August Images

Jack and Tyler

cousins Alice and Sydney hit the waves

(root) beer at the pier

                                                                     Hanging ten

Cameron and Goose at sunrise

Five cousins out to dinner

Cameron and Clara, cousins

Uncle Mike surrounded by girls...as usual

Alice

birthday

Alice launched by Uncle Matt

Cousins:  Brendan and Jack

Andrew (don't worry, it's gone now)

Cousins Clara and Scarlett

Stella's first night out on the town

Uno in the afternoon

Sisters

Clara and Alice float

Andrew catching dinner

3 children + 550 pieces = 3 hours of quiet

Redfish; caught by Jack

Her first red...caught totally unassisted

one tired Goose

Sweet Cousins

the live well at the pier never fails to fascinate

Bliss!

We are going back to Walt Disney World!

Disney just released some fabulous discounts for 2011, so we are going to, again, be the responsible parents that we've always been (of particular note are the nearly annual visits we get, after about nine days of school absences, from the local truant officer during which Andrew laughs maniacally when the officer tells us that it was parents like us that put our public schools in jeopardy!!) and yank the kidlets out of school and go back in January.  This will likely be our last trip at this super time of year as Jack will be in middle school the following year, and thus truly, unable to miss a week.

We love the January season.  Low crowds, no lines, low humidity, temps in the mid-70s to mid-80s.  And huge discounts.

I snagged a beautiful room at the Polynesian Resort for January 21st through the 30th for 40% off the rack rate!  This type of discount is usually reserved for annual passholders who are also last minute travelers.  The fact that this a general public discount and that it was released in August is almost unbelievable!  Disney is fun, nostalgic, exciting, clean-cut, shiny and happy.  But one thing it is not, is cheap.  You can rarely count on discounts when going to Disney.  All I can figure is that the economic downturn must still be affecting Disney travel.  And I'm happy to take advantage of it.
 
The schools have scheduled a couple half days during this January week and we can usually count on a couple snow delays or cancellations to not make Jack's make-up load too, too bad.  So we're off!

And we just love the Poly.  It's one of the two original resorts that opened with the park in 1971.  It's been luxuriously refurbished many times, but retains its timeless magic.

I love to arrive back on its grounds at night and stroll to our room through the lush, tropical vegetation.  Tiki torches light the paths and charming island music plays.

I love stepping out of the lobby straight onto a monorail.  I love the volcano pool with its zero-entry, waterfall and surprisingly long and exciting waterside contained within the volcano.  I love how smoke rises from the volcano day and night and am always amazed by the glow of the lava that oozes down its sides.  I love sitting in the pool at night and watching the Magic Kingdom's fireworks show from across Bay Lake.

The four parks (Magic Kingdom, Epcot, Disney Studios and the Animal Kingdom) are amazingly magical and vast.  We have been going to WDW annually since 2001 (missed one year due to pregnancy) and we still have not seen and done nearly everything.

One really cool thing about WDW is that it is truly a vacation for anyone and everyone.  We've been with all three children, with just Jack and with just the girls.  We've traveled with other families, with grandparents and with other adult couples.  And each trip has been really neat in its own way.  Whether your focus is toddler Disney, kid Disney or adult Disney, the vacation will be a quality experience.  No matter how many times you go, you'll never do it all.

And now I get to start planning again!  Which is really my favorite part.  I've been lurking on some cool fan websites (Disboards, Intercot, Mouseplanet, and Mousesavers), planning our flights (on Kayak), meals, park schedule, nighttime entertainment, and Cirque du Soleil night.

And this year, I think I'll be sending the truant officer a postcard with Mickey on it, and a promise that after this year, she can go harass other families.

Simple Treasure

Sunrise Solitude

I'm Taking a Break

I am halfway through my vacation and am finally feeling up to writing.  It's been really nice so far.  Lots of sleep, snuggling, swimming, cooking, puzzling, reading.  Lots of just staring at the horizon and wondering how in the hell I got to 39 years of age so quickly.  And plenty of wondering if I've done enough to show for that number. 

Significantly, I am taking a break from the other 11 months.  I am taking a break from:

* my alarm clock

* constant fatigue

* ungrateful patients who make me work for free until 11 AM (which is when I actually start getting paid for what I do)

* difficult airways and back-to-back epidural placements

* surgeons with endless add-ons

* nurses who think room air contains adequate oxygen for desaturating patients or announce loudly that if they were "anesthesia" they'd throw their bodies in front of the OR door rather than let a particular complicated patient be brought to the operating room or think they know better than the rest of us how to handle acute crises.

* 2 AM pages I get because someone else forgot to put the right orders for a patient.

* the feeling I get in my own neighborhood that I, or rather we, live there but don't quite belong. 

* the constant anxiety I feel that I'm not doing enough, in both quantity and quality, at work and at home.

All those moments are in the past and exactly 305 miles away.  Now I am in a time and space of healing and rest.  I'm eating food from the sea and local gardens.  I'll listen to waves crash, sea grass rustle and the constant chatter of my children.  Now I'll inhale the scent of the ocean, salty and fishy and soothing, and just be.

The Elevator Fart

Is there anything funnier than hearing a stranger fart in public?

It can happen in a bank lineup, hotel lobby, or airplane.  It can happen in a restaurant, movie theater, or local bar.  But the funniest of all has got to be the Elevator Fart.  And it happened this morning at the hospital on my way up to the OR.  The Elevator Fart is the king of public farts, for two main reasons:

1. Acoustics.  It’s almost always dead silent in an elevator.  People usually keep quiet, stare firmly at the front door, and wait for their floor.  Any whisper or laugh echoes around the box with full force, reverberating loudly for all to hear.  So a giant, rippling fart trumpeted out by a bald businessman in a suit holding a briefcase in front of him?  That’s like a 21 gun salute.

