One of the requirements for us as PhD students in the Epi department is that we have to TA a class.
This is not the glamorous job it may seem at first glance.
First off, I have to sit in class every week for a three hour lecture that goes over material I have heard about 20x. Now, this doesn't mean that I remember everything perfectly, but guys? Epi class is boring enough to sit to through one time.
Add to that, the professor occasionally says things about medicine that are patently false (he is not a clinician) -- for instance yesterday he said there was no rabies vaccine -- which is FINE except when a student questions something? I can't exactly run in and interject what we learn in med school. It just doesn't work that way. So I have to sit there horribly uncomfortable while he tells the students wrong crap. Ad nauseum. Does this sound fun to you?
FWIW the seats are also horribly uncomfortable, and would be that way even if I wasn't pregnant. So I sit squirming in mental and physical anguish the entire lecture.
I thought office hours were going to be painful, but so far they haven't been. The two students I've seen have been bright, lovely individuals, who ask good questions and are respectful. I almost wish more of them would come to office hours because?
Everyone else is BOMBING the homeworks.
Now, I know that when I was a student, I fantasized that teachers took perverse pleasure in marking students down on homeworks and exams. Let me dispel that notion once and for all.
First, it is SO MUCH easier to grade a HW where everyone gets the answers right. When students start getting wrong answers, I do what I like to call the partial credit dance. I try really really hard to give my students as much partial credit as I can. Sometimes it's really difficult because they don't show their work, or because I can't figure out what they did if they did show their work.
Second, the professor likes asking really really tricky questions that honestly belong in the reading comprehension section of the MCAT more so than on an Epi HW assignment. True, it's good to teach the kids to read carefully. But COME ON. And then I get to deal with the fallout when they receive their grades.
Students: I have to tell you, if you want to discuss a HW with a TA? The best approach is NOT to tell the TA that it was unfairly graded. What is a TA supposed to do with that? If we agree (which is possible, we don't invent the questions or the grading schemes in most cases), we STILL can't change your grade because then we would have to change everyone elses too. You are much better off going to the TA to ask them to clarify concepts and whatnot. We are relatively powerless to improve fairness in the classes we teach.
Third, I know that once I pass out a bunch of HWs with bad grades on them, I will get a number of students coming to me complaining that I was unfair. Remember how I said that office hours were not that bad in the past? Well, next week I am DREADING them.
Look students, I really would like to help you learn. And unfortunately, Epidemiology is a really dry topic where professors like to drill you on obnoxious details and trick you in the ways in which questions are worded. So PLEASE pay a bit more attention to detail and read the questions on the HWs carefully. Please LOOK UP definitions when you're doing your work. And please don't think we're out to get you. I'm just a TA. I have no power. Believe it or not, I remember what it was like to be in your shoes. I really am there to help you to learn, but it makes me very uncomfortable to have to argue about fairness. Especially regarding decisions I did not make.
Friday, September 30, 2011
Tuesday, September 27, 2011
Weighty matters
At my last Ob appointment, I got the fattie lecture.
At 23 weeks, I have gained somewhere between 10-12 lbs according to my scale at home. The 10-12 is because I don't know what my baseline weight is. My Ob decided that it MUST have been 123 lbs, and since I didn't want to get a lecture the first day about trying to lose weight during the first trimester (Because I didn't even know I was pregnant until 13.5 weeks!), I didn't argue with them. In reality my baseline weight was 125 or thereabouts. I haven't weighed 123 in quite some time.
So reality: My net weight gain as of week 14 was about 0.5 lbs.
This morning I weighed 135.4 lbs.
But I figured at the time, meh, 2 lbs. It probably doesn't matter.
Ha. Ha. Ha.
Boy was I wrong about that.
Welcome to ObGyn-land - where they will give you lectures on 2 lbs. 2 lbs! Essentially an amount that is smaller than the error around a single measurement!
Of course this is all according to MY scale. But I weigh myself at the same time every day, right after I get up in the morning. And it's worth pointing out that the weight on my scale matches a) the scale at the gym, b) the scale at the reproductive endocrinologist, c) the scale at the hematologist.
