My New Job

I have started a small part-time job as a choir accompanist. I was not looking for a job, and didn't really want to start working, since I have Gunner at home and Spiff is a busy 3rd-year bee. And then an opportunity jumped out at me from out of nowhere, and I couldn't turn it down. A voice teacher I knew while working as an accompanist at a local university called me a few weeks ago and offered me the job. I hadn't spoken to him in a year and a half, and I am quite surprised that he remembered me. He told me that his former pianist quit at the last minute, and he practically begged me to take the position. The choir is a "class" at a pharmacy school, made up of students who want a form of artistic release in the midst of all of their scientific studies. They meet twice a week, and usually only half of the choir is present at each rehearsal. He assured me that it is a very low pressure, low stress gig. So after talking to Spiff and convincing many of my friends to help watch Gunner, I decided that it was a good opportunity for me, and I took the job.

I have been doing this for about a month, and so far it seems to be working out. I think it is nice that Spiff has a scheduled evening to be with Gunner. It is also nice for Gunner to spend one-on-one time with daddy, and to get out and play with other moms and kids during the weekly rehearsal. It's so much fun for him that he thinks he has died and gone to heaven for two hours a week.

It is also giving me a chance to play the piano and exercise my brain. I am so badly out of "piano shape", and I can feel my fingers and my mind being stretched like taffy while I play warm-ups and parts, and sight read. This is pretty easy stuff, too, and I'm surprised at how much I find myself working at it, considering that accompanying (sight reading, sight reading and sight reading!!!) was what I spent the majority of my time doing while in college and grad school. So, I am grateful for this new tiny job because it's giving me a small chance to get back some of what I have lost over the last few years of ignoring the piano.

Let's Go For a Walk

Big news around here. Gunner is walking! Well, Gunner can walk. He normally chooses not to. We practice with him in the usual way. We stand him up and coax, encourage and plead with him to give it a try. Because "we know you can do it!" "Come on, little guy!" "Come to Mommy!" And then he gets his balance, lets go of our hands, takes that little step, and then another one, and pretty soon, he is hobbling around, with his arms flailing in every direction. He has absolutely zero control over his direction. In fact, if we send him in a straight line, when he is aimed right at his daddy, his body just veers its little self a completely different direction, and pretty soon, he finds himself landing on his nose. Again. And then we cheer, and we act like there has never been a more exciting event, ever. And no one has ever been more proud of any accomplishment. And he smiles.

And then we start it all over again.

He is getting better at it, and he knows it. Little by little, he becomes more daring. This morning, I left him cruising around the kitchen chairs while I puttered around the house. I walked in on him standing in the middle of the kitchen. I could tell that he had a goal, and he was getting up the guts to go ahead and walk right on over to it. He was concentrating so hard. And then, of course, I interrupted him, and I had to cheer and praise him, and rush right over to him and tell him how awesome he is. So he never made it to whatever it was that was exciting enough to let go of the kitchen chairs and walk across the room on his own, with no coaxing and pleading.

I'm loving this. It is so much fun to watch him discover, and to see how he learns so quickly, and to see how independent he is becoming. It will take me some getting used to. I remember when he was learning how to sit up from his army-crawl. He would be crawling around the room, and then I would look over at him, and all the sudden he was sitting up. It surprised me every time for a good week. Especially those times I walked in on him when he was in his crib and he was just sitting there in the corner, looking at me like, "Hey, Mommy. I'm sitting here, and I can't figure out how this happened." I seriously almost tripped over my own feet when I found him standing in the middle of the kitchen this morning.

I'm sure I will get used to it quickly enough. And then I'll probably be pining away for those days when he not only didn't stand or walk, but didn't run all over the house. Like I already pine for my sweet chubby 4-month old who was just happy to see me, and happy to be held, and happy to play with any toy I happened to throw his direction. I really loved that stage. I love this one, too. There really is almost nothing more exciting than watching my baby take his first steps.

