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.”

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.

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.

What I mean to say is that there was no nap, and at no point did Zoe even appear to be tired. Around 9:00 PM, we cuddled and watched her current favorite show, Imagination Movers, on the cozy sac. A couple of times during our cuddle, I was smelling her hair, kissing her warm little head, and generally floating on a cloud of bliss, when she said, sweetly and contently, “I luhboo.” Those last 30 minutes with her were more recharging to my heart than a whole week of beach bum vacation. Finally, she drifted off to sleep for the night. I watched a movie and a half, wishing I would never, ever, have to put her down.

I told Joel that what I missed most about the baby time is that it’s basically all like that, except for when they’re crying or needing to be changed. The majority, or what I remember anyway, was holding her while she slept and nursing her. And it was sweet. Really sweet. Now there are fewer of those times, but it’s extra sweet, because she chooses it. As a baby, they really don’t have a choice, and I could be loving the heck out of the cuddling, while the kid might be totally unaware of me beyond a comfortable place to lie and a food source. We definitely communed when she was a baby, and I felt like she was digging me, too, but now, the happiness seems more reciprocal. Maybe because she can talk or hug back or choose not to wriggle away.

I asked if I still will get to cuddle her when I go back to school in a month. If she’ll allow it, if she’ll begrudge my more frequent absence and commitment to something else and resent me. Not just in August, but later. Because she’ll never have a closely spaced sibling to share my attention. Med school, and then my profession, is the new baby dividing my energy. Only she won’t get the built-in best friend down the line.

I guess that’s the price of doing things a little backwards. I waffled in undergrad and abandoned pre-med, changing my major with no real plan. I got married before I was a grown-up. I had ovarian cancer before having children, creating an urgency to have a family. My experience with illness also reignited what I feel is a call to medicine. Despite my poor performance thus far, I know it’s what I need to do.

But it makes things more difficult. A lot more difficult. And I feel selfish. I don’t want her to pay the price for my doing things backwards. The fact is that Zoe has more adjusting to do than she would if I had been able to wait until I was all set up to have children. But if I had been all set up, I might have had two kids, and then she would adjust to that. Or something else. Life is a series of adjustments, right?

I swear I had a point. I wanted my baby, and I wanted to pursue medicine. I’m fortunate to have the opportunity to do both. The timing may be off by most people’s standards, but I have what I want. I just hope we all can get what we need.

A bit of good news for the allergy sufferer: our apartment has installed astroturf in the courtyard. That’s right. Astroturf.

Last week or so, there was a commotion down there for about a day and a half. The grass had started to look a little peaked, probably due to frequent dog visits. Workers dug about two feet deep and filled the area with large pebbles. Drainage – good show! That should help, I thought. They then covered the rocks with what from the second floor balcony looked like the greenest grass I had ever seen. I was impressed. Today we took Zoe for a little playtime in the courtyard (which was great, by the way, and I’m realizing this about nine months too late, since we’re moving in two weeks), and we inspected this awesome grass further. No wonder it is so nice. Joel commented that one would have to be a real asshole to leave dog poo on astroturf. One would. I agree.

Although it is technically Sunday, I would like to wish Katie a very happy birthday. We had a great time playing Wii and eating OTB and cake last night.

Today we managed to get some pre-move tasks accomplished, which is good, because the panic arrived about a week ago. Moving… sucks, as I believe I have probably expounded upon in writing and in speech about one thousand times. I’m sure everyone is tired of my whining. New adventures and places and people – I like all that. But the actual figuring out this worldly possession thing WITH A BABY is grossly unfun. Boo for moving away from friends and a job I have come to love.

However. I am looking forward to getting out of limbo and staying in one place for at least four years. We can have a routine, a real routine. With purpose. Have I mentioned that I’m going to medical school? I still can’t believe it. My heart flutters when I think about opening that email that said I was accepted and dancing around the room with Zoe.

