meanwhile, back at the ranch...

We took the kids to The Rock Ranch this weekend, which is a cattle farm owned by the founder of Chick-Fil-A. I think the cattle ranchiness of the place is somewhat beside the point, though, as most of the grounds seems dedicated to its "Fall Family Fun" activities--train rides, corn maze, Tiny Town, what have you. I was all set to bring my real camera but at the last second , I just couldn't stomach the idea of lugging around one more bag, so all the pictures from the day were taken via the Hipstamatic app on my iPhone. I do love that app. I have a couple of other apps that simulate toy camera or instant camera-looking effects, but none do quite as nice a job as Hipstamatic. (I usually shoot with the John S lens and the Ina 1969 film, because I think it has the sharpest focus and I like the color of the resulting shots, even though they do tend to veer towards the green end of the spectrum.)












(Above: becoming Southern, exhibits A through I.)

Oh, on the topic of the book now being available for pre-order, I've gotten email from a good number of people asking me if the book will be available on Kindle or equivalent e-book reader. The answer is that I don't actually know. But I myself read a good percentage of books on Kindle now (rather, on the Kindle app for my iPad) so I totally understand the demand. I just went to the book's Amazon page and clicked the "I'd like to see this book on Kindle" link under the picture of the cover. Go ahead and do the same if you're interested in an e-book version. Not sure what kind of numbers they're looking for before they decide if Kindle-izing the thing is worth it, but I figure it can't hurt.)

switch-hitter

I'm almost done proofing the galleys for the book, and there's only been one part that has made me cringe--one part that frankly has always made me cringe--and that is the six or so pages in which I am explaining why I switched residencies.

Some background for the new kids, and a little explanation to the readership in general, since my residency switch is easily one of the most popular topics about which I receive e-mail: a long, long time ago, I was a medical student who didn't know what she was going to be when she grew up. So I thought I would go into Pediatrics, because I liked my Pediatrics rotation and I liked the residents and attendings that I worked with (read: they never yelled at me) and I thought kids were cute or at least easy to overpower. But about a year into my Peds residency, I realized that I had probably made the wrong choice. This is not a condemnation of the field of Pediatrics in general. Pediatrics is a fine and noble field populated with some of the best doctors with whom I have ever had the honor to work. But it is not for everyone, and as it turned out, it was not for me, much the same way that Orthopedics, Emergency Medicine, or Psychiatry are also not a good fit for my personality and interests. Basically, I thought I would be a good Pediatrician, and I was wrong. The field of Pediatrics did not fail me, I failed the field of Pediatrics. Luckily, I had a chance to correct that error, and I was able to switch from the Peds residency program to the Anesthesia residency program without too much fuss. And now you know the rest of the story.

However, reading over the few pages in which I detail the rationale of my switch, I keep feeling like I come off as a spoiled, squeamish ingrate. Like: Ugh, well-child visits, flu season, overnight shifts in the Peds ER? Get me the fuck out of here and back behind some surgical drapes, where I all my patients are unconscious and I can fastidiously rearrange syringes to my heart's content! And maybe the pages still read like that to me (after umpteenth rounds of revision--that was one of the more difficult parts for me to write, frankly) is because it all is to some degree true, and I just feel like it highlights some central failure of character on my part. Why couldn't I stick with Peds? Why couldn't I finish what I started? I love being an anesthesiologist, but does switching out of Pediatrics make me a quitter? Whenever I revisit the switch in my mind, no matter how much I know that it was the right decision, part of me thinks exactly that. You quit. You're a quitter. You left because it was hard, and then you found something else. Traitor.

(And then I push myself down, take off my own glasses and step on them.)

I am nothing but grateful for the two years of residency training that I received in Pediatrics. Those two formative years helped me become the kind of doctor that I am today, and provided a strong foundation upon which the rest of my training was built. I moved on, but I'm not ungrateful, nor do I bear any disrespect or animus towards the field of Pediatrics nor the people who took the time and effort to train me. Peds, I know from experience, is one of the most challenging specialties in medicine. But it's true, I just didn't want to be a Pediatrician anymore. And reliving that realization feels bad, like revisiting the breakup with your first serious boyfriend, or remembering the look on his face when you told him.

Has anyone else out there switched residencies? Switched careers? Was there any long-term guilt involved with that, even if it was the right decision in the end?

either this is a very elaborate scam or this book might actually be published after all

First (and mercifully brief self-promotional) things first: look! My book is available for pre-order on Amazon!




Please go reserve your copy, before my parents go apeshit and buy them all so as to avoid the potential embarrassment of me not selling any books at all.

Also, thanks for all the nice comments in the last entry! You're all very sweet. One of the problems with writing a book about your own experience is that everything is necessarily more personal. If I wrote a book about, say, the plight of the endangered spotted owl, I don't think I'd be quite so nervous about presenting it to the world as I do a book about the inner workings of my medical education and marriage and the birth of my kids. People can feel free to like it or dislike it, but it does take an extra layer of mental insulation against inevitable criticism when the subject matter is your own experience. That said, the readers of this blog have always been tremendously supportive and I cannot, nor will I be able to thank you enough for reminding me along the way that I could do this thing. So in case I don't thank you enough: thank you.

