Blow

Sailboat in the Hudson Bay

“How much time are you spending on social media?” 

“Well, I stopped completely until about a week ago. I’m easing back into it.”

“Really? You stopped it all? Completely?” I tried to keep the suspicion out of my voice.

“Yeah. For about six months.”

“Why?”

“I didn’t like how it made me feel.” There was real, actual eye contact, no phone in sight. 

“Now that you are back at it, what do you think? Does it make you feel good?”

“No.”

“So what do you think you are going to do?”

“We’ll see.” She shrugged. “Maybe I’ll pull the plug again.”

That, folks, is a kid who is going to be all right…

Getting the Worm

Flowers in the NYC Metropolitan Museum of Art

“Mommy? Can I go potty?” 

Her voice pulled me out of a deep sleep in the midst of a nightmare about a movie set with Nicole Kidman and a patient who ran a telephone ministry dial-a-prophetess line. The movie was to be a psychological thriller. The prophetess had just robbed me of money and souvenirs I had pilfered from the set. I am not sure what a dream like that says about my life right now…

“Sure, baby. You don’t even have to ask, you know.” I have lost count of how many I times I’ve said this to her. 

“Ok!” 

I heard her skip down the hall to the bathroom. I glanced over at the clock. 3AM. I would have groaned out loud but that would have taken too much energy.

A minute or two later…

“Mommy, I wiped but I didn’t flush because I didn’t want to wake anyone up.”

“Thanks, sweetie. Go on back to bed.”

“Ok!”

And I heard her skip back down the hall to her bedroom.

Sleep? For me, it was gone. Just like that I was turned into the early bird. Too bad I don’t like worms.

A Supporting Role

Bridge in NYC

“She just won’t eat healthy stuff! If I give her a cupcake and some broccoli she always eats the cupcake.”

“Think back to when you were eleven. If you have a cupcake and some broccoli in front of you, what do you pick?”

He shrugged. “The cupcake.”

“Right? Me, too. We’re not idiots. We pick what tastes best to us. As kids that’s the sugar. So you cannot put them both in front of her and expect her to pick the broccoli. That’s just cruel. She’s eleven. YOU have to make that decision for her until she is able to make it on her own and that is not going to be for a great many years. Get the cupcakes and junk out of the house. She is beautiful no matter what size she is but you and mom both have diabetes so she is at higher risk herself. Be the parent. Don’t sabotage her. Help her learn healthy habits that will last the rest of her life.”

We had this conversation every summer for five years running. Each year the same thing, like it was her fault. But this time? This time, somehow, was different….

This time he listened.

What made the difference? I don’t know.

It gets discouraging, saying the same things over and over again. There are days when I open my mouth to say, “Stop smoking!” for the millionth time and wonder if there really is any point. You never know, though, when the seeds you sow will fall on fertile ground and take hold. 

A Mistaken Identity 

Hudson Bay clouds

My heart sank into the floor.

“You did what?”

“I gave the wrong immunization! I didn’t look close enough at the orders.”

The baby ended up getting a double dose of one of the routine childhood vaccinations because my medical assistant gave the wrong combination vaccination and overlapped. It was not a terrible error, as far as medical errors go, and would not cause harm but try to convince a parent who has gone through multiple miscarriages and IVF to get this one beautiful baby boy. It was not a phone call I looked forward to making.

I could ignore that it happened, sweep it under the rug so to speak. Make it disappear. They would never know….

Still it had to be done. They had the right to know. So I did it. I called and explained and reassured. They seemed to take it very well at the time, or so it seemed.

I see FOUR generations of this family. 

Four.

Or rather, saw. 

They left my practice. 

To be honest, if it were my own kid I would have probably not been nearly so nice about it and I would have also taken my kids elsewhere. I am not upset at this family at all. It hurts but I totally get it. 

Trust is gone.

This was the first time an incorrect pediatric vaccination was given by a staff member to my knowledge in my practice. Fourteen years. That means nothing when it’s your kid. One mistake. Made by one of the best medical assistants we have, the absolute last person I would have expected to make an error. She will carry that one around for a very long time. 

So will I.

We can learn from every mistake, can’t we? 

If I told you I had never made a bad call or made a mistake myself I would be lying to you. There is no perfect doctor. Sometimes we lie to ourselves. Sometimes we lie to other people. That is how we keep going each day. We are not perfect. I know each and every mistake I have made over the years and they play in my mind over and over again, their faces pop out at me usually when I am already upset about something else that is unrelated. 

See? You suck, you suck, you suck! 

Why does our brain do that to us? Kick us when we are down?

Sometimes it is hard in the aftermath of a “mistake” to clear the mind and keep focused. There are other patients to see, my family to take care of. Still, I also need time to grieve and process. To forgive myself. To forgive others. I need people around me, my family, to let me do that without trying to “fix” me. Eventually my mind will settle down and move on.

Because life goes on.

It always does.

Oops! I Did It Again….

Inside the Intrepid aircraft carrier in New York City

“MOM*!!!! Gross. Say ‘Excuse me…'” 

“What?”

“You farted!”

“Nah….”

Technically she’s right. I did fart, not that I would ever admit it out loud. It just sort of escaped. I don’t know if you truly get grassier in old age or if you just get less motivated to curtail the explosions when they rise to the surface. All I know is that I fart. I fart a lot. 

In fact, I come from a long line of farters.

One of the few times I was brave enough to have friends over in high school a sound erupted from the next room. The longest, loudest, wettest fart I had ever heard. My friends grew silent. One whispered, “Was that what I think it was?” Yes. Yes it was. That was the sound of my own mother making sure I never, ever had an adolescent social life to speak of. 

It is old news, that smelling farts may actually help prevent stokes and heart attacks. Unfortunately, my kids are not interested in the research. In their minds, it is chemical warfare. AND they are big enough that I cannot blame it on them anymore without them fighting back. Maybe I need a dog?

You may be expecting at this point that I will wrap up the post with some pithy moral lesson or propose a solution to an ethical delimma. Not this time, folks. But if you, too, fart a lot you do not fart alone. 

* To convey the proper level of shock and disapproval the word “MOM” here should be read with two syllables as in MOoo-ooOM.

** The photo above is from a WWII era aircraft carrier in NYC named the Intrepid. I highly recommend a visit if you are ever in the area.

To The Rock Star…

Radio City Music Hall in New York City

“Don’t tell Dad I broke the plate, OK?”

“But it was an accident, sweetheart.”

“I know he won’t be mad but I still don’t want him to know.”

He cares what you think about him.

“Mom, I miss dad.”

“He’ll be back before you know it.”

“Can we set a place for him at the table even though he isn’t here?”

“Sure!”

Your presence is missed when you are away.

“Mom, I let her have the rest of my Gatorade even though I really wanted it.”

“Because she wanted it, too?”

“Yeah. It was the right thing to do.”

He is paying attention to the example you set.

So… thank you. Thank you for being such a great dad!

Reflective

Central Park duck pond

“He had an awful lot to say about you.” 

I steeled myself for what was to come. I had no idea how physicians in the group I left perceived me now, almost eight years later.

Eight years? Had it really been that long?

She laughed heartily.

I relaxed.

Her dentist, apparently good friends with the other provider, referred her there for a work up for bone loss he had picked up on dental X-rays. I stumbled upon the visit in her medical record in the EHR when she requested a refill on one of her medications. Aside from the fact that it was a work up I could have easily done and referring her to another primary care provider when she had one already was itself a bit unprofessional, I did not know if she would make her way back to me or stick with him. Patients always loved him. 

So I waited.

“I told him you were my favorite doctor ever. He said you had to be right about everything but he missed working with you.”

Right about everything? Really?

Admittedly there are certain things I do not compromise on. You routinely lose my patient’s vaginal specimens and I will insist that you come and spread your legs for a speculum exam as punishment. Ok, not really that drastic but I take that sort of thing very seriously. Pelvic exams are not just physically uncomfortable, they are emotionally uncomfortable for patients and saying, “just have them come back for a repeat” is not an adequate response when I am dealing with a lost specimen for the fifth time in as many months. I will raise holy hell if I have to. But I am rambling….

It is interesting sometimes to see what people remember or think about me. Sometimes it hurts, though, and most of the time I would just rather not know. Is needing to being right about everything what I wanted to leave him with? 

No. 

Not really.

But it could have been worse. At the end of my tenure at that office there was all sorts of drama, he had been involved in some of that, and I was glad to leave it all behind when I left.

A few weeks later I ran into that same former partner at a restaurant. I was there with my kids to get something to eat after a long, tough Friday. They were beat. So was I. 

He saw me and walked over say to say hello. We chatted for a few minutes about how his kids were all grown up now.

“I used to work with your mom,” he said to my son and daughter. “Do you know what she did?” 

My kids swung their tired eyes over to him and focused on his face, warily. He was a stranger. They were used to strangers addressing their mom in public but were not used to being addressed directly themselves. I again braced myself, not knowing what he would say. 

