A Matter of Respect

I have speculated before how this year would be different for me. As a medical student and resident I was always very subservient. The hierarchy in medicine is very well defined and while it is more flexible in pediatrics than other branches of medicine, it is still definitely observed. I was always painfully aware of where I fit in the hierarchy which was basically at the bottom.
I had a year off, however, and worked as an attending, definitely closer to the top of the hierarchy. Accentuating the position difference was the fact that I worked at an adult hospital where the nurses call you doctor, instead of using your first name like they do at a children's hospital. I really felt like an in-charge professional. In addition, I had Nathan and my priorities underwent a major frame shift. Because of those things I knew I would be less content to be subservient and be a much better advocate for myself and my time. Until now, I really had not been tested.
Yesterday, however, I did something I would never previously have done. I walked out on a conference.
I was at a conference that was supposed to start at 4pm. Now, no one really expected it to start at 4pm because the attending has a reputation for perpetual lateness. His patent quote? "The name means good time, not on time." It's supposed to end at 5:15 but it basically ends an hour and a half after it starts, no matter when he deigns to arrive.
I am the opposite. I am almost pathologically on time. I know I used to make my mom crazy because to me, on time was actually late. I firmly believed that the only way to ensure being on time was to be early, and got a little hysterical if my chauffeur did not support me in this. Today, I still feel that way, preferring to be the first to arrive rather than risk being late. I find being late extremely disrespectful to the people who are waiting for you. Its sends a message that the person being late believes their time to be more valuable. I used to put up with it, but I no longer believe my time is less important than anyone else's. I have a lot of things to do and a lot of people depending on me, and I put in an effort to be on time. I deserve nothing less.
Yesterday, it was 5pm and the 4pm conference had not yet started, and I just snapped. I knew that he expected to walk in when he was ready and find us all sitting there expectantly waiting to be taught. I also knew he would offer no apology and that it had never crossed his mind to call and tell us he would be late. So I left.
A little finger of guilt nagged me as I walked out the door, but it was gone by the time I got to day care to pick up my boy; someone whose smile is undeniably more important to me than the good opinion of someone who doesn't respect me at all.

I love my husband.
I love my son.
I love my family.
I love my friends.
I love my job.
I am loved.
I love my home, but on a day like this, how could I not?

Thoughts on the Beginning

"Every new beginning comes from some other beginning's end." - with apologies for not knowing the source.

I have made it through the first three week rotation of my fellowship. I spent those three weeks on the inpatient oncology service taking care of patients at all stages of cancer diagnosis and treatment. I guess it sounds like it could be sad, but to me it is a place of incredible hope. A place where we treat every child as if they have a chance of growing up and going to college, and really, most of them do. For me, it flew by. The hours were long. It was challenging. I learned a lot. I met wonderful families and acquired my first few patients. I had an excellent teacher. I missed out on several hours of sleep. I turned out to be very good at what I do. I also loved just about every second of it.

The only downside for me was missing my family. I don't think much about it at work because I am busy and time flies, but when I get home I ache for how much I am missing. While I have been working, he has learned to sit on his own, sprouted a tooth, and gained excellent hand eye coordination. One of the best parts of my day is snuggling him to sleep at night. He reaches up and grabs my cheek and then snuggles his face into my chest and we usually doze off together - sometimes me first.

This next 3 week period is supposed to be a little easier and maybe I'll get to spend more time with my family. I'll miss it though. It really helped clarify what I want my grown-up job to look like.

Aren't baby butts cute?!?!?!?!?!?!?!?

Vanquished

When I thought about staying in Pittsburgh to do my fellowship, there was only one thing that truly scared me.
It was a person. A person with a reputation for an abrasive tongue, a short temper, and a long memory. This reputation was not only amongst the pother residents at my hospital, but also was made evident when I traveled across the country interviewing at other programs.
Outside of reputation, though, I had reason to be afraid. This person had attempted to get me kicked out of residency when I was an intern. I never was entirely clear on what I had done wrong, but it was clearly VERY wrong. Though I still don't know if they remember me and the incident, I know what it is like to be on the receiving end of that anger.
Still, I am no longer a scared to death intern quaking in my shoes when someone looked at me cross-eyed. I was the one in charge for a year. At this point, no one's expectations for me are higher than my own and I strive to live up to them. With all this in mind, I was very philosophical about coming back to fellowship and having to work with someone who probably didn't like me. Calm. Zen. In control.
And then I found out that on my second week as a fellow I was on an inpatient service with this person and my heart sunk. Bravery/bravado is one thing, but I really wanted to get off to a good start. I wanted to enjoy this bit at the beginning and suddenly I expected only to endure and try not to cry.

