This is a job for...

Accomplishment Girl! I love it when she comes to the rescue. What James & I accomplished by 11:00 this morning:
We were both showered/bathed and dressed by 8:00 a.m.
We were out of the house by 9:00 a.m.
And we took our first solo trip to the grocery store.
Big steps!

I have been nervous about the trip to the store, which is why it has taken me over a month to attempt it by myself. Thankfully, James was a dream! He slept almost the whole time, and when he started fussing, I popped his new beloved MAM-brand binkie in his mouth, and he was happy as a clam.

Also, I enjoyed all of the elderly people who adored my baby at the store today. I'm such a proud mommy!

And on a side note, I'm wearing my wedding ring again. I haven't been able to fit it onto my swollen hands since April. I was beginning to think I would have to get it resized. I guess I'm recovering from the pregnancy after all!
Like I said, big steps!

Nanny

My sisters have been here this week, and now I am wishing I could afford a nanny. I have loved having extra hands around the house to hold my baby. I feed him, change him, and pass him off to someone else who will cuddle him while I take a shower or a nap. Also, as Spiff mentioned, the baby has been sick, and we have had to hold him almost constantly over the past couple days. Every time we tried to put him down to sleep, the congestion would pool in his head, and he would wake up hurting and scared that he couldn't breathe. So, we held him upright or slightly inclined all day and night. It has been wonderful to have the aunties around to help us hold him so that we could all get at least a couple hours of sleep. They're leaving today, and we're all going to go through withdrawals.

Anyone know of a good nanny in town who will love my baby like his aunties?

Pulm

So I pretty much haven't posted in a while because I haven't had much to say. G.A. is doing pretty well, he has a little more food reserve on his body so he at least doesn't wake up starving anymore (much). We're studying pulmonology right now. The leung is pretty interesting and I enjoy the physiology, even if it's hard to wrap my mind around sometimes. So far most of the lecturers have been pretty strong, which is a nice change from cardio when some of the lecturers were pretty terrible. I'm looking forward to being done with this next test so I can have a week off for thanksgiving. Life is good, and will be much better when GA is no longer sick. A sick little infant is hard to have because you know he would feel better if he only knew how to sniff, rather than sitting there with a stuffy nose. Having 2 sisters-in-law around is also great because there are more hands to hold him at night when he doesn't want to sleep.
SS

Accomplishment Girl

I love superheroes. Some of my favorites: The Incredibles, The X-Men (only the first two movies), Batman, Heroes, and I admit that I used to faithfully watch Lois & Clark, the New Adventures of Superman. When I was in grad school, I created my own superhero persona to help me gear myself up to tackle my always way-too-long To Do List. I was always much more productive when I dubbed myself Accomplishment Girl than I ever was as just plain old Mindy. Sadly, when I graduated three years ago, Accomplishment Girl hasn't been needed as often, and I have rarely felt as productive as I did on those days in grad school.

Saturday, I felt like Accomplishment Girl made a return appearance! As a new mom, here is what I was able to accomplish in one day:
I fed my baby and put him down for a nap.
I did some dishes.
I took a shower!!!
I did some filing that I have been putting off for weeks and weeks.
I called the phone company and had them fix several problems with our bill. (Waging war with large corporations is never fun, but I was very pleased to speak to a competent customer service rep today! Rare occasion!)
I fed my baby...while talking on the phone to the AT&T lady.
I fixed lunch for George and me--post Cardio exam #2!
George and I went to a wedding reception.
Then we went to the grocery store.
I fixed dinner, proving to myself that I can be a mom and still make pizza.

All that in one day! Oh, and Friday, I did the laundry...all five loads of it washed, dried, folded and put away! Hard to believe, since I have spent every other day the past three weeks doing hardly more than getting myself out of the chair to wolf down a bowl of cereal before tending to the baby again. Anyone else impressed with me? I certainly am!

We're parents!

