Even though the past six months have flown by and I feel that it can’t possibly be time for this, or perhaps *because* of how quickly things happened, I might need to reflect, if only for a few minutes. Many of these answers are the same from year to year, which either means I’m not growing, I’m living in my own personal Groundhog Day, or I’m incredibly consistent. Yes, that.

Keeping the tradition alive…

In 2011, I gained a deeper appreciation for my colleagues.

I lost my external hard drive. And, intentionally, a bunch of stuff that was taking up space. So I gained some space, but then we moved to a smaller place, so I lost that. Hmm. I also lost some inhibitions; that’s good. And 80 points of total cholesterol by eating more veggies!

I stopped worrying so much about what other people think. (And will have stopped playing Zombie Cafe. Will have stopped. It’s still on my devices. Yes, plural. It’s a franchise. DON’T JUDGE ME.)

I started direct patient care.

I was hugely satisfied by recognizing a little confidence and experience can be very freeing.

And frustrated by balancing my responsibilities (same as the last two years).

I am so embarrassed that our apartment is constantly a wreck. But we’re working on it.

Once again, I resolved to stop biting my nails.

Once again, I bit my nails.

The biggest physical difference between me last December and this December is my hair is longer.

The biggest psychological difference between me last December and this December is a thicker skin.

I loved being with Zoe, being in the OR, working in the pedi clinic, and baking.

Why did I spend even two minutes worrying about the small stuff? (Repeat, but a good reminder: don’t sweat the small stuff!)

I should have spent more time being 100% present with whatever I’m doing. (Also a repeat.)

I regret rushing to 40% of my scheduled activities. And being distracted.

I will never regret quality time spent with Zoe.

I worried way too much.

I didn’t exercise nearly enough.

My internal medicine rotation nearly drove me crazy.

The most relaxing place I went was the Hermann call room.

Why did I stress so much?

The best thing I did for someone else was care.

The best thing I did for myself was power through.

The best thing someone did for me was encourage me to power through.

The one thing I’d like to do again, but do it better, is Disney World!

Happy New Year!

(Fill-in-the-blank template from Mary Schmich at The Chicago Tribune)

“Mom? Please don’t get mad. I did two things to make a mess. First, I dropped my paintbrush, and now there’s paint on the carpet. Then, I went to wipe paint off my hands, and so now there’s paint on your red towel in the kitchen. I’m sorry.”

I hug her. “Thank you for telling me so we can fix it.”

“It’s important to tell the truth!”

I LOVE HER.

Zoe began receiving an allowance a few weeks ago. We decided a dollar per year of age weekly would be a good start. Joel the economist programmer has been tracking her income.

The hardest part has been allowing Zoe to make her own spending decisions. The idea, of course, is to teach her about money, saving, and value. The first two weeks, she received the money, was rather nonplussed, and saved it more out of boredom or confusion. We were pleased. Then we went to The Great State Fair of Texas where she saw a Hello Kitty sewing machine, and once we suggested that she start saving her allowance toward it (perhaps to split it with us), she suddenly became very interested in money.

She’s a four-year-old girl, and as such, has many wants. Most of these are capricious, and we are able to talk her out of them fairly easily. She found herself at the mall with her Dad one night while I was on call with the purpose of using her allowance to buy a special bed for her Build-a-Bear Hello Kitty with the Aurora outfit. Apparently they also stopped at the Disney store. She wasn’t set on anything in particular as they left, yet the dollars were burning a hole in her Hello Kitty purse. “Hmm. I guess I’ll just get this princess camera.” Joel convinced her at the time that if she didn’t REALLY want anything right then, she should save her money for later. The rest of the week, she asked to go to the mall so she could get her princess camera from the Disney store. She couldn’t tell me how much it cost or what it DID exactly, only that she desperately, desperately wanted it.

Saturday morning we were again at the Disney store to buy her friend a birthday gift. I’d like to thank the associate who brought us a reusable shopping bag (price tag: $3.50) to carry the armload of stuff Zoe had acquired, despite my reminders that we were there for a present, not to add to our giant pile of useless items at home. The princess nightgowns were two-for-one, and since nightgowns are useful and Zoe is about to outgrow hers, we could justify this choice as good for a present AND a take-home. Then we set about the task of sorting through Zoe’s selections to choose the ONE item she could afford with her allowance, putting in our two cents that none of this was worth whatever it cost, that experiences are better than stuff, and it would be a good idea to save her money toward something really cool.

Anyway she bought a dumb fake cell phone that she loves. She thinks she has a direct line to Ariel. It was not the princess camera, by the way.

