Saturday, February 25, 2006

Letting It Go

A little while ago I made a promise that I'm going to break.

I am not going back to the fertility clinic. No more tests.

I'm done.

Not necessarily done as in no second child ever, but done as in no needles in my ass again ever.

And it feels like a great weight off my shoulders.

I've been circling around this realization for a long time, without being able to see it clearly. If I'd really wanted to go the ART route again, I should have been back at the clinic a year ago, and I knew that. But something kept me from saying aloud that I didn't want to.

Partly it's that saying I didn't want to go through it all again feels like saying that my son wasn't worth it, which is of course not true — I would certainly do it all again, knowing I'd have him at the end. But doing it all again not knowing how it will end — and it could easily end in heartbreak — is something quite different. And doing it all again with him here is also different. I have realized that the question of what to do next is interfering with my enjoyment of the baby I have. When he's being adorable, I'm thinking in the back of my mind, this will be hard to enjoy when I'm distracted by treatments, or even when I'm distracted with a newborn. And when he's being hellacious, I'm thinking, how can I possibly manage treatment and him, or even two like him? It makes the good times feel watered down and the hard times more difficult.

It's also hard for me to admit that I can't handle much more than I have on my plate right now. It's not like my life is so tough — my job could be a lot harder, I could have a husband who doesn't split the home stuff fifty-fifty, we're all healthy — yet I'm not sure I could cope gracefully with much more. I've always had a problem admitting anything is too hard — I've got pride issues. And it seems somehow wrong to say that it's too hard to try for another baby; in an ideal world, I would like another, so if I can't do whatever it takes to have one, I must be weak.

As long as I'm admitting hard truths, I have to say that I don't find caring for a baby to be especially fulfilling. I adore my son, and somewhat to my surprise I love sleeping with him and breastfeeding him and singing to him and carrying him around. But I love when he heads off to daycare and I head to work, too. I don't daydream about staying at home with several kids — for me that would be more of a nightmare. When I am sleep-deprived and bored and isolated, I get depressed, and I don't mean down, I mean clinically depressed. Of course I wouldn't have to stay home if we had another baby, but I would certainly be more home-bound. I know this would be temporary, and it's hard to weigh a temporary bad thing against a possible permanent good thing. But then again, now is all I've got. I always tell my students, you have to decide what you want to do based on what you like doing every day. You won't find your joy by being miserable every day, even if you're working toward a goal you think will probably be wonderful.

Life is pretty wonderful right now as it is, and it's time to let all this go and just be here.

Feels good.

Sunday, February 19, 2006

At Least I Brought Donuts

I was sorely, sorely tested this weekend.

Please note that I said I "will do my best to be as positive, helpful, and ungrumpy as I can be" — whole lotta wiggle room there. And wiggle I did, because man oh man, did I get it from every angle. Some highlights:

  • Page at 9 pm, while at a party, with HellBoy clinging to my leg and weeping: "My husband saw Dr. Z the other day for a cough and stuffy head and a low-grade fever, and I'm not sure he's getting better as fast as he should ... he coughs a little more at night but also during the day and his temperature is 99.8 and his nose is stuffy, not clogged stuffy but hard to breathe a little but it's a little better if he takes decongestant but not all the way better and his throat hurt but it doesn't anymore and ..." I finally got her to stop and told her it sounded like they were doing all the right things, and she says, "That's what Dr. Z said too — here, I'll have him tell you!" Before I could say "Oh, I don't think that's necessary!" her husband got on and said, "I saw Dr. Z the other day for a cough and stuffy head and a low-grade fever, and I'm not sure I'm getting better as fast as I should ... I cough a little more at night but also during the day and my temperature is 99.8 and my nose is stuffy, not clogged stuffy but hard to breathe a little but it's a little better if I takes decongestant but not all the way better and my throat hurt but it doesn't anymore and ..." At which point I cracked and said, "I'm sorry, but I have a crying baby here and I'll have to go, sounds like you're doing ALL THE RIGHT THINGS! BYE NOW!"
  • Page at 9:30 pm, still at the party,* HB now with his dad in the other room howling "Mama! Mama!": "I'm a patient of Dr. C's, and he told me I shouldn't go to the emergency room anymore, because I could just pick up an infection there. But tonight I have a headache. Do you think I should go to the ER?"
  • Page at 10 pm: "I just took a shower? And I'm itching? You know, down there? It's the same soap I always use and I don't notice any discharge? And ..." I closed my eyes, remembered my resolution, and sweetly suggested she go the drugstore to get something over the counter.
  • Page at 10:30 pm: "I'm here in the drugstore? And I notice that it says on the box to ask your doctor if you're pregnant? And I'm not pregnant, but we're trying? And ..." I admit I was much less sweet on the second call.
  • Page at 4 am: "I've been having pain in my shoulder for weeks and I saw the doctor and all she gave me was 20 Perc0cets. Now how am I supposed to deal with pain like this if they only give me 20 Perc0cets? I went to the ER and they gave me ibuprofen. That's like taking nothing. I want you to do something about this pain." "Well, I'm just the doctor on call for emergencies, and I'm afraid I can't do much for you because I'm HOME IN BED." Which is always the wrong thing to say. She said, "Well, I'm sorry I woke you up, but I'm awake too, because I'm IN PAIN." When I told her I wouldn't prescribe narcotics over the phone at night she said, "Well you doctors just all stick together, don't you?" and slammed down the phone.

Then I got twice the usual number of patients dumped on me to cover at the hospital, which wouldn't have been too awful except that the damn pager Would. Not. Stop. Beeping. I think every nursing home resident in the state slid out of their wheelchair this past weekend, and the staff was required to report every single one to me. The poor house staff got essentially no help from me, and heard a lot of bitching and moaning.

But they did get donuts.

*Yes, we tried to go to a party while I was on call, and we took HB with us, and kept him up past his bedtime. I know, what was I thinking? Well, what I was thinking was, god dammit, I never get a chance to go to parties, and I don't want to leave HB with a babysitter when I won't see him during the day the whole weekend. He did take a late nap, which we figured would hold him over. And in fact it did — he refused to go to sleep until midnight. It was a fun party, or so TrophyHusband told me later. I spent most of it on the phone.

Thursday, February 16, 2006

I Am An Asshole

My colleague who announced her pregnancy last month had an ultrasound that revealed no heartbeat. She's scheduled for a D&E next week.

Now I feel really rotten about feeling jealous. And when she told me about it, she said, "People are asking if I'm going to try again, but I don't think so ... this got me thinking about how shaky my marriage is, and how much easier it's gotten for me since my son is getting a little older. It would be so hard to go through the early part again." She has a chronic and painful medical condition, but she does basically everything around the house. She asked her husband to put their son to bed the night after the ultrasound, since she was feeling pretty low, and he refused. To top it off, he wanted to have sex. (She declined.)

Then one of my other colleagues, Z, who's done several unsuccessful IVF cycles, overheard a medical student receive news that her father died. Z didn't really know the student, but she was worried about her driving the hour and a half to get to her family's, so Z cancelled her Valentine's plans with her husband so that she could drive the student home.

Now our wonderful friend E is going to spend part of her precious free day tomorrow babysitting for HellBoy, who is febrile and coughing and can't go to daycare. (E discovered this blog and was worried that I might feel like I can't complain about her here. AS IF.)

Basically, this is making it clear to me that I'm a selfish asshole.

I resolve to turn over a new leaf. No more Schadenfreude for me. I'm on call this weekend and rounding in the hospital and will do my best to be as positive, helpful, and ungrumpy as I can be to everyone I see.

Maybe I'll even bring donuts.

