Move Over Childhood…

Trestle bridge through a car window
It happened, folks. 

My son decided that he does not want to wear his PJ’s to go into the donut shop anymore.

“Mom, someone might see me.”

A lump immediately lodged in my throat and has not yet let go. My baby is growing up, entering that self conscious stage where his life will forever be filtered through perceived societal norms. 

Next, he’s going to stop believing in Santa. 

I am not ready for this…

*Please note, I was not driving when I shot that photo and yes, the windshield IS a bit dirty. 

ProlongedĀ 

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I looked around the room of somber faces. They were looking to me to intervene, to work some miracle because so far no one else had.

“She had a bad stroke one night. She was sent to rehab but didn’t progress so they sent her to a nursing home to do physical therapy. But she didn’t do well with that, either. So now she has been there at the facility for six months with a tracheostomy and a feeding tube.”

We had had this talk every year for five years:

If your heart stops and you stop breathing what do you want your doctors to do?

Every year she told me very firmly that she just wanted to be allowed to die. She did not want her life prolonged, especially if it was going to be like this… not able to communicate or do anything on her own.

Doc, I know I should get that paperwork done, but I just have not gotten around to it. I will soon, though, I promise.

But she never did.

My family understands. They’ll make the right choice even if the paperwork isn’t completed.

Her daughter, standing here, believed fervently that her 92 year old mother was going to make a full recovery. She cried when I told her what her mother had told me.

“No! She wouldn’t want that. She wouldn’t ever want to give up…”

I would rather die.

Death comes for us all. Sooner. Or sometimes later.

On Stage

  

“Dancers should be in costume with their make up on, ready for the photographer at 7PM.”

Make up?

Make up?

Truthfully, I am not ready for this. I am not ready see what a grown up version of my little girl is going to look like.

Oh, sure, she loves make up, but she still thinks that a beautiful application of lipstick extends about an inch beyond the actual lips, hardly realistic and I am just fine with that.

I was not allowed to wear make up growing up. Even all through high school. None. Now, I had my ways of getting around that, to be sure… For instance, I had art pastels. The colored chalk sticks made great blush and eyeshadow in a pinch. Or black acrylic paint could stand in for mascara (I was too desperate at the time to worry about what that might actually do to my eyeballs). The trick was keeping it subtle so that my parents couldn’t tell and my brothers wouldn’t realize and rat on me but still enough that I did not stand out to my peers as a repressed, prudish freak. A very delicate balance.

I swore through all of that I would not do the same to any daughter of mine.

Then I had one. And now she is five and in dance and has to wear make up!?!??!!?

So now I am left wondering if the whole issue with make up for my own parents was not that it would make me look like a whore, as they said, but rather having to adjust to the reality of their daughter growing up. 

Maybe both.

I am not going to ask them, though.

Excuse me while I go watch some tutorials on dance make-up application.

Cycling

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My baby girl is turning five soon.

It is bitter sweet. On the one hand, I love watching her grow up, becoming her own woman. Sure, she has already formulated detailed plans to marginalized me and cut me from her life but for now she is still dependent upon me. We have fun together.

On the more sinister side of things, though, now momma needs a new IUD.

(insert groan of agony)

I have dreaded this day since the IUD was placed. I have enjoyed not having periods and not having to worry about pregnancy, having sex whenever I want. 

BUT….

Insurance changes say I cannot see the woman who placed my last IUD (she did a terrific job) and delivered my last baby. I am only allowed to see someone that is employed directly by the corporation I work for. Aside from the fact my patients are not particularly fond of the OB/Gyn’s employed by the system and the fact that I run into these people at meetings, the records will be in the EHR that I and everyone else in the system use every day. 

This makes me exceedingly uncomfortable. 

Intellectually I know that anyone who is messing with my hoo-hah in a clinical setting is not going to remember what it looks like when they run into me at a meeting. They are not going to care if the area is hairy or smooth or if the hair color matches what is on my head, or if I have stretch marks from babies. I also know that, in theory, anyone accessing my chart will be documented and recorded and will have to account for why they are there.

Still. 

How many sexual partners have I had? You can be dang well sure that I am not going to be honest about that question, no matter what the real number is. Am I engaging in risky sexual behavior? If I was, I sure as hell am not going to tell them. What about screening for STD’s? If I were in a situation where that needed to be done, would I be honest about THAT? No frickin’ way.

