Monday, August 28, 2006

when I was one

We had a little party. There was cake and ice cream and balloons and an over-tired baby and lots of cameras. Oh, and lots of wine. But it was a nice little time to celebrate a little someone who's had a big impact on my life for the last year, or so. Hee hee.
My parents and my grandmother came out from Colorado. They have forgiven us, apparently, for the horrors visited upon them when they agreed to help us move in, a mere 4 months ago. They brought presents (too many) and tomatoes from their garden. I can't believe they're gone again already, but it was a really nice visit. And the dog loved it. Fili and my dad have a special relationship.

Saturday, August 26, 2006

August 27th, 9:20 am

I’ve been thinking about writing down my birth story, that is, the story of Gabriel’s birth, for quite a while now. Tomorrow, he’ll be a year old. Some details may have faded (mercifully) into the hazy outlines of hormonal memory. That’s okay. I keep telling myself the story, reciting it in awe and amazement, and it turns out the same every time.

I woke up around 4:30 am on August 27th. My dream leftovers handed me an image of a particularly heavy piece of canvas lawn furniture being snapped open, which didn’t make a lot of sense until I went to the bathroom to pee and discovered after I was done that I was still leaking. I stood up, looked at myself in the mirror and thought, “I’m going to have a baby today.” I did a little waddle dance of joy as yet more amniotic fluid trickled into my slippers. I woke up M and told him,
“My water broke!”
“Oh, yeah.”
“What should we do now?”
“Go back to bed, I guess.”
I lay back down on a waterproof pad scavenged from the baby’s room. We cuddled up, too excited to sleep, but conscious that this could take a long, long time. I was expecting it to – everyone knows that first babies take forever to travel five inches south.
Five minutes later, the first contraction arrived and I realized I would not be lying down for it. I sat on the edge of the bed, kind of rocking back and forth, feeling nauseated. By golly, it DID feel like a menstrual cramp, but of such magnified intensity that it was the only thing I could think about. It passed. I laid back down. 5 minutes later, right on the nose, another contraction. The dog pranced in, stumping for breakfast in that subtle way of hers. M realized there would be no more sleeping and got up to wrangle the animals. He came back in, took a picture of me peeking out from the quilt I had over my head. Contractions did not mess around after that. Within a couple hours they were arriving one after another, like waves rolling up on the beach. M had the brilliant idea of timing them, and we realized they were indeed about 2 minutes apart, lasting a good minute and a half. M called the midwife. The plan was to labor as long as possible at home, then set out for the birth center, a mere 40 miles down the freeway. Luckily, though, the midwife on call, Sallie, just happened to live in our town, not a mile from our house, so before setting out she came over to check on me.
I had developed a system for dealing with the contractions. I was obsessed with staying upright leaning slightly forward in a seated position. Rocking helped, covering my eyes helped, breathing audibly like they teach in yoga class helped. I have no idea why. Sallie arrived and the first thing I remembered her saying is, “I have a class this morning. I told them not to put me on-call.” The normal part of me wanted to apologize for the horrible inconvenience I’d put her to, but another voice spoke up and said, “That’s stupid. Don’t apologize. What I’m doing is more important than any class.” And I smiled at her and said, “Hi Sallie.” I felt really hazy and warm. It was going to be just fine.
In characterizing labor, I would hesitate to say it’s painful. I mean, it’s easily the most viscerally uncomfortable I’ve been in my entire life, but it wasn’t agony. The only time that contractions seemed unmanageable was when Sallie had me lay on my back so she could listen to the baby’s heart rate as my uterus squooshed the bejezus out of us. It was pretty unpleasant when she performed the internal exam, as well, but I forgave her when she announced I was dilated about 5 cm. Hooray!
“You can stay home a little while longer, or you can leave for the Birth Home, now. Your choice.”
“I guess we can hang out a little longer.”
She looked at me funny and asked, “Did your mom have fast labors?” I replied that I thought she did (and actually, my brother was nearly born before my eyes on the backseat of a ’68 Plymouth Fury hurtling down the dirt road with a cyclone of dust behind, as we raced to the hospital). “Maybe you should head out pretty soon,” she suggested.
We took our time, though, as we gathered our wits, still sure that this labor-thing would be long, drawn out marathon. M made sandwiches, and let the dog out. Then he nearly got into a fight with someone who parked in front of our driveway for our neighbor’s Saturday morning garage sale. This I was aware of only peripherally. “Oh, M’s yelling at someone. How strange,” but I figured it would all work out. He came back in and put on a CD that I’d bugged him to make for just such an occasion, entitled “CMM’s Labor CD.” I yelled at him to turn it off. Too freaking distracting. I brushed my teeth between contractions because that seemed important and then slipped on a sundress and waddled out to see what happened next.
I’d imagined that sitting in the car during labor would be just excruciating, but it wasn’t that bad. I continued with my obsessive keeping upright, leaning forward, covering my face, breathing. M drove pretty smoothly and the 45-minute trip passed incredibly quickly. As we were angling off the freeway, I had a couple pushing contractions in the car that made me grunt and groan. M asked, “Are you okay?” kind of panicky. Oh, sure, doin’ swell! We arrived at the Birth Home in the middle of a contraction. M ran around to open my door, which I snatched back closed. I needed the enclosed space. He carried our bag inside and after the contraction subsided I made my way gingerly through the gate and across the yard and up the stairs into the house.
The back bedroom was open and the lights were soft. I sat on a chux pad on the bed and breathed through another contraction. Sallie was there. She took my blood pressure. She and M were just watching me as if waiting for the baby to come shooting out of my eye. I said, “Tub?” “It’s all ready,” said Sallie. And it was! I pulled my dress up over my head and walked up the step every so carefully and submerged myself in the deep warm water. It was heavenly. And it seemed to loosen everything up. I felt the baby move down through my bones and the next contraction was another pusher. I had a couple more like that and then felt down between my legs, expecting a baby’s head to be there. I could feel a wrinkled piece of scalp inside and realized that I would tear. I wanted to stay in the water, but Sallie was fussing about the temperature and I could tell she wanted me to get out. I should have stayed, but I stepped out, awfully gracefully, I thought, and got wrapped in a towel. I got up on the bed but wasn’t sure how I could best stay upright to push out the baby. No way was I lying down, and I there was nothing to brace against or pull on. I opted for hands and knees. I was just following the contractions, not pushing consciously, just letting my body tell me what to do. I yelled. I bellowed. Sallie suggested I push. I did and, wow, that hurt. The skin stretching and threatening to tear was an entirely different sensation from labor pain. No way to move that to the side. I think I just decided to hell with it, let’s get this over with. I pushed and pushed. I said, “I don’t think I can do this.” M said, “You’re doing this!” Another push and “The head, they head,” they said. Another push and out plopped the body, tumbling right onto the bed. A boy! I knew it. The whole time I was pregnant, I was sure it was a boy. I moved so I could see him as he breathed and cried. I just remember saying, “Oh my God! Oh my God!” I have never been so happy, so ecstatic, so amazed by life. He was in my arms immediately, still wet and waxy and warm. We just looked and touched and were amazed. Gabriel. We were so amazed.