At the Ob's office, their scale consistently weighs me 3.5 lbs heavier than my scale at home.
I pointed this out and they said they knew. The question on MY mind is do they keep it calibrated wrong on purpose.
Add that to the fact that I don't think that they have adjusted (their version of) my baseline weight to their scale. Meaning at my last appt, my weight measured 138.4 for a net gain of 15.4 lbs.
That's quite a bit different from 10-12.
Anyway. I really didn't appreciate being harangued about my weight. Especially since I started off at a BMI in the 19-range. Especially since I weigh exactly what I'm supposed to weigh right now. They were concerned about my "trajectory," i.e. that I put on all the weight in 2 months.
Fair enough, but in my defense, those two months included my quals where I was essentially immobile for 2 weeks, and a trip to Italy where food was shoved in my face for 2 weeks. I think all things considered I'm doing pretty freaking well. Even not pregnant, it would have been impossible not to gain weight that month.
And furthermore, I have been tracking my own weight in Excel, and plotted a regression line of my trajectory and lo! Even if I keep putting on weight at my present rate, I will still end up gaining less than 35 lbs by week 40.
(Don't mind me, I'm an Epidemiologist. Regression equations are what we do.)
Anyway, I knew I couldn't say anything because it would come off as defensive and/or neurotic. Still, it made me furious that they would pick at me over basically 2 lbs. And now I'm terrified of my next visit.
Why?
My next visit is in the afternoon, and I consistently weigh 2 lbs more in the PM than I do in the AM. So unless I gain 2 lbs or less this month I'm probably going to get another lecture.
Do you have any idea how much I hate these appointments?
At 23 weeks, I have gained somewhere between 10-12 lbs according to my scale at home. The 10-12 is because I don't know what my baseline weight is. My Ob decided that it MUST have been 123 lbs, and since I didn't want to get a lecture the first day about trying to lose weight during the first trimester (Because I didn't even know I was pregnant until 13.5 weeks!), I didn't argue with them. In reality my baseline weight was 125 or thereabouts. I haven't weighed 123 in quite some time.
So reality: My net weight gain as of week 14 was about 0.5 lbs.
This morning I weighed 135.4 lbs.
But I figured at the time, meh, 2 lbs. It probably doesn't matter.
Ha. Ha. Ha.
Boy was I wrong about that.
Welcome to ObGyn-land - where they will give you lectures on 2 lbs. 2 lbs! Essentially an amount that is smaller than the error around a single measurement!
Of course this is all according to MY scale. But I weigh myself at the same time every day, right after I get up in the morning. And it's worth pointing out that the weight on my scale matches a) the scale at the gym, b) the scale at the reproductive endocrinologist, c) the scale at the hematologist.
At the Ob's office, their scale consistently weighs me 3.5 lbs heavier than my scale at home.
I pointed this out and they said they knew. The question on MY mind is do they keep it calibrated wrong on purpose.
Add that to the fact that I don't think that they have adjusted (their version of) my baseline weight to their scale. Meaning at my last appt, my weight measured 138.4 for a net gain of 15.4 lbs.
That's quite a bit different from 10-12.
Anyway. I really didn't appreciate being harangued about my weight. Especially since I started off at a BMI in the 19-range. Especially since I weigh exactly what I'm supposed to weigh right now. They were concerned about my "trajectory," i.e. that I put on all the weight in 2 months.
Fair enough, but in my defense, those two months included my quals where I was essentially immobile for 2 weeks, and a trip to Italy where food was shoved in my face for 2 weeks. I think all things considered I'm doing pretty freaking well. Even not pregnant, it would have been impossible not to gain weight that month.
And furthermore, I have been tracking my own weight in Excel, and plotted a regression line of my trajectory and lo! Even if I keep putting on weight at my present rate, I will still end up gaining less than 35 lbs by week 40.
(Don't mind me, I'm an Epidemiologist. Regression equations are what we do.)
