Archive | January, 2013

singing to my daughter

31 Jan

singing 1

When all else fails, singing nearly always works.  At first I thought it was me.  I once glowingly told John, “You know, it sometimes feels like it’s been so long since college (and my music major days), I think I forgot that I’m actually good at this.”  Oh the arrogance!  I thought I was the freaking baby whisperer.  And then I saw Eric put her abruptly to sleep with a few choruses of “Row, row, row your boat.”

Thank you, Megan, for the picture above; it was a good moment.



sunday morning

27 Jan

sunday 2sunday 1

We are SO close to capturing her first giggles on video tape.  But she either sees us whip out the iPhone and goes silent, or we cut camera a split second before she starts chuckling (like below).  Right now she’s really digging some Mat Kearney…

welcome to day 100 of life!

24 Jan


My daughter somewhat resembles a troll doll, nest-ce pas?


our favorite

24 Jan

John got home from his overnight shift, ate some eggs, then fell asleep on the couch, a dram of scotch balanced precariously on his lap.  As Ari’s squawks from upstairs increased in frequency, I urged him to get up so he could join me in what’s become our favorite time of day–it’s also the least painful way of moving him from couch to bed.

Every morning, when she sees us in response to her high-pitched barks, her pissed-off pout melts away into the most heartwarmingly ecstatic grin you could ever imagine.  She starts cooing excitedly and kicking her legs wildly as if she’s saying, “OH!  It’s YOU!!!  I know you!  You’ve come to rescue me!!!”  And then she nestles so effortlessly against our chests.  It’s. The. Best.

favorite time 1favorite time 2

to my friends (pro-life & pro-choice)

23 Jan

Yesterday was an interesting day to go on Facebook.  Roe v. Wade was decided 40 years ago.  A number of my friends posted links or strongly worded sentiments to convey their opinions about the ruling.  Some of them, due to the manner of expression not the opinions themselves, offended me.  Some of them made me curious, namely this article (fact check strongly needed), this one and, most tragically, this story, which took place along my commute to and from school.  I think that the best way to not be heard would be to post another argument so, I assure you, this post is merely personal anecdote.

One day, but not today, I will write about my infertility diagnosis.  We received medical help in order to achieve pregnancy.  I look into my daughter’s face, I admire her small hands and feet and the healthy rolls of brown fat around her little thighs, and the idea of life without her is unfathomable.  We are so lucky.

And then I think about a conversation I had with one of my physicians a little over a year ago when we were concerned about hyper-stimulation and risks of multiple gestations and what our plans would be if we conceived more than twins.  Reduction of pregnancy is recommended for the safety of mother and the other fetuses.

And I think about the women I met during my OB rotation.  I think about the woman who had over three previous c-sections, fallopian tubes completely inaccessible due to scarring–another pregnancy was a serious threat to her health, yet, after discussing her options, her physician helped her continue with her pregnancy without judgment.  I think about the woman living in abject poverty who was pregnant less than four weeks after her last delivery; she couldn’t imagine doing it all again.  She chose a dilation and curettage, and then she scheduled an appointment for the Mirena.

Abortion sucks.  Everyone thinks so.  This summer I briefly worked with a physician who said that the only doctor who had performed more late-term abortions than he had was dead–he too thinks abortions suck.  I’m hopeful that people and systems are offering alternatives, and I hope they continue to.  But reason informs me that neither their access nor their impact will improve should abortion be made illegal.

Whether you’re pro-life or pro-choice, I doubt very much that anything I say could sway your opinion.  So, if you’re still reading, I think that the face of abortion is varied and profound, and the arguments surrounding them cannot be summarized by the extremes.  Psychopaths on either side exist, and they scare the shit out of me.  But neither Scott Roeder nor Dr. Kermit Gosnell is representative.

It saddens me deeply that we have, in part, stopped tolerating each other, that our arguments only serve to anger rather than challenge each other.  I am, by all accounts, an open book, yet the topic of abortion has become the only taboo in some of my friendships.  In my Facebook newsfeed, I feel shear rage emanating from some of the profiles.  I hope you’ll let me know what I can do to improve our conversation styles, to show you respect, as I hope you’ll show me.  In my humble opinion, this might be a good step in reducing abortions.