Saturday, August 19, 2006

hi mom

Gabriel loves his new shoes. I tried them on this morning and he fussed for a minute but then totally forgot about it. He's having a nap with the geckos on right now.

wherein I feel the wee-est bit sorry for myself, but also learn some valuable lessons

I'm back. But without any deep thoughts. Probably for the best.
I've been mulling over the struggles I've had during the last 8 weeks. Now with just a little space to breathe, I think I've got a little (miniscule) bit of perspective. I have to accept that one of my most cherished self-images, that of competence and cleverness, needs to be relaxed just a little. Despite the fact that I am in my thirties, now married and with a child, feeling old and tired, I am still a student, still green and inexperienced in the medical world. In everything I do, I betray myself as the total ignoramous that I am. I get in people's way and am reliant upon their good will not to push me right over. And I do so like to please people. I need to get over that. I will not please people until I can singlehandedly cure cancer. I just need a little more time to get comfy with the struggle.
I'm not as fascinated by medicine as I was in the classroom. I enjoy talking to patients and doing procedures and exams, but it seems like most of medicine in a hospital is administrative. I'd see a patient for 15 minutes in the morning and then spend three hours (because I am slow) filling out paperwork so they can be admitted or scanned or discharged or whatever. Hard to get excited about that. Hard not to end up with writer's cramp. Hard not to end up bored and just wanting to get people home where they can actually get better.
Maybe part of it was the preceptor I was assigned this time around. She was not so much with the teaching. I felt like she tolerated my presence as long as I didn't slow her down. Which I did, daily. I believe that her approach was meant to be that you should come up with the answers on your own. Very Socratic method and all that. Other doc's I've known have done that, too, but usually after torturing you with questions for a few (interminable) minutes, they actually give you some information you can use. Dr. L never relented. She would press until you were squashed flat as a grape and then inspect the bottom of her shoe before turning around and walking away. Really disconcerting. And depressing. On the other hand, I probably did improve my presentation and history taking skills, just to avoid that stare. And also to avoid any more leg-humping by her overly-groomed canine.
And so on Monday I'm off to a new hospital. A private hospital about 5 minutes down the road. I'll be doing ICU. Yay for fresh starts.

