Taking Aim

Battleship communications tower

Let go of the anger and the hurt so it does not destroy you, too.

Big, fat tears welled up in her eyes and spilled over, running down her cheeks. Her voice changed as she tried to talk around the lump in her throat. 

“But mommy, I’m going to miss all of my friends! Jackie and Bennet and Katie and all of my teachers…”

I wrapped my arms around her even tighter.

“I know, bug-a-boo, but we don’t know if your school is going to be there much longer and we need a plan B for just in case.”

“I miss my principal!” she wailed.

Changing schools at the start of a school year is hard. I remembered. But doing it suddenly like this mid year was going to be that much worse.

My son wiped tears from his wet face. “I am really going to miss my teachers.”

“I know, hon.”

You need to show a more charitable response.

They gutted the school in front of the kids. During class the teachers had to take down all of the wall and window decor. Furniture was moved. Locks were changed. The beloved principal was fired without warning while she was on vacation celebrating her wedding anniversary.

They’d promised nothing would change for the first year. It was November. Not even three months in.

Parents showed up and cussed out the new owner’s representatives. I rescheduled some patients and went up there myself to check on my own kids, to check on the teachers. Hollow eyed, people wandered about and spoke in hushed tones, shellshocked. 

Be a good steward, not just of your money, but also of your love. Give freely…

There were rumors teachers were being fired or resigning.

“I’m here for the kids. I will stick it out for the rest of the year no matter what. I can take a beating when it comes to those kids if need be. If THEY will let me…”

Meanwhile, the new owners refused to communicate with the parents or the teachers. The kids were left in a scary limbo. Friends were pulled out of classes and transferred to other schools with no opportunity to say goodbye.

Choose to show love when it is least expected.

I could not sleep. When I did sleep it was fitfully, dreaming nightmares that they were taking the kids and not letting us have them back.

The nightmare has been running for four days now in my brain, and it won’t shut off. I am struggling with what my response should be. The brain does crazy things under stress. How do you express that much anger, hurt, and betrayal in a sane way so that the person who did it can really understand? 

Would they understand?

Let my love for them show through you.

We tried out a new church because I will be transferring my kids to an Episcopal school and I wanted them to understand chapel. 

“Mom, why are they kneeling?”

“Mom, why did they take the book out into the aisle to read from it instead of up on the platform?”

“Why did he touch my forehead?”

It was part of the adventure. New church. New school. I found there was comfort in the symbolism and ritual.

“Come up to the front and get one of these crosses for your family then get one of these envelopes with $5 in it and use that this week to show kindness to someone else in a bold and daring way. Don’t just stick it into the Salvation Army donation bucket. DO something with it.”

And then I knew.

My response… 

Do something unexpected.
“It is not your fault what the new owners did to the kids and the parents and the staff. It was wrong, though, and I cannot keep my kids in this school. I do want you to know that I wish you luck as you try to repair the damage done to the relationships here. It is going to be a long road back.” I handed the new director a small gift bought with that $5 and gave her a hug. 

And then I walked away. 

Forever.

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Music to My Ears

River in the fall

“Your son has a lovely boy soprano voice. I would like for him to sing a solo at the Christmas program….”

“Mom! I get to sing! In front of everyone. She said I have a gift!” He beamed as he scrambled into his seat. 

I reread the note several times over the rest of the evening. My kid is special! Isn’t that what every parent longs to hear? And yet there was part of me that felt sad. Music might very well be the thing that takes him away from me. 

He is so brave, getting up in front of people to put himself on display like that. I would have been paralyzed by the prospect at his age. 

“You know there are boys choirs that travel all over the world,” I offered tentatively, imagining his sweet face singing Ave Maria on television. 

He loves music so much. He is playing piano in second grade at the level I was at when I was in junior high. It comes naturally to him somehow.

“I want to share my gift, Mom, but I don’t want to be away from you and dad.” He started to tear up. “I like being with my family…”

More than anything else, more than hearing that someone thinks my child has the voice of an angel, what I am most proud of is that my kid feels loved enough that he wants to hang with his family. 

He will spread his wings and fly off soon enough but he knows that he will always have a safe place to come back to. Well. At least until he turns 18. That is how I know that all of the difficult choices and sacrifices I have made are worth something. 

My kid feels whole.

That is the best gift of all. 

