Communication

I wonder what my baby would say to me if he could talk. Yesterday, Spiff and I were running an errand, and Gunner had a meltdown in his car seat. There was no apparent reason for it. He wasn't tired or hungry, and Spiff was in the back seat with him. Yet Gunner cried inconsolably for about fifteen minutes. Once we reached our destination, he was fine.

It makes me wonder what babies think when weird things bother them. I wonder if his foot fell asleep, or if he was being pinched by something in the car seat, or if he was too hot. I also wonder what he thinks when he gets a sore throat. I have also wondered how it is for him when he wakes up hungry in the middle of the night, and it's dark and he has no way of getting food for himself. He can only cry and hope that those big friendly people who take care of him will eventually come and help him.

Even though he doesn't talk, Gunner is pretty good at communicating to us. He cries when he's hungry, and he squawks when he's tired. He fusses when he has the hiccups. It still makes me wish he would say, "Momma, my foot has gone to sleep and I'm stuck in this uncomfortable car seat. Would you please pull the car over and get me out?"

But then again, even if he could say this, I have to wonder if I would listen. I would probably just say, "Just a few minutes. We're almost there." And I would keep on driving because the errand has to be run...Doesn't it?

Lies People Tell

People tell lies sometimes. I'm not talking about deliberate lies people use to cover up something bad they have done. I'm talking about the lies they tell to make you feel better about a situation. When I had my baby, I was told that babies sleep so much when they're newborns that I really wouldn't be that sleep-deprived. Simply sleep when the baby sleeps, and I wouldn't get that sleep-deprived. They said that this is especially true since this is my first baby, and I don't have to chase after a toddler. I believed that one until we had a newborn who wouldn't sleep longer than 30 minutes at a time. I have never been so sleep-deprived in my life.

The most recent lie I'd like to discuss is one I have heard many times at the doctor's office, at the lactation consultant's office, and from many friends. They say that breast fed babies don't get sick. There is something about the mother's antibodies that get passed through the milk to the baby, and the baby isn't supposed to get sick because he has "breastmilk antibody power" to fight off whatever hits him. This is such a lie! My baby now has his third cold in three months.

Here is my theory: I haven't gotten sick. Maybe it's backfiring and I'm getting double antibodies from the milk. Maybe it's helping me instead of the baby. So, student doctors, go on and tell me what a bunch of poo this theory is. I don't mind. I'm just trying to make myself feel better about my baby being sick again.

Going public

On my mission, my mission president taught me a few valuable principles regarding goal setting. First, the goal must be quantifiable, i.e. you can measure it numerically somehow, or have some other definitive way of defining accomplishment. So, it would not be a good goal to say to myself "get in shape". What does that mean? Unless I assign some quantifier, then the goal become mutable and therefore useless. Secondly, it is beneficial to go public with your goals so that you become accountable for their accomplishment. So, here goes:

We joined the YMCA several months ago, but until now I haven't used my membership. Here then, are my fitness goals for 2009, and you, the readers will hold me accountable (if you care to) for their accomplishment. If nothing else, I will have to hang my head in shame and tell you why I did not follow through. I am doing this in order to avoid the stereotypical new-year's-resolution-fitness-bandwagon-jumping that peters out by mid february.

Since I can only control my schedule through the end of June, these goals are only to be accomplished or worked on until June 30.

Row 15K in 60 minutes on the erg.
Run 10k in <45 minutes.

To accomplish:
at least 3 days/wk rowing and lifting or running.

We'll see how these pan out. I'll post them on the sidebar to keep them fresh.
-SS.

Coulda, but not Woulda, and not Shoulda.