Friday, August 18, 2006


I finished my sub-i today. Totally anti-climactic. I signed out my one remaining patient to the back-up intern, turned in my pager and high tailed it home, where I was greeted by a teething baby and a fussy spouse who needs to study for a test tomorrow. Oh well. I had two glasses of wine and a big dish of chocolate ice cream to celebrate. I have a whole weekend off. I shall think of something more exciting to write about, I promise.

Sunday, August 13, 2006

shoeless joe

There have been a few subtle hints from the daycare contingent. We have the only unshod toddler at Fantastic Babes. I find shoes for infants hilarious, though, and have steadfastly refused. It's summer. It's California. And it's better for his feet, they say, to be the barefoot wonder. But now that Gabriel is pulling himself on everything he can reasonably grip, I'm willing to acquiesce. Hookworm and splinters. It's time to buy shoes.
We bought some extremely cheap shoes at Old Navy over the weekend. Gabriel can kick them off with a flip of his foot. Grandma is sending us these.
Thank God for Grandma!

Wednesday, August 09, 2006

hee hee

So I have a day off today. And do you know what I did?
I sent the baby off to daycare and stayed home! I know! It's shameful, but oh so nice to have a few hours to myself. Actually, I wanted to get my residency application done and, by god, I did. Schmaltzy personal statement and all. That I found myself looking forward to this for days, speaks volumes, no doubt.
I'm going to pick G up. I swear. Any minute now...

Saturday, August 05, 2006

surreal life, part deux

So this morning we were post-call, which is when we all sit around and talk about the patients we admitted yesterday. We met at the attending's office at 9 after pre-rounding on them all. The formidable Dr. L was there right on time, and she'd brought her dog, Max. A little yappy terrier with a silkie hairdo. Seriously, the dog has nicer hair than I do. He was pretty cute, actually, running around and chasing his tail and barking merrily as we all staggered in with our oversized styrofoam cups of coffee after too little sleep, found seats and started nervously shuffling our papers. H & P (history and physical) forms, the green copy, not the yellow, because Dr. L wants that copy for your presentation. Afterwards you need to switch them out in the chart. Oh, and stickers. Must bring at least two stickers with patient name, DOB and medical record number to hand to Dr. L so that she may affix them to her note. And EKGs for perusal. I was sitting there sweating because my last patient presentation hadn't gone so hot. My patient had a thoracentesis and I was all over the composition of the pleural fluid, bursting at the seams with differential diagnosis of transudates vs exudates (whatever). And I total failed to recognize that this nice old lady was hypothyroid. Oops. Dr. L did not, however, and totally raked me over the coals. Fun! Anyway, I was waiting to discover what blatently obvious thing I'd forgotten THIS time, when little Max the dog comes over for a pat. I obliged and tousled his well-grommed locks. He then proceeded to get very friendly indeed with my leg. I tried to ignore it at first, but I didn't want things to get out of hand (a doggy tease? quel horreur!), so I tried pushing him down with my hand on his floppy-haired head, then I tried pushing him away with my leg. No avail! I wanted to punt the little shit across the room, but figured that would earn me no brownie points and, let's face it, I could really use some. Finally, after far too many agonized minutes, Dr. L said, "Max, what are you doing?" "I don't want to say," I squeaked. Max was scolded but not shamed. He was back for more within 5 minutes.

All I can say is: two more weeks until I'm out of this freak factory (and smack dab into another).

Wednesday, August 02, 2006

like a breath of fetid, well, breath

Have not written in a while. Hard to fit it in between rounds and crying jags. Am seriously questioning my career choice. Also, M is out of town and 4 days as single mom has just left me wasted. Or perhaps that's the gin. Missed Gabriel's doctor's appointment (ear recheck) today. There was chaos involved and much shuffling of papers, but I can't think now of exactly how that happened. Only that it did and I must cope with the fact that I am a callous heartless bitch who puts her career before her child. And by career I mean abuse that I pay for. Also, I lost my pager. Tomorrow should be fun.