Thursday Thoughts From the Throne

Bones at the American Museum of Natural History in NYC
At first I told myself I would NOT write a grumbly post-Halloween post. I held off for a good whole week and a few days but here I am on the toilet stewing about it still and so I feel compelled to just spill my guts, literally and figuratively…

In case you were ever unsure, an adult taking their dog trick or treating is NOT cute if the adult is collecting candy, not wearing a costume, and there are no kids around. If you are an adult who does this, stop. Go ahead and dress up your dog or pup or hamster or whatever pet you can coax into a costume without getting your eyes clawed out and feel free to take a walk through the neighborhood. Show off. Just don’t go begging for candy. 

Second, rollling an infant around in a stroller asking for candy is on par with the pet thing. Sure, they are cute. Feel free to walk around and show them off. But trying to roll a stroller up my front steps is dangerous and we both know that bag of snickers and gobstoppers is not for anyone but you. Buy your own damn candy!

Kids with two bags collecting for a mysterious “ill” sibling…. yeah. If your brother really got sick and you want to do something truly noble, share your own candy half and half. THAT demonstrates love and sacrifice and I won’t be left wondering if that sibling really exists or not as you giggle while walking away with your two heavily laden bags.

And lastly, if you are a kid who shows up at the end of the night when my candy is running low, you may very well end up with a sucker or a box of Nerds because that is all I have left. You don’t like that? Don’t throw the candy on the ground and mutter some expletive as you storm off. I just gave out over 2,000 pieces of candy and you not liking the fact that I am out of chocolate reflects poorly on you, not me.

Ah…. Now that feels better!

Changing Times

Fall colors on the water

I love the fall. I love the colors, the pumpkins, the hint of cooler weather. I love the baking, wearing sweaters, fires in the fire place. I do not, however, love the time change.

Who likes it? That’s what I want to know. And if everyone hates it so much, why the hell hasn’t anyone changed it?!?!!??! Every year we all complain. There are news articles decrying the needlessness of it. And yet, it still happens. 

The dreaded “Fall Back”…

So, the time change alone is bad enough by itself but this year I also forgot to turn back my kids’ clocks so their alarms went off an hour too early yesterday morning. Gah. Who can remember to turn back ALL of their clocks? Worse? It was dark by the time I left work to go pick them up from school. 

Cranky kids. 

Cranky mom. 

For the next few months I will exist in a disorienting cave of darkness, a fugue state of sorts, confined to a building during daylight hours. My brain does not like this. It craves the feeling of sunlight on my skin, the deep red glow of sun filtered through closed eyelids. I find that this matters more and more to me each fall and winter. 

Bottom line? Gaining an hour of sleep is a farce. We don’t get more rest. We don’t have more energy. It is all a sorry pack of lies we tell ourselves every dang year. 

Real Terror Is….

Central Park, NYC

“Mommy, there is a fifth grader at school whose mommy had her when she was thirteen! Maybe I will get lucky and have a baby when I am thirteen. Then I will have someone to boss around.”

“Uh. Sweetheart. You don’t want to have a baby when you are thirteen.”

“Why not?” She was incredulous.

How to communicate that it is a terrible idea without tearing down the other girl’s mommy?

“Because having a baby when you are a teenager is generally frowned upon.” 

“Why?”

“A baby is a lot of responsibility. A lot of dirty diapers. Tons of poop. It is also very, very painful. You want to wait until your body is big enough.”

She was undeterred. “How do you get a baby?” There was silence as I pondered whether or not my six year old daughter was ready to learn the specifics about baby-making when suddenly she brightened up and blurted out, “Drinking alcohol. Is that how you do it?”

“Um. Yes? Sometimes?” My mind wandered to the patient who had recently gone on a so called booze cruise and came back pregnant with triplets…

“Alright!” She smiled sweetly at me, finally satisfied that now she knew the secret and then without missing a beat she said, “I am going to drink some alcohol.”

The Apple and The Tree

I don’t usually post on Mondays anymore because the clinic is usually crazy but I did want to reblog this post from Twindaddy at Mental Defecation. Typically I don’t get a ton of people popping over to read reblogs but I would encourage you to hit the link on this one.

Mental Defecation

The apple doesn’t fall far from the tree, the old saying goes. It’s an obvious statement, of course. Unless an apple tree is at the top of a hill any apple that falls from it isn’t going far at all.

My tree has dropped three apples, so to speak. None of them have fallen far from the tree. To be frank, I’d bet money the genetic engineers of Jurassic Park cloned my “apples” directly from me if I didn’t know better. I can see my likeness in their jokes, their intelligence, their behaviors, and their personalities. But nothing quite dissected how similar we are until I read a short essay today.