As we walked back through the mall, we explained that we’re really happy she’s happy with her phone, and she gets to choose what she does with her allowance. Joel said something to the effect that next time she wants to buy something, she might not have enough money, and she’ll have to save up her allowance from a lower balance. Then she counted her remaining money, and she seemed disappointed. Baby’s first buyer’s remorse. It was so cute and sad.

Then she looked up with giant blue eyes and asked, “Um, do you guys have any money?”

Loved orthopedic surgery. On emergency general service now. Life at the speed of sound, most of the time.

Tonight we slowed down for some family time and an impromptu, very informal piano lesson (which necessitated clearing off the piano bench). I reviewed the basics with her and we went over a few simple Dozen a Day exercises (from the pink book, of course). With the attention span of a goldfish (both of us, actually), it was a lesson in futility for the most part. Trying to close on a positive note, I asked her to walk her fingers over the keys and say the letters of them, A through G, before we left the piano to get ready for bed. She started at the highest note and said, “You’ve got to be kidding me! A is over here, and it goes all the way down through Z! You can’t tell me it ends at G – that’s just not how it is!”

I tried. Bless good teachers.

I reference Bill & Ted’s Excellent Adventure. Joel stares blankly.

I’m incredulous. How is this possible?

But Keanu Reeves and I share a birthday, I say.

“That’s always been one of my least favorite things about you.”

It has been added to our Netflix queue.

She sees Joel’s new red-ink pen that has a reddish grip.

“Is this pink?”

Joel: Well, it’s actually red, but I can see why you might think that.

“I think it’s pink. Can I try it out?”

I have never been so proud. She has a hypothesis, and she wants to test it.

“Oh, it’s red. Okay!”

We cannot reject the null hypothesis.

Zoe had a diversity/international celebration at school today. The request was that each child dress in a representative ethnic costume for a parade and bring a dish for everyone to sample. It’s a great idea. Until we remembered that we’re white. We (w)racked our brains for the better part of a week to come up with something interesting. We considered we could include my Choctaw heritage or both of our European ancestry, adopt someone else’s culture based on what food we wanted to bring, perhaps a more creative princess theme, or the easier route: traditional “American” or Texan. In the end, we have pink boots and a hat for her, and we figured the menu would otherwise be lacking in chocolate, so as soon as I got home this morning, Zoe and I made a Texas sheet cake. Ours was the only one, though others had thought the same way we had – there were a couple of token, store-bought apple pies and cookies. We might have reflected a bit more on what it means to be American, or delved into our heritage, but life is busy and we ran out of time.

Today I’m post-call, meaning that I started working yesterday at 0630 and got home (early) today at 0830. So I was kinda tired. Then Zoe had that thing at school yadda yadda yadda we’re just now eating dinner at 2200. Despite our intermittent efforts to plan meals, it came as a bit of a surprise to us after the evening swim that Zoe was hungry. We fed her, finally finished cleaning up the three-days-worth of mess in the kitchen, and looked at each other with the more and more familiar, bedraggled gaze that says, “Does sleep/apathy trump food again? I mean I’m kinda hungry but it’s late and who knows what we’d eat.” I suggested tuna patties, which was met with a grimace.

We surveyed the fridge, finding:
- leftover rice that Joel made in my absence, described with frustration as “not good at all”
- leftover tikka masala – but oh, nope, that’s just the sauce
- leftover salmon – when did we make that? I don’t know. Zoe ate some the other day and she’s been fine, so it’s probably okay.
- leftover turkey burgers – those were great the first time around

As I assembled two small dishes of this abomination, I felt like saying, “This is pathetic.” But I stopped myself. We’re busy and doing the best we can. So I said, “This is resourceful.”

Joel, who provides much comic relief in my life, responded with, “It’s just like your People. We eat all parts of the fridge.”

Sooooo hi. Life on the wards. My first rotation is internal medicine at the county hospital. My team was on call the very first day. It was a harrowing, soul-sucking, what-the-eff-have-I-gotten-myself-into 30 hours and I was 99% certain I would not return for another minute of it. But I did. And after that day, I was 99% certain I would not return for another minute of it. Lather, rinse, repeat. I’m off today, and chances are better than not that I WILL return tomorrow, so at some point the scales tipped in favor of continuing this path. I’m trying not to analyze it too much, but I’ll offer a few things that may have contributed: investment of all involved, including but not limited to the $100K+ student loan debt, encouraging words from my family and friends, wanting Zoe never to see me give up, and all the previous analyzing I’ve done when I wanted to quit. Last but not least is the fact that I just started this part, and I shan’t expect to be an expert yet. I’m doing the best I can every day, which admittedly is inadequate, but if I keep trying it has to get better. Right? RIGHT?

Things I do like: the hospital. I’m weird but I’ve always liked hospitals. They’re kind of like airports – everywhere you look there’s something to experience, often a deep human emotion that, if you’re tuned in enough, enriches your life in a way you never expected. Turns out there are people who spend their days as bystanders, onlookers, people-watchers at malls and airports and even hospitals – I could have joined them for this experience alone and not tortured myself with medicine, but I think there’s not a lot of money to be made just sitting there, and my family likes groceries.

Plus there are other things I’m enjoying, like my team. My team is awesome. There are five third-year students (MS3 from now on, for medical student year 3), one MS4 (guess what that means), two interns (first-year residents), two residents (one post-graduate year 2, one PGY3), and our attending physician. It’s a large team. If you’re a long time reader you’ll know that I haven’t been my class’s (as a whole) number one fan, but as I’ve gotten to know people I’ve appreciated them more in most instances. I’ll be professional and work with anyone, of course, but I actually LIKE working with these people. All four of the residents and the attending are super, take time to teach us, and are helping us ease into this. My team has figured out a way to make the hours more tolerable, and we work well together. And really, it goes by quite quickly – I’m never bored, for sure. Anyway my team: good.

A few other details (sorry if it’s too much but this is my blog and my memory is bad): once a week we also have a core faculty session with another team and different attending, and so far I’ve learned SO MUCH from these short sessions. Yesterday we focused on the physical exam and everything you can tell about the patient just from seeing him or her, before looking at labs or imaging or anything in the chart. Awesome. I actually prefer to have a little more intensity/higher expectations because I think I learn more that way. Sure, I die a bit when I don’t know um, all of it, but as long as I’m not being personally attacked I think it’s character- and knowledge-building. For example: one thing we do is called Fred Rounds, where a seasoned and very respected doctor who has been practicing for near as I can tell approximately 120 years puts a resident in the hot seat to teach us all important things. The take home is to be precise and thorough and the very best doctor you can be. I’m sure it’s painful, and I was sweating bullets on behalf of our resident. People dread it but I really think it’s one of the best learning experiences we’ve had so far. What else… we go to conference and grand rounds during the week, and those are extra learning opportunities, too.

And of course: the patients. That’s why I’m here, really. Our main job as MS3s is to know everything – EVERYTHING – about our patients. We carry two or three each right now, and our team caps at 20 patients. (Later we’ll have up to five, then as residents oh, ten.) So there’s no excuse not to know absolutely everything about our two. There’s always something else to learn about a disease process or treatment, so I’m doing a lot of reading. We write our notes in the system, and I’m getting that down slowly but surely… All the while I’m adding to my knowledge which I hope will help when I take my boards – this year we take the internal medicine shelf exam after only two months, whereas in the past there have been three. Frightening. I need to study more. But already having a patient to associate with everything I’m learning really helps me retain it.

The only person being mean to me is this girl named Blake. She just won’t let up! Her expectations are ridiculously high. I mean, we just started, and she’s acting like we have to know all the answers already. She tells me my grades and scores are bad, that I’m not doing as well as everyone else seems to be doing, that every time I speak I’ve said something embarrassing, and that I shouldn’t even be here – there’s no way I’ll make it, and when I don’t, my daughter will be angry with me about all the time I’ve missed. She always has something critical to say about me, and I’m tired of her negative attitude. STEP OFF, B*+CH. Plus she’s really crabby when she doesn’t get enough sleep, and between you and me, I think she’s insecure and anxious.

Other than that B, shortly and sweetly, the main problems are exhaustion at times, and the runaround. The system. The frustration at the larger forces at work. The claustrophobic feeling I have when I consider the human condition. Being sick…SUCKS. I know first hand. I think that is the true soul-sucking part – I have the unfortunate awareness to realize that there is no way to avoid suffering in this world, and some people have more of it than others, and sometimes we can’t do anything about it. You guys, death is not the worst thing that happens to us. My heart aches in these cases.

Oh and presenting. I’ll get better at it – I know I will – but DAMN I’m bad at it. I want to melt into the floor and erase everyone’s memory every time I speak. Sometimes I know answers, and sometimes I even say them aloud. But when I have to present a patient – summarize their condition and spout off all pertinent information, including lab values that should be memorized – I tank. TANK, I tell you. It’s terrible. I’m getting sweaty just typing this. Ugh no more.

I’m making a conscious effort not to focus on what I don’t like. Because this is my life. It WILL get better. I’ll get better. I just have to take it one little bit at a time.

In other news: Zoe and Joel seem to be holding up well in my relative absence. Right now Zoe is entertaining her Cap’n and Gigi in Garland – she had been begging to go see them, and I’m really happy it worked out. I love that she loves all her grandparents and talks about them often. There’s a lot of love here.