When it comes to book promotion, I actually have no idea how it works, so please forgive me if I don't provide more information. It's not coyness, it's ignorance. I expect there will be stuff going on in Atlanta around the time the book comes out, as well as stuff in New York, but beyond that I have absolutely no idea. I've read as much as you have about the changing face of the book industry and how in this age of new media and the...what do you call it? Internet?...that in general there are fewer book tours and in-person readings unless you happen to be David Freaking Sedaris or what have you. That said, I am open to everything and hope that I will have a chance at least somewhere along the way to meet some of you lovely people and really impress you with my poor social skills and extremely fast talking. Until then, just continue to think that I am normal. It's for the better.

Anyway, enough of that. Check out these awesome gummy candies that I found for Halloween:




Now, color me easily impressed but this is just one step shy of the gummi Venus de Milo in terms of artistry. What I wouldn't do to buy these, and then go back in time to my first year of medical school, so that I could be Queen of the Nerds. (I know, I know, you want them too. Go buy them here, 44 pieces for $6.99. You're welcome.)

This was officially going to be the first year that Halloween was not going to catch me with my pants down. Usually I kind of remember Halloween about a month and a half before, dismiss the idea of planning my kid(s)'s costumes on the excuse that it's way too early for that kind of thing, and then promptly forget about Halloween until three days before, when all that's left on the shelves are those terrible semi-porno costumes for adults who wait until the last second because they can't decide what they want to be, Slutty Nurse or Slutty She-Devil. And then I have to somehow make some last minute costume out of clothes that they already own, and although this occasionally turns out OK, I figured that a little foresight was usually better.

However, my kid is a weirdo (I'm speaking of Cal; Mack is still oblivious about Halloween and therefore essentially malleable) and he insists that he doesn't want to dress up for Halloween at all, and prefers, instead of going trick-or-treating, if we could "just stay at home that night and relax." I didn't want to push the candy issue that hard (after all, he's going to be finishing up some major dental work just two days before Halloween itself--though the dentist is very nice, I have no interest in creating as self-perpetuating revenue stream for him) I did have to ask Cal whether or not he thought it would be fun to go out with his friends and get candy, because that's what trick-or-treating is, after all, dressing up and going to get candy, not to mention more candy and did I mention CANDY? Now wouldn't that be fun?

He shrugged. "There are other fun things." Like what, canasta? Child, you are five years old. Now you will get into this Superman costume padded up with fake muscles and you will like it.

(Here's a little blast from the past, Cal circa Halloween 2007, when his costume was "Medical Resident." Gone are the days when I could dress him up for my own selfish amusement. Also gone are the days when I could use him for candy bait and then eat all his M&Ms on the pretense that they are a choking hazard.)

what is happening now is this

GALLEYS!




So, the galleys. While it's fun to see what the book is going to look like actually laid out on the page (the layout nerd in me takes particular pleasure in the fonts and the spacing), I also have this weird feeling when reading through that like I'm watching a monster movie through slitted fingers. Because I know that if I find a section that feels clunky or a paragraph that reads awkwardly, I've for the most part moved beyond the point where big changes can be made. Want to rewrite Chapter Nine? That ship has sailed. So I'm just kind of holding my breath and hoping that, aside from the errant typographical error or stray hyphen, nothing that's in this version of the book is going to be too humiliating. You know, because my name is on the cover.

I've had to think a little more about self-promotion, and it's led me to realize how horribly uncomfortable it makes me to talk about myself. I know, I know, I just wrote a 319-page first-person non-fiction personal narrative, I should be pretty good at talking about myself, but I'm not. That's writing. Writing is solitary. Self-promotion involves other people. Tooting my horn in front of other people.

I am not one for tooting.

In general, I have no big problem with public speaking. I have given speeches in front of audiences. I was in student government in high school and college. I have presented at Grand Rounds; Power Point slides, laser pointer and all. But the difference between that and what I will probably have to do for book promotion is that before, the public speaking I had to do was not about me. It was about graduating high school or about the college resident advisor system or pulmonary hypertension. Talking about myself makes me feel like an egomaniac. I could just try to stick to talking about the book, but unfortunately, the book is also sort of about me. So like it or not, I'm going to have to talk about myself. And not only does that make me feel like an egomaniac, it makes me worried that other people are going to think that I'm an egomaniac.

I never really liked being the center of attention. It's not that I'm shy per se, I just get embarrassed in situations where I might be perceived as self-aggrandizing. Even on my wedding day, I wondered if I could skip the part where I walked down the aisle and everyone had to stand up and look. It just seemed so self-indulgent and beside the point, somehow, like, can't we just skip to the party, which is the real fun part anyway? I don't like to be fawned over. I don't like situations that invite fawning.

When I was in medical school, one of my medical school teachers (the late great Steve Z. Miller) said of our transition from second to third-year medical students that there had to be an essential change in how we viewed ourselves as part of the picture. Until that point, he told us, we all strove to be awarded "Best Actor." We studied hard to get the best grades, we worked day and night to make ourselves better, smarter, more prepared to be good doctors. But once we stepped on the wards the July of our third year of medical school, that would all be in the past. It would not be about ourselves anymore. From now on, the patient was the important thing, the focus, the center of the picture. And from now on, we would strive to be not the star, but "Best Supporting Actor." I've been living that truism for the past nine years. It's not about you. It's not about ego. It's not about whether you had a bad day or if you think the surgeon you're working with is a shithead or if you have to get out of work early to pick up your kid from school. When you step up to the patient's bedside, it's not about you anymore. Best Supporting Actor. It's a good and noble thing to be.

Anyway, this awkwardness I feel about attention is something that I'm going to have to get over, because like it or not, I'm going to be doing some book promotion, and part of me does kind of want to do it. I want people to read this book. I want them to like it. I just wish it wasn't so embarrassing for me to say so.