I was talking with Baby B about meds and school when he mentioned he’d finished an essay he needed to turn in for English tomorrow was finished. I inquired more about it and found out that the topic he’d…

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Lift

Bomber

There are times when the anxiety overwhelms. Pressure on my chest. Can’t breathe. A dysphoric and irrational sense of impending doom falls like a curtain, separating me from the rest of the world.

I need to move, to escape. 

But I can’t. 

Why? Why now?

It comes in phases. There are times when I fly through the day, a smile inside and out. I feel the joy. I am the joy.

And then? The darkness descends.

You aren’t good enough or smart enough. Someone is going to figure it out. Then everyone will know your secret. You don’t belong here.

I can’t focus. I type words that aren’t right and don’t make any sense. I cannot follow the conversations people try to have with me. My brain is paralyzed. No. My brain is in overdrive running from one imagined catastrophe to the next. I cannot sleep because I cannot make it stop.

“Doc, it’s like you know me. How do you understand it so well when I am not even sure how to describe everything?”

Because I am you.

Sometimes there is good reason for it, an event which serves as trigger. Like a supoena to testify in a patient’s lawsuit against an multi billion dollar international corporation. Sometimes there are dozens of good reasons for it. Being on call, stressful patients, behavior issues at school with my kids, extended family conflict, pressure from the suits, my virtual desktop at work is overflowing, the WordPress app reader is frizzing out again and I am missing posts, … Very often, though, there is no good reason at all.

It is then that the pill calls to me.

Die to live another day…

I keep a bottle with my name on it. Not to literally kill myself. Just to make life easier. Kill the anxiety. End the suffering. A pill a day to make the anxiety go away.

But I am a coward it turns out. I am not good at taking pills. I try to do other things. I take a hike in the woods. Being among the trees often helps. Instead, I get a bad case of poison ivy. I try attending an opera, but I can’t enjoy that because of the itching from the poison ivy. I buy a new skirt but it doesn’t fit because of the steroids for the poison ivy. I want to hug my kids…. hugs from my kids often helps… but good squeezes set off the itching again.

All I can do is laugh. There is nothing else left to do.

Suddenly I am rising up out of the abyss. 

Name Dropping

Interior, B25 Bomber
“Do you want to put on a flight suit?”

My daughter nodded, a grin starting to form. She had not been one bit happy about being dragged to an air show.

“They didn’t make flight suits that fit women so the ladies had to roll up the legs and sleeves to make them fit.” She zipped up the suit, then rolled up the cuffs. “Come on, I’ll show you how to fly!”

She helped my daughter scramble up the wing and into the cockpit and proceeded to explain how the instruments worked, letting her use the pedals and rudder.

“During World War II, women flew planes like this all over and in some cases taught the men how to fly…”

It was a fascinating thing watching the change that come over my daughter. She held her head higher. She seemed more confident. She positively glowed. It was a striking transformation.

The key?

Her brother was not getting to do this.

I used to think that girls just needed the same opportunities as boys but I am thinking that is maybe less true. If her brother had been there he would have commanded all of the attention. She would have faded to the background. She needed her own opportunity, her own experience. My daughter needed the woman in the B-25 bomber to pull her to the side specially and tell her that she flew in this plane all the time, that girls, that women, CAN do amazing things.

This post was going to be about how grateful I was for all of the women in the world who take the extra time to help girls understand their history, to understand science, to help them reach their dreams.

And then the Boy Scouts announced girls could join up.

Now, I’ll be honest. I know the Girl Scouts are not all about cookies necessarily but that is what the world knows them for. I never wanted to be in the Girl Scouts as a kid. I didn’t want to have to compete at selling cookies. I wanted to do what the Boy Scouts were doing, having adventures, learning survival skills, but I never wanted to join the Boy Scouts because… boys… ick.

As a parent I have not enrolled my kids in either scout program. I simply don’t have time to be jetting off to two meetings and doing camp outs and projects for two different organizations. So, on some level I see the appeal, having both kids in the same program. But girls need their own space to feel special. Too often they get lost in the male crowd. They need mentoring from strong women.

All of this begs the question, what is wrong with being a girl? Why do we have to be more like the boys? Why can’t we be successful and adventurous in our own right? Why do we have to join the boys?

Why do we have to sell cookies?

I don’t think girls who want to join the Boy Scouts are bad but part of me feels the “allowing” girls thing is a bit insulting and maybe a bit embarrassing. Come, girls, join the BOY Scouts! Is being a girl such a shameful thing? Is being different bad? For all of the emphasis on cookies, perhaps the message is that Girl Scouts have missed the point. They are no longer relevant. 

Thursday Thoughts From the Throne #7

Clock feature in a small park in NYC

Is the day over? No?

Phew!

Made it. 

My colon has been awfully out of whack this week. So has my running schedule, come to think of it…

So, most of the time I try to avoid talking politics and religion with my patients and my friends. There are only a few trusted people I feel I can have a rational conversation with. Today, though, I ran across one of those people who was trying to convince me that my theology was misguided and that abortion was wrong in all circumstances. Even in the case of an 11 year old girl who was molested by her uncle.

Don’t get me wrong, I like this guy. He is a good man, even if we fundamentally disagree. However, he made a comment about prayer in school that got my dander up. Specifically he said that Christian prayers only should open every school day and that more of it probably would have prevented the Las Vegas shooter from killing all of those people.

Um. No.

I am going to skip the theology question and the abortion issue and hit on that school prayer statement.

Being prayed at is not the thing that prevents hurting people from lashing out. Love does. Good parents who try to do right by their kids and their spouses, fellow human beings who show kindness…. these are the things that prevent damaged people. 

Loving people who need it is awfully darn hard. 

I am not saying don’t pray. Go ahead and pray. I pray. Prayer is powerful. Prayer can help you love, help you find kindness when you don’t think there is any left inside of you. Here’s the thing, though: Don’t you ever think for one minute that your prayer means you have done your duty and your responsibility to other people stops there. No. You have to physically reach outside of yourself and help those around you or you are just saying empty words. 

I used to be that person, the one for whom the world was black and white. No amount of arguing or reasoning could change my mind. I was so full of anger back then. Why doesn’t everyone see the logic that I see? Life had to show me the all of the other shades of gray and the myriad of vibrant colors that make up this world. It had to show me that I am not as smart as I thought I was. 

Life is still teaching me.

Kind of makes me wonder what I will think of this post in ten years…

Dollars and Senseless

IMG_3774

People in the US are used to this sort of thing but I wanted give everyone a peek into the way healthcare is billed:

The price charged to insurance for OR use and three days of babysitting for a ruptured appendix was $42,500.  No ICU. This does not include the surgeon’s fee or the anesthesiologist’s bill or the pathologist’s examinationof the removed offending organ.

The amount actually paid by insurance was $8,950 with an additional $680 of patient responsibility (what the patient has to pay). 

The other over $30,000 was “adjustment”, money that will never be paid by anyone. 

The games we play. 

After the birth of my child, I received a bill from the hospital for my care… over $2,000. There were also bills for the OB, anesthesia, pediatrician, the NICU stay, etc. 

I expected the bills to be high. My baby was worth any price but I still wanted to know what my money was paying for. Being on the physician side of medicine, I don’t often get to see the $ side from the standpoint of a patient so I decided to dig.

What I found most annoying was that the bill was not broken down into anything meaningful, so I requested an itemized bill so I could see the details.

When I reviewed the several pages of information that came a few weeks later, I found several charges for questionable lab tests as well as medications that I was fairly certain I had never received. Propofol, a sedation medication commonly used in ICU… the one that killed Micheal Jackson. Dopamine, a vasopressor that is used in the ICU to keep your blood pressure up. There were a couple of obscure infectious disease tests that there was no reason for me to be tested for. I called the billing number and listed my concerns to the woman who answered.

“So are you requesting a review of the charges?” She sounded astonished.

“Yes. Yes, I am.”

A week or two passed and I received a call that said that over $700 of the charges had been removed but there were still two items that I was disputing, the lab tests that should have never been done, that they were not going to budge on.

“Well, I would like to see proof that they were done and I would like to know why because they do not make any kind of sense.”

“I cannot provide that.”

“Then I would like to request a copy of my records.”

“Ma’am you are more than welcome to request a copy of your medical record. The charge is $4 per page.”

“How big is my record?” 

“I don’t know but I expect probably over 40 pages.”

(Was it really $4/page? Maybe it was less. Were there only 40 pages to the record? Probably there was more. Much more. It was a few years ago, and I don’t remember the details exactly but suffice it to say, the cost was going to be quite high.)

“Can I come by and just review my record?”

“Absolutely not.”

I did some quick math and figured that the disputed charges were less than the cost of the copy of my medical records and I ended up just paying the dang bill as it was.

Fun, huh?