I have been wanting to post for a while, but have been at a complete loss as to what to say. We have our baby, and he's wonderful. We are also 100% overwhelmed and exhausted new parents. Having a baby is an indescribable experience. The whole experience is so much more physically, mentally, and spiritually consuming than I ever imagined. I knew it would be hard. I have seen friends and family go through it, and I know it was hard for them. I just didn't know how hard it actually was for them because everyone I know who has had a new baby is very good at putting on a happy face. Either that, or they're just big fat fakers who say they're okay when they are anything but.

We went on a walk yesterday. We bundled the baby up in some warm clothes, put him in his Snuggli carrier, and we walked to our neighbor's house to return the dishes they left with us when they brought us dinner just after we got home from the hospital. Our neighbors have two little boys, the youngest who is just a year old. They asked how we're doing. We smiled and replied, "We're okay." They laughed and said, "Don't lie to us." They know exactly how we feel, and they saw right through our happy faces. Everyone also says that the two-week mark is the hardest. I hope they're right, and that something gets easier from here.

The details:
James Reed was born at 7:56 a.m. on Friday October 17, after a 16+ hour labor and a 5-minute delivery! He weighed 7 lbs. 1 oz. and was 20 inches long. He weighed in at 7 lbs. 4 oz. at the doctor's office the other day! And we can tell that he is getting bigger and fatter, since his cheeks are filling out, and he is developing fat rolls on his thighs.

Two aspects of my current emotional roller coaster...
Moments I experience overwhelming joy:
~When my tiny baby curls up on my chest like a little frog.
~When he's hungry and triggers his rooting reflex with his hands and moves his little head back & forth.
~When he's awake and content, and his big dark eyes peer around at...whatever it is that fascinates little babies.
~When he spends time with his daddy. I have loved watching my husband become a father.
~Watching his face when he's dreaming. He has a very expressive little face, and I love catching the occasional little smile!
~When he gets done eating, and he gives me his "I'm done" face. It's the same every time. Pretty cute!

Moments I experience overwhelming frustration:
~When James has slept all day and decides to be wide awake at 2:00 in the morning.
~When he is fussy and crying in pain, and I can't figure out how to help him. (We think he has a tummy ache. And yes, we can tell the difference between his "I'm Hungry" cry and his "Something is hurting me" cry.
~When I have to take my 5-day-old baby boy to the doctor's office for a routine checkup. I wonder why I take so many precautions to keep my baby germ-free when I just have to take him to a germ-infested doctor's office at 5 days old!
~When I realize that I have gotten frustrated with my two-week-old tiny, helpless baby. Motherly guilt sets in very quickly!

I'm so grateful for all the help we have been given from friends and family. I have never been so grateful for my mother when she came to help us. She brought sanity with her when she walked in the door. And our friends have been unbelievably generous with us, giving so much time and energy on our behalf. I only hope that I am as willing and able to help them when they need it.

And Heath, I'm sorry for the Sap. But I'm a new mom, so I'm entitled to a little sap.

Change

Our little boy arrived last week. He's perfect and we love him. He has sandy blond hair, dark eyes, tiny hands and feet, and an insatiable apetite. Monday was a very difficult day for us, and tuesday was even worse. It's difficult to have a little boy whom you know is hungry, but can't eat very well, and who gets frustrated with our clumsy attempts to help him. He is doing much much better now, and has more or less figured out what breastfeeding entails. I love rocking him back and forth and watching his eyes track my face, even in his cross-eyed way. I can't really convey the wild emotional oscillations that we have both felt this week, but I haven't had as many profound spiritual experiences in so short a time as I had this week. We are all doing well, and so is our little boy.

The Debts We Owe

I am firmly convinced that the fact we have so many wonderful friends here is not chance. I know that we were all brought to this city to go through medical school together because Heavenly Father, in his wisdom, knew that we would need each other. I cannot express the gratitude I feel to our friends who are far more selfless than I'll probably ever be. Our friends who will drop what they're doing and be with my wife as she struggles with our newborn boy, who will help her learn to nurse, who will hold my crying baby so I can take a 35 minute nap, people who will just sit with mindy and be with her, these are people whose service I can never repay. You know who you are, know that your efforts are welcome and have bolstered our flagging spirits. Thank you.
-G, M, and J.

