Archive | September, 2014

belly button specificity

30 Sep

We’re in Charlottesville!  On Friday we packed up the family and moved down to Virginia for four weeks so that I could do an away rotation at UVA in ambulatory peds.  We are thrilled to be here, but the process of getting down here was brutal, made worse by the fact that Ari was febrile for most of the weekend and I wasn’t feeling so hot myself.  But we are all on the mend and settling in.

We rented a lovely cottage-like old home not too too far from the hospital.  John is taking two weeks of vacation (though he is working hard to tie up [or tie together] a number of research projects and academic obligations), followed by a week of CME (continuing medical education) so we can be together.  The last week down here with the girls will be a bit of a scramble, but I have an overly generous friend swooping in to help out!

Day one pediatric primary care pearl: If a small child comes in complaining of a belly ache, when asked about the location, he will almost always point directly to his belly button.  As the stated location becomes further and further from the belly button, there is increased likelihood that there is true underlying pathology.

And regarding my heart: I am, now as always, so grateful for a loving husband who is an awesome father, two daughters somewhat willing to take things in stride and make adjustments, and nurturing, thoughtful, and trust-worthy childcare.  Particularly with Charlottesville making national news recently, I have been having anxiety about leaving my girls with new caretakers, neither of whom I had met prior to this Sunday.  I don’t think my kids could be in better, more loving hands.  (If anyone is looking for childcare in the Charlottesville area, let me know, I have some recommendations!)  Knowing that they are safe and happy has allowed me to focus on my education and take full advantage of the privilege it is to be here.

It helps that the caretakers aren’t shy about snapping pictures:



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women’s health elective

24 Sep

I started med school truly believing that I was meant to go into either geriatrics or women’s health.  Things change.  Since I am now most certainly going into peds (at least I hope some of the programs to which I’ve applied consider my application), I tried to cram as many peds electives as possible prior to Evie’s birth.  But now I’m at the tail end of my clinical requirements–I literally only require three more days  of clinic in order to graduate–so I decided this block to scratch an itch.  As a candidate for the Certificate in Women’s Health at Penn, I am required to take one elective in women’s health, but there are a number of reasons why I wanted this elective, for me:

  1. Personal interest: the female body, it’s not simple.
  2. On the first day of our reproduction course (first year), the course director said something to the effect of, “There will likely be, in one way or another, women involved in your life–mothers, sisters, wives, daughters, friends.  And, as a medical professional, you will be counsel to them.  It’s crucial to know the basics.”  Perhaps I shouldn’t be asked for advice regarding health care, but some do, and I am overwhelmingly flattered (especially since I’m married to a real authority).  I guess that roughly 85% of questions I field right now are ob/gyn related: My gynecologist says I have to have a colposcopy–what’s a colposcopy?–the description sounds terrifying.  Is it true that I can’t lift more that 35 pounds while pregnant?  Hey there, I’m having contractions, when should I go to the hospital?  Although I can always play the student card–as in, “this is just what I’ve learned, and you can’t take it as real advice, what do I know?”–that’s not going to fly as well when I have (hopefully) an M.D. next to my name.
  3. Approximately half of pediatric patients are female, and adolescent females in particular (not to mention younger girls experiencing precocious puberty or abuse) require some of the same health and preventative care as older women.  I think what I’m learning this month is hugely applicable.
  4. There was a period of my life when I thought ob/gyn was the field of medicine for me.  As much as every peds elective I’ve completed has reinforced my desire to go into pediatrics, I wanted a women’s health elective to affirm that I do not belong in that field.

I’ve enjoyed the last 3.5 weeks tremendously, though feeling a bit spread thin at times juggling family, now convinced that we will need more (likely live-in) childcare lined up during my residency.  And I do feel convinced that ob/gyn is not field for me, but I’d like women’s health to be an integral component to my pediatrics practice.

Oh, and I’m now terrified of my bone health.  When women hit 30, they’re no longer building bone as rapidly.  And all those years of multivitamins and calcium supplements have not been shown to help.  Today I bought my first container of Vitamin D3, 1000 IU softgels.  It’s a necessary component of bone health.  Although we get it from the sun in the summer (if we show skin outside), an endocrinologist once told me that, in the Northern hemisphere, we could lie naked outside all day during the winter and still not absorb enough Vitamin D.  I am also paying more attention to how much calcium I get in my diet–45% daily requirement in a cup of almond milk!

Since I’ve been awful at posting, a few from our last-day-of-summer romp through Chanticleer:

chanticleer 1 chanticleer 2 chanticleer 3

Oh goodness, either my arm or her neck just isn’t long enough for a proper carrier selfie…she looks concerned:

chanticleer 4 chanticleer 5


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


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!


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


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!”