After half an episode of Sesame Street and no signs of going back to sleep, I started a shower to cleanse my gunked hair. Zoe had designs on a bath, however, so we took a bath. She ate a good breakfast (fed herself oatmeal with a spoon very neatly). For the next hour or so she whined and grunted nonstop, not really wanting to be held or be alone, sleepy but not sleeping, and generally playing the role of an amateur terrorist. Joel is dealing with Army stuff, so we’re trying to stay out of his irritable way.

So I was grouchy anyway. I thought we might make it to the store to get some cocoa powder to make these cookies. (How the hell I am out of cocoa powder is anyone’s guess.) The outing plus the baking was sure to cheer us up. I could take the goods to work later, I thought, since my baking attempt earlier in the week did not go as planned.

Then the office of our (hopefully, I guess) future residence called; they need more documents, the girl informs me rather hatefully. Telling myself it’s better than all the paperwork to buy a house, I bucked up and got everything together, including bothering my parents who are guarantors on the place (another long and stupid story). This was supposed to be easy – we will be renting from the same property management company, and I have a connection, but so far they have been a bit of a pita.

Continuing. My Mom was coming by to drop off a document, so I decided to take Zoe sandal shopping while we waited. We needed to get out of this apartment and clear our heads.

Things perked up from there: Zoe experienced her first BOGO event, getting a pair of pink tennies and white sandals with hearts, and on the way back, an adorable grandparently couple strolled with us, admiring Zoe and showering her with attention.

I received a call from work that I would be put on call for the shift, which normally frustrates me a little (especially when Zoe is tugging on my last nerve), but I was kind of relieved. There is a patient there who ruffled my feathers yesterday, and she won’t be leaving anytime soon. Apparently I have the same name as someone she dislikes intensely, and she can’t separate us in her mind. Normally I just shrug off the patients’ tenseness; they are ill, I’m there to help them, and it isn’t personal if they have a problem with me (or hasn’t been so far). I am professional, did not let on that she had ruffled my feathers, and will deal with it if I do go in today. But I would rather make cookies at this particular time.

WOW I am long-winded today. The point is that Zoe has gone down for a nap, it’s overcast outside, and my documents have been faxed; I think I might be able to take a nap myself, albeit brief after this post… And later, we might try those cookies.

When a person is at work, one should not treat customers/patients/coworkers as an inconvenient interruption in one’s day. These people are the reason why one is at work. (This also applies to family life, I am realizing.)

Also, tonight we will finally celebrate Joel’s birthday – there is a restaurant that Zoe and I picked out for him (we called ahead to make sure they serve Coca-Cola products).

The first memory came about while making my midnight snack (which tonight is dessert for “second dinner” – how Joel and I eat so much/often and are not tubs of lard is a subject which should be studied). As I placed a ramekin in the microwave, I thought of a tweet for twitter* and blurted, “I have the perfect tweet for twitter!” I took off running toward my computer and was immediately reminded of a scene from our childhood. Amanda and I would put something to warm in the microwave and take off running in circles around the kitchen island, I suppose as a way to burn off calories. It was way fun.

Secondly. A common snack for the patients where I work is graham crackers and peanut butter. I have always liked this combination, and being around it all the time is starting to cause intense cravings for peanut butter. And I always crave chocolate. As such, Reese’s items are a staple in our home. I have Kroger’s version of the Reese’s cereal so I can curb cravings for chocolate and peanut butter without eating an entire bag of chocolate chips and tub of peanut butter. Tonight my snack was a small spoon of peanut butter with a few chocolate chips melted in the microwave, as I did not want the corn product found in the cereal because I think that corn gives me corn belly and inflames my system. Call me crazy, but it does. None of this is either here or there.

The point is that I thought of the cereal as an option, and in thinking of Amanda while running as the microwave was on, I was reminded that one morning I woke her up, very excited about the Reese’s cereal, by saying, “WOO WOO!!! PEANUT BUTTER!”

*twitter was down (GRRRRR), and this is kind of the last straw, so twitter is now somewhere between on notice and dead to me. But my tweet was going to be: Very little damage can be done within the confines of a ramekin.