So, I continue to agonize daily over which physician I will end up have to spread my legs for. 

Decisions, decisions.

At least I have choices. Many women do not. 

Running Out of Time

IMG_3304It was them.

They were on the schedule again. 

I let out a groan. Every time I see them I feel guilty, ashamed.

Please don’t come.

50% of the time they no show and yet I cannot bring myself to fire them as patients like I would with anyone else.

He was almost as big as his mother. He screamed at all hours of the day and night. He ate spoiled garbage. He ate his feces when he soiled himself. He was becoming more violent. He had the vocabulary of a two year old in a ten year old body.

Someone somewhere had labelled him autistic. He had health insurance but with that label no one wanted to help him. 

There was something else going on here, though. My gut told me that it was not simply autism. 

The neurologists said, “Not my problem! Send him to psychiatry.”

The psychiatrists said, “Autism is not my problem. Send him to MHMR.”

MHMR said, “We cannot see him. Try a developmental specialist…”

The developmental specialists refused to take him because he already had a diagnosis.

Meanwhile, the family was on their third apartment in a year because he could not be controlled. The neighbors always complained. 

Who could blame them?

The parents took him to the emergency room at the children’s hospital whenever things got really bad. The ER would send him to the inpatient psych unit. Meds would get tweaked but then none of the psychiatrists would see him as an outpatient. He would be sent home in a few days with no outside support. I struggled to manage his psych meds myself. I was all there was.

The cycle would start again. 

At one point his mother was told he needed to be turned over to a state home, that there was no more hope for him, nothing that could be done. 

You have to save yourself…

She refused.

I called every specialist I knew. I begged, pleaded, cajoled, and tried to call in favors. I even yelled at one. The wall never crumbled. They all stood their ground.

And then I gave up.

I gave up trying to help.

You have to save yourself…

But they still kept coming to see me, driving 45 minutes each way to my office. 

Then, after a few years of this, he started having seizures. 

Finally, the neurologists could no longer turn him away.

I thought about all of this that day as I prepared for his possible visit by again reading through the consult notes from the pediatric neurologist (the one I yelled at), the psychiatrist, the cardiologist, the nephrologist, and finally the geneticist…

He has a chromosomal abnormality.

A duplication. A syndrome. Now, finally, he has help. But it was too late for that family. The father lost his job. His mother cannot work because she has to be taking care of him. The parents separated, then divorced. Now the kiddo and his mother and siblings are all on welfare, Medicaid. 

It should not be this hard to get these kids help. I am angry with every one of those doctors who told me no. I hate them for making me feel like I had to give up and I hate them for making this boy and his family suffer for so long.

Mostly, though, I hate myself.

They did end up not showing for the appointment. I can hide my shame a bit longer…

Eyes Of The Beholder

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My mother has an uncanny knack for capturing the most unflattering pictures of me with her camera. 

Every damn time.

All of these years I have believed she was doing it on purpose (she can take really great photos of landscapes and other people) but rather than ask her why, I would silently, sullenly lick my wounds as I cringed over the odd angles she chose to accentuate each bulging thigh, each fat roll, each double chin.

You will have to trust me when I say that I am not hypercritical of these photos simply because of body dysmorphic issues. There is some of that, admittedly (what woman doesn’t), but these are genuinely bad: 

Bugging eyes. My mouth caught gaping open in some sort of snarlish way that I did not know was possible. Are my teeth REALLY that crooked? OMG. Please tell me that is not a nose booger!

In a group photo I will be the only one with the red demon eyes. No one else. How does she DO that so consistantly?!?!?? Is there a reverse red eye photo editor?

It struck me today, however, as I was looking at terrible photos of my kids that I really didn’t want to delete because it was THEM, that rather than this being an indication of a well orchestrated systematic attack on my self esteem driven by complicated maternal jealousy, perhaps this is actually a symptom of love. Love blinding to the flaws. Love that blights any photographic skill. Love that negates all of those unpleasant angles. She does not see how bad the pictures are because when she looks at them, she sees me.

Maybe she really does hate me. I don’t know and I don’t really care anymore. I am choosing to believe it is love. AND I am choosing to hit delete on all of those godawful pictures of my kids. No need to give them a complex when I have plenty of beautiful ones to keep! 

Sewing Lessons

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“Come on sweetheart. Let the nice doctor take the stitches out!”

The four year old with dark curls was sobbing hysterically. Her mother was trying to soothe her. I was standing there awkwardly by the counter with the suture removal kit in hand…. still waiting.

“I can get some help with this….” I said quietly, trying to catch mom’s eye so I could mouth holding her down.

Mom shook her head no.

“I’ll buy you a toy if you let her,” Mom pleaded. “Anything you want…”

The kiddo pondered this. She held her arm out, warily. “Ok, ok. I’m ready.” 

She sniffed.

The wild look in her eye and the huge quantity of snot pouring from her nose told me otherwise.

I took one step forward with the forceps and little scissors and the sobbing and screaming started up again. We had tried this five times already. I was done, my patience worn thin.

I took a step back.

“How about if I leave and come back in a few minutes, let her calm down a bit?” I had three other patients already in rooms and two more still in the waiting room. I had already spent 30 minutes of a fifteen minute appointment (and they had shown up 12 minutes late to start with) explaining what I was going to do over and over again, even going so far as to let her hold and touch the scissors, all to no avail. 

“Yes, please!” Her mother sounded grateful.

Relieved, I left.

I knew from experience that with kiddos like this it was not going to work without restraining her. Once she realized after the first snip that this was going to be fine, she would relax and it would all be OK. It was clear that she had been tricked before. She knew not to trust adults, especially in this context. She was bound and determined that she was not going to be tricked again. She didn’t know me from Adam. All she knew was her past history. 

I couldn’t blame her.

I also knew that I could not do that restraining without parental permission. It was looking like I was not going to get that permission. 

Grumbling under my breath, I reviewed the next patient’s chart in the computer. I saw a couple of patients and then taking a deep breath, went back in.

“Are you ready to try again?” I smiled.

She nodded her head. Her puffy eyes and tear stained cheeks still said otherwise. Sure enough, as soon as I picked up the scissors, hysterics again ensued.

“Do you want me to get help?” I looked at mom. Please, please let me get help. She emphatically shook her head no, again.

“Sweetheart, do you want to come back again later?”she asked.

“Yes!” The water works stopped immediately and she hopped down off the table, smiling. She was at the door, hand on the knob, in half a second.

Of course she said yes.

I started assigning codes and printing the super bill. There was still going to have to be a charge for the visit. 

Her mother stared at me.

“She does not need those sutures left in indefinitely. That will increase scarring. Try to schedule in the next day or two…”

Her mother opened her mouth but hesitated like she wanted to say something.

“You want me to go ahead and grab some help?” I asked for her.

“Yes, can you? I really don’t want to pay another copay or spend another hour or two here again. Let’s just get it over with.” 

So I did. 

There was ear splitting screaming and that munchkin fought like a well trained ninja initially but she relaxed after the first suture was removed and stopped crying by the third. She was holding her hand out by herself for the last three. 

When we were done, she beamed proudly at what she had accomplished and literally skipped down the hall and out of the clinic afterwards, curls bouncing, chattering away happily, no worse for the wear.

It is terribly difficult for me to remember this with my own kids, that letting them experience something scary and overcoming it makes them stronger and happier and less anxious later in life. 

“Mommy I can DO it!” my son said as he started across by himself. All of the what if’s flew through my mind and my hand reached automatically for his. He swatted me away. “Let me do it!” He took one careful step after the other with me trailing close behind, but still letting him do it on his own, growing more confident with each movement forward, each step away from me.

Practice. That is what it is. Practice. And we all need it, early and often, though not necessarily in stitches…

Ugliness

 Rusted out boiler room. 

I painted my daughter’s toenails last night. Happily, she gave me a huge hug after admiring the pink sparkle then whispered in my ear, “You are the BEST mommy, ever!” I basked in my most honored parent status because it never lasts long…

The first time I had my toenails done was when my husband gifted me a spa day as a graduation gift from residency. After so many years of slaving away under florescent lights and hospital grime with stress piled upon stress, it sounded like the perfect gift to everyone except me. 

I was thirty years old.

Some girls grow up getting their nails done. With moms. With friends. By themselves. 

But I had never done it before.

The anxiety was overwhelming. 

For weeks I stressed about the condition of my feet: the rather large bunions I had inherited from my father, the years of callous buildup from marathon training, the shape of my nails… Hell, did my feet smell bad?