Anyway, I knew I couldn't say anything because it would come off as defensive and/or neurotic. Still, it made me furious that they would pick at me over basically 2 lbs. And now I'm terrified of my next visit.
Why?
My next visit is in the afternoon, and I consistently weigh 2 lbs more in the PM than I do in the AM. So unless I gain 2 lbs or less this month I'm probably going to get another lecture.
Do you have any idea how much I hate these appointments?
Monday, September 26, 2011
Take a picture, it'll last longer!
I went swimming on Friday, and for the first time I noticed it: the staring. Though I am only 5.5 months pregnant, I am most definitely showing, and it's especially apparent what's going on when I put on my bathing suit.
At first I thought I was just being paranoid, but I noticed three people that I passed in the locker room IN A ROW had their eyes riveted on my abdomen. And the lifeguard could not get his jaw off the floor. If only he were cute or I weren't huge I would have felt flattered.
I went swimming again with Luca yesterday and he confirmed that I am not crazy. After a while I started pointing out to him the various people as the walked within three feet of me staring at my abdomen.
"See, she's doing it too!" I'd exclaim, intentionally within earshot. He'd look, and he see what I was seeing. But they wouldn't look away!
Seriously, what is wrong with people!
At least I feel normal-ish sized in the pool. I can still do flip turns and all four strokes, and I'm only about 5 seconds per 100 slower than I'd probably be at this level of fitness if I were not pregnant, which I'm pretty happy with. It's also really fun to be the pregnant lady who is faster than the male menopause triathlon guy who tries to race you and then loses. :-)
(I swear, I don't have a competition problem, really. Haha.)
The only thing that's different now is that I have to use the ladder to get out of the pool. Yesterday Luca and I had a good laugh over my repeated attempts to gracefully vault out the side the way I used to. It just wasn't happening.
As far as the staring goes, it IS a little unnerving, but I suppose the only thing I can do is do my best to ignore it, and then whoop their asses in the water. If I can. I wonder how long THAT will last.
:-P
At first I thought I was just being paranoid, but I noticed three people that I passed in the locker room IN A ROW had their eyes riveted on my abdomen. And the lifeguard could not get his jaw off the floor. If only he were cute or I weren't huge I would have felt flattered.
I went swimming again with Luca yesterday and he confirmed that I am not crazy. After a while I started pointing out to him the various people as the walked within three feet of me staring at my abdomen.
"See, she's doing it too!" I'd exclaim, intentionally within earshot. He'd look, and he see what I was seeing. But they wouldn't look away!
Seriously, what is wrong with people!
At least I feel normal-ish sized in the pool. I can still do flip turns and all four strokes, and I'm only about 5 seconds per 100 slower than I'd probably be at this level of fitness if I were not pregnant, which I'm pretty happy with. It's also really fun to be the pregnant lady who is faster than the male menopause triathlon guy who tries to race you and then loses. :-)
(I swear, I don't have a competition problem, really. Haha.)
The only thing that's different now is that I have to use the ladder to get out of the pool. Yesterday Luca and I had a good laugh over my repeated attempts to gracefully vault out the side the way I used to. It just wasn't happening.
As far as the staring goes, it IS a little unnerving, but I suppose the only thing I can do is do my best to ignore it, and then whoop their asses in the water. If I can. I wonder how long THAT will last.
:-P
Sunday, September 25, 2011
Stuff to do
Luca and I had a long conversation this morning about how his hours have gotten completely out of control (he's at work at 6AM-6:30PM M-F with a 60 minute commute on either end, plus he works on the weekends), and how I have had to take on all responsibilities pertaining to the house, the baby, and the dog as a result.
In reality, my schedule is A LOT more flexible than his is. I can "work from home" so that I can meet with the contractors during business hours, and the hours I've been putting in haven't been nearly as onerous as his have been lately. I would feel HORRIBLE asking him to take on additional responsibilities at home since he has so little free time anyway. It just doesn't seem fair to him to ask him.
Still, I could run into the very real problem that if I spend too much time on this other stuff (house, baby, dog), I don't have much time left over to do work on my dissertation. And, I really really want to finish my PhD by March 2013, and the MD by May 2014.