Sunday, February 12, 2006

The Club

Before I became a mother, I assumed that once I had a baby, I would be magically inducted into the Motherhood Club, complete with ID badge, secret handshake, and most important, invitations to play dates. It seemed like all of my acquaintances who had children participated in these mysterious activities. Once I was a mother, I too would have a huge circle of friends!

HellBoy arrived, and I waited with anticipation. Would the invitation come by mail? Or would there be a sudden knock on my door?

Maybe word got out about HellBoy’s hellishness, or about my social ineptitude, or both. Whatever it was, I was never invited into the Club. To be honest, I didn’t mind too much, because I never liked the uniform. But! Not long ago I (or rather we) did receive an invitation to our very first Play Date, from the parents of a little girl who is a classmate of HB’s.

I was excited and nervous. What to wear? Should we bring something? If so, what? Wine? Flowers? Toys? Were we supposed to arrive at the stated time, or fashionably late? (TrophyHusband and I can never get the timing right for attending social events. We never arrive earlier than the appointed time, but we’re commonly the first people there by half an hour or more, and have startled hosts in their sweatpants on more than one occasion. The one time we were inexcusably late, to a party given by my boss, I arrived with profuse apologies on my lips only to discover that for the first and only time we had timed it exactly right.)

Eventually we decided not to bring a gift, because in addition to being too busy/lazy, we reasoned that if this Play Date thing became a tradition, we didn’t want to be obligated to do it every time. We arrived 15 minutes past the scheduled time; hard to tell if this was okay or not, because we were the only guests. Nobody was in sweatpants or looked startled, at least.

We said our hellos (Smile! Look them in the eye! Ask how they are! Admire the house!) and were led inside, where I was pleased to see treats laid out on the dining room table. Oh good, I thought, we get to eat!

But no. We were led past the food and up the stairs. TH and I eyed each other. Where are we going? I mouthed. But he shrugged, at as much of a loss as I.

At the second floor landing, we paused, and I thought Oh, maybe we’re taking the tour of the house? I admired their baby’s room. HB ran the other way, into the master bedroom, which didn’t seem to alarm anyone unduly until he scampered around to the other side of their bed and located their lube and condoms, which he snatched up and brandished with glee.

Once the sex supplies were traded for a toy, we continued up another set of stairs to the top floor of the house, which turned out to be the playroom, and we finally understood that we were all to sit around and play. This disappointed me greatly, because I had hoped that we would all sit around and eat goodies and perhaps drink wine, and let the children play. This setup was beginning to look like work.

Then another slightly uncomfortable situation arose. It turned out that the little girl’s father was German, and spoke to the child in German. The uncomfortable part about this is that I speak German too (most useless language ever taught, by the way), and I wasn’t sure what to do to let him know that I could understand what they were saying. Announcing “I speak German too!” seemed unacceptably geeky. Simply breaking into German myself seemed unacceptably snobby (and besides, my German is way rusty, and there was a risk I’d say something unintended, like “I love your sex lube” instead of “I love your playroom”). Eavesdropping while not saying anything seem unacceptably sneaky. (Not that they were talking state secrets; it was just the usual “Up! Up!” “Do you want Daddy to pick you up?”) In the end I just tried to have a comprehending look on my face. Later TH said, “That was really weird that you didn’t say anything about speaking German!” Sigh.

So we all played and made stiff small talk. At one point HB insisted that we all hold hands in a circle and dance, which maybe some people can pull off without feeling idiotic, but I am not one of them. We were finally released when HB figured out how to turn on their stereo and crank the volume to 11 and insisted that this was the only thing he wanted to do for the rest of his life and how could we be so cruel as to refuse it?

So back down the stairs we went, and were finally allowed to have at the snacks. Which were very fancy. No wine, unfortunately, but good coffee. The small talk did loosen up a tad. It was a little hard to concentrate, though, because their house was very nice, much nicer than ours, and I was terribly nervous that HB would use his sippy cup as a cudgel and mar their (responsibly harvested) tropical hardwood table. Nothing of the kind occurring, we decided to get while the getting was good, and said our goodbyes.