2. Time.  If you’re climbing a high rise, you’re spending a minute or two with these people.  It’s you and them, locked together.  Hearing a stranger fart on the sidewalk is one thing.   Hearing a stranger fart in a tiny, enclosed room is another.  Nobody can escape the full experience, from the big bang to the first whiff to total elevator saturation.

Hearing a stranger fart in public is great partly because of everybody’s reactions.  There are really four main types of fart reactions you see:

■Concealed Laughers.  These folks purse their lips tightly, pop open their eyes, and try not to laugh.  If they’re with friends then the sight of their friend also trying to hold in their laugh can be too much, and they suddenly explode into a full-blown snort and roar attack. 

■The Business Class.  Folks in suits often try to pretend that nothing happened.  “Nope, everything’s just chipper here, I don’t smell anything at all.”  The only reaction you might see would be a very subtle step away from the culprit and a few extra looks at their watch.

■Deep-Sea Divers.  These folks try to hold their breath as long as possible.  They hear the fart and it’s, “Come on lungs, don’t fail me now.”  They’re the ones with the chipmunk cheeks who eventually pop and gasp desperately for air when the door opens.

■Innocent Children.  Little kids are always the funniest . I once heard a child in an elevator say, “Mommy, that man just farted!" with a full-on finger point right into the well-dressed ass in front of his face.  But hey, I guess if you’re going to fart in a kid’s face, you deserve to be called out.

Yes, hearing a stranger fart in public can be a tiny, hilarious moment in the middle of any day . If you’re the farter, I say be loud and be proud!  We’ve all been there, so no need to be embarassed.  If you’re in the audience, I say enjoy the hilarious social faux-pas and resulting reaction in the room.

So... thank you, unknown businessman, for adding a great bit of comic relief to the beginning of my day.  And thanks to the elevator full of people whose reactions I got to savor. 

Oh, and thanks to my mom and sisters who, along with me, appreciate the inherent funniness of public farts.

I *HEART* Mirena

The thing about the uterus is that it's a very demanding organ.  When’s the last time you thought about your jejunum? That damned thing is eight feet long, but most people have never even heard of it. Or how about your parathyroid glands? You’d be so up a brown creek if something happened to those, you know.  But, the uterus... it craves acknowledgement and respect.  It needs to have you thinking about it all the time.  From age 12 until finally, mercifully, it rests in dormancy.  A mere 40 years later.

Now, it was a lot easier before babies.  We all just went on the pill for, like, decades.  Had short, light "regular Tampax" periods.  Went off, had a baby, then went back on the pill.  Repeated the process until our families were complete.  Then we sent our husbands to the urologist for a little snip, snip and we thought our troubles are over.  But they certainly were not.

Because then the uterus' monthly tantrums start.  Worse than they ever were before.  The curse of women who have had babies and are now in their late 30s and 40s.  The heavy, gastly things that ruin clothes and bedsheets and make you think of nothing but having a hysterectomy for 5 straight days every month.  A "Super Plus" Tampax plus a maxi-pad, extra long, with wings might allow you to get through the night.  As long as you stayed in one position and then rushed to the bathroom the next morning while somehow keeping your thighs clamped together.

After so many years of suffering under her rule, and taking all she had to offer (thanks for the three kidlets!), I started to daydream about sinister ways to shut the bitch up. 

Simply, there are four choices.  And they follow, with my thoughts on each:

1.  Hormonal birth control:  Pills, shots, implantables, patches, vaginal rings.  Been there, done that.  I'm getting too old and I need to worry about estrogen and strokes and heart attacks.

2.  Hysterectomy:  Big deal of an operation.  Could lead to chronic pain states.  Plus, insurance won't pay and I don't have time for it.

3.  Uterine ablation:  Good option.  My only hesitation is the potential inability to detect uterine cancer due to uterine scar "trapping" the tell-tale bleeding.

4.  Mirena IUD:  What I chose.  (official website)


And I LOVE it!  I mean, I am singing from the hilltops.  Best thing since being pregnant!

You have it inserted in the office, which is really not a big deal.  Then it begins emitting a tiny bit of progesterone (no estrogen!) into the uterus.  None gets into your blood stream so you have absolutely no systemic effects from the hormone.  You still ovulate, your endogenous hormones still cycle normally and monthly.  But because the progesterone causes your uterine lining to thin, you barely bleed.  And after 3-6 months, most women stop completely. 

Yes, it's a miracle. And it lasts for five years.  (Then you can have another one placed.) 

It is fairly expensive up front, and, unfortunately, rarely covered by insurance.  (Unless you're on the dole.  Then it's free.)  But I can guarantee that I will pay for mine in a year with savings gained from skipping the "Feminine Hygeine" aisle.

Anesthesia v. Orthopedics

Some genius, somewhere, made this video and put it on YouTube recently.  I first watched it last week, with a bunch of anesthesiologists.  By the end, were all howling!  Wiping tears, rolling on the floor.  It was one of the funniest things I have ever seen in my life.  Throughout the day, I showed it to more colleagues, orthopedic surgeons, OR nurses.  Everyone, I mean everyone who watched it needed a few minutes to re-compose afterwards.  HIGH-larious to the nth degree. 