Here’s what just happened:

A curly-headed blur zoomed past me as I carried the dog’s full bowl of water to his tray. Zoe, don’t run with a pen, please. It’s dangerous.

“It’s not a pen, and anyway I was skipping with it. It’s my pencils.”

ALRIGHT WELL WHATEVER YOU’RE RUNNING WITH STOP IT AND WALK – you don’t wanna put an eye out.

Yeah I said that.

This comes on the heels of her very first stitches Saturday night. She was refusing to eat dinner with us during a half hour of being an utter pill for an unknown reason, most likely that she was tired after a long day of doing

Hold on. I just had to save this draft and return to it because there was a crash in the kitchen. It seems someone had climbed up and gotten plates to set the table for tomorrow morning’s breakfast (SUPER SWEET right?) and long story short we have one fewer plates.

Where was I? Oh yes, the stitches. So in a fit she shoved off our lofted dining table in her lofted pink chair, which fell back in slow motion. I said, “Awesome,” as she fell, because I was thinking that surely THIS would teach her, not injure her, but scare her into thinking at least twice before her next display of stubborn hostility, when she landed, quite gracefully, upright and without any limbs under any part of the chair. Whew, I thought, but in just as slow a motion, unfortunately as an aftershock of the landing she bumped her chin on the padded part of the chair and began crying in pain. Joel picked her up and brought her to me, in his infinite wisdom warning me to hold back the I TOLD YOU SOs until we determined she was okay, when I saw blood gushing from her chin. After we stopped the bleeding I got a better look and could see muscle fibers and adipose tissue coming through, so off to get stitches we went. To me, lacerations are the worst – I mean, to look at or even feel the chair, you’d never think it would break skin.

The urgent care place was awesome. We were in and out, they numbed her well, the treatment team was really nice, and although a white sheet papoose/taco was necessary,

Wait so I’m not making this up. She just came in, wide-eyed, and said, “Mom, you better not step on all the towels because I spilled a WHOLE BUNCH of water.”

Right now you might be thinking many things, such as why isn’t your four-year-old in bed? And why are you continuing effectively to ignore her, and where is your husband? Exactly. Now they are playing something called fishkitball and I’m going to wrap this up.

So the three stitches come out in a week. A week during which she can’t be in the pool. During the last week of her swimming lessons. But we’re so fortunate that these are the worst of our concerns regarding her health.

In other news, third year has begun, and I’m really excited. More on that later, surely. Today during orientation attention was paid to our responsibilities and cautions regarding any online presence we may have. I like to think I’m aware of these issues and walk a fine line both personally and professionally, trying to balance privacy with creativity and honesty. It was a good reminder never to betray the trust of the people for whom I’ll be caring medically and with whom I work, and I also thought about Zoe. I hope she doesn’t mind and maybe even will think it’s cool to have grown up online. I know we’re taking some risks and that not everyone would do it this way. She knows I write about her and post pictures of her; if anything I just want to share the joy she brings to our world, even when she’s breaking skin and plates.

So. It’s quiet around here. The Girl and her Dad-O took off for cooler temperatures and more entertaining people last week, leaving me with a wide open schedule to take this test prep by the horns. I finished the Doctors in Training Step 1 review course (15 days, 3 lectures per day) and am reading and doing questions most of the day now. This morning my friend and I did a dry run to the testing center; we even did some reconnaissance regarding temperature and lockers inside. I’m not ready to take the test yet, but I have a week to review and plane tickets for the next morning, so there’s no turning back now!

Have you ever spent a week away from your child? Because I hadn’t. I think the longest we’ve been apart approached 5 days once, until this time. The first couple of days I did a lot of milling around and not sleeping – put it on my tab – but was able to put about half of those extra hours toward studying. They return tomorrow, thank goodness. Every Mom yearns for alone time and lots of space to stretch out and be comfortable and do whatever she pleases. Did I appreciate the opportunity? Yes, and I’ve been productive. But I’ve grown accustomed to their faces and am disoriented without them here.

In their absence, Chief has stepped up been here to receive my extra love and ramblings. (BTW, I still can’t believe this happened.) We’ve gone on long walks with Goljan audio and frequented the dog park. New landscaping has meant water runoff into the dog park, creating fantastic mud pits for wallowing. So we’ve had a few baths. Confirming Joel’s suspicions that his main objective in life is to be in everyone’s way, he has avoided the bed for all but a few hours the whole week. Without Joel’s long frame to impede, what point would there be?

Enough of my lonesome musings and avoidance of First Aid. I gotta make today count!