I think that this was a relatively successful event. I’m sure I’m overanalyzing it, it being the first play date I’ve ever been invited to and all. I do wonder if the hosts had to report back to the Club on my behavior, and if so, will I be invited in after all?

I sure hope there's no hazing.

Friday, February 03, 2006

To the Bedside Manner Born

A friend mentioned to me recently that she's thought about going to medical school, but believes she wouldn't have the necessary bedside manner. I think she was referring to the fact that she's a little shy — she's certainly not rude, though she is wicked funny — and I realized that the things that are predictive of a good bedside manner aren't exactly intuitive.

For instance, a good schmoozer is not necessarily good with patients. I myself have never been able to schmooze properly. Part of this is the way I was raised; my mother never taught us many of the standard social niceties, like introducing oneself, saying hello and goodbye, shaking hands. (Truly, we didn't say hello or goodbye in my family. People are often startled by the way my mother will just get up and walk away.) I can shoot the shit with people I already know, but when I first meet someone, I have to keep reminding myself, Now you say hello and smile. Ask how they're doing. Maintain eye contact. I said maintain eye contact! It can be exhausting. (I find that meeting fellow bloggers is less of a strain, I think because I feel like I already know them.) But give me a patient to talk to, and I'm better than Oprah. Because a good doctor doesn't talk; a good doctor listens while the patient talks. I am the Queen of the Pregnant Pause. It's a rare person who can stand a silence longer than I can. On a blind date, this is death, but in an exam room, it's pure gold. And by the time it's my turn to talk and try to explain something or sell the patient on my plan, the ice is long since broken.

This may come as a shock, but in general, the people who are attracted to medicine as a profession are not the social superstars. Doctors tend toward shy and quiet; they're the sort of people who are more interested in observing others than being the center of attention. And I have often noticed that the way doctors behave socially is rarely the way they behave in front of patients. Which is a good thing, because I've met some real wackos. I am a real wacko. But I can say: "What brings you here today?" and then shut my trap. (And no, nobody ever answers "the bus.")

Of course, there are some schmoozy types who go into medicine. We call them "surgeons." I'm kidding, but only a little. We attendings amuse ourselves when meeting new medical students by trying to predict each student's future career path. Schmoozy, hail-fellow-well-met men: Surgery. Assertive women: OB/Gyn. Geeky shy cerebral types: Internal Medicine. Sweet happy types: Pediatrics. Crunchy happy types: Family Medicine. Intense oddballs: Psychiatry.

I have a meeting with each student halfway through the clerkship so that I can get their impressions of how it's going and give them feedback on what the residents and attending are too chicken to tell them to their faces. (I keep a box of tissues handy.) There are really only about three scripts that I have to remember, because there are themes that recur. One of the most common is the Shy Student. The problem with the Shy Student is almost never bedside manner; it's the interaction with the other members of the team. If you don't speak up, people think you don't know anything, but what's worse is, your good ideas about and knowledge of your patients go to waste. I myself got the Shy Student talk my first month on clinical rotations as a med student. The attending said, "I'm giving you a High Pass for this month instead of Honors, because you haven't spoken up enough." I have to say, I was furious. I thought it was ridiculously unfair. I mean, it was OBVIOUS that I knew more than the other medical students! Wasn't it? Er, maybe it wasn't. So I started being Mouthy Student, or as mouthy as I could be. And it worked: I never got anything but Honors ever again. What I tell students to do is: pretend you're someone else, someone you think is a bit of a loudmouth grade-grubber. No matter how hard you try, you won't really become one, but you'll definitely crawl out of your shell a little ways, and it's not as painful as you think.

So if all that's preventing you from applying to medical school is your quasi-Asperger's personality, I say go for it.