So I got home that day and raced into Andrew's study to show him.  He watched and just blinked blankly at the screen.  Looked at me, looked back at the screen, and said "Cool, now let me show you what I've decided to invest our HSA money in this year."

Some things are truly inside jokes.

Whew...

Well it is FINALLY, mercifully, over.  I hope.  (I'll find out in 4-6 weeks.)

The six week cram for my anesthesiology re-certification exam has come to an end.  Which wouldn't have been so bad if it weren't for the fact that I worked 28 of the last 28 days.  And 8 of the past 28 nights.  90-110 hours per week of doing anesthesia, in addition to the cramming.  And then, as always, trying mightily to give my children and husband the vague impression that they are my true priority. 

I had to put books for pleasure down.  I didn't read a single page.  Didn't watch a stitch of TV or a single movie.  Didn't cook or bake at all.  My herb pots are wilting and the garden is weedy.  No exercise beyond walking to work.  No fun days at the pool.  It's been a summer....

But this is what did happen, mostly in my absence:

*Jack went to basketball camp at Roanoke College and loved it.  9 hours a day.  He built up a whole lot of confidence and is really looking forward to rec ball this year.

*Alice went to Patrick Henry High School's annual soccer camp.  She was not a big fan.  It was huge and the kids were mostly older.  Apparently, there was a coach with one arm and that scared her.  And she was afraid of the high school bathrooms.  I told her that I am, too.

*Both girls went to an art camp for a week.  It was run out of the home of a lovely young couple, both of whom are art teachers in the public school system.  The girls absolutely loved it.  And the coolest thing was that they came home with genuine treasures at the end of the week (that will not end up well hidden in the bottom of the garbage can late at night.) 

*The kidlets all attended vacation bible school.  Which was a good thing because at the rate we've been making it to church, they were in dire need of some spiritual enhancement.

*We finally biked the Virginia Creeper Trail.  Loved it and can't wait to do it again.

*Some friends, whom we met a year and a half ago in Europe, came for a visit.  And it was like not a day had passed.  Guess that's why we liked them so much when we met them.

*I found out that iPhones don't travel well on tops of cars.  And I found out the importance of backing the daggone thing up every now and then and what a pain in the ass it is if you haven't.

*I have not seen my baby nieces in far too long.  They are sitting up and babbling and wouldn't know me from the man in the moon now, which just kills me.  But I will be seeing them soon, thank goodness.

*My dad's stage 4 melanoma is wreaking havoc on him psychologically.  And my mother is suffering tremendously as a result.  And there is not a damned thing I can do to help either of them.

*Swim season.  Now this has definitely been a source of much needed positivity this summer.  Andrew, Jack, Alice and Clara all swam and had a blast.  Alice wound up being given the award for Hunting Hill's top 6-and-under female swimmer.  Andrew got the award for the top point earner in the men's 24-39 year old division.  At age 39 and 3/4 I might add.  Jack got the award for most determined swimmer.  He received a beautiful trophy and the coach spoke at the banquet about how Jack had decided this year that he no longer wanted to be an average swimmer.  So he practiced twice a day and really started to distinguish himself as one of Hunting Hill's top swimmers in his age division.  And Clara, my sweet bundle of charisma, received the Hounddog Award.  Her coach, Jourdan, gave a beautiful, tearful speech about how Clara spreads happiness effortlessly.  The Sherman Family was tenth in top scoring Hunting Hills families.  And again, HHCC won the RVAA championships.  (This is a happy paragraph, so I won't dwell on the fact that I was not present at the banquet.  That I was at the hospital, feeling about as low as I'd ever felt, knowing what I was missing.)


So, it's been a summer of highs and lows.  Overall, I feel anxiety, sadness, pride, fatigue.  I really, really am happy that I have 3 1/2 weeks of Topsail time coming up.  I need it bad.

100 Things That Make Me Happy

A friend of mine recently shared her list with me.  I found myself reading and smiling and simultaneously thinking, "There's no way I could come up with one hundred different things that make me happy."

But you know, it has got to be fun to try.  And since I've been working and studying so hard, I'm going to allow myself the pleasure of coming up with a list of my own.  I am happy simply contemplating an hour of thinking about and constructing this list.

