Updates, and asking for advice

Thanks, K for the good wishes!  It was overall a wonderful Match Day with congratulations flowing between the residents.  Actually, even my kindergarten teacher sent me a congratulations on Facebook! I treated myself to my favorite artisan pizza (fresh basil and roasted garlic, and a mixture of sumptuous cheeses on a perfect thin crust).  Several of us in the third-year class met afterward at a local movie theater-bowling alley where I thoroughly embarrassed myself by bowling gutter ball after gutter ball.  But it was good fun.  Actually, we very much looked like a commercial for world peace: an observant Muslim girl wearing the traditional hijab, several Indians from various states (and probably castes too), and little Ashkenazi Jewish me.

So how will this fellowship work?  I will do seven months of consults (meaning, seeing patients in the hospital) followed by twelve months of research followed by another five months of consults.  Throughout, I will see patients in the Infectious Diseases clinic one half-day each week.  Mostly I will follow them for HIV, some for bone or joint  infections, and some for hepatitis C or confection with HCV and HIV.  I am so excited!  The program director is excited too.  And I have no regrets at all that I will be staying in my current location.

My enthusiasm is somewhat tempered, though, because a friend who applied for gastroenterology didn't match.  He is a hard worker, a great physician, and really should have gotten a position.  Worse, the GI program at our institution took another resident who isn't as strong.  It must feel like such an affront and I heard he is despondent.  I sent him a text message, letting him know I am thinking of him and his wife and that he is a wonderful physician and that I hope happier times are ahead and that I do believe things will eventually work out for him.  I didn't call because I thought he might not want to talk when so upset.  I might text him again in a few days.  But it sure feels unfair.  He really deserved a spot.  You can't be happy when you know other people are sad.

I have also had the challenging experience of leading "morning report" twice this week.  Morning report is a tradition in Internal Medicine.  Interns (i.e. first-year residents) or senior residents present a case from the hospital, while the rest of the residents (and sometimes students) are asked to discuss the case: differential diagnosis, workup, and sometimes treatment.  We have historically had an outstanding morning report.  The level of discussion, the faculty participation -- it's actually one of the reasons I chose Internal Medicine.  But a large part depends on the chief resident, who is the facilitator.  Those are people one year post-residency who dedicate that year to educational activities and administrative duties as well.  Our program added two junior chief positions this year, one for a second-year and one for a third year.  I was chosen.

I have always wanted to lead morning report.  It's been my dream since I was a third year student.  But teaching is NOT as easy as it seems!  And it is SO DIFFERENT teaching a large group from the teaching I do leading a small team on the wards.  I still haven't got the hang of it.  I learned a few things:  I summarize three key points from each case at the meeting's end.  I have a a question or two from an internal-medicine question bank at the end.  But I don't just want to be adequate.  I want to do as good a job as the fabled SH, former resident and now awesome attending.

How do I get there, dear readers?  Anyone in an educational field -- tips?  Because I could use them.

In baby news, things are, thank God, going okay.  We are thirty-two weeks and five days today.  Surrogate was diagnosed with gestational diabetes but her HbA1C (a measure of glycemic control over the last three months) was only 4.5, and her glucose readings have been very well-controlled with diet alone. She will soon start doing NSTs and more frequent monitoring, I guess because she is advanced maternal age now that she's thirty-six.  We will start looking at flights soon!  I still refuse to believe fully, but it feels nice to tell people.  And, I actually had a very fake-pregnant moment last weekend:  I was at a baby shower, and the mom-to-be received a copy of the book Love You Forever.  It's about a mother and baby, and the baby grows into a mom, who ages and becomes ill.  I have never been able to read it without crying.  My sister was at the shower too, and asked about the book.  I burst into tears.  Seriously!  Full-blown tears, over a book!  And I wasn't even reading it!  I thought you had to be hormonal for that sort of thing, but apparently not.

Anyway, we are off to a family friend's holiday party, so have a good rest of the weekend everyone.

ID? I do!