Gunner's first steps: Sept. 18 (the day after his 11-month day)

The autopilot

When I was a phlebotomist, I used to have a set schpiel that I would say as I entered a patient's room. I would knock on the door and say "Good morning, this is Spaceman Spiff, I'm here from the lab to draw a little blood today." Every single patient was greeted this way. This morning, as I walked into my patient's darkened room, I knocked on the wall and said "Good morning, this is Spiff from the la-....medical school, I'm here to draw- examine you this morning." I guess I have a pretty deeply ingrained pavlovian reflex.

-SS.

The Strange

My sister and her husband were fascinated (well, fascinated might be too strong a word) by some of the stories of neurological disease I had to share with them, so I thought I'd pass along a few.

Neglect syndromes: After a lesion to the parietal lobe of the brain, patients can have what is known as neglect. This can be limited to 'not seeing' parts of their visual field. This would manifest itself if the patient were to draw a clock, it might only show the numbers 1-6 and be drawn in a semi-circle. Alternatively, the patient could no longer recognize a part of their body as belonging to them. We had a patient whose arm was limp after his stroke, and when the attending brought his arm over within the patient's sight, and asked whose arm it was, the patient replied that it was the attending's. Curious.

Amok: I learned what amok was today. Doubtlessly you are familiar with the phrase "to run amok". Well, now I know what the etymology is. Amok is a psychotic disorder found primarily in Malaysia. The patient suffers from persecutory delusions, procurs a weapon, and attacks everyone and anyone he sees. The episode usually ends in the death of the patient, either by suicide or by perishing in the frenzy caused by his attacks.

Koro: I have not seen a case of this. Koro is a delusional disorder in which a man believes that his penis is disappearing, and that when it does in fact disappear, the man will die. Don't believe me? Check out this abstract. Be careful, however, not to confuse Koro with Kuru, an encephalopathic disease similar to Mad Cow, but which is caused by the cannibalistic consumption of brain. It is found exclusively within the Foré tribesman of Papua New Guinea.

-SS.

Onwards to strokes

Today was my last day of pediatric neurology. We only had two patients on our census, so rounds went quickly. On psych/neuro we have afternoon lectures during the weekdays which, while necessary didactically, really detract from the patient care portion of neurology. I would rather be working up a patient and learning about their disease first hand than hearing a lecture about it and trying to remember a presentation rather than a patient. A more efficient system would be to have a noon lecture series like we had in pediatrics, that way we still get the lectures, but we aren't tied up for 90 minutes in the afternoon.

My next assignment is the stroke team at the adult hospital. I've been at the pediatric hospital for 10 weeks now, it'll be strange working with adults. Also, I won't know where anything is or how things are done, so I will yet again enjoy the clueless newbie feeling. I'm sure that just as I'm getting comfortable with finding my way around the neuro-ICU I'll be on my next assignment in psychiatry.

This year is going very quickly. I still haven't found something to fill the three week hole in my spring schedule that was left when I deferred Family Medicine in favor of anesthesiology. I'm considering a critical care elective, but I'm not sure if it's better to do before I do anesthesia or not.

Discrepancy

Gunner was weighed and measured again on Friday, two days after his doctor's appointment. On the same scale, with the same measuring system. Here's what we got:

Height--29 inches

Weight--24 pounds (which puts him in the 75th percentile, instead of 60th)

I almost had the lady do it again, just to see if we could get a different third set of results, but I didn't. I guess it doesn't really matter. He's still as healthy, sweet and cute as can be. But I am curious about why there was such a discrepancy.

Gunner's 10 1/2 month stats

Gunner's doctor was out of town most of the summer, so we are a little bit behind schedule. Instead of seeing her at 9 months, we went today, a week before Gunner's 11-month day. We had a whole long list of questions for the doc, since we haven't seen her in five months. And then we have to go back in six weeks, after Gunner's 1st birthday, when he is scheduled for a whole slough of shots. He escaped today's appointment without any shots.

10 1/2 month stats:
Weight: 22 lbs. 9 oz. (60th percentile)
Height: 30 inches (70th percentile)
Head Circumference: 48 cm. (80th percentile)

If you are curious about how our little man is growing, you can check here (2 months), here (4 1/2 month), and here (6 months).

