submitted!

16 Sep

Yesterday was the first day we could submit our applications for residency.  The website went down at some point during the day and, by the time I returned from clinic, it provided a cryptic message that it was temporarily out of service and would likely be opened again at 9am today.

I reviewed my application one last time while pumping in the colposcopy room this morning.   I sincerely hope that I (and my fellow supporters who were kind enough to read over my application) caught all typos; by lunch time, I couldn’t critically look at my personal statement at CV any longer.  I hit “submit” at 12:48pm.

Now I’m just hoping.  Hoping that programs will want to interview me, despite a less than ideal step 1 score.  Hoping that I’m received well at interviews, that I appropriately show my passion for pediatrics and for the programs to which I’ve applied, that I appear confident without crossing the line to arrogance, that I show myself to be a capable future physician.  Hoping that I’m overwhelmed with joy on March 20, 2015, because I was offered a job.

Please, wish me luck!

And, speaking of capable, look who keeps working to improve herself in the roles of big sister and helper, insisting on carrying her sister’s milk to daycare…

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oh my five (five?!!)

12 Sep

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It doesn’t freak me out that I’m 30.  What freaks me out is that it does not feel so long ago that 18-year-old Anna turned the corner of the Lawn across from Old Cabell Hall, ran into a bunch of Glee Club boys (we’ll let that sink in a moment), and was introduced by my boyfriend to “John, a pretty great guy.”  Blink, and we’re married (John and I, that is).  Blink again and it’s been five years and two babies later.  What, the what?

On my lunch break at clinic, I’ve been looking through posts of our anniversaries past: drinking our first anniversary dinner; happily celebrating two years, though I might have burst into tears at dinner out of worry that we would never have children; then spending both years three and four pregnant with thing 1 and thing 2.  We’ve had a good run!

Tonight we’re celebrating at Serpico, a collaboration between James Beard Award-winning chef Peter Serpico and restaurateur Stephen Starr.  The food looks incredible, but I’m also pretty excited for the cocktails, leaning toward the Midnight Society.  We had initially been thinking of going to a BYOB so we could bring our bottle of Barboursville’s Octogan, which we’ve been saving since we got married.  Just an excuse for our evening to continue when we get home to happily sleeping little ones, thanks to our fun, energetic, and kind babysitter.

Happy anniversary, John!  I can honestly say that I still love you more…than last year, than yesterday.  Excited for what our sixth year of marriage will bring!

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Just remembered this gem of all the UVA singers, and my heart was glad:

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why do doctors commit suicide?

7 Sep

I think I must have read a dozen articles of a similar message in the last couple months, each one scaring the bejesus out of me.  As this article explains, physicians are more than twice as likely to commit suicide than non-physicians, with female physicians three times as likely as male.  A staggering 9.4 percent of fourth-year medical students and interns reported having suicidal thoughts in the previous two weeks.

I don’t believe I have ever had suicidal ideation.  But, while I have been eager for the start of residency for quite some time (the first time I can prescribe a stool softener without the approval of an intern or senior resident–that’s going to feel good!), I can’t grasp how demanding it’s going to be.  I can only liken it to becoming a parent for the first time…but, for me at least, that was just one tiny human who, as challenging as she was, I’m not sure can overwhelm to the same degree as an entire floor during my first week of night float.

One particularly comforting excerpt, as I approach my hopeful employment:

It was over a dinner of Thai food that I finally opened up. One of my most accomplished colleagues in residency had complimented me on my clinical knowledge a couple of times during the meal. Sick of feeling like a charlatan, I told him about the trouble I was having with collecting clinical data and presenting it in an organized way on rounds. I confessed that I did not think I belonged in the program. He listened thoughtfully, and then uttered the three most beautiful words I had ever heard: “Dude, me too!”

ditch day

31 Aug

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This summer we elected to keep Ari in daycare despite the fact that I was home on maternity leave for nearly 11 weeks after Evie was born, and then another couple weeks between the culmination of my Frontiers course and my next rotation.  It’s a decision about which I felt some anxiety and guilt–sending one kid off to be looked after by other people when I, myself, was available; spending thousands of dollars on childcare that most mothers aren’t able to afford.  I acknowledge that it’s a luxury, let’s just start with that.  But here are a few of our reasons:

  1. We don’t have family in the area, and John was back at work less than 48 hours after Evie was born.  Especially in the early couple of weeks when my body was still repairing, I appreciated help with a toddler so I could focus on feeding and keeping alive our new little barracuda.
  2. After the initial period of repair, I still wasn’t sleeping consistently at night.  A nap during the day when Evie was sleeping felt necessary for maintaining my sanity, or at least my happiness.
  3. Probably the most important: Ari loves being around other kids her age, and she loves her daycare, or “school” as she calls it.  I honestly believe we would have been doing her a disservice, taking her out of a stimulating environment only to have her be bored watching me nurse Evie every 90 minutes, not to mention the harsh transition of leaving for a few months and then returning again when I resumed rotations.
  4. Tied for most important: I know Evie isn’t going to remember, but I think it’s good for her to also get some one-on-one attention.  I loved some of our tender, uninterrupted moments, just her and me.  And, if the weekends when John is working are any indication, Evie tends to feed and sleep much better if she isn’t anxiously anticipating Ari’s next onslaught of kisses or tickles or large packet of wipes…all meant in the name of love and attempts at being a helper, but distracting nonetheless.
  5. With waiting lists as they are, I’m not confident we could have gotten her (or her sister) back in daycare when I went back to school.
  6. Finally, I had responsibilities outside of family–residency applications, papers, certifications required for graduation from medical school–that required attention, and I certainly appreciated being able to spend several good, productive hours working on them during the day rather than relegating them to post-bedtime activities.

I’m not trying to defend our decision…well, maybe I am.  Bottom line: we had the option to have extra help, and we took it.  It felt like the right decision for our family, and I’m still working (a little) on not feeling lazy or like less of a mother for it.

I start back on my next rotation on Tuesday.  I really wanted to set aside some time with just Ari, which, between John’s crazy schedule and me putting last minute finishing touches of my residency application (available for submission September 15th!), proved challenging.  We found a window on Thursday this past week (I wish we had found more!) when John had the afternoon off and was available to take Evie, and I called the daycare to tell them we were playing hooky, taking a mental health day.

In the morning, with both nuggets, we took our time.  I think Ari must be going through a growth spurt, because she housed three eggs and two bowls of cereal!  Nothing felt rushed, and I sat back and watched Ari spend 20 minutes deciding whether or not she wanted to wear a shirt that day.  We went in to Crossfit for a WOD and then enjoyed a post-WOD sprinkle for a friend and fellow athlete expecting her fourth (!!).  In the spirit of Ari-day, we missed the group shot because I didn’t have the heart to tear her off the erg, but we couldn’t help documenting Evie and her matching “cousin”:

 

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Solo Ari-day officially began after lunch, books, and nap.  I fed Evie one last time, passed her off to Daddy, and Ari and I were off!  We took a second trip to the zoo.  Although the company of the last trip couldn’t be beat, I’d have to say this trip was more enjoyable, sans 94-degree heat or a febrile, diarrheal illness.  And it felt good being able to let her call the shots…like spending a disproportionate amount of time just staring at the goats, because goats really do go “BAAAHHHHH!”  And so can my daughter.  (They go “baaah” a lot when there are several male goats fighting over a female goat in heat.)

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On the way home, we stopped for froyo.  I was such a proud mama watching my baby use her spoon so well, not spilling a drop until the finale when she secured her lips around the side of cup and tried to pour the remainder down her throat (and then dark chocolatey brown yogurt got absolutely everywhere–in her shoes, in fact).  

Before heading in, Evie joined us visiting our neighbors and Ari’s most favorite canine named Dex, a bowlegged bulldog with quite possibly the largest head and tongue you’ll ever see.  Walking back up to the porch, John snapped the photo at the very top–I love it.  I seriously stare at it while nursing Evie in the middle of the night.  Our girls!  We just look so calmly content, rested, and well fed–a great moment at the end of a summer I’ll never be able to repeat.

 

cry-it-out epic fail

18 Aug

It isn’t right for everyone (like my friends in a one-bedroom Manhattan apartment, neighbors on the other side of three walls), but the cry-it-out technique of sleep training worked wonders for us.  After three months of spending every night pacing the downstairs, gently bouncing the constantly swaddled Aurelia (facing in, facing out, football hold, side/stomach position, you name it), and another two months of total dependence on this godsend, John and I sat down (per our friend’s suggestion) to some of our favorite movies and a bottle of malbec, and we gutted it out.  It took about three days and a lot of tears (Ari’s and mine) and stress eating (me), but then our nighttime terror became a (knock-on-wood) good sleeper, reliably going to bed by 7:30pm and sleeping a solid 10-12 hours.