The March 2013 deadline is basically non-negotiable, given the number of electives I have to take when I go back to med school in order to remind myself how not to kill people, and to decide what specialty to go into. I also have to take Step 2 which is another month. If it looks like I won't be done by then I will have to take a WHOLE ADDITIONAL YEAR. Which wouldn't be so bad.... except that my department has no money, and I really really don't want to get into the situation I was in when I started this program where nobody wanted to pay for me and I had to get my own grant.
Also, I worry about Luca and his job when the baby arrives. He currently works with a bunch of men who all have stay at home wives and family in the area. When he told his boss that I was pregnant, his boss basically brushed him aside ("My wife's pregnant with #3 now!"), and he got the distinct impression that his boss had never so much as changed a diaper.
Luca is committed to being an involved father and doing his share around the house, but I worry that he will sacrifice his own career to do it. I'd hate to think that people at his work would think he was shirking on his responsibilities because he has to stay home with a sick baby when his wife becomes a resident, for instance.
I guess the long and the short of it is: Luca is too overstretched to contribute to running the house. He will do things if I ask, but I HAVE TO ASK which makes me feel guilty. And I constantly feel like I should be doing more than I am. But the more time I spend taking care of this crap, the less time I can devote to my PhD, thus increasing the risk that I will need an extra year.
I just feel like sometimes there's no winning.
In reality, my schedule is A LOT more flexible than his is. I can "work from home" so that I can meet with the contractors during business hours, and the hours I've been putting in haven't been nearly as onerous as his have been lately. I would feel HORRIBLE asking him to take on additional responsibilities at home since he has so little free time anyway. It just doesn't seem fair to him to ask him.
Still, I could run into the very real problem that if I spend too much time on this other stuff (house, baby, dog), I don't have much time left over to do work on my dissertation. And, I really really want to finish my PhD by March 2013, and the MD by May 2014.
The March 2013 deadline is basically non-negotiable, given the number of electives I have to take when I go back to med school in order to remind myself how not to kill people, and to decide what specialty to go into. I also have to take Step 2 which is another month. If it looks like I won't be done by then I will have to take a WHOLE ADDITIONAL YEAR. Which wouldn't be so bad.... except that my department has no money, and I really really don't want to get into the situation I was in when I started this program where nobody wanted to pay for me and I had to get my own grant.
Also, I worry about Luca and his job when the baby arrives. He currently works with a bunch of men who all have stay at home wives and family in the area. When he told his boss that I was pregnant, his boss basically brushed him aside ("My wife's pregnant with #3 now!"), and he got the distinct impression that his boss had never so much as changed a diaper.
Luca is committed to being an involved father and doing his share around the house, but I worry that he will sacrifice his own career to do it. I'd hate to think that people at his work would think he was shirking on his responsibilities because he has to stay home with a sick baby when his wife becomes a resident, for instance.
I guess the long and the short of it is: Luca is too overstretched to contribute to running the house. He will do things if I ask, but I HAVE TO ASK which makes me feel guilty. And I constantly feel like I should be doing more than I am. But the more time I spend taking care of this crap, the less time I can devote to my PhD, thus increasing the risk that I will need an extra year.
I just feel like sometimes there's no winning.
Saturday, September 24, 2011
HeLa
On the plane ride back from Italy I started reading The Immortal Life of Henrietta Lacks. Since I've been back, I've progressed all of 5 pages further, not because I don't like the book, but because there's too much freaking stuff to do! Anyway, I would recommend it. It reads like fiction, AND you might actually learn something.
Win, win!
One of the things that struck me was how the author talks about her consent procedure, and how awful it was. Now, a lot of other scientists at the time really were horribly unethical. However, from what people say, the real problem with Ms. Lacks's consent procedure was that it was poorly documented. She was asked/told about donating her cells, and she agreed, according to them. What seems to be the problem is that nobody else in her family really understood what was going on. Which is a real problem. I just don't know that all the consent procedures we have in place now actually prevent that from happening today. We're just better at covering our asses as researchers.
