anna in med school

We could not be happier to welcome Jéssica to our family in less than two months!  Since Match Day, we had been searching au pairs through Au Pair Care (chosen mostly because it is the agency one of my mentors uses).  There were many people who looked kind, responsible, and capable.  But when Jéssica’s profile popped up in my search, something clicked.  Her photographs looked not just friendly but genuine.  Her profile description didn’t seem canned.

Jéssica is from Santa Catarina, a state in southern Brazil.  I have vague memories of my girl scout troop representing Brazil for World Thinking Day when I was in second or third grade.  I think I attempted to make a mosaic out of poster board; we might have cooked good food.  Clearly we know not nearly enough about Brazilian culture and stand to learn a huge amount from Jéssica.  Although she would like to practice her English (which, we learned from our interviews with her, is already excellent), it will be wonderful for John’s grandparents to be able to speak Portuguese with her.

There are certain details about her personality–her likes include cooking, hiking, dogs (she has one named Marley), and of course children–that resonate with the jive of our family.  Per her own admission, she talks a lot (she will fit right in!).  She has a degree in nursing and experience driving in New York City!  She has two older sisters.  And her family is very important to her.

“On paper” she looked awesome.  But it was our interview with her that did it.  We skyped with her twice, but I think John and I both knew it was her (if she would have us) within a few minutes.  She is warm, playful, thoughtful, and sincere.  And she won several smiles and giggles out of both girls–rare feats when so close to nap time.

We received her travel itinerary today–it all feels very real!  I admit, a little bittersweet.  While there is nothing wrong with more people loving on my daughters (thanks for the reminder, Mama Mills!), and I am sure she’ll quickly become part of the family…my transition from being full-time mom to working 60-80 hours a week will take some adjustment.  I want my girls to love Jéssica (I’m sure they will), and I hope she loves them.  But it’s gonna sting the first time I see Ari run to her after she falls down, or Evie reach for her when she’s hungry.

And, again, 80 degrees but insists on a wool cap.  Oh, my heart.

One of my favorite moms often listens to NPR in the background throughout the day.  While wrangling several small kids, she likes hearing news and stories told by other adults.  And, as she explains, it gives her something to talk about (other than her kids) at dinner parties.  I could never do that.  NOT because I would be concerned about distraction from my kids…but I hate missing words or fragments of stories.  Ask John.  I am the worst person with whom to see a movie, always frustrated and fixated on the word I didn’t get from the last dialogue.

But I have been trying to get in the rhythm of turning on podcasts while cleaning up after the kids are asleep.  I stumbled upon a TED Radio Hour from a few weeks ago that felt oddly applicable to life.  In “Press Play,” the speakers describe how all different forms of entertainment–spontaneous play, sports, video games–can make us “smarter, saner, and more collaborative.”  I was particularly taken by the work of Dr. Stuart Brown, a psychiatrist and founder of the National Institute of Play.  He was one of the experts charged with examining Charles Whitman’s motives to commit the murders from the Tower of the University of Texas, Austin.  Brown discovered a disturbing lack of spontaneous, free play in Whitman’s history.  Any natural playfulness was suppressed by an overbearing and abusive father.  Anyone who knew him growing up admitted that they never saw him engage in play.  Brown’s “research of other violent individuals concludes that play can act as a powerful deterrent, even an antidote to prevent violence.  Play is a powerful catalyst for positive socialization.”

I mentioned I thought this was applicable to life.  There are two main reasons.  First of all, I have recently had some guilt over not having enough planned activities for my kids, or not engaging with them enough so I can clean, make a phone call, cook dinner, etc.  While I never thought I was doing my kids any lasting damage by letting them figure out their own fun using toys/books/crafts/coasters/paper bags/whatever-other-household-item-that-strikes-their-fancy (all of which I maybe ought to swamp out every now and then), I’m a little relieved that this kind of play (seemingly mundane when Evie studies a green plastic ball for 5 minutes 🙂 ) is good for their development.

Secondly, we are in the midst of signing up for preschool for Ari in the fall, and I am blown away by how much they vary.  One our close friends, who is also an educator, mentioned to me something about the importance of “play-based” learning for her kids.  What in the what now?  After poking a little bit around on preschools’ websites, I am onboard with this teaching/learning style–giving small toddlers extra freedom, allowing for self-discovery and self-guided play in the school (not that I really know anything about anything yet).

