Not updates in Internal Medicine, but updates from someone board-ceriotifed in Internal Medicine!

Hello again, dear readers!

First off -- if you had a rough Thanksgiving, I was in that same spot three and four years ago.  I can't guarantee each of you will hold a baby in your arms.  I wish I could.   But I can tell you that even when you are absolutely convinced you will never reach your happy ending, it might be just a matter of time.  My happy ending is currently sleeping tucked beneath a quilt my grandmother made for me.

Since I last wrote, some updates are probably due.

I am now officially certifiable...oops, I mean board certified by the American Board of Internal Medicine.  And yes, I am darn proud.  I may have bought myself a "pass present" in the form of a sapphire ring from Overstock.com -- which would have cost $75, except I had no idea of my ring size and consequently had to order four different sizes before getting it right.

My sweet A is now 22 months, sweet, loving, smart, funny, and generally the light of my life.  But that wasn't news.  She has her own personality.  Tonight she force-fed me cake.  She's also impressive.  We took her to her first Nutcracker last weekend and she watched the entire thing.  Actually watched, interested, enjoying herself.  This, Dear Readers, is a Very Big Deal.  The Nutcracker was my first ballet and the story goes that I thought intermission was the end and consequently threw a fit because I wanted more.  I aways dreamed of taking a little girl of my own to the ballet and now that dream came true.  Also yes, I will never stop wishing I had the talent, turnout, and arches to be a ballerina.

I went to a Mom's Night Out from A's nursery school class last night.  It went better than I thought, considering my social awkwardness.  I made it through the usual birth stories and interestingly, when it came out that we used a surrogate, I got a universally positive response.  When I told them I was a physician, I was also met with unexpected admiration.  It was a good feeling.  Coming from a family of physicians, spending time with friends who are almost all physicians, it seems so normal to be a doctor.  I am incredibly honoured by the privilege it is to practice medicine, but it never occurred to me that it is impressive.  Yet think about all those people who wish they could get into medical school, or residency.  I am pretty lucky.

As for Operation Sibling: we have six chromosomally-normal embryos "on ice" at CCRM and transfer date is approaching.  This will actually be my first time attending a transfer.  Yes, out of seven transfers, I have attended zero.  We already had plans to be in Israel for the first transfer, and after that it was just too painful to be at Northwestern.  Now I'm excited to see it from a medical perspective.  I'm thrilled to see N again.  I'll bring A, so I'm especially looking forward to N getting to see how much she's grown (although I send pictures all the time).  Have any of you attended an embryo transfer?  What was it like?

We have also decided to do a single embryo transfer.  I'm a little worried.  They quoted me a 75% take-home baby rate with our embryo quality (5AA), which is amazing, but still leaves a significant failure rate.  But they also quoted a 60-70% risk of twins, with all the associated complications.  I would love twins if you could guarantee they'd be born normal.  But with a 20% prematurity rate, and a 15% gestational DM rate, and increased preeclampsia, my first priority has to be N's and Baby's safety.  We probably won't have additional children after this one.  It feels wrong to me to keep risking other people's health, and it feels greedy.  before I knew about Turner's Syndrome I always wanted four children.  But some women don't get any children, and I already have one.  So I am pretty lucky, don't you think?  But I do wish we could get to Beta day already.  Positive or negative, I would just like to know.

Lastly...I suppose...career.  it has recently come to my attention that this July I will graduate.  I could be done with training forever.

Let me rephrase that.  After twenty-seven years of formal education, I could be done.  A real adult, looking for a job.

The last time I applied for a job it was a cashier position at Borders.  This was in no way motivated by the 30% employee discount, of course.

Interestingly, there aren't exactly a plethora of jobs in academic infectious diseases.  I don't want to go into private practice.  I want to teach students and residents and fellows.  I want to be a part of grand rounds and morning reports.  But a highly-placed person at our medical school just told me there are no part-time jobs in academic medicine.  I can either have a job that makes me happy, or I can be the mama I want to be.

If you know me at all, you know this decision isn't actually hard to make.  A wins, every single time.  But maybe I don't have to give up on academic medicine?  Mama thinks Highly-Placed Person may be wrong.  It remains to be seen.  But another questions is whether I should take up Highly-Place Person on his offer of a two-year PhD in molecular micro (exact field TBD) which would provide me the research skills I need to continue in academia as well as the funding to do so.  No need to find a grant.

Mama thinks perhaps with a PhD in hand, I could convince somebody to hire me part time.  Anyone out there with experience?  A doctor doctor?

Anyway, my eyes are closing as I write.  Shabbat shalom everyone, and I will try to update again soon.