joined my anesthesia group three years ago, which makes me the most junior member of my practice.  And as such, I have had the Junior Person Desk.

I took that picture my first day of work.  (See on the chair my old OR sneakers, which have since disintegrated from overuse/dry gangrene--I have a new pair of the same sneakers now, but in fuschia.  OR sneakers should always be a color on which blood will not be visible.  My brief stint with khaki sneakers lasted all of two days for that very reason.)  Anyway, it's a perfectly fine desk, but the shortfalls of its location reflecting my status in the pecking order became readily apparent the first time I sat down.

It's right next to the door of the break room.  Hell, my desk practically was the door of the break room.  And it seems like a small deal (because obviously, in the global sense, it is), but...it's a really high-traffic area.  Also, usually that door is closed.  So every time I sat at my desk, people would open the door, and it would slam right up into my chair.  Or people would forget the combination to get in and out of the break room, and I'd hear them beep-beep-boop-BZZT entering the wrong code and then struggling to puzzle out why the door wouldn't open, so eventually I'd just stand up and open it for them.  Or occasionally folks would forget pieces of debris on my desk, just because...I don't know, the garbage can was too far away.  Oh, a half-eaten bagel and a chewed coffee stirrer, a present for me?  THANKS GUYS!

A number of people in my department have rotated through that particular desk location over the years, and the universal agreement is that, given the option, one should decamp as soon as possible.  The good thing is that, as an anesthesiologist, I rarely have reason to be sitting at a desk anyway, but sometimes I do have to sit and write something, or return a call, or, you know, fluff my paperclip collection.  And in those moments, I hated having The Junior Desk.

We have a new anesthesiologist joining us next week.  Everyone is very excited.  We're excited to get our new colleague, but I in particular am excited because, in order to make room for our new colleague, two of our part-time physicians are now sharing a desk space, thereby freeing up physical room for an extra person in our department.  And a few weeks ago, I got a note that said that, if I wanted, I could get first dibs on the free desk, moving on up in the desk lineup and clearing off my Junior Desk for the new guy.  I made my move today.

Welcome to the practice, Dr. K!  And, all kidding aside, I hope the desk will be as good to you as it has been to me.  I'm not one to ascribe talismanic properties to things randomly, but it's been a very lucky three years for me, and I'm open to the fact that it might be because of the desk as much as anything else.

(I'm still moving to the new desk, though.)