When Ari was about six months old, sleep trained for a few weeks at that point, she woke up crying in the middle of the night.  Instead of rushing to her, I waited about 5-10 minutes, and the crying subsided.  When I went to get her the next morning, I opened the door and was immediately hit by the stench of vomit.  Vomit all over her crib, all over her.  She was cheerful enough.  I, of course, felt a huge pang of guilt.  It took a fair amount of lysol and oxyclean and open windows to get the smell of partially digested food and stomach acids out of the room, but we all survived.

We’ve been lucky to have gone nearly a year and a half without similar incident.  Much, much more frequently than not, if we do go in to rescue her in the middle of the night, we do more harm than good and just rile her up.  Most of the time when she cries she’s not even conscious, and there’s very little we can do to console her.  So we wait, and it normally works.

Yesterday morning was our first Sunday in a long time in our own bed without John having to work.  I was just putting Evie back down after a feeding at 5:45-ish when I heard Ari start to stir and cry.  By 6am, there was quiet.

At 7am, Ari started crying again, this time more insistently, calling, “Mommydaddy!!  Daddy!!!  Mom-mEEEE!  DADDYMOMMY!!!!”  John took one for the team and rolled out of bed.  I rolled the opposite direction and closed my eyes.

But the cries didn’t quiet; if anything, they intensified.  After a minute I heard John turn on the faucet to the bathtub and high-pitched screaming followed, loud enough to rouse Evie (she can normally sleep through the noise of a jackhammer), who looked at me perplexed.

Poop.  I suspected poop or vomit.  Or both.

John confirmed the former.  It was everywhere–her crib, her stuffed animals and lovey tiger Neville, her books (the poor cat in the hat had it caked all over every page), the floor.  She had it matted into her hair and her pajamas, under her fingernails and IN HER MOUTH.  My poor daughter was literally eating her own feces.  When John discovered her, she was holding out her hands and crying, pathetically begging for someone to FIX THIS SITUATION.

She was bathed and changed.  Teeth were brushed.  As soon as we got 2 bowls of Multigrain cheerios and a couple eggs in her belly (I suspect a growth spurt, therefore increased food consumption leading to high poop volumes), spirits were raised, and she seemed to have forgotten most of the trauma from the morning.  Still, we tried to make the day extra special.  All was forgiven after our family outing to Melodie’s–iced coffee for us, a fresh croissant for her–followed by please touch.  We’ll also be treating her to some new books, because some, I’m afraid were poop-i-fied beyond repair–I didn’t even bother recycling them…can you recycle poop-covered literature?

Because it’s just been too long since we had a post about bodily fluids…

Will write more about our recent trip and epic wedding (so much happier than CIO epic fail), but just a few pictures of one of our favorite Philly families, transported to Virginia for the celebration.

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And a choo-choo…

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cheese!!

16 Aug

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Guh!  She tries so hard now when you encourage her: “Cheese!”  Makes me think of these first attempts…

At the old duPont garden home:

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It felt right to spend my mother’s birthday surrounded by orchids.

 

definitely the best part

7 Aug

The single greatest impediment to error prevention in the medical industry is that we punish people for making mistakes.  (Lucian Leape, MD, “Error in Medicine,” JAMA 1994)

The last two weeks have been a helpful crash course in patient safety.  I’ve enjoyed nearly all of it, but I admit that I’m sensitive to what I perceive as busywork.  I’m giving a presentation with a classmate tomorrow on one possible intervention for improving the current method for incorporating a patient’s outside imaging into his hospital record.  What has been, I think, a productive thought exercise and possible tangible product, has also been tangled in a mesh of unnecessary, frustrating, fruitless efforts, which have taken up more than just my own time.

You could argue that the frustration, the perhaps unnecessary efforts are all part of it, helpful tools and experiences in their own right.  But this afternoon I just couldn’t wait to come home to this:

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It broke my heart this morning to have to rush her and Evie out the door this morning, while she tried to crawl into her backpack, desperate to go for a walk.  God, Ari makes me laugh the way she insists “Hah!  Hah!” (Hat), while tapping the top of her head.  And our sweet, docile second child…not quite sure where she came from.  She likes having her fontanelle stroked, her soft forehead caressed.  One of her caretakers at daycare said that she will be our family’s peacekeeper, and that we’re gonna need it!

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