 1.  Alice's curls
 2.  watching the surf at sunset
 3.  eating yellowtail and salmon sashimi
 4.  cruising
 5.  planning Disney World trips
 6.  coffee in the morning
 7.  thinking about the evenings my children were born
 8.  the feeling after two glasses of wine
 9.  pranking with my sisters
10.  handmade cards
11.  Christmas mornings
12.  the way Andrew curls into me asleep at night
13.  watching Clara dance
14.  baking
15.  watching something I planted grow
16.  my herb pots
17.  being in my new house
18.  the last 45 minutes of the drive to Topsail
19.  writing
20.  being able to read for a long stretch
21.  movie nights in bed
22.  texting like a teenager
23.  watching the cousins all play together
24.  pictures of Rosie as a puppy
25.  the big chair under the big windows in my room
26.  being with our extended family (parents, siblings, cousins, grandparents)
27.  haunted houses
28.  a slice of a hot loaf of bread
29.  hearing my children laugh
30.  the smell of our house at Christmas time
31.  a steam shower with Andrew
32.  the feel of sliding in between cool sheets
33.  walking the streets of Pompeii under the shadow of Vesuvius
34.  driving along the Amalfi Coast
35.  tater tots
36.  going over and under waves, depending on their size and strength
37.  showering outside
38.  picking crabs
39.  cheering for the Steelers with my Pittsburgh family
40.  my iPhone
41.  going to see a musical theater production
42.  looking in on my sleeping children
43.  sleeping under a down comforter in the winter
44.  decorating the Christmas tree
45.  the feeling of getting it taken down and the house clean after Christmas
46.  watching snow fall from inside a warm house
47.  the vibe all five of us in a hotel room together
48.  Las Ramblas in Barcelona
49.  the fact that my sisters and mother and I end all of our conversations with "I love you."
50.  swimming with dolphins at Topsail
51.  the excitement before a vacation
52.  childhood memories
53.  laughing until my abs ache
54.  knowing I found my soul mate
55.  the smell of cool autumn days
56.  exercising with Andrew
57.  driving my station wagon
58.  talking with lights out in bed before we go to sleep
59.  waking up leisurely without an alarm
60.  an ASA 1 patient
61.  walking through a museum
62.  snuggling
63.  riding Splash Mountain
64.  reading to my girls in bed
65.  Clara's eyes
66.  dinner at home with friends
67.  making old family recipes
68.  my children's names
69.  the fact my extended family no longer exchanges gifts, but travels instead
70.  blogging
71.  photo editing
72.  really spicy foods
73.  Friday nights
74.  airplane meals
75.  my mother's cooking
76.  my son's love of reading
77.  the smell of eucalyptus
78.  classic martinis
79.  my pillows
80.  freshly bathed children in pajamas
81.  my four nieces
82.  the fact that Allison and I both have twin girls
83.  movie nights with all five of us
84.  Thanksgiving dinner blessings
85.  the confidence and satisfaction I have in my late 30s
86.  trips to The Homestead
87.  pedicures
88.  being kissed while Andrew holds my head
89.  purring, kneading cats in bed with me
90.  the way Goose groans when he thinks I'm disturbing him
91.  being on my back deck in the evening
92.  Augusts at the beach
93.  tubing with Allison and Matt
94.  the smell of the Polynesian resort at WDW
95.  eating at Artist Point
96.  watching The Lion King at the Animal Kindgom
97.  the satisfaction I get out of being in my profession
98.  Japanese office supplies, particularly the Uniball Signo pen with lavender-black ink
99.  AOLs Adult Alternative station
100.  the fact that this is, by far, a very incomplete list

That was a really, really nice way to spend an hour. 

Summer Eats

I'm still studying away and have been successfully staying off the computer as of late.  But, it's been tough.  I have so many things I want to write about right now! 

So far, I'm feeling really confident with my recertification prep.  Historically, a score of 67% or so is considered passing and I'm now consistently scoring in the mid-80s on practice tests.  When I started, I was scoring about 67%.  It feels really good to have the information coming back easily.

We've had a great first couple weeks of summer.  Bedtimes have stretched later.  Afternoon naps come easily.  Mornings have a different, more relaxed tone. I still get up early but am enjoying the quietness of the house.  I feed Goose and the cats and sip coffee and eat toast while reading a bit.  The children and Andrew get up sometime later.  Breakfasts for them have evolved from the hurriedly eaten granola bar to hot bowls of slow-cooked oatmeal with fresh fruit or eggs with homemade bread toast.  Summertimes are so nice all around.

Our cruise friends, Kha and Ivy came for a weekend recently.  We got to meet Kha's sweet husband and her adorable baby bump.  They are the kind of friends that no matter how infrequently you see them, you can pick up where you let off.  Effortlessly.  It was a great weekend.

We're now in the thick of swim season and the children are essentially living at the pool.  Alice recently enjoyed a week of soccer camp.  Jack is going to Roanoke College's basketball camp soon and Clara will be attending art camp.  Andrew's mom and dad have been here for a couple of days and we've really enjoyed seeing them.

Our beach trip is around the corner and our summer eating is in full force.  Our garden is being quite generous right now.  Raddishes, squash, tomotoes, beans, lettuce, jalapenos, cucumbers, onions.  I love seeing the children popping onions or tomatoes in their mouths while they are out playing. 

Every summer, it seems I develop a seasonal obsession or two.  Last year it was watermelon.  I ate at least one every two days.  The year before it was sliced cucumbers and radishes soaked in apple cider vinegar with fresh cracked black pepper.  Couldn't get enough.

This year, I have three obsessions.

1.

baby greens +
sliced onions +
freshly grated parmagiano regiano
tossed with balsamic vinegar and white truffle oil

2.

Jack's salsa, hot (from Kroger's prepared food section) +
chopped fresh peaches (preferably from SC, thanks Kha!)+
a handful of chopped cilantro from my deck pot
eaten with tortilla chips or, better yet, a spoon

3.

fresh shucked corn, grilled +
painted with half mayo and half sour cream, both light +
rolled in freshly grated parmagiano regiano +
sprinkled with chili powder +
and drizzled with fresh lime juice
(recent Southern Living recipe)

Mmmmmmm....

(Back to the grind.)

Beach Dreaming

I really, really shouldn't be blogging.  I've got my recertification exam in anesthesiology coming up on July 30th.  I decided to take it at the last minute (about a week ago) after finding out that the price of the exam is increasing by $800 next year, and even if I take it and fail it and have to pay a re-examination fee, it will still be cheaper that waiting until next year to take it.  So really, it's just a practice test at this point but IF I pass, I pass, and that is IT for TEN YEARS!  So I really, really want to pass.  And to do that, I MUST stay off the computer. 

But I just can't help thinking about August at the beach.  The annual month-long sojourn that has become so essential to my mental and physical well-being.

We went for a quickie over Memorial Day weekend and the tease was almost unbearable.  We drove down Friday in time for dinner.  Brought a cooler with beer and juice and stopped in Surf City and picked up pizza.  Drove straight to the beach and had a picnic as the sun set. 