“She told a bunch of kids at an office picnic that she would pay them $5 if any of them hit me with a raw egg. All of a sudden this whole herd of kids was running at me with eggs in their hands.” My son snickered. “So do you know what I did?” They shook their heads, leaning in close to get the scoop. “I told them I would pay $10 if any of them got her with an egg. They chased her all over that park.”

“Did they get her?” My son asked eagerly.

“Sure did.”

I interjected here. “With ONE egg, alright? Just one.” I held one single finger up for emphasis.

Now? I am a legend as far as my kids are concerned. My son in particular loves pranks. He loves knowing mom does, too. I am grateful to my former partner for giving us that.

Time passes, doesn’t it?

Time heals wounds by bending memories. It tempers recollections and feelings until sometimes bygones truly can be bygones. 

I haven’t played a good prank in years, though. That is drawback to the passage of time. I am getting so awfully dang old!

The Tipping Point

Buildings in Philadelphia

“Do you have an appointment?” she asked.

“Nah. I’m just going to sit here until the weather passes,” the man said gruffly. He sat down in the corner out of her line of sight.

She shrugged and slid closed the clear glass window to the waiting room. He didn’t look threatening. Rain was pouring down outside. What did it matter if he sat for a few minutes?

He began talking into his phone loudly, clearly agitated about something. Patients looked at each other quizzically, shifting uncomfortably in their seats. They stole furtive glances at him, watching him mutter into the phone pressed against his face. It was impossible to hear exactly what he was saying between the growls.

When is the nurse going to call me back? Please let it be soon.

As he was talking the phone rang loudly. Clearly, he hadn’t been talking to anyone at all….

Then he stood, yelling into the ringing phone, threatening to kill anyone and everyone. As shaky fingers dialed 911, he bolted out of the door and ran across the parking lot never to be found again.

Perhaps I’m a silly dingbat but people behaving like that never would have bothered me in the past, at least not where I would have taken them seriously. 

Now though? We were all shaken up. I find myself wondering what is lying in wait around the corner of every person’s mind. I get nervous at airports and look over my shoulder at large events. Where is the next explosion going to come from? Who will fire the next bullet? Could I have stopped them?

Fear is sexy. Fear sells. Fear drives a wedge, keeping us from reaching out to help others. Fear protects us. Fear hurts us. Fear is necessary and yet it multiplies and it divides us. 

Part of me wants to just stay home, to never go anywhere anymore and then I remind myself that acts of courage are the only way to really combat fear. Anger only feeds fear. So does isolation. 

And so I get onto airplanes and take my kids to places that probably live as targets in someone else’s mind so that at least for me, fear will not win. 

Motherhood Sucks

Looking out of a window in Venice, Italy
I have taken care of all manner of sick people and their unpleasant smells and secretions: purulent drainage, vaginal discharges galore, fecal impactions, decayed appendages, amniotic fluid from strangers, sputum in every color of the rainbow…

But none of that prepared me for the disgusting onslaught that is motherhood. 

Poorly wiped kiddo bums. You know… when they are learning to do it themselves but are not willing to admit they need help. There is nothing like the smell of stale sweaty bum crack poo that has been fermenting all day long on the school playground. I will never understand why my kids had to pop their bums into my face when the odor was the most offensive. Then there is the poop and pee smeared all over the bathroom. MY bathroom. WTF? I have lost track of the number of times I have ended up with their vomit in my mouth!!! Snot. Never ending snot. The forgotten frogs that die in their containers and are found weeks later in a semi-liquified state. That is a sight that cannot be unseen, a smell that cannot be unsmelled.

So help me, no one said, “Brace yourself…” I would have appreciated some sort of warning. Instead people said, “Savor this time, it is over all too quickly!” 

Not quickly enough, I’ll tell you.

So let this serve as a warning to all of you who are contemplating the beauty of motherhood, thinking of reproducing. Turn back NOW before it is too late. Seriously. 

Fortunately, now that the Ebola threat has passed (for now) I have hazmat stuff from the office that begs to be used. So at least there’s that. 

Good thing they’re still cute.

Fatherless

Rose window example, San Antonio

“Can you tell me anything about your father’s medical history?”

“No. I don’t know him.” He shrugged as if it was no big deal but his voice said otherwise. 

Next patient…. 

“What about your father’s medical history?”

She scrunched up her face. “I think he’s still alive? I don’t know for sure. I never knew him.”

Next patient…

“So your mother is alive and has diabetes. Do you know anything about your father?”

“I’m not in contact with him.” The disdain came across loud and clear in her voice. “I hope he’s dead.”

If fathers ever think they don’t matter, they should sit in my seat and listen to the pain they can generate even when they are not there.