Gratitude

So I was studying some pharmacology for cardio and my mind wandered, as it usually does in the evening, to a talk by Elder Bednar given in conference two weeks ago. In it, he recounted a story wherein an apostle asked Elder Bednar's wife to pray, but only to express thanks. I made a little goal to try that for a week in my evening prayers and see how things went. I guess I'm pretty needy because I only went 2 days. Here are a few of the things I'm grateful for though:

Mindy's health
Our very nice but affordable apartment
The fact that our car hasn't died despite being close to 200K miles
Academic succcess (pending our neuro grades)
Our babie's health in utero
Good friends who are generous
The Bach Cello Suite in G prelude. Pretty much a perfect piece of music.

Endurance

I am 39 1/2 weeks pregnant. I went to the doctor yesterday, and all the news was good. I am 100% healthy, and so is the baby. My blood pressure was fine, the urine test was normal, the baby's heart rate is fine. I'm just a tiny bit dilated, and even just a tiny bit more than last week. I should be so relieved that everything is okay. But instead, the hormones of the irrational pregnant woman set in, and I broke down crying to the doctor in the middle of the examination room. I also continued to cry off and on for another two hours after leaving the doctor's office.

In a high school English class, we studied a story of a war-time message runner. He was assigned to take a message to the next unit over as quickly as he could. He took off running...and kept on running because he had no idea how far away the next unit was located, or how long it was going to take to get there. I ran my first half marathon this past spring, and it really wasn't all that bad. I trained for it, paced myself, and I really enjoyed it. Mile twelve wasn't even that bad because I knew that the finish line was only a mile away.

I feel a bit like the message runner right now. I have a general idea how long this pregnancy will last, and I know that I won't be "running" forever. But there is no finish line in sight. I am having a difficult time enduring the unknown distance. So I cry when the doctor tells me that everything is fine.

Nostalgia

After my neuro exam, we went out to dinner and stopped at an international market along the way home.  Finally, I've found somewhere that can both sell me individual quail's eggs, as well as individually shrink wrapped Norwegian Mackerel.  If they're out of those, I can make do with canned pig tongue or box of dried goldfish from the snack aisle.  Aside from the unique and bizarre (to my occidocentric mind) the international market stocks a candy from my childhood, the Kinder-egg.  

My visit to the market made me aware of a fluke of neuroanatomy.  The olfactory portion of our brains involves, in part, the amygdala which is part of the limbic system.  The amydala, among other things, integrates incoming smells with visceral input, and mediates such reactions as salivation in response to a savory scent, or nausea in response to a foul odor.   Though closely related anatomically to the hippocampus, to my knowledge, the hippocampal and amygdaloid paths do not share any common, direct connection.  The hippocampus is thought to be involved with the creation and consolidation of new memories.  Though I don't know, I postulate that the lack of common connections is why we can't remember smells the same way recall visual information.   We can all picture our first apartment or picture what an airplane looks like without too much difficulty.  I doubt, however, that you can 'remember' what a lemon meringue pie actually smells like, in the same way you recall visual information, which would be by actually mentally 'smelling' the pie at the moment of recall.  We all know that sweaty feet stink, but upon reading this, you don't actually smell feet (unless they're your own) instead, we can only recognize a smell upon smelling it again.  At the international market, we purchased a box of Lu butter cookies as as post-exam treat.   Upon opening the box, I instantly recognized and pictured my childhood time in France when I must have eaten those very same cookies as a kindergarten child in Paris.   It's strange that you can't smell something upon recall, but that olfaction is still a very powerful component of memory. 

The end of Neurosciences.