The children walked around the beach, calf-deep in the water, not in their usual play and banter, but individually and quietly.  Staring out at the horizon, and then down at the water swirling around their legs.  Almost as if they were checking-in, reconnecting, if you will, with they ocean that has been a major part of all of their lives since before they were born.  (I spent a lot of time in the waves when I was pregnant with them.)

Andrew and I sat together against a dune and ate and drank and watched the children silently communicating with some force that has no name.  And I don't know if it was the long drive, or the (what is for me) intoxicating sound of the surf, or the beer or whatever.  But I shifted in spirit, too.

I remember when I was young.  Occasionally my parents would have me out late and I would fall asleep in the back seat of the car on the way home.  When we got home my dad would carry me to bed.  Now I always woke up to a certain extent when he carried me in.  But never let on that I was awake because I relished that half-asleep, half-awake feeling of being carried to bed by my strong father.  It was a feeling I absolutely loved.

Sitting on that dune with Andrew, feeling slightly buzzed, with the sun setting and no one else in sight but my children, silent and deep in thought, reminded me of being carried to bed by my father.  Warm, loved and secure.  And my soul, at that moment, existed just outside of it's normal, solid reality.  Mmmm...

Anyhoooo....I am really looking forward to August.  My sister-in-law and her husband and sweet girls will join us for part of the month.  Our four girls are really, really close cousins.  In age and in friendship.  And they love to dress alike.  All four girls love to be, what they say, "twins together."

I just bought all four girls sun dresses to change into after a long day on the beach and a big group outside shower.  In which they will scream and squeal that Jack is peeking at them.  He wouldn't dare and truly has no interest in little girl's bodies.  (Six years of two little sisters running around nude and he is DONE with that!)  And they will certainly toss out buckets of cold water as he walks past.  Poor guy. 

At any rate, Alice and Sydney like blue and Clara and Cameron are pinki-philes.  So I ordered two of each.  And I think they will look adorable in their dresses.  And they will just be thrilled to go out and eat a Mexican dinner in them.

Summer Swim Season is Here!

We had our first swim meet of the season last night and the Shermanators are on a roll!  Hunting Hills Country Club hosted Stonegate and it was a great meet!

Some highlights:

Alice won the girls 6 and under 25 free and Clara got third place.  Out of 20-some-odd girls!  They both got silver times and just looked gorgeous in the water. 

Jack scored in the top of his events (back and free) and was even asked, as a ten year old, to step up to the 11/12 boys division to compete in the 200 free relay.  Which they won.

And Andrew, God love him, barely made it to the pool on time.  He had to stay home and peel linoleum paste off the laundry room wall after I misplaced my new wrapping paper station.  But he made it and got 2nd of nine 25-39 year old guys in the 50 free.  Was beat out by a fellow Hounddog and ex-UNC-Chapel Hill swimmer.  He also placed a respectable 4th in the 50 back.

I was so proud of my swimmers last night.

The new GM at Hunting Hills has come up with some great new revenue-generating ideas that include providing an outside buffet at our swim meets.  You buy wristbands for $10 for adults and $5 for children (actually, we charged ours to our account so no cash was needed) and you can come and go into the buffet as many times as you wish during the course of the three hour meet.  Last night they had a pizza bar, a baked potato bar, chicken nuggets, hamburgers, hotdogs, cookies and drinks.  And they have converted the old pool table veranda into a full-service bar.  So the adults were really having a great time.

It was so much fun to see friends that I don't see much during the school year.  And, of course, to watch my children and husband score some major points for the home team.

Alice and Clara hung out with the Moore twins (Caroline and Elizabeth).  Their dad is a pediatrician in town and I was their mom's anesthesiologist when they were born.  And they hung out with the Grant twins (Katie and Caroline).  Their dad is a UNC-trained radiologist.  All 6 twins are 6 years old.  Two, two, two cute!

Dude!

Please, just go to sleep already! 

I was just about to lie down here at 5 AM and BEEP BEEP BEEP!   Sucking chest would in the ED.  I could hear the accusation from the hallway outside of the Trauma Bay.

"I don't know man!  I was just sleeping in my bed and Some Dude just came in and stabbed me!"

(I was so hoping to get an hour or two of sleep before my girls' Author's Teas this morning.)

Some Dude Has Struck Again

Well, it is 2AM and here I sit, feeling a bit of deja-vu.  I have just put to sleep a man that was assaulted by Roanoke's most infamous churl:  Some Dude.  I have just gotten the victim to sleep and all tucked in and my nurse anesthetist is taking most excellent care of Mr. S while I reflect for a minute. 

I met Mr. S in the ER about a half an hour ago, after he was brought in by a paramedic unit.  His neck has a deep, near circumferential gash with clear arterial bleeding emanating from it's center.  There are also deep, jagged gashes in both of his arms, with yellow, globular fat and strandy muscles poking out of them.  Amazingly, he arrived coherent and absolutely intent on telling us his story.

He was..ahem...walking home from bible study about 45 minutes ago, at 1AM, minding his own business, when Some Dude jumped out from behind a dumpster on Williamson Road and visciously slashed his neck and stabbed his arms.  With a broken beer bottle.  Oooooo-kay.  Some Dude is just rude.  I mean, to assault a God-fearing man, on his way home from bible study?!!?  What, on God's green earth, is up with that?