We have several friends here who aren't in medical school, but are rather pursuing degrees in history, or law, or other paths not connected with the diseased human form. In speaking with them, I can sometimes glimpse the world of what might have been. I studied history and french literature as an undergrad, before turning my sights on medical school. I thoroughly enjoyed history, and have since I first read Winston Churchill's "Memoirs of the Second World War" as a 4th grader in france starved for english reading material. My sister is also studying history, in fact in a domain that I find fascinating, the Great War. When listening to their stories of school and the esoterica of their respective fields of interest, I feel a sense of loss for the intellectual discourse and discovery that the pursuit of historical research provided me as an undergradate, and which I no longer have as a medical student. In many ways the first two years of medical school are not very challenging from an intellectual standpoint. School is not easy, it requires lots of work and time, but the material itself is, with the exception of renal physiology, not too challenging. The challenge of these first two years is not in articulating and researching new interpretations of bygone machinations of the Hapsburg empire, but rather in simply force feeding my brain a large volume of material in a small amount of time.
When I consider the alternative, which I did 3 years ago when I applied to medical school, I would not choose to study history or French literature, however. As I wrote my senior thesis, such as it was, I was more depressed than I had been since my mission. I didn't realize it then, but that pushed me more firmly away from history and towards medicine. I enjoy medical school and the material I'm learning, even at the expense of having the joy of intellectual discovery a graduate history degree might have afforded me.

Piano Teacher's Musings

I visited some of my former piano students and their parents while we were in Oregon over Christmas vacation. My students were so adorable, and so much taller than they were when I left them 18 months ago. One student got all dressed up to perform for me in her nicest dress, necklace and shoes. Some other families had a little recital for me, each of the kids taking turns to play their most recent recital pieces. Some other students I met with played their Christmas songs for me because none of them could remember their most recent recital pieces! They have all improved with their new teachers, and it was a lot fun to hear them play. I realized as I listened to them that I miss being a part of the process. I love that part of teaching...helping them figure out the technical challenges, guiding them through the form, finding the details that make it extra special, and watching as they feel the satisfaction of finishing and performing a challenging piece.

I have a new piano student. She is my neighbor girl and will be taking lessons from me temporarily until she moved to CA in June. She is 13, a transfer student, and a beginner with three months of experience. I taught her first lesson today. It was my first lesson in a year and half, and I can tell that I'm rusty. She is very bright and talented, and I am excited to work with her.

I was so spoiled in Oregon, and I have a feeling that I will always remember my time there as the Glory Years. I had the very best type of students and families to work with: talented, hard-working, smart, fun kids with dedicated parents. I left Oregon with extremely high expectations, and I am afraid that I will never find such good families to work with ever again. I am also afraid that I won't want to teach because any new family just won't be as good as my Glory Years families. I think this new student is a good one. I'm hoping that she will help me get over my irrational fears, and I will find the courage to build a studio again some day.

He exceeds even himself

No, the title is not some immodest boasting about my academic performance. Instead this is another episode in the continuing saga of foolish classmates in medical school. Faithful readers will no doubt recall a certain individual who, when questioned about diarrhea caused by food poisoning, confidently asserted the diarrhea was indubitably due to duodenal atresia (a congenitally non-patent gut tube). This same individual surpassed that poor showing yesterday.

The picture above is of a Littmann Cardiology III stethoscope. What you can see is one side of the stethoscope that is configured to be a pediatric diaphragm. The opposite side looks exactly the same, only larger as it is an adult diaphragm. Just for absolute clarity, this stethoscope, configured as shown, has two diaphragms.

In our physical diagnosis class, we have been learning to do an abdominal exam. Part of the exam requires that the medical student auscultate the abdomen to hear bowel sounds. In order to do so, we are to use the diaphragm of the stethoscope. The protagonist of our tale (not me, but duodenal atresia boy), took his turn to auscultate the standardized patient. With his Littmann Cardio III, configured exactly as the image above shows, he sheepishly asked to borrow one of the other medical student's stethoscopes since his lacked a diaphragm. This confounded everyone in the room, including the standardized patient who asked him "how does your stethoscope not have a diaphragm?", to which he replied "this is a pediatric stethoscope, it doesn't have a diaphragm."

Now, to be fair, this could be an honest mistake for a medical student to make. The only problem is, we're not first years anymore who only have stethoscopes we've received as gifts and no formal instruction in their use. Dr. M has lectured twice on medical equipment, there have been presentations by 3M, makers of littmann products, as well as by Welch Allyn and other equipment manufacturers. Scariest of all though, is that we've been instructed and tested on the cardiac exam, which requires knowledge of where and what sides of a stethoscope to use, as well as the respiratory exam which requires the use of the diaphragm on a stethoscope. So, barring attendance-optional corporate presentations, there have been 3 physical exam lectures, 3 reviews, and 2 equipment lectures that should have clued our protagonist in regarding the parts of his stethosope. Even more shocking, is that, regardless of how he would have put the stethoscope on the patient, assuming of course that he wasn't using the earpieces or the tubing, he would have put a diaphragm on their abdomen, yet he didn't have the sense to realize this. Wow. Strong work lad.