I finally finished Neuro. The last two days saw me in the lab and lecture hall taking my exam. There were a total 240 questions. Let me say just this: I HATE NEUROLOGY. There has not been a course in medical school that I have liked less. I hated learning the stupid pathways, I hated how everything is reversed and upside down, I dislike learning anatomy by cross section, I don't like localizing lesions, I don't like memorizing psych drugs that all sound the same (fluvoxamine, flurazepam, fluphenazine, flumazenil, fluoxetin, phenterezine, etc..). I do not like it on a bus, I do not like it, it makes me cuss! I would not, could not, like neuro, I will not, shall not like neuro. I will not study it Sam I AM! I hope I passed this execrable class because at least then I don't have to take it again. I pity neurologists who have subjected themselves to a lifetime of this specialty. NOPE, not for me; I can cross this one off the old list and never look back. Onwards we go, to Cardio! where things make sense, and you can actually intervene and have a beneficial impact. The fact that you can precisely localize someone's capsular stroke or their MS or their pontine hemorrhage is nice, but you CAN'T DO ANYTHING about it (ok you purists, you can treat MS with steroids, interferon B, Natalizumab, cyclophosphamide, interferon alpha, and other crap, but the disease isn't going away.) IT'S DONE, AND I DON'T HAVE TO LOOK BACK. The longest and worst block of MSII is over with.

Sentimental Piano Teacher

I have been reminiscing about my former piano studio lately. My friend, Maggie, used to be a children's art teacher, and she originally started her blog to record stories of her students. I really wish I had done that with my piano students. But since I didn't, here are a few little memories of conversations I had with some of my students that explain a bit why I love teaching so much:

#1: Dots
I taught a brilliant little six-year-old boy for a couple years. He picked up on piano very quickly, and he rarely had to work hard at it. He was very inquisitive, and sometimes the conversations we had in lessons would get a bit off-base. For example, in the middle of a lesson one summer day, he looked at my arm and asked,
"What are the dots for?"
Puzzled, I replied, "What dots?"
He pointed and waved his finger at my arm.
I said, "Oh, they're freckles!"
He said, "Yeah, but what are they for?"
I have never contemplated the purpose of a freckle before. I still don't know.

#2: Piano
Same little boy, same type of situation. In the middle of a lesson, he stops and asks,
"What is the piano for?"
Caught off guard by the question, I offer my best explanation, "It's for making music."
He says, "Yeah, but what is it for? Can I sell it?"
I reply, "You'll have to ask your mom."

#3: Lines
I taught another very talented little six-year-old girl. She was a beginner and was quickly progressing through the primer-level piano books, which begin with learning how to read music notes off the staff. She looked ahead in the book one day and got very excited to see that she would soon be learning the staff. She exclaimed to her neighbor (at whose house she took lessons and practiced), "Look, Bonnie, I'm only six, and I get lines!"

I have had a few inquiries about piano lessons recently. I don't know if anything will come of it, but I would love to start teaching again. With comments like these from students, wouldn't you?

On the edge of the maelstrom

The historicity of today compels me to at least note that I was aware of events. Today Congress rejected a $700 Billion bailout of the banking industry. I am both secretly pleased that the Bush administration's attempt to once again consolidate power failed, but I am also displeased that the banking industry appears about to slide into the abyss. I have no idea how this is going to affect me personally. If banks are unable to lend each other money, and consequently, lend their customers money, then presumably I might have difficulty in securing loans to live for the next two years. I don't fully understand the interconnections between retail and investment banking, so perhaps teh failure of major investment banks might not be as catastrophic as if the retail banks were failing. At least I have duly noted that on September 29 2008 I was scared as the stock market tumbled.