As of about 10:30am today, there are only 15-20 pages of writing between me and the M.D.!  And yet I feel like I know nothing and have to study ALL THE THINGS before July 1.  My friend recently posted this article about some of the problems (and impact) of resident work hours restrictions.  Any other rising interns out there starting to sweat a little?  Yet, graduating from medical school, that is going to feel good (at least the day of).

My little firecracker is going to be 30 months old tomorrow.  I sometimes take pause when, intertwined with the songs about Frozen or the weather or magical eggs, I hear her call “I’m bringing booty back” and something about “all the right junk.”  Maybe we should listen to more Putumayo.

Still young enough to insist on sandals and a winter hat when it’s 65 degrees:

Ah, it’s a big one this year!  But in the mess of getting everything organized for the move (and so many life changes), we have only had little celebrations here and there (like some close friends over for a simple meal last week)–and I think this guy deserves a little more fanfare.  I’ll be brainstorming, but suggestions are welcome!

Happy birthday, love!  Your girls and I adore you!

By 6 months, Ari was chewing on lemons.  Evie, well…fruit (save really ripe bananas) might as well be Warheads.

I. Just. Can’t.

The girl loves a good tutu, what can I say?  I wish I got a good picture of her in her tutu while playing construction site or ooohing and ahhing over a real life-sized excavator.

Last night, she insisted on wearing her fleece footsie froggie pajamas.  After realizing that it was, in fact, really freaking hot, she demanded to wear her tutu.  Only her tutu.  I forgot where I first read that one secret to parenting toddlers is to just say yes, whenever possible.  The sight of her opening the door to her bedroom at 6:30 this morning, rubbing her eyes, in nothing more than a tutu…the sweetness almost made up for next moment, when she first saw me on the other side of the door, slammed the door in my face and screamed, “NOOOOO!!!!  Want DADDY!!!”  Nevermind that she had been calling for me for the last 5 minutes.

It’s a sensitive subject.  The American Academy of Pediatrics recommends that television and other entertainment media be avoided in children under 2 years, but recent evidence suggests that it’s use might be appropriate if used judiciously.

I’m not going to lie.  We first reverted to the use of an iPad when Ari was 13 months old, during a flight home–the dizzyingly repetitive song “Ten Little Numbers.”  Now that she’s nearly 2-and-a-half, we often watch 2 episodes of Daniel Tiger a day, plus FaceTime with Dad or cousins right before bedtime.  Maybe 70 minutes a day?  And it’s not like I have some power to avert Evie’s eyes during that time.

So, not a ton of TV, but not minimal.  And definitely not the the most interactive form of media.  I feel concerned when we reach for the remote for a third episode.  I feel proud during the days I’ve kept them so busy that Ari never asked for her beloved furry friend.  I have three main fears: 1) Screen time will negatively affect their development and attention.  2) I’ll use the screen as a babysitter.  3) They’ll become as addicted to the use of TV and other media for relaxation as I sometimes fear I am.

Right now it’s fear #2 that’s at the forefront in our household.  John’s been working strings of 3p-11p shifts, leaving me for solo dinner, bath-book-bed routine.  I know tons of parents do it, all the time.  Still, after a while I felt like all the joy was sapped out of bedtime as an exhausted Evie wailed on the ground as Ari and I brushed teeth, or as she tried to turn the page of a favorite book prematurely (much to the annoyance of her older sister) and Ari would finally aggressively claw at her hand.  Bedtime became more about alternating tantrums and timeouts rather than stories, songs, and cuddling.  And the entire process would take me 90+ minutes.  Success was never guaranteed.

Then the other night, after the girls had their bath and were in pajamas, I let Ari watch an episode.  I then gave Evie 20 minutes, just her and me–she fell asleep on my chest and transferred peacefully to the pack-n-play (poor girl still doesn’t have a crib…a project for the new house).  And after that I had my time alone with Ari, reading about the dot or a giraffe and a half without tantrum or really any argument about bedtime.  I’m not saying that a little television is a silver bullet, or that it’s appropriate long term, but in that moment it gave us a breather I felt we all needed.  (This could also be an argument that my kids need to learn how to play independently better.  That might be true.  However, I do think that their normal abilities and coping mechanisms seem to unravel at the end of the day.)