The crazy thing is....Some Dude does shit like this ALL of the time.  Just last week, another guy was brought in from the local flea bag motel.  He was apparently "gettin' wit his girl" when Some Dude broke into the hotel room and shot the guy in the ass!  Really!  And for no reason at all, according to the guy.  Now the girl also happened to be the girl of another guy, too.  Was the other guy Some Dude?  That was a matter of much debate in the OR that night.

And then not long ago, a local and quite notorious mid-level drug dealer limped into the ER with a gun shot wound in his right foot.  Coincidentally, the local drug culture dictates a shot to the right foot for the first offense of unpaid drug debt.  The police came to question him and what do you know?  The gimp absolutely refused to identify his assailant.  All he would say was that it was...you guessed it.  Some Dude.

Amazingly, none of Some Dude's victims ever get a really good look at him.  And Some Dude must have shape-shifting skillz, too.  Sometimes he's tall and skinny, other times he's average and muscular.  There are usually some vaguely remembered details, but nothing really detailed or specific that can help out the City Police.

Some Dude really gets around.  He manages to be involved in the majority of the subversive, after-hour happenings around town.

I don't know much about thug culture, drug dealing or bible studies.  But I do know this.  I hope and pray I never run across Some Dude.  But I know that if I ever do, I will run for my freaking life.

Don't Worry, Be Happy!

“We see it as an entrepreneurial bill,” Pelosi said, “a bill that says to someone, if you want to be creative and be a musician or whatever, you can leave your work, focus on your talent, your skill, your passion, your aspirations because you will have health care.”




Get that? Go ahead and quit that low-paying (or high-paying, for that matter) job, because the rest of us will carry your load. What happens when we reach that tipping point, though?  Who pays the piper when no one's working?
 
As Margaret Thatcher once thoughtfully observed: "The problem with socialism is that eventually you run out of other people's money."

A Day in the Life...

5:50 am - Alarm goes off.  Get up, get dressed, go downstairs.  Feed two impatient cats and one dog who always waits his turn.  Pour coffee and place travel mug in two ziplocked bags.  Hope to never have an in-backpack coffee spill again.  Eat last piece of toasted home-baked bread and remind myself to bake a couple more loaves tonight.  Throw Mojo bar, Cheese-Its, apple and string cheese in backpack.

6:15 am - Greet Clara and Jack who come downstairs.  Answer, as I do every morning that, yes, I do have to go to work so can't get them dressed, eat breakfast with them or walk them so school.  Feel a bit shitty about that and somewhat jealous of Andrew.

6:25 am - Walk to the hospital with Goose.  Enjoy exactly 17 minutes of peace and good conversation with our ex-stray.

6:45 am-  Dress in greens and see my first patient.  Unlucky man who broke his neck in a car accident.  Explain to him that I will have to put his breathing tube in while he is awake to avoid damaging his spinal cord.  Reassure him that it is not nearly as bad as it sounds.  Glad that it is not 8 years ago, when I was new at doing awake intubations and lacked the finesse that I will use today to back up my reasurances.

7:00 am - Set up my operating room, check my anesthesia machine, draw up drugs.  Check and double check everything.  A mild case of OCD is a prerequisite for this field.  Eat Mojo bar and drink coffee while doing all of this.

7:15am - Patient rolls into the room.  Numb his upper airway with tubes and jelly and aerosols and sprays.  Inject lidocaine through his neck and into his windpipe.  Use a shockingly large-bored needle to do this as it's got to have enough tenacity to poke through the cartilagenous tracheal rings.  Shutter as I do this as I've never gotten used to stabbing people's necks until their breath wooshes out at me.  Snake a fiberoptic bronchoscope through his nostril and his vocal cords.  Slide breathing tube over scope.  Finally, mercifully, put him to sleep.

10:00 am - Finely tune drugs, gasses and ventilator settings in order to take the man as close to death as he'll ever go (until he dies, of course) while keeping him comfortably asleep and his vital signs stable.  Wake him up as the bandages go on.  He remembers nothing of his intubation.  Silently praise amnestic drugs.

10:15 am - See second patient.  Three year old who needs his humerus fracture fixed.  Read the chart and realize that this is a suspected child abuse case.  Which explains the nurse who does not leave the child's side.  Automatically despise the mother.  Take a history from the mother and see her red-rimmed eyes and the regret and love contained in them.  Realize I want to hug the mother and tell her that only by God's grace have many of us not been in her shoes.  That love, exhaustion, anger and frustration are intimately entwined. 

10:30 am - Gently put the toddler to sleep, while stroking his cheeks and whispering in his ear, hoping to give him a moment's peace.

11:00 am - Answer page from recovery room.  The neck patient is having nausea.  I order more drugs and hope they help as I figure vomiting with a neck incision has got to be fairly miserable.

11:05 am - Answer page from pre-op.  Order versed (anti-anxiety medication) for my next patient after being told she is sobbing and disturbing the other patients.

noon:  Wake baby up.  Skeletal survey has been read by the radiologist, who calls in the room and reports his findings of multiple fractures in various states of healing in his ribs and legs.  Take him to recovery and ask the nurses to be very gentle since he probably hurts all over.

12:10 pm - Go to doctor's lounge to sign charts, eat apple, cheese and Cheese-Its.  Listen to news about health care reform.  Wonder how many hospitals will have to close due to Medicare cuts and how many physicians will be able to stay out of hospital employment situations.  Realize there is nothing I can do about it.

12:20 pm - See third patient.  36 year old for a D and C for a miscarriage.  Turn my name badge (with the small photo of my three children taped on it) over before I meet her.  She is a G4P0 (four pregancies, no children).  She looks sad and resigned.  The husband can't even look at me.  He has his hand on her belly.  They saw a heartbeat six weeks ago.  It was gone yesterday at her OB appointment.