Becoming a Doctor

We had a lecture on psychological defense mechanisms in PPS a few days ago. Defense mechanisms are ways our psyche uses to cope with an adverse event, for example recieving bad news or coping with an illness. Denial, acceptance, humor, projection, or splitting are all subconcious or concious efforts to transform reality into a more palatable alternative. Dissociation is commonly found in the medical setting, especially in situations wherein the physician's emotions might otherwise compromise judgement; commonly we refer to this as being 'dispassionate' or 'professional.' The separation of emotion from analysis of the present is something we learn very early in medical school. For most, it probably begins with the first dissection in anatomy, where the expectation is that you will not be repulsed by the cadaver, but rather to just begin to treat the cadaver in a 'clinical' way, devoid of emotional overtones. Dissection, for me, was not the watershed event that many first years claim it to be, rather, in my dissociative way, I simply began the dissection. Most medical students I imagine, pretend to a greater degree of dissociation than they truly feel, since somewhere long before medical school we knew that doctors are not emotionally wrapped up in the illness, diagnosis, analysis, or treatment of the patient. The fact that most doctors probably aren't like this is irrelevant; what is important is that medical students think they ought to be dissociative in order to be a 'good' doctor.

I realized the frailty and insincerity of my dissociative defense mechanisms during our lecture on the pathology of head trauma. The lecturer was a forensic pathologist who spoke to us about the various injuries that can occur to the skull and how that injury affects the underlying brain tissue. She explained, with graphic pictures, just what happens when the head is run over by a tire, shot with a high velocity bullet, low velocity bullet, shotgun shell, stabbed, crushed with a hammer, crushed with something blunter, crushed from a low fall, high fall, and many other gruesome injuries. I could barely look at these images when looking up from my notes. The lecturer herself was pretty blasé, which I guess is understandable since this is what she does for a profession. It's curious that we strive to cultivate a degree of dissociation to normalize what would otherwise be repugnant.

The Balloon Glow

The Balloon Glow

Toys

I love our new apartment. We have a lot of space, a beautiful kitchen, and a neighbor who supplies the yard with beautiful flowers! We have been very happy here since we moved in July, and I am getting more in love with my new place as we slowly get it settled and organized. Yesterday, some friends came over and helped me set up our baby's crib and move around furniture in the baby's room (Thanks, Maggie & Bonnie!). Then I spent the morning putting away clothes, blankets and toys, and getting a little more ready for our baby. I think I'm nesting, but I do like how the apartment is turning out.

However, I had an experience today that made me realize how non-child-proof our apartment really is. I had some friends over for lunch today, and as I got ready for them to come, I cleaned and put more things away. I felt great about how organized, clean, and sparse everything looked. I got out some toys and books for the kids, and put on a movie to entertain them. I was feeling very proud of myself, until my friends' sweet little children educated me about what they really like to play with, and that things that we generally don't think of as toys...most definitely are!

My lesson: Kids' favorite toys are not generally the pretty books, wooden blocks, or stuffed animals we usually supply them with. Also, kids usually aren't that entertained (i.e. distracted) by Disney movies. These are the things that are much more fun to play with:
The Piano
Green Magic Markers
Magnets
Simpsons DVDs
Electronics (especially if they are attached to wires)
The Paper Shredder
The Bike Pump (which is more effective when used as a hammer)
Earplugs (the little foam parts apparently taste good, too)
Anything small enough to fit into small hands...which then goes directly into the garbage can.

I guess I'm in for a big surprise when our little boy starts moving around and discovering all of the excellent toys in our house. And to think, all this time, I have been worrying that we don't own enough toys to entertain our child! Apparently, instead of toys, we really need to be investing in child-proofing supplies!

October 1929, part II?