I am pleased to report that it went MUCH better than my expectations. We actually had a good time. There was teaching and learning and a little laughter. I was only snapped at once and while it did make my head spin, it was quickly followed by a sincere apology and a statement of appreciation for how hard I was working.

I actually am looking forward to working with this person again. I believe they have a lot to teach and realize I am motivated to learn.

All in all, I would say the first dragon has been vanquished.

Guess What?!?!?!?!

I'm only doing a rose this week.

5 months 1 week

My Bigger Boy

I have devoted a couple months now to talking about the life of my little boy. I now want to talk for a minute about my bigger boy.

I met Noah when he was five months old. I was babysitter/friend/nanny/playmate/partner-in-crime for a few years before I moved to Pittsburgh for med school. I always talked about him so much that when Dave and I met, Dave thought "my boy Noah" might actually be my son. When I met him, he's didn't even sit up on his own. Now he's graduated from fifth grade and had a poem published in the Harvard Educational Review. I'm bursting with pride.

Of course, I've always known he was brilliant. He met just about every milestone early, and taught me all sorts of valuable mommy lessons along the way.

1) Just because it's in the book, doesn't mean it will work for your child. - I used exactly once the trick of saying "good-bye" and walking away when he was refusing to leave the place where we were playing. He was supposed to run after me, but three year old Noah looked up from his sandcastle, smiled happily, and waved. "Bye Nana! Tell mommy boy stay beach by self!" And so I dragged him kicking and screaming from the beach instead.

2) Nothing is better than being hugged around the knees and being told "You're my best."

3) It's important to keep perspective when a child tells you they want to throw you in the trash. Chances are you have earned their wrath by preserving one of their vital physical features. Besides, they'll be your best friend again soon.

4) Think of popcorn as a vegetable and it makes a fine dinner. Subtext: pick your battles.

5) No one can plan a felony like a pre-schooler.
Nana (Jen): How can we get one of these cool swing sets?
Noah: I can make some money.
Nana: (thinking employment) How are you going to do that?
Noah: (exasperated eye roll) Um, on the the printer.

It really is an accident that "Nathan Isaac" has the same syllables and cadence as "Noah Hawkins", but it's been perfect because I know where my son's name fits seamlessly into all the baby songs I used to sing. It's also been complicated because "Noah Hawkins" or "baby Noah" ARE the words to those songs in my head. Putting in Nathan's name has been a little like learning a spoof when you can sing the original in your sleep. When it is late at night and I am tired, "Hush little Noah" is just as likely to come out as "Hush little Nathan". The first time it happened I felt bad all around. Bad for Nathan who was getting someone else's second hand song. Bad for Noah who's song was being passed on. Bad for me who was so far away from my big boy who I miss every day. Now, I just smile. After all, I couldn't love either of these boys more than I do.

Fellowship - Day One

For anyone who's wondering what I am thinking this morning as I get ready for my first day back at a "real" job.

1) I'm tired because my sweet boy stayed up late and woke up early (almost as if he was trying to prove the folly of my ways)

2) I'm happy because I got up a wee bit earlier than I had too and so 15 more sweet minutes of sleep are mine in mornings to come.

3) I am excited because I get to go back and see all the people in the Heme/Onc department whom I like so much and genuinely have missed the last year. (I am going armed with baby pictures, of course.)

4) I am nervous about having to find my way around the new hospital. Despite the fact that Children's is home, I have no idea where I am going this morning.

5) I miss my visitors, the Wheelers from California, who selfishly went home yesterday and left me with reality again :) but not before a whirlwind tour of toddler friendly Pittsburgh!

6) I don't want to send Nathan to day care all day. I am more than a little nervous about how he will react to the change, especially since he was "all-mommy-all-the-time" last night.

7) I am now pleasantly full off Egg Beaters, Veggie sausage, and blueberries, so it is time to pour my coffee and go!