I bring this up because of the following:
In my labor and delivery consent form, all it talks about the entire form (all 11 pages of it -- I'm serious) are the complications that can happen during labor. And then, right before you sign your life away there is the following 3 line statement:
I understand that during this procedure, certain of my tissue(s), bodily substances and/or fluids may be removed and used, disposed of, or transferred by the University of X Health System for educational and research purposes not specifically related to my treatment.
Nowhere else in the document is research mentioned.
And you know? I found that to be pretty unethical. I DO research, for Christ's sake, and I'm all for expediting the process, but I can tell you for a fact that the IRB would want consent from my research subjects to use their body parts for any study, and that the specific studies they could be used for would have to be specified.
I also found it unethical that this was mentioned only at the end of an 11 page consent form which most people probably do not read, and many people probably do not have the literacy to make it through. Nobody went over the consent process with me verbally, nobody was available to answer any questions I might have, and nobody ever verbally mentioned research to me.
It's a giant fail as far as I'm concerned, and borderline coercive. If I don't sign away this right, are they going to refuse to provide me care? There's no place for me to even initial that I agree or disagree with this particular clause. It's not that I would definitely say no to the use of my tissues for research, it's that I want to know what they will be used for. They are my body parts, and I SHOULD know that.
Anyway, does anyone have any thoughts about this?
Win, win!
One of the things that struck me was how the author talks about her consent procedure, and how awful it was. Now, a lot of other scientists at the time really were horribly unethical. However, from what people say, the real problem with Ms. Lacks's consent procedure was that it was poorly documented. She was asked/told about donating her cells, and she agreed, according to them. What seems to be the problem is that nobody else in her family really understood what was going on. Which is a real problem. I just don't know that all the consent procedures we have in place now actually prevent that from happening today. We're just better at covering our asses as researchers.
I bring this up because of the following:
In my labor and delivery consent form, all it talks about the entire form (all 11 pages of it -- I'm serious) are the complications that can happen during labor. And then, right before you sign your life away there is the following 3 line statement:
I understand that during this procedure, certain of my tissue(s), bodily substances and/or fluids may be removed and used, disposed of, or transferred by the University of X Health System for educational and research purposes not specifically related to my treatment.
Nowhere else in the document is research mentioned.
And you know? I found that to be pretty unethical. I DO research, for Christ's sake, and I'm all for expediting the process, but I can tell you for a fact that the IRB would want consent from my research subjects to use their body parts for any study, and that the specific studies they could be used for would have to be specified.
I also found it unethical that this was mentioned only at the end of an 11 page consent form which most people probably do not read, and many people probably do not have the literacy to make it through. Nobody went over the consent process with me verbally, nobody was available to answer any questions I might have, and nobody ever verbally mentioned research to me.
It's a giant fail as far as I'm concerned, and borderline coercive. If I don't sign away this right, are they going to refuse to provide me care? There's no place for me to even initial that I agree or disagree with this particular clause. It's not that I would definitely say no to the use of my tissues for research, it's that I want to know what they will be used for. They are my body parts, and I SHOULD know that.
Anyway, does anyone have any thoughts about this?
Friday, September 23, 2011
Consent
I had an Ob appt today. Just one where they measure you and whatnot, and everything is fine. I'm still feeling good. Tomorrow will be 23 weeks! Next visit is the glucose challenge test where I somehow have to manage to make it to campus without passing out after not eating anything for breakfast.
Good times.
They gave me the consent form for Labor and Delivery today, and reading it I can totally understand how a woman might freak out and decide to go with a homebirth. Note -- I would NEVER EVER do that, but I understand that feeling that if you run far far away from the medical establishment then nothing they say can go wrong will be able to. They make it sound horrible. Really horrible. Which, intellectually I know is for liability reasons, but I still cried when I read it.
I also noted that it kind of slips in the "clinical students may be present / assist with the delivery" which I am NOT ok with. NO NO NO. These are people I am going to graduate from medical school with, my classmates. It is NOT ok for them to see me deliver my baby, or for them to touch my vagina. Sorry, not ok at all.