I am not very familiar with the world of international finance. It seems that the nationalization of two major investment firms in as many weeks is not good, though. I think that we might have ringside seats to another economic downturn like our grandparents faced. Hopefully I won't be reduced to selling apples and pencils on wall street. What will happen to medicine if we are faced with another depression? The last time we were in a depression, the Democratic president attempted to revitalize the economy with federal funds injected via public works projects, in the form of the TVA, CCC, and others. What will happen to the plans for centralized health care? Will a left-wing executive nationalize health care in an attempt to cover unemployed persons unable to ensure themselves? Will the government decide such a course of action is too expensive and unsustainable, despite its political popularity? People will always need doctors, for which I am grateful,but who will pay the doctor if nobody can pay for insurance because they're unemployed, or their employer can't afford insurance? During the last depression, health insurance was more or less an oddity. Patients paid their doctors in cash (or favors, or probably even in kind). The health insurance industry is more or less a relic of WWII when companies needed to provide incentives for workers in the presence of wage freezes. I'm probably betraying my profound ignorance of the health care system , so I will ask you, the readers, to post your thoughts and estimates for economic situation. Two of you I know were finance majors, so c'mon, be famous, and comment something constructive.



In other news, I bought a new stethoscope today. It's a Littman Cardiology III, and, as far as I can tell, is very nice. I find it peculiar that we buy expensive equipment before we really have an idea what we're looking for and what our preferences may be. The vendors at the equipment were really hawking their $600 panopthalmoscopes. What medical student has $600 to drop on something that is fastened to the wall of every clinic? Even the navy kids can't afford that kind of stuff.

Medical students are pretty ruthless with their time. Yesterday we had a lecture that was very difficult to follow, both because of the lecturer's accent, and because she chose to lecture at the level appropriate for 9th graders. At halftime, the entire class left, with the exception of about 15 people. Without exaggeration, there were no more than two dozen students left, from about 85 present initially.

Remnants of Hurricane Ike

This is the dregs of Ike as it hit our little home. We're doing ok, and the basement is dry.

Editor's Note: We recieved 5 in (12.8cm) of rain that day.

8 Months Pregnant...

And I feel like this lately:



Who's got the better waddle? The really pregnant lady or the duck? (Clarification Note: I am the really pregnant lady, and I am not in the video.)

Another trip to the ER

I judge people. There, I've said it. Today was day 4 of my shots, only one more round to go. The ER was really busy this morning. No traumas or anything, at least that I know of, just a busy day in the outpatient clinic. Oh wait, I mean ER. I was in the waiting room for about two and half hours to get my shot, which gave me ample time to watch and pass judgement on my fellow patients. The first thing I noticed was that, for the first hour and forty minutes, I was the only white patient there. I don't think there was anything special about that, since previous trips to the ED have shown a more or less balanced racial composition in the waiting room. Ever since our execrable class "Critical Issues in Healthcare", I have been more aware of my own attitudes towards racial issues. I'm from western Oregon, an area of the country which is nearly entirely racially homogenous. Surprisingly, my hometown also prides itself on respecting diversity. I guess that's easy to do when everyone looks like you, the only differences being in which gender you find attractive (your own or the opposite). I wonder how much self proclaimed respect we'd find if Eugene had a region of town like the north end of town here. Would Eugenenians embrace their violent, poor, black brothers as readily as their gay brothers? I doubt it, but I'm an inveterate cynic. I would wager that all the diversity talk would evaporate. Before I left home, I considered myself 'tolerant'. Faced with an opportunity to prove my tolerance, however, I'm rather disappointed with myself. Of course I'm not an overt racist, but I have discovered that outside of the insular homogeneity of my hometown that my attitudes are not quite as magnanimous as they ought to be.

On another note,
Today in the ED we had two sterling examples of people who don't know what the 'E' in ER stands for. One was a white woman who had a laceration on her finger. It was maybe 1cm in length, like you might get slicing an onion. You or I would have probably put a bandaid on it and called everything okay. The next patient was a black lady who had sprained her ankle 4 weeks ago (!) and was coming in for treatment with a loosely wrapped ACE bandage around her lower leg. I'm not sure if she was trying to scam the workman's comp system or what, but I'm pretty sure her case was not in any way emergent. Now, yours truly of course did not have an emergency either, far from it. It happens, however, that the only place you can procure the rabies vaccine happens to be the ER. Consequently, every week, I traipse my healthy little butt down to the ER for a $75 copay and a shot. $375 is what it costs to keep yourself free of rabies 'round these parts.