Go on, take a sniff.

I darn near chickened out. I sat there throughout the procedure, mortified. Each touch of the nail tech’s hands was painful. Not physically painful. Emotionally painful. 

Someone was touching my horrible feet!

In the end my feet looked beautiful. For the first time in my life my feet, my toes… they looked beautiful. At least to me.

My feet could be beautiful?

As a very little girl I always felt beautiful. Then I saw the reality of me in a photograph and all of that magic disappeared. I have spent the rest of my life trying to recapture it. There are times when I can catch a glimpse, however fleeting, when I can successfully hide the myriad of perceived flaws beneath clothes or makeup enough that I can forget about them for a moment.

Maybe it is silly that something little like nail polish can do it for me?

Perhaps I am actually lucky. Some women go to extreme measures…

I am still terribly self concious about my feet. Having my nails done is not my favorite thing to do. I can bring myself to it maybe once or twice a year, but I never regret it.

As for my daughter, I will paint her toenails pink whenever she likes and hope that she, too, can some day find that magic again and maybe escape the bunion problems…

It’s Not You, It’s Me

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My son has made it an artform: Slow motion. Procrastination. Dragging out the getting ready before school until the absolute last possible minute.

Truly. 

He is gifted.

The past two weeks have been more stressful than usual at work. His delay tactics have been perfected and so getting his clothes on can take upwards of 40 minutes or longer. 

This is sending me over the edge.

You may recall the timer incident some time back. I thought I had it all figured out. We are back to ground zero here. The thing about kids is just when you think you deserve the Mom Of The Year Award, they show you that you don’t know jack.

Sigh.

I have a closet full of his toys again. I have tried time outs and cajoling. Rewards. I pulled out the timer again. I tried making him miss breakfast if he does not dress in time. 

He didn’t care. 

Not one bit.

It is infinitely more interesting to practice karate moves, watching his reflection in the mirror. Is he really that vain?!?!? Please tell me he isn’t that vain…

“Mommy, I am a bad person.”

“Why do you say that?”

“Because I do bad things. I can’t stop doing bad things.”

So I took a deep breath. I listened to myself and the meanness I hear in my voice as I am trying to motivate him to get ready and out of the house on time.

It’s not you, it’s me, sweetie…

I can’t control what is going on at the office so I am trying harder to control what is going on at home. The dressing thing matters more right now. He is sensing this and pushing back. THIS is the problem. MY problem. I am taking it out on my family. It isn’t fair and he does not have the words to articulate this. 

So he acts it out.

Mommy took a chill pill (figuratively) this morning. Things went a bit better and I praised him for it.

“I like it when you are happy with me, mommy.” He smiled from the back seat. 

I am not perfect. We will have this battle again soon, I am sure. Being a mother guarantees short term memory loss. I won’t remember and I will catch myself again as my sanity starts spiraling down the drain. 

And so for Mother’s Day this year I told my kids that I was sorry, that I loved them… 

… that I will work harder to leave work at work from now on.

Payback For What?

Cambodia 119

“Doc, my knee still hurts!”

“Still?” Flipping through the chart. “Wait. We haven’t talked about this before.” 

“I know.” She smiled sweetly and expectantly.

“So still?”

“Right. It never got better.”

“What have you been using for it to help?”

“Nothing.”

“Nothing?”

“Nothing.”

“Has it been swelling?”

“I don’t know.”

“Did it look swollen?”

“I wasn’t really paying attention. I just don’t want you to rule out the possibility that it might have been swollen at some point.”

“So it is not swollen now?”

She pulled up her pants leg and carefully examined the knee. Then she pulled up her other pants leg and carefully examined her other knee. “Well, I guess I don’t know. What do you think?”

“Uh. No. It does not look swollen right now.”

“Good.”

“Ok. How long has this been going on?”

“Oh, it’s been going on a little bit.”

“How long is that?”

“Well, a little while.” She seemed a bit frustrated over the restatement of the question.

“Really, you need to give me a time frame. A few days? A few weeks? A few months?”

“Well…..” Long pause as she thought back. “I don’t know exactly.”

“That’s OK. I don’t need an exactly. You can approximate it….”

Going with my mother to see the orthopedist. She does this to me on purpose, doesn’t she? Surely.