I think we may have to have a talk about that one. Hopefully nobody will give me any grief about it.
Today the NP who saw me asked if I wanted to go to any childbirth classes, and I said no. I wondered a bit if that was a mistake, so I said if she felt that I should go I would.... but that I'd participated in a number of deliveries as a med student, even delivered a couple of babies myself (and placentas.... oh Jesus the placentas), and I felt like I kind of knew what to expect. She said that she didn't feel it was necessary.
Whew!
Just to give you the rundown on my impressions of delivery from my Ob/Gyn rotation, I remember the first time I saw a vaginal birth, I thought to myself, "Wow, that looks pretty awful."
Then I saw a c-section and thought, "Huh, well that is even worse."
I just figure that delivery will be a really really unpleasant 24-48 hours, and I will get through it, and it will be fine (as long as nothing on the consent form actually happens....). And life will go on, we hope. And then the *actually* hard part will begin when we bring the baby home.
Oh joy.
Good times.
They gave me the consent form for Labor and Delivery today, and reading it I can totally understand how a woman might freak out and decide to go with a homebirth. Note -- I would NEVER EVER do that, but I understand that feeling that if you run far far away from the medical establishment then nothing they say can go wrong will be able to. They make it sound horrible. Really horrible. Which, intellectually I know is for liability reasons, but I still cried when I read it.
I also noted that it kind of slips in the "clinical students may be present / assist with the delivery" which I am NOT ok with. NO NO NO. These are people I am going to graduate from medical school with, my classmates. It is NOT ok for them to see me deliver my baby, or for them to touch my vagina. Sorry, not ok at all.
I think we may have to have a talk about that one. Hopefully nobody will give me any grief about it.
Today the NP who saw me asked if I wanted to go to any childbirth classes, and I said no. I wondered a bit if that was a mistake, so I said if she felt that I should go I would.... but that I'd participated in a number of deliveries as a med student, even delivered a couple of babies myself (and placentas.... oh Jesus the placentas), and I felt like I kind of knew what to expect. She said that she didn't feel it was necessary.
Whew!
Just to give you the rundown on my impressions of delivery from my Ob/Gyn rotation, I remember the first time I saw a vaginal birth, I thought to myself, "Wow, that looks pretty awful."
Then I saw a c-section and thought, "Huh, well that is even worse."
I just figure that delivery will be a really really unpleasant 24-48 hours, and I will get through it, and it will be fine (as long as nothing on the consent form actually happens....). And life will go on, we hope. And then the *actually* hard part will begin when we bring the baby home.
Oh joy.
Wednesday, September 21, 2011
Why I disabled anonymous comments on my blog
Not so long ago, anyone could comment on my blog. I used to think that this enabled people with dissenting viewpoints a way to present their views without erecting excessive barriers to doing so. Also, I thought that being forced to listen to this kind of dissent was in some way character building, and that only bad and selfish people who never wanted to hear that they were wrong would ever not allow such a thing.
I wasn't alone in this viewpoint. A lot of other prominent bloggers, such as Michelle Au, have taken great pains to give people who anonymously tell them what horrible bitches they are an audience on their blogs. True to that, I got 1-2 comments per week that I would classify as "unproductive."
Some examples include:
"U R a fat bitch."
"You are going to be a horrible doctor."
"You are completely immature. I feel sorry for your patients."
"I hope you rot in hell."
"I hope you never have children you disgrace of a woman."
"You are going to be a terrible mother. I hope your husband divorces you."
"I fucked Luca last night, what do you think of that you bitch?"
There were some others constituting somewhat more nuanced / articulate dissent, indicative of at least 5th grade education, but nasty enough that they probably wouldn't have posted had the authors been required to log in.
Now, some of these comments are just silly, but some could be quite hurtful. And this blogging thing is supposed to be a fun release for me, not fodder to fuel obsession over whether or not I'm a bad person.