12:25 pm - Place a long thin needle in the woman's back.  Wait for clear cerebrospinal fluid drip back out at me and then inject some numbing medicine.  Marvel that a single cc (or gram) of fluid can make a person completely numb for hours.  Sedate the woman after her spinal is in place.  (She couldn't really explain why she didn't just want to be put to sleep for the procedure.  She just preferred a spinal.)  Quietly discuss with obstetrician her odds of ever completing a pregancy.  They are slim, unless they do IVF with donor eggs.  Of course, who has the money for that in this recession?

1:30 pm - See fourth patient.  Post-partum tubal ligation.  A Medicaid (welfare) patient who just had her 6th child in the wee hours of the morning.   Ask her if she understands the permanence of the procedure.  She assures me that she does.  As a matter of fact, she wanted it done after her 5th baby, but got tired of waiting for her doctor who was attending to a delivery.  So she went home and got pregnant again.  I call the OR to encourage the nurses to hurry up and take her back.  I do NOT want her leaving again. 

1:35 pm - Realize that with the new Medicaid/Medicare cuts Obama just approved, I will get paid exactly $126 dollars for anesthetizing this woman.  After expenses, I will get well less than half.  Sigh.

3:00 pm - Finish the case and take her to recovery. 

3:15 pm - Use ultrasound to locate the brachial plexus, the network of nerves supplying sensory and motor function to the arm, in the neck of a man who just had shoulder surgery and is in exquisite pain.  Carefully deposit numbing medicine on these nerves and feel really good when I see his heart rate and respiratory rate slow.  He thanks me.

3:45 - Go perform a pre-operative evaluation on a patient who is having surgery the next day.  Enjoy talking to her and her family.  Take a history, listen to her heart and lungs, examine her airway, answer questions.

3:55 - Tell a nurse on the floor, who approaches me while I'm there, that, yes, I will do the anesthetic for her upcoming breast augmentation.  Call my secretary to schedule same. 

4:00 pm - Walk home.  Feel so thankful that I am not on call that night and that my day was short.  I rarely get out so early.  Talk to my mother and my sisters on the walk home.  Try to get my heart rate up because this will probably be the only exercise I get today.

4:20 pm - Walk in.  One dog, two cats, three children and a husband all compete for my attention immediately.  Try to make each feel that they have it, undivided, all at the same time.  Help with electricity project, math homework, go through school folders, get dough mixed up for bread.  Help Alice and Clara knead bread for me while enjoying the feel of their hands on mine.

4:50 pm - Drive the girls to ballet with Andrew.  It's only a thirty minute practice so we walk to the local Irish pub and share a Guiness.  Talk about our respective days.  I don't talk about my patients.  It would take too much time.  And he wouldn't fully understand.  You can't undertand the intensity of those situations without looking in the eyes of the people involved.  Plus, he needs to discuss life insurance, summer camps and the fourth grade trip to Baltimore.  I try to listen but my mind wanders to the three year old's mother.  Wish I had the whole beer for myself.

5:30 pm - Pick up girls.  Reassure them that they will do fine at the recital.  Drive home.  Bathe girls while Andrew finishes dinner.

6:00 pm - Eat black eyed peas served over jasmine rice with shredded cheddar, chopped onions and sour cream.  And lots of Texas Pete.  It's delicious.  Pop bread into the oven and feel thankful that I know how do something so tangible for my family that they absolutely relish.

7:00 pm - Finish dishes and then Clara reads for Andrew and Alice reads for me.  Alice is almost done with the last Bob book box and I'm proud of her.

7:30 pm - I read to both of them while Andrew does homework with Jack.  Or they model.  Or read books side by side.

8:30 pm - Put Jack to bed.  Discuss whichever topic he's chosen for the night. He always saves his "heavy" topics for the nighttime.   I used to think he was procrastinating lights out, but now I know he really needs to discuss issues he feels are important in the evenings with me.

8:45 pm - Shower.  Answer emails.  Try to study a bit for my recertification exam in anesthesiology.

9:45 pm - Read.  If I'm disciplined, I turn my light off at 11.  Say a prayer of thanks that I've been given such a full life.  And pray for strength as I muddle through it.

Thoughts on Mothers-in-Law

I've been thinking recently about mothers-in-law.  I think because someone with whom I'm very close is going through a tremendously rough time with hers.  And we've been talking about her experiences.  These discussions we've been having have got me thinking.  Thinking about the kind of mother-in-law I hope to be one day. 

It seems that the simplest relationship involving a mother-in-law is that with her son-in-law.  I rarely hear of troubles with that particular kind of relationship.  But the mother-in-law daughter-in-law relationship?  Now, that one can have some problems.  

Let me preface these thoughts of mine by saying that I have a wonderful MIL.  Andrew's mother is loving and kind.  She is very good to her children and grandchildren and loves us all tremendously.  She and Clara are pictured above, doing what they love to do best:  just being together.  In many respects, I am lucky in my MIL relationship.

My wonderful friend?  Not so much.  Her MIL is hateful to the very core.  My friend used to tell me stories about her MIL and I'd say, "Just give it some time.  She's adjusting.  Being a MIL is not easy."  So she waited...and things only got worse.  The MIL says hurtful things about her DIL to other relatives.  She posts mean things on Facebook.  She has called her vulgar names on multiple occasions.  And always in a sneaky, cowardly manner:  when she thinks she can get away with it without others finding out.