Yes, I have officially matched into an Infectious Disease fellowship at my top choice institution, which also conveniently happens to be my home institution.  I can't wait to get in the Gram stain game :o)

I'm not especially surprised, but I am still one hundred percent thrilled about this next step in my training.  The ID docs at my university are the best, and the current fellows are so smart that it will really make for a great training opportunity.  I do have small doubts about being "inbred" (i.e. doing all my training at the same institution) but I can't imagine a better program.   And yes, that includes what locals call "the U."

Otherwise, things are going well.  My loved one is doing well.  And so are Surrogate and Baby.  We're really getting close, now.  We still haven't found a name, though.  It's tougher than I thought!

I'm currently on Rheumatology.  It's very interesting and the pace is relaxed.  I will hopefully write more tomorrow,

Good night and shabbat shalom!

Not-so-happy birthday beginnings

According to the English calendar I have been thirty years old for one hour and eight minutes (well, technically I was born at 14:24 so I suppose there's still a bit of my twenties left), and by the Hebrew calendar, 9 Kislev passed a few days ago.  Thirty!  A new decade, hopefully filled with exciting changes.

Except I'm not excited, even by the thought of birthday cake.  And I have a sweet tooth that should be in a dental museum.

Someone I love very very much is suffering from a serious alcohol problem which has worsened dramatically in the past couple months.  This person is one of the most wonderful people in know: generous, loving, creative, and always putting other people first.  And this person has no insight into the problem alcohol is causing.  And the rest of the family is concerned enough that they are talking about organizing an intervention and inpatient rehabilitation.

I love this person so much!  He or she (I'm trying to respect this person's privacy) is not a bad person, but is suffering from an addiction which has led to lack of insight and poor decisions.   If anything happens to him or her, I don't know what I would do.  And as a physician, I'm scared to death because I have seen end-stage alcoholism, and I could not bear to see my loved one in that place.

I hope there is a chance for recovery.  This person is a strong individual and has been through a lot but always come out resilient, and this person wants to be healthy to be there for our Little One.  That's a pretty strong bit of motivation.  I wish somebody could give me a hug and make me a glass of tea with sugar and lemon and tell me everything will be okay.  But I know it doesn't work like that, and even if someone is motivated to quit, it's a lifelong uphill battle.

So I have spent the first hour of my thirties trying not to cry too much, because it makes it hard to read about dizziness and Meniere's diease -- oh, yes, I also have the pleasure of starting my birthday working overnight at the local VA hospital -- and trying to self-sooth with Chopin.

At least there will be Shabbat dinner tomorrow night (today now, I guess) and my brother has ordered a delicious lemon-white chocolate cheesecake torte in which to drown my sorrows. (The meal will be dairy.)

..And yes, things are going ok, thank God.

Surrogate is twenty-nine weeks today.  She and Little One are doing well, thank God.  But I won't truly  exhale until the proverbial fat lady sings.

A stand up routine that does NOT make me laugh.

A college acquaintance recently shared to Facebook a stand-up routine entitled "People with no kids don't know." I consider myself possessing a reasonable, if somewhat dry, sense of humor. But this particular routine did not tickle my funny bone.

 The premise of the routine was that couples without children don't have a clue how much more difficult everything is with children, and how these couples are living a carefree life of ease because they haven't any responsibilities outside themselves.

I nearly vomited.

 Many people come from large families and raise their younger siblings. I was changing diapers at ten, driving carpools and reading bedtime stories in high school, and was entrusted for an evening with a nine-day-old baby at eighteen. We may not be the true parents, but we witness the demands of parenting and we do our share of helping out.

Many people care for elderly parents or grandparents. And let me tell you, a fully-dependent adult is a lot more difficult. Have you changed a diaper on someone who weighs two hundred pounds? Or tried to dress him/her? I have only the minimal experience of caring for geriatric patients in the hospital, and even from that small bit of experience I see how difficult it is caring for ill adults.