I got to figuring, if the comment's not something you care enough to log in to post, then it's probably not worth posting. Plus, I was about to announce I was pregnant, and I really wasn't interested in hearing from the masses who think that women who work/ use daycare/ eat the wrong things/ fail to clean up after their husbands/ what have you, are bad human beings. Being a physician scientist is hard. Being a mother physician scientist is even harder. And frankly if you want to tell me off, then you should have to log in to do it.
The downside of not allowing anonymous comments is that you get fewer of them. And of course, part of the fun of blogging are the comments I receive. However discussions have been so much more pleasant since banning anonymous comments. You can still disagree with me, it's just now you are at least a little accountable for what you say.
I'm not the first person to have this observation. Farhad Manjoo over at wrote a piece about this a few months back. This is the link to that article (http://www.slate.com/id/2287739/) since blogger is being annoying and not letting me embed this morning. Most of the news sources I follow no longer allow anonymous comments. Their rationale is that anonymity provides a cover for people to say things that they normally would not in ways that are more likely to be unnecessarily incendiary, and that the discussion is elevated to a more productive level if people at least must at least use linkable pseudonyms.
Now the question: am I a big hypocrite because I use the pseudonym Old MD Girl rather than my real name. To clarify, I'm not anonymous, I just don't want to make it any easier than it has to be to link my blog to my name. I try not to say anything here that I'd worry about coming back to bite me in the ass. Obviously, some people think I still say too much, or at least more than they would say, and that's fine. They are entitled to their opinions.
However, I do feel that providing a linkable pseudonym provides an extra layer of accountability over an anonymous post, or even a post where you can write your name, but not provide an actual link. Evidence of that is in the quality of comments that I receive, that the New York Times receives, that Slate receives in the post-log in era. Mothers in medicine is another good example. Generally comments telling people that they are selfish, lazy, bad mothers, that they shouldn't go into medicine.... those comments tend to be the anonymous ones. Just an observation. Maybe it's the linkability. Maybe it's the fact that a true troll won't want to be bothered by logging in. Whatever it is, it seems to be somewhat universal. And while providing some sort of "handle" rather than anon may alleviate some of this, it's really not the same thing as having to log in, despite what some people over there seem to think.
The other nice thing about prohibiting anonymous comments on my own blog is that now I can post dissent on another blog that includes a link back to this one, and if you disagree you can't just link back over here and post what a bitch you think I am anonymously. And yes, that used to happen, so haha on you anonymous trolls.
I can also say from personal experience that occasionally I leave anonymous comments myself. Usually I do it when I am revealing something personal about myself and / or my husband that I don't want to be traced back to me. And if I have something unpleasant to say, I'm more likely to say it if I can be anonymous. So I guess that means I've done some trolling of my own, though not so much in the past couple of years. So, there it is.
:-)
I wasn't alone in this viewpoint. A lot of other prominent bloggers, such as Michelle Au, have taken great pains to give people who anonymously tell them what horrible bitches they are an audience on their blogs. True to that, I got 1-2 comments per week that I would classify as "unproductive."
Some examples include:
"U R a fat bitch."
"You are going to be a horrible doctor."
"You are completely immature. I feel sorry for your patients."
"I hope you rot in hell."
"I hope you never have children you disgrace of a woman."
"You are going to be a terrible mother. I hope your husband divorces you."
"I fucked Luca last night, what do you think of that you bitch?"
There were some others constituting somewhat more nuanced / articulate dissent, indicative of at least 5th grade education, but nasty enough that they probably wouldn't have posted had the authors been required to log in.
Now, some of these comments are just silly, but some could be quite hurtful. And this blogging thing is supposed to be a fun release for me, not fodder to fuel obsession over whether or not I'm a bad person.
I got to figuring, if the comment's not something you care enough to log in to post, then it's probably not worth posting. Plus, I was about to announce I was pregnant, and I really wasn't interested in hearing from the masses who think that women who work/ use daycare/ eat the wrong things/ fail to clean up after their husbands/ what have you, are bad human beings. Being a physician scientist is hard. Being a mother physician scientist is even harder. And frankly if you want to tell me off, then you should have to log in to do it.