Full disclosure: I absolutely resorted to Daniel Tiger this weekend.  I threw out my back (damn awkward car seat!), John was working, and it’s nearly impossible to find a babysitter on Easter weekend.  I took a dose of Motrin and Flexeril, and lay down for a blissful/still painful 30 minutes on my kids’ play mat as Evie cruised over me and Ari sat perched on the couch above, tucked with three blankets.  I am feeling loads better today, and so thankful for the spring breeze!

I’ve been thinking a lot about the Match process and those who are unmatched (and I’m feeling ridiculously lucky to have a job when I get out of school).  This article touches on some of the problems, though it focuses predominantly on those who received medical education outside of the U.S.A. and attempt to complete residency here.

I wish I could figure out how to give all readers access to this article; if you’re able, I highly recommend “Manipulation and the Match” by Dr. Carl Erik Fisher, a former member of the National Resident Matching Program’s Board of Directors.  Like many other professions, I assume, the hiring process becomes a sort of game; and a “successful” match is often determined by how well one plays the game.  For good reason, we’re required to read this article prior to meeting with our Dean of Student Affairs and applying for residency.

Personally, I’m not sure how well I played the game…I think the honest answer is “well enough.”  I do feel grateful to be married to possibly the most strategic partner I could hope for, who went over with me 98% of my communication with the people who were influential in my match.  The mentorship I received from both Penn and UVA during my away rotation also helped guide me.  If you remember, I made some mistakes during the application process.  But here are the things I think were most beneficial to me:

1. I did an away rotation at the institution at which I hoped to train (UVA).  I showed up early and left late.  I always volunteered to see the extra patient.  The fact that I moved my whole family to Charlottesville for four weeks showed that I was honestly passionate about the program.  And (at least to my knowledge) I wasn’t a jerk.
2. I didn’t take “no” for an answer.  I applied to 12 programs.  I interviewed at 11 of them.  Two of those 11 likely would not have interviewed me if I hadn’t communicated directly with them about my genuine interest in their programs.  I believe programs tend to look more closely at students who are actually serious about them.
3. The Advocacy Call.  After many, many discussions with John and my mentors, I decided that I wanted to go to UVA.  I then met with the Program Director at CHOP, the children’s hospital affiliated with Penn, and I told her that I would be ranking UVA as my first choice.  She then kindly offered to make an advocacy call for me.  You can argue that applicants (and programs) lie all the time.  But considering that, if we didn’t match in Central VA, we would want to stay in the Philly area, a phone call from the CHOP PD really shows commitment.  We were all in.

During the inspection last Friday, I was uncomfortable walking through the beautiful (and apparently very well made) house we’re hoping to buy.  “This is an adult’s home.”  Over 3 times the size of our duplex, it can comfortably house our whole family and an au pair and a dog.  (John wants a dog.  I want John to be happy.  And I like the idea of a dog.)  I could park the stroller in a garage instead of our dining room.  I could get some of our wedding gifts out of boxes and into kitchen cabinets.

“You’re a 31-year-old mother of two.  You don’t feel like an adult yet?” John responded.

Something about being the perpetual student…it feels like an extension of adolescence.  Do you know that there are adolescent clinics?  Not the typical child you would see at the pediatrician’s office, but not someone who has fully embraced the adult medical world either.  The range of accepted patients is typically 12-40 years old.  40-year-olds??!  That feels like a generous inclusion.  Then again, maybe I’ll feel differently when I’m 40 and a mere few years into my first real job.  When I was a teenager I thought I would have my whole life in order by age 25, but instead I was filling out applications for medical school.

Residency, from my understanding, is like an apprenticeship.  We learn by doing, so we do and therefore learn a lot, never without the watchful eye of one or multiple more senior physicians making sure we don’t make a catastrophic error in patient care.  But it does feel like a true job.  The salary helps.  Despite it being not terribly significant when compared with the numbers of hours I’ll be working, it’s the biggest salary I’ll have in my lifetime to that point (not saying much).  And it should more than cover all our childcare expenses, which I’m hoping will take away the pangs of guilt I feel from hiring help so I can spend more money to attend medical school.

Then there are the reams of paperwork I have to complete in order to be credentialed to work–background checks, medical training license application, drug screening, to name a few.  And the process of interviewing and hiring a live-in au pair.  Yet I still sometimes feel like a little girl playing house.  In a few months, I’m going to introduce myself to patients and their families as “doctor,” so I need to suck it up and fake it until I make it.

More pictures from last weekend coming, but for now, here is Evie cultivating her C’ville friendships: