A Cry in the Night

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My daughter screamed bloody murder from the day she was born. 

What was I doing wrong?

At first I thought it was because my milk supply had not come in but then that was no longer a factor and still she did not stop.

She was well fed. I changed her diapers. I dressed her in adorable clothes. I cuddled her. I played with her. There was nothing wrong medically. 

What was I missing?

I went through everything I knew how to do everything they teach you in medical school and residency, all of the advice I always gave parents struggling with this. I scoured the internet like other desperate mothers. All worthless. Once she started screaming, I could not make her stop.

I was a failure but not just as a mom. I was a failure as a physician.

When I look at pictures of her early infancy now, I am ashamed. I missed out on so much of the joy and love I should have felt then. Instead, I used to wear earplugs just so I could be around her. 

What kind of mother DOES that?

The only thing that would calm her down was bouncing on an exercise ball. I bounced for hours. When it was her fussy time, God forbid I ever stopped bouncing…

Wails and wails and wails.

Which is worse? Sore thighs and butt from an exercise that never seemed to make them smaller or the painful high pitched unrelenting screech of an angry infant? In time I felt imprisoned by her. Trapped. I didn’t want to keep bouncing on that goddamn ball, I didn’t want to listen to her scream, either. Bouncing with anyone else was not cool by her.

I desperately wanted to send her back.

Eventually, after a few months, it did stop. Colic always does if you can just endure, and while the scars have dissipated to some degree now years later, they still remain. I never appreciated how disruptive it is, how much it wounds your heart, until I lived it. Colic robbed me of being the mother that I thought I was, the one that I wanted to be… doting on my beautiful baby girl.

So much for fairytales.

We survived. I love her. She loves me. She screams but not for hours and hours and when she does, I can now put her into time out until she cools off. Interestingly, I still find her to be terribly temperamental and prone to tantrums. But is that really the case? Or do I just judge more harshly because of our past? 

My heart still hurts when I remember and even today I don’t like to talk about it, but the advice I give to parents is much different now that I have lived it myself. 

Pests. I mean pets.

gray long haired kitten wrapped in a blanket

The kids suddenly stopped their fussing over the cranberry and Gorgonzola salmon patties with couscous and grilled asparagus on their plates. 

My ears were still ringing, though. We had already had a time out for the each of them and I was bracing myself for more. 

But no. There was silence.

Was it a miracle? Had we finally had a breakthrough? 

This is good food, kids. Come on! Just try it.

“Mommy! Someone is at the door!!!”

Then I heard it. A soft knock. I could see a shadow through the glass.

“I am not answering it. We are in the middle of dinner.” 

They stared at me, waiting for what would come next.

“Go on. Eat!”

The knock came again. This time louder and more insistent. Then again.

Fine. Fine! I’m coming….

The man spoke in broken English, explaining there was an injured cat in the street and he did not know what to do about it.

I walked out to look and there was the most pathetic looking teeny tiny gray kitten wobbling down the road. He fell on his face every other step. One of his eyes was glued shut with pus. I could see a mangled left paw and blood on the leg and torso from a large gash.

What to do?

Now my kids really want a dog. 

I don’t blame them. I have always wanted a dog myself, except that we don’t have a lifestyle that supports having a dog. Not right now, at least. Furthermore, boarding or finding a sitter for it when we are traveling is a challenge and I really don’t want to take it with us, babysitting a dog AND two small kids.

You may recall that we have had a run of interesting pets: the goldfish named Mr. Fish, the tarantula named Harry, and the lizard named Changie. 

Mr. Fish died.

Harry died.

Changie escaped during a cage cleaning and roamed the house for a few months surving probably on those giant cockroaches we get in the South, the ones that are the size of your fist. Gag. The lizard resurfaced one day. And then died.

So now we have a mangled kitten. Except he is no longer mangled. His name is Whiskers, in case you were wondering.

We will see how long this little fella lasts….

Down The Pipes

ventilation shaft on a boat

He had just been here last week. Why was he back so soon? 

The tag line on his visit said, “NOT BETTER.”

What do you mean you’re not better?!!?!!?

Somehow, I always feel a bit defensive when patients don’t get better, it is as if the illness has exposed my weaknesses. I have come up short. I know it isn’t logical, but this is the way I feel.

Do they think I did something wrong?

Sometimes they do.

I took a deep breath, burying that defensiveness so it would not show on my face, then knocked on the door and entered. 

“Hey, Doc.” He looked at me apologetically. “They told me I couldn’t work and would have to get paperwork from you.” 

He passed me a thick stack of FMLA forms.

“You couldn’t work? You had said your cough wasn’t that bad. Did it get worse?” 

“The cough got better. Everything was better but I lost my voice. I went to work every day and each day they sent me home. Other people, they just take them off the phones and put them somewhere else. I don’t know why they wouldn’t let me do the same.” He looked ashamed. “I really needed the money. I got a family to take care of.”

For five days his employer told him he couldn’t work because his voice was raspy. Each day he was sent home. Now I had to complete pages of paperwork for FMLA* stating he had a serious medical condition that prevented him from working. 

A hoarse voice does not constitute a serious medical condition. 

And yet, if I did not complete his paperwork, he would lose his job…

I am constantly backed into the corner by employers in various ways. If you want to get rid of your employee, tell them. Do it for legit reasons. Don’t make me the bad guy. Really. But it is so much easier to pass the buck, to let someone else take the fall, to make them do your dirty work for you. 

Look, we like you, but you missed too many unauthorized days. Too bad your DOCTOR wouldn’t fill out your paperwork…

“Please, Doc?” His eyes pleaded with me. 

I completed his paperwork. 

“Hey, maybe you need to start looking for a new job. Just in case, you know?” 

He nodded. He understood.

At least he was being honest. I checked. 

There are plenty of patients abusing the system, too…

*FMLA (Family Medical Leave Act) allows certain employees to take up to 12 weeks off in a calendar year for a serious medical condition or to care for someone else with a serious medical condition. It is unpaid leave but it does make sure you have a job to come back to. For a physician it is about five pages of stupid questions to complete.

Trampled On

wall sculpture of a battle scene with men crushed under foot
“Her neurologist took her off work for six weeks. He told her that her primary care physician had to complete the FMLA and short term disability paperwork**.”

“But I haven’t seen her in three months. He has been managing her. HE is the one who took her off of work. AND I have no records. No consult notes or anything!”

“She’s pretty upset.”

“I don’t blame her.”

I picked up the phone and dialed the neurologist’s number. I told his staff that I was not going to complete the paperwork*** because I felt it was his responsibility. 

“I’ll talk to him and then get back to you.”

Fifteen minutes later:

“Fine, we’ll do it but sometimes these things get denied.”

“You think that I will have better luck getting it covered? Or is this about making the patient mad at me instead of you when it gets denied?”

Silence.

I have had a ton of these situations come across my desk lately. All specialties. When did this become standard? The truth is, I hate filling out that paperwork as much as the next physician but if I am referring a patient to a specialist, I expect that physician to manage all aspects of care pertaining to why I sent that patient to them. If you don’t think they need to be off of work, I support you 100%. You shouldn’t have to fill out anything.

But if you DO take a patient off of work, YOU do the paperwork. 

….Or, I stop referring to you.

*FMLA (Family Medical Leave Act) allows certain employees to take up to 12 weeks off in a calendar year for a serious medical condition or to care for someone else with a serious medical condition. It is unpaid leave but it does make sure you have a job to come back to. For a physician it is about five pages of stupid questions to complete.

**Short term disability is a policy you have through your employer that pays you a certain percentage of your salary when you have to be off work due to a health condition. It is another three to five pages of questions.

***I would never, ever leave a patient without their paperwork completed. If the physician had continued to refuse, that patient would have gotten their paperwork done by me.  The patient should not be penalized for something they have no control over.

Feeling Queasy

black and white clouds reflected in water

I checked on my son in the night and noticed that an odd smell, like fermented poop, permeated the air in his room. It was a strong odor.

How odd. 

I flicked on the light from my smart phone and flicked it around in the darkness, wandering around the room in an attempt to locate the source. Eventually I made my way to the bedside. His cute little pajamaed butt was sticking out from under the bed covers. I bent low to sniff in case what I was smelling was some gawdawful fart he had just made or perhaps he had not wiped well enough earlier that day…

Nothing.

I straightened up, glancing around again. Was it possible that some poor, unwitting creature had been kidnapped and then hidden by him somewhere in this room, subsequently starving to death?

Maybe….

Then I saw it.

He had puked in his sleep. 

Vomit covered his head, the pillow, and the wall. Hotdog chunks the size of a thumb were splattered all about. He had marinated in it for a couple of hours, apparently, and it had dried in his hair. A bit of hotdog was even stuck to his cheek.

How many of those things did he eat, anyway?!?!!!?!?

Then I panicked.

Was he breathing? He wasn’t moving. Did he aspirate and choke to death? Is that why he had not alerted me? 

I called his name. 

No response.

I shook him, gently. 

No response.

I shook him harder, my other hand on his puke covered neck feeling for a pulse….

His eyes opened wide.

“Mommy! What’s wrong?”

I flashed to the bit of cheeseburger that he had left on his plate at dinner time. I had snatched it up and polished it off myself because I hate to see cheeseburgers go to waste and because food that you eat from your kids has no calories…. 

But it does have germs, doesn’t it?

Starting the countdown now… Incubation period for a viral gastroenteritis? Ah, yes. It should be hitting right when my on-call week begins.

In The Hood 

thistle flower

I am a terrible single parent.

“Oh,” you say, “that cannot be true! You seem like a woman who has it all together.”

Through the magic of blogging, I have been fooling you. 

The truth is that when it is just me taking care of the kids, there are no baths. There is pizza every night. Tons of videos. The kids sleep in their street clothes. The house is in shambles. No dishes get done. Bedtime may or may not happen.

Mayhem reigns supreme. 

Their dad is awesome. I don’t talk about him much here but, honestly, I could not do the things I do without him helping to hold things together. He makes me look like a better person than I am. He makes the kids into better kids. He makes a fantastic chicken piccata.

So to him and to all of the other men who take fatherhood seriously, who serve as great dads to kids everywhere, we may not always tell you how special you are but please never underestimate the impact you have. 

Thank you for being you.

Their Fantasy

yellow flowers against a blue sky reflected in rhe water

When I was in residency, I worked hard to be more like the guys.

I played fantasy football. 

I cussed. A lot.

I learned to like scotch and cigars and golf.

Despite my best efforts, though, I was still always a woman. You simply cannot run away from the vagina. 

Fortunately, though, you can run away from fantasy football and cigars….

Fishing for Something More

shadow of fisherman in the water with float visible on the water surface

“If you are going to fish you need to learn how to cut a worm in half with your fingernail.” He grabbed my hand and placed a long squirmy pink one into the palm. We had dug it and half a dozen of its siblings up from my grandmother’s flower beds that morning.

Sometimes you have to get your hands dirty.

I squinted up at him in disbelief. “I can’t do that, Grandpa! It’s a worm.” I was five years old, old enough to have a sense of what was really gross and what wasn’t. 

There was no way…

“You can always do things you think you can’t.” He said it in such a way that it left no room for argument. 

He stood waiting.

I sighed as I tore the slimy thing into two wriggling halves. Brown and yellow colored worm guts were all over my fingers and under my thumbnails. 

He was right. 

Listen to your elders.

It was not as hard as I had imagined… and I was surprised to find that my hands washed off clean in the river. Clean enough to eat a bag of Cheetos with, at least. 

I hadn’t really wanted to go fishing. Fishing was for boys. But I really, really didn’t want to stay at home with my grandmother to help with the canning. That was too hot and messy and boring. Plus, grandpa had Cheetos.

Girls can do boy things.

Mmmmm. Cheetos. Finger lickin’ good…

He showed me how to thread my bit of worm onto the hook properly and how to cast without injuring anyone. We stood there for hours. Casting. Reeling back in. Casting. Reeling back in. I watched the bobber dunk below the surface countless times, felt the hard tugging on the line, only to pull up a bare hook again and again. Bastards. I never caught a thing. 

The fish were taunting me.

Sometimes you don’t get what you want, even when you work hard for it.

I was terribly disappointed but strangely addicted. I knew I could get those buggers next time…

My grandpa stopped to clean the fish he had caught so my grandmother could cook them up for dinner that night. He made me help, even though I begged him to let me play in the water instead. Worm guts were bad enough. Now fish guts?

Unpleasant things are often necessary and as much as you might want them to signal the end of the world, the world will not end. Not for you. 

As we were packing up my grandfather took my hook to pull off the last bits of remaining worm. I was not paying attention and ended up pulling the hook through his index finger.

Somehow, he didn’t cuss at me. He was a good man.

Always say you’re sorry. AND carry wire cutters in your tackle box in case of emergencies.

“Can we go again tomorrow, Grandpa?”

He grinned his lopsided grin as he slung the poles over his shoulder and led the way back to his beat up green Chevy truck. “You bet.”

I was secretly hoping for more of those Cheetos…

Bedtime

creepy black and white hotel hallway interior

The corridor stretched on and on, black and gray of various shades mingled with the shadows, creating an atmosphere that was more drab and depressing than avant garde. She was the only bit of color, save the tiny glowing red exit sign in the far distance.

There was no real exit, though. 

The sign was just for show. She had already tried. 

Several times. 

The carpet dulled the sound of her steps into soft, muffled thuds as she walked down the hallway to room #32521. 

She stopped, her hand poised to knock on the cool wood.

What if I don’t do it this time?

But she already knew the answer. 

Sirens sound, men in plastic suits appear. Nowhere to run. Pain. Then there is nothing but the blazing, searing whiteness. You cannot escape the blinding whiteness.