Along a similar topic…

hope in the next four

21 Jan
Taken by my friend Leslie at the Inauguration.

Taken by Leslie at the Inauguration.

We, the people, declare today that the most evident of truths —- that all of us are created equal —- is the star that guides us still; just as it guided our forebears through Seneca Falls, and Selma, and Stonewall; just as it guided all those men and women, sung and unsung, who left footprints along this great Mall, to hear a preacher say that we cannot walk alone; to hear a King proclaim that our individual freedom is inextricably bound to the freedom of every soul on Earth.

It is now our generation’s task to carry on what those pioneers began. For our journey is not complete until our wives, our mothers and daughters can earn a living equal to their efforts.  Our journey is not complete until our gay brothers and sisters are treated like anyone else under the law —- for if we are truly created equal, then surely the love we commit to one another must be equal as well.  Our journey is not complete until no citizen is forced to wait for hours to exercise the right to vote.  Our journey is not complete until we find a better way to welcome the striving, hopeful immigrants who still see America as a land of opportunity — until bright young students and engineers are enlisted in our workforce rather than expelled from our country.  Our journey is not complete until all our children, from the streets of Detroit to the hills of Appalachia, to the quiet lanes of Newtown, know that they are cared for and cherished and always safe from harm.

~President Barack Obama, January 13, 2013

I love that our daughter was born while this man was in office, was present during his reelection, was developing her so impressionable personality while these words were spoken.

coming home

19 Jan


Wouldn’t it be sweet if I said that it was only this little hobgoblin that got me into my car and out of the city, back home before midnight?  In truth, as I alluded to so very awkwardly to a few friends this evening, dilemma #9 is what I have to look forward to if I’m out past curfew.  When you have a growing babe who vomits half of what she eats and therefore eats all the time, it is difficult to be away more than three hours without feeling like a porn star…and, with stretched out flabby abs, a porn star well past her glory days.

God I wonder what my kid will think when she discovers this blog…


philadelphia protocol

18 Jan

One of the biggest arguments/fights John and I got into was in mid-November when I took Ari with me to a good friend’s 30th birthday party.  Ari was just shy of 30 days old, and I took her without confirming that every single person at the party was free of disease, though I did hand out Purell as soon as I walked in the door.  In all honesty, John was right to be miffed as he was, though, in my defense, I thought exposing her to some germs was probably safer than spending another night in the care of a sleep-deprived mommy with a case of cabin fever so severe that she thought she might literally push her head through a window.

I know we medicine types must seem crazy overprotective when it comes to newborns.  It’s because we know what’s in store for them if they even hint at being sick.  Turns out these little tikes can somewhat easily develop what we call a Serious Bacterial Infection (SBI), such as meningitis, pneumonia, pyelonephitis, and gastroenteritis.  Fever may be the only sign of illness.  Evaluation of a potential SBI includes a full sepsis work-up: blood work; urinalysis via catheter; lumbar puncture; chest x-ray; possibly CT, MRI,  and ultrasound of the head in cases of meningitis.  The treatment for an SBI includes empiric antibiotics and hospital admission.  No fun.  Possibly the most un-fun situation you could imagine except, of course, not providing empiric antibiotics and admission to a kid who actually has an SBI.

If the kid is 28 days or fewer in age, he is considered to be at high risk of having an SBI.  Therefore, a full sepsis work-up, hospital admission, and antibiotics are required.  Age 29-60 days is a grey area.  There are a number of different protocols used to determine which infants in this category require the whole rigamarole .  In Philly we, not surprisingly, use the Philadelphia protocol.  A full sepsis work-up, pleasant as it is, is still required to determine which kids are at “low risk” and can therefore be sent home without antibiotics as long as there is assurance of 24-hour follow-up.

Although there is no protocol, that I know of, that guides our treatment of the febrile infant at 61-90 days of life, I understand that most pediatric emergency med docs are cautious.  If a kid less than three months old comes in with a fever, he’s likely to undergo the diagnostic work-up.

Therefore, it is with one great sigh of relief that I quietly celebrated Aurelia’s three-month birthday yesterday!  She’s still pretty squishy, but she seems just a little stronger each day I get to know her.  We got through three months with nothing worse than a little reflux and labial adhesion (yeah, that apparently is a thing…don’t be too aggressive with them wipes!); nothing some zantac and estrogen cream can’t fix!


the plan

16 Jan

I was recently arranging a visit with a friend during her study break.  She, like many of my classmates, is studying for Step 1 of the boards, the first in a series of tests on the way to becoming a board-certified physician.  Most students at Penn choose to take this exam in February/March of their third year of med school, after the completion of the year of core clerkships the December prior.  From what I understand, they typically study about 10 hours a day, 6 days a week, for 6 weeks.  This exam tests the basic sciences, which I’m sure is interesting to some, but biochem and physiology are not the stuff that gets me up in the morning.  That said, I admit I’m starting to feel a bit envious of my classmates, both for the opportunity to study 10 hours a day (I can’t believe I’m writing this!) and for the continuation of their progression toward becoming a doctor.  I feel left behind.

I don’t believe I publicly confirmed my plan for the completion of medical school.  After many, many conversations, John and I decided that I will be taking a year out of school, though a bit unconventionally.  I will be returning for nine weeks April-June to complete my remaining clerkships: neuro (three weeks) and psych (six weeks).  John’s grandparents will be staying with us during that time to look after Ari.  In the summer, my hope is to prepare for and take Step 1, and hopefully take the Clinical Skills portion of Step 2 as well.  I’m currently looking for daycare options for that time.

In the fall, I will be a full-time graduate student of bioethics.  The MD/MBE is normally completed within the four years of medical education at Penn.  At this time, I’ve completed a little over half of the requirements.  We thought that, though it’s feasible for MD students to get this Masters and still finish in four years, and it’s feasible to have a child and still finish in four years, an MD + Masters + child seemed a bit overkill.  I will resume my MD pursuit in January 2014.

Truthfully, even if I wasn’t working on a Masters, I think I would want to take a year out.  I feel like it’s a very rare privilege to be able to take this time to be with my daughter–to witness all her small discoveries (the look of wonder and the muttering “guh! uh!” as her eyes fix on a lamp…never gets old)–that I might never have again, with any of my children, if we’re lucky enough to have more.  From what I understand, it’s so much easier to take time off in school than it will be in residency and beyond.  And, although being six years behind one’s husband in professional training does have it’s downsides, we feel so lucky that one of us is making an income, so it actually makes some short-term financial sense for me to stay home to avoid some childcare expenses while not paying tuition (in the long-term, it’s probably better for us that I get out of school as quickly as possible and start making an income but, hey, we’re living in the now!).

I spoke with one of our pediatrics course directors a few weeks prior to Ari’s birth.  She had taken a year off after the birth of one of her children.  She said that it was a great year, but that it also helped confirm that she was a happier (perhaps better) mother if she was not stay-at-home.  I imagine my first day back in the hospital will be painful.  I’m not ready for it now, and I doubt I’ll be ready come April.  But I miss school, I miss it very much.  There are moments when I’m holding Ari, and she’s so sweetly clinging to the folds of my clothing, breathing rapidly on my neck, and I can’t help but think, “Why the hell did I go to medical school?”  Then I find myself getting jealous when my friends talk about studying for the boards, or I can’t wait to run home to read up on chronic lyme disease after I learn that a mom at my yoga babies class suffers from it, and I know that I will be a better mom if I have a career that I love outside the home.

The plan is for me to graduate from medical school in May 2015, hopefully figuring out how to strike a good balance between motherhood and medicine and other good stuff in the mean time.  Suggestions welcome.

what a champ

15 Jan

We’ve taken Ari out and about a bunch in the last week.  Our three dinner parties this weekend seem to have sufficiently worn out our little champ, as she has been found napping while she was supposed to be burping.  Submitted as evidence:

rough nightrough morning

Her hair and eyes might scream “John,” but her sleeping habits she definitely got from me…I can just see her years from now, in one of the front rows of a lecture hall, nodding off mere yards from the professor.  Or, worse yet, if she chooses to go into medicine, falling asleep in an OR like her classy momma.