She has been caught in multiple and flagrant lies, too.  For instance, just recently the MIL responded to a thread on FB, involving her DIL, with one simple word:  BI***.  Now, everyone who had previously made a comment on that particular thread, including myself, received an email from Facebook, with a copy of this comment.  When asked about it, she denied it.  Flat out lied.  A grown woman!

And something that she did that was particularly hateful and seemed intended to be destructive to her son and DIL's relationship: she told the DIL that her son used to be happy, but since he married her, he has become unhappy and is not himself anymore.  What kind of mother and MIL does this?  And I should point out that her claim is so untrue, it is laughable.  While the past year's hardships with the MIL have indeed presented a challenge to this couple, and I do personally believe the the MIL is out to destroy their marriage, these trials have only made this loving couple stronger.  They are lucky though.  This is the kind of stress and grief that destroys marriages.

Worse, the woman clearly has some serious mental illness, and likely has for a long time.  She has even been kicked out of a public venue due to her irrational behavior.  All of her family members, close ones and more distant ones, acknowledge this in private to the son and DIL, but no one steps up to insist that she gets help.  So, she just continues to abuse and torture her DIL. 

Equally horrible is the fact that her own son is suffering tremendously.  He grieved about the situation for a long while, but now seems resigned.  Sad, defeated and resigned.  His recent experiences as an expectant and first-time father have been overshadowed with tension and sadness.  How could a mother do this to her son?

But in the end, it is the MIL who will suffer the most.  She will never have any kind of meaningful relationship with her son, her DIL, and perhaps most tragically, her grandchildren.  She has burned bridges that can never be rebuilt.  Both the son and DIL agree that she is too unstable to ever be left alone with the children.  And, as a matter of fact, they avoid seeing her at all.

Sad, sad, sad.

So...what are the qualities of a good MIL?  The kind of MIL I want to be when Jack makes me one...

1.  I will try to see my DIL through my son's eyes.  I will try to see her for the person with whom my son fell in love. 

2.  I will not let her religion, cultural background, educational background or philosophical background define her.    If she is a Japanese Buddhist who meditates half of the day, I will try to understand that.  I certainly will not ridicule it.  I will accept it and support her. 

3. I will not stop over on my whim.  I will always call first and respect their home as theirs.

4.  I will talk honestly, openly and humbly about miscommunication or conflict.  I will pursue resolution and that fact, in itself, will speak volumes.

5.  I will be responsive to my DIL's needs and feelings.  Even if I don't understand them.  Empathy is key.

6.  I will be flexible.  For instance, if they can't see us on Christmas, I will gracefully celebrate the holiday with them during the time surrounding the actual day. 

I will do all of these things because they are the right things to do.  I will do them so that I can have a fulfilling relationship with my DIL.  So that there is peace in the family.

But the most important reason for following the above rules is simple.  It is because I love my son.  And I would never want to disappoint him or hurt him, or, in any way, jeopardize my own relationship with him.

We've Got Three Bike Riders

Yesterday, Saturday, was just one of those glorious days for the five of us:  most of the day spent in our awesome new house, some exercise and a nice dinner out.

 Jack had had a friend spend the night on Friday and the boy was picked up early by his father as he had a baseball game.  And I was on 4th call and had to hang out around the house until I went off call at 3pm,  in case I was needed at the hospital.  Turns out I wasn't needed at all. 

Before the addition was finished, a day like yesterday would not have been a fun day.  Being in the kitchen would have required being away from the rest of the family.  Additionally, there was no decent yard in which the children could play.  No garden.  Disorganization galore.  Just not a pretty scene all around.

But now a day at home is just plain old fun.  We lingered over coffee and breakfast.  The girls read some Bob books to us.  And they are just reading like champs.  Then they played Barbies together nicely.  Jack got a work station set up in the garage for his modeling and read a bunch of his current Harry Potter book.  Then we streamed a movie for the kidlets from Netflix through our Wii (LOVE this feature).  My Girl 2, I think it was.  While they watched, Andrew and I went upstairs and enjoyed an hour long eucalyptus steam bath.  Luxurious.

Once three o'clock rolled around, and we were no longer obligated to hang out at home, we took a 7 mile bike ride.  We rode from our house down to the Roanoke Greenway.  Meandered along the greenway for several miles, let the children play at a park for a while, then rode home.

On the way home, we rode on a path through the River's Edge playing fields and Clara, who was riding in a cart that Andrew was trailering, piped up that she'd like to try to ride Alice's bike.

Now, all previous attempts at teaching Clara to ride a bike have been disastrous.  They've resulted in shrieking and crying and falling.  And other parents looking at us like we were evil child abusers.  As a result, we actually hadn't even tried with her since last autumn because we were trying to forestall yet another scene. 

So we all stopped riding, slightly shocked and gun-shy.  Clara climbed on Alice bike and took off.  Rode for about five minutes like she'd been doing it her whole life.  She was strong and steady, negotiated curves like a pro, sped up and slowed down well.  The only problem was that she hasn't figured out how to pedal backwards to break.  So when she wanted to stop she would just throw herself off of the bike and log roll to a stop.  That was truly hilarious.

Thrilled for Clara, we all rode home, showered and enjoyed a nice celebratory dinner out.

So we can all now ride bikes.  Great job, Clara, our lone bicycling holdout!  We're glad you're in the saddle.

(The idea that Clara could ride all along but hid that fact due to being inherently lazy and preferring to ride in the cart is, definitely, a possibility.  If so, her cleverness and scheming are hear by acknowledged.)