The door clicked unlocked, an unseen entity granting her entry. 

She stepped inside and allowed the door to close behind her. She could hear the lock sealing her inside. 

After stepping out of the high heels, she placed them in the closet of the antechamber. There was a gray gown hanging on the customary hanger inside. She unzipped her bright green dress and let it fall to the floor. She did not wear underwear. Ever. Not here. 

Not anymore.

The bathroom was to her right. A quick shower under warm water. The harsh cleanser was in a boutique bottle on the counter but the pretty packaging did nothing to hide the antiseptic odor. 

A white towel waited for her on the warmer.

Scars crisscrossed her abdomen. She had lost count of how many cuts had been made. She quickly covered them up with the gown, grateful for the steamed up mirror so she did not have to see the horror reflected back at her. 

She pushed through the plastic curtains into the bedroom. The whole room was white and very cold. There were heavy white drapes along the far wall but she knew there were no windows on the other side. 

She longed for sunlight again.

How long had it been?

Damp hair hung loose about her shoulders making the cold air seem even colder. It gave her goosebumps and her nipples grew hard beneath the thin fabric of her gown as she made her way to the bed. 

She placed the sticky pads across her chest as she had been taught, the cold gel adhesive made her shiver, involuntarily. Lying down on the metal bed, she placed the black mask over her face and breathed deeply. It smelled of stale rubber.

Another deep breath.

And another.

The light overhead grew brighter until the walls blended and ran together and there was nothing else left but that blinding, searing whiteness.

Cold metallic hands that she could not see pulled off her gown and pinned her down as she breathed even more deeply of the gaseous cocktail. The beeping of the monitor sped up, matching her panic. She did not want to be concious. The pain would happen whether she was awake or not. 

She wanted sleep, not pain.

What she really wanted was to sleep forever…

What Is Real Anymore?

hotel ceiling in Las Vegas, Nevada

“MOM! I want an iPad! Can I have an iPad?” He breathlessly scrambled into his booster seat, still sweaty from his karate class.

“No. I let you use mine now and then, don’t I?” I put down my phone and put the car into gear, reorienting myself to my surroundings as I merged with the traffic.

“I don’t want yours. I want my own!”

“No.”

“What about a phone? Can I have a phone?”

“No.”

“Nintendo DS?”

“No.”

“What about for my birthday? Can I have one for my birthday?” 

“No.”

“Christmas! I can ask Santa.”

“You can ask but mommy will tell Santa no way, no how.” A stop light. My hand reaches for the phone and I stop myself.

“But, Mom! EVERYONE at school has one.”

“No they don’t.”

“Yes they do! You don’t know…”

I caught myself about to argue with him. He’s right. I don’t know. Maybe his classmates all own some sort of electronic. He is six, though. He is in kindergarten. He does NOT need any of this.

“The answer is no.”

The conversation repeats itself several times every day like a broken record. Except that he has no idea what a record is…

To be honest this all became an issue when his teacher started allowing those who scored 100’s on their spelling tests to bring an electronic to school the next day. Now my son feels left out. He realizes these things score him cool points. He is allowed to play games once a week for 25 minutes on my iPAD, five minutes for each day of good behavior at school, but he needs to be SEEN with the device at school or it doesn’t matter socialy. 

When he does play, he is like an addict… hands shaking as I pull the screen away when his time is up. It takes him a while to resurface from the alternate reality he has immersed himself in, to return to the normal little boy I know. I hate that the iPad is such a powerful motivator for him. I hate that is brain craves it so much.

This is not reality, even if it feels like it.

Ultimately, I want my kids to be able to use technology, to interact without feeling intimidated, but I don’t want them to lose their identity to it, either. How do you balance this? I have no frame of reference from my own childhood. I was in my late teens when we got our first computer, when I first started to play King’s Quest. The graphics were awful by current standards and it certainly didn’t feel real. That was the scope of my technology exposure. 

Today, technology is ubiquitous and sophisticated and as an adult I am not sure I even have a healthy relationship with it. Do any of us, really? 

Mommy, would you PLEASE get off your phone? 

I watch as zombified adults and teens and kids in my office punctuate their conversations with me by checking out their “smart” phones, lost somewhere in SnapChat or Instagram or Facebook or some other social media that I am too old to “get”. They are not here in my office, not really. They exist on some other plane. 

So do I.

Most of the time, I am a virtual entity, the doctor living inside my clinic’s electronic health record. 

Or inside my blog.

I am not Victo….

I know what it feels like to be attacked online. I know what it is like to not get enough “likes”. I know what it feels like to lose yourself and your identity and it frightens me for my kids and their future. 

My future.