A Visit to the Doctor

I took Gunner to his two-month check-up yesterday. Apparently going to the doctor's office is a stressful experience for me. I was terrified the first time I took him, and I shook the whole time. I was still shaking this time, and especially nervous because it was time for his first round of shots. He did amazingly well throughout the appointment. He was a happy baby while being stripped down, weighed, and measured. I fed him while waiting for the doctor, and he promptly fell asleep. He slept through the medical student's exam, and when the doctor woke him up during her exam, he just smiled at us. The doctor kept commenting on how amazing it was that he wasn't cranky from being awoken during he exam.

That is another reason that the shots were so awful. He was in such a pleasant mood that when the nurse stuck him, the look of betrayal on his face was heart-breaking! He screamed, and I cried, too. He got three shots in his legs, and with each one, there was a new scream. Poor little guy! It was my first lesson in teaching "That Lesson" to my child. You know the one..."I know this hurts, but it's good for you." I'm hoping it will be easier to teach those lessons to a kid who can reason and make his own decisions. Hurting my completely innocent and dependent baby was very difficult for me to do. But I'm a believer in immunizations, and I know it's necessary.

He only cried for a couple minutes, and he has been mainly pleasant ever since. He has been sleeping a lot today, and I'm grateful for that. For anyone who is curious, here are Gunner's new stats at 2 1/2 months:
Weight: 13 lbs. 14 oz. (birth weight: 7 lbs. 1 oz.)
Length: 24 1/4 in. (birth height: 20 inches)
He was in the 75th percentile in weight, height, and head circumference.
He's growing perfectly! He's getting so big and tall, and I love his chubby little body.

Aye-aye-aye!

This is what happened between 8:20 and 8:45 this morning:
I was up quite a bit with the baby last night, so I slept in this morning while Spiff got ready for school. I woke up when I heard something clank to the ground and him holler out in pain. Turns out that he had sliced his finger with a knife while preparing his lunch. It's a pretty deep cut, and I'm grateful that we invested in first aid supplies a few months ago. He tended to his finger while I groggily bustled around and finished packing his lunch.

Since his finger was still bleeding, Spiff asked me to take him to school. Thankfully, the baby woke up in a good mood, so we packed him up in the car seat, and I threw on some jeans and my Keen clogs. Spiff commented on the icy conditions caused by last night's freezing rain while he took the baby out to the iced-over car. I locked the door behind me and then preceded to slip down the icy concrete front steps, falling on my back and head. It knocked the wind out of me, but other than a sore neck, no damage was done. I didn't realize that my Keens don't have the greatest traction for this kind of weather. I'm also incredibly grateful that I wasn't holding the baby when I fell. Spiff helped me back up the stairs, and I left him to scrape the ice from the car and to try to get to school on time.

I went running yesterday for the first time since having the baby. My faithful running partner and I ran a measly two miles, with walking breaks. It was cold, and my lungs felt out of shape. And now my legs are terribly sore, and I feel like a weakling for getting sore after a two mile jog. Add that to my newly sore neck, and I feel like a Moaning Myrtle every time I move.

I'm proud of Spiff for going to school today. After his cut, the icy car, and my fall, I wanted to give up and spend the rest of the day in bed.

You're a sick man, charlie brown

So, I guess I really belong in medical school. A good friend of ours recently had hand surgery to remedy a mass that had been there for years. On his facebook page, there were 25 comments expressing sympathy and encouragement. And then there was my comment which was essentially, "what's going on with the lesion? what was it?" Sadly I was more curious to know all about the pathology and the surgical management than how our friend was coping post operatively. I can't help it, can I? I really want to see a cross section of that thing histologically, and see the gross specimen. So, that's how it happens folks; those callous doctors start in medical school. No soft Florence Nightingale here, just someone with clinical curiosity that surpasses his empathy.

School starts tomorrow and I'm really going to miss hanging out with my little boy all day.