Neuro/psych

I am now one week into my neurology/psychiatry rotation, having just completed a week of pediatric neurology. Last year our first block was neurosciences, and I detested it. It was a well taught and well organized unit, I can't fault the administration of the class. I just really didn't like neuroanatomy. I currently am not enamored of the clinical side of neurology either. Maybe it's because I hated neuroanatomy so much that I can't remember the basics very well so I struggle to diagnose people on the clinical side. I think it's the patients with intractable illnesses like cerebral palsy and refractory seizure disorders which by definition are untreatable that get to me. I don't think "success" is putting a kid on 5 different seizure meds so that he's so gorked out of his mind he can't seize, but he can't do anything else either. I don't like how the only tools at our disposal are physical exam, EEG, and MRI. If those don't turn anything up, you're out of luck as to the etiology of some child's seizures. As the old saw from The House of God says "they can always hurt you more, but they can't stop the clock." So, in that very unenthusiastic spirit, I have 7 weeks left.

Caravan of Wet Women and Babies

I mentioned in a previous post that I have recommitted to running. I'm happy to report that it's true and going well (for now). For the past five or six weeks, I have once again been a regular at the park early in the mornings, with Gunner in tow, tucked comfortably away in the jogging stroller. What is the secret to your success, you might ask? Well, faithful running partners and a goal, of course! My running partner and I decided that we needed a new goal to kick our bums into gear, so we decided to train for a 10K this coming October. We sent out a general invitation to people we know here, and we are so very pleasantly amazed at the response. Usually when I invite people to run with me, the response I get is "Are you nuts? I only run if I'm being chased. Why would you even consider asking me?" So, amazingly, we have about 15 women now training with us, some experienced runners, and some completely brand spankin' new.

We don't all live close enough together to train as a big group during the week, so we train in small groups during the week, and then get together for Saturday Long Runs. This morning's run was scheduled as a 6-miler, and I was awoken early by a healthy thunderstorm. As I lied in bed, listening to the rain and thunder, my mostly-still-sleeping brain contemplated how on earth I could make my baby "run" with me in the rain. Thanks to the years I lived in Oregon, I enjoy running in the rain, as long as it's warm enough outside. But I can't say that I was all that excited to experience Gunner's opinion of a rainy run...for six whole miles.

But we packed our little selves up, and we met our group. We had nine girls and four running strollers, and we set off in the drizzle that rapidly turned into Rain. You know, the kind of rain that makes you say, "Man, it's really coming down out there." And we ran. We ran through the puddles with rain dripping down our noses into our mouths. We ran past a group of middle-aged men who couldn't help themselves from commenting. Could you help it if nine women caravaned past you in the pouring rain, pushing four babies? After hearing them tell us that we were "torturing those poor babies" and how "those babies are going to hate us for this", I decided that I was proud of us for being tough mommies. And I'm mostly sure that Gunner is going to be happy to have a mommy who not only isn't afraid of the rain, but will be happy to go out and run right through it with him.

The babies all did amazingly well. In fact, two of them slept right through it. Gunner seemed to thoroughly enjoy himself. His blankie and feet were completely soaked, but that didn't stop him from singing to himself and (I'd like to think) cheering me on. We did cut the run down to three miles. We figured that we should probably quit while we were ahead. And although my shoes are soaked now, and the stroller is going to take days to dry off, we got our run in for the day, and I'm feeling like I have a bit of a rainy runner's high.

Little Life Lesson

Earlier this morning, I was thinking about some of the blogs I read for fun and about the funny stories people share about their lives. I got thinking that I haven't had an amusing story to share for a long long time. I then decided that my life just isn't that amusing, and that I've got things so under control that funny and embarrassing things just don't happen to me.

And then my little Gunner pooped on the floor. I decided to let him run around in the buff for a while to give his poor little rashie bum a chance to air out. The next thing I knew, there was a little pile of poo under the table.

Maybe I shouldn't wish for my life to be more entertaining.