Other people are not carefree because they take on tremendous work responsibilities, or volunteer, or fill their lives in other ways. I can understand the argument that it isn't the same of having children, but it doesn't mean one doesn't have true commitments.

But mostly -- what infuriated me was this: a good percentage of the people with children chose to have children. Did they know what they were getting themselves into? (Forgive my ending the sentence with a preposition; it just sounds so much better.) If so, then why complain? After all it was a choice made fully informed. And if they didn't, then why should they mock those who are in the SAME position the parents were prior to having children.

And honestly, here's the true hurt: WHAT ABOUT ALL OF US WHO WOULD GIVE EVERYTHING TO JOIN THEM?

You see, fertile people also don't know.

• They don't know what it's like to lie in bed wondering if a baby's cry will ever punctuate the night.
• They don't now what it's like to cry oneself to sleep after a third miscarriage and wonder if it's possible to be happy again.
• They don't know what it's like to face the embarrassment of providing a sample as a man, or of a transvaginal ultrasound as a woman, or the pain of a progesterone-in-oil injection.
• They don't know what it's like to hear "you're next" for the hundredth time.
• They don't know how painful it can be to answer the seemingly-innocent "Do you have kids?" question.
• They don't know what it's like to attend a baby shower just after you learn your road will be infinitely more complicated.
• They don't know what it's like to hear someone tell a new mother how much a baby looks like her, when you know yours never will because you have no viable eggs.
• They don't know what it's like to worry every minute that a pregnancy will end in disaster, no matter how far along into the "safety zone" one is (because there is no safety zone).
• They don't know what it's like to hate one's uncooperative body.
• They don't know what it's like to question what defines female because one's body can neither create nor sustain life in the way that is classically the epitome of womanhood.
• They don't know what it's like to sing someone else's baby to sleep and wonder if your turn will ever come. And I do mean "if" and not "when."
• They don't know what it's like to time intimacy until the romance is gone, or how tortuous a two-week-wait is.
• They don't know what it's like to feel out of synch with everyone else, who are now having their second child when you started beforehand and are still empty-armed.

I could go on, but I just want to leave it with this: They don't know how much it hurts when someone complains about that which you want most.

This same routine could have been far less hurtful. The comedian could have done it as "before kids vs after kids" and that would have made me chortle along with the rest of the audience. Because of course life changes, and gets more complicated. But go easy on those of us without children. It wasn't always a choice. And we aren't all "free."

Yes, it is 2:38am in my time zone.

And yes, I have to be at the hospital close to 5:30am.  And I will be giving a presentation on secondary syphilis in an HIV +ve patient at 11:00am.

I have yet to finish the presentation to my liking.

I am not sure I will even be awake enough to give this presentation.

On the plus side, thank God things are going well with dear Surrogate.  We are just over 24 weeks.  Continuing to hope and pray.

More to come...if I ever get a break from this rotation!

Happy and healthy and sweet 5774 שנה טובה ומתוקה לכולם! And it's a...but you'll have to read to find out.

Welcome to the year 5774.  Or, תשע"ד.  I'm still terrified, but I am a little excited that it might be a really wonderful new year.

Yes, thank God, things are going well.  We are about halfway there, and our Little One is doing well, as is her dear Surrogate Mama.  And yes, that was a "her" -- it is a GIRL!  Husband and I would of course been thrilled either way, but I have to admit I would have no clue how to raise a boy.  (And then of course there would have to be the conversion asap before the brit milah, meaning within eight days.  So a girl sounds like sugar and spice and everything nice.

Which brings us to the Name Game.  Welcome and prepare to play as often as you like, free of charge. We're looking for L names that sound good in both Hebrew and English, and preferably Biblical.  Husband doesn't like Leah, although I do.  And while the Internet has provided numerous options, none of them appeal.

And one other note -- while I wish I could grow this baby myself, it IS definitely amusing to tell people we are this far along and have them stare confusedly at my lack of bump.

When life gives you a fragile aorta, you gotta get a few laughs for it!