The downside of not allowing anonymous comments is that you get fewer of them. And of course, part of the fun of blogging are the comments I receive. However discussions have been so much more pleasant since banning anonymous comments. You can still disagree with me, it's just now you are at least a little accountable for what you say.
I'm not the first person to have this observation. Farhad Manjoo over at wrote a piece about this a few months back. This is the link to that article (http://www.slate.com/id/2287739/) since blogger is being annoying and not letting me embed this morning. Most of the news sources I follow no longer allow anonymous comments. Their rationale is that anonymity provides a cover for people to say things that they normally would not in ways that are more likely to be unnecessarily incendiary, and that the discussion is elevated to a more productive level if people at least must at least use linkable pseudonyms.
Now the question: am I a big hypocrite because I use the pseudonym Old MD Girl rather than my real name. To clarify, I'm not anonymous, I just don't want to make it any easier than it has to be to link my blog to my name. I try not to say anything here that I'd worry about coming back to bite me in the ass. Obviously, some people think I still say too much, or at least more than they would say, and that's fine. They are entitled to their opinions.
However, I do feel that providing a linkable pseudonym provides an extra layer of accountability over an anonymous post, or even a post where you can write your name, but not provide an actual link. Evidence of that is in the quality of comments that I receive, that the New York Times receives, that Slate receives in the post-log in era. Mothers in medicine is another good example. Generally comments telling people that they are selfish, lazy, bad mothers, that they shouldn't go into medicine.... those comments tend to be the anonymous ones. Just an observation. Maybe it's the linkability. Maybe it's the fact that a true troll won't want to be bothered by logging in. Whatever it is, it seems to be somewhat universal. And while providing some sort of "handle" rather than anon may alleviate some of this, it's really not the same thing as having to log in, despite what some people over there seem to think.
The other nice thing about prohibiting anonymous comments on my own blog is that now I can post dissent on another blog that includes a link back to this one, and if you disagree you can't just link back over here and post what a bitch you think I am anonymously. And yes, that used to happen, so haha on you anonymous trolls.
I can also say from personal experience that occasionally I leave anonymous comments myself. Usually I do it when I am revealing something personal about myself and / or my husband that I don't want to be traced back to me. And if I have something unpleasant to say, I'm more likely to say it if I can be anonymous. So I guess that means I've done some trolling of my own, though not so much in the past couple of years. So, there it is.
:-)
Tuesday, September 20, 2011
The downside of being a pregnant MD-PhD student in clinical epi
If I did twitter, it would currently read:
"Just saw the fellow who did my anatomy scan walking around my office. Um, I thought she said she was starting the Master's program NEXT year? Hi awkward. Oh well, at least she didn't examine my cervix...."
Though it does make me wonder a bit whether I should have chosen someplace other than my home institution for my prenatal care, even though it would have been much less convenient.
On the plus side, I'm hoping that if that resident who was a total bitch on that rotation winds up attending my delivery, I'm hoping I can attribute any obscenities I scream at her to pain vs. my true feelings.
:-)
"Just saw the fellow who did my anatomy scan walking around my office. Um, I thought she said she was starting the Master's program NEXT year? Hi awkward. Oh well, at least she didn't examine my cervix...."
Though it does make me wonder a bit whether I should have chosen someplace other than my home institution for my prenatal care, even though it would have been much less convenient.
On the plus side, I'm hoping that if that resident who was a total bitch on that rotation winds up attending my delivery, I'm hoping I can attribute any obscenities I scream at her to pain vs. my true feelings.
:-)
Kick
Ok, I guess I am saying this not having had my baby kick me in the liver yet, and not yet having been kept awake all night by it, but it always makes me smile when I feel my baby moving around during the day, and sometimes during the night as well.
The other day I was reading a book, resting the book on my stomach, and every so often a kick would make the book bounce ever so slightly. It's probably just foreshadowing of things to come, as in, "Mommy! Put down your book! Pay attention to me!"
I met with the MD-PhD program administrator today to tell her my news, and she was very happy and enthusiastic, and agreed with my overall plan. I just feel so fortunate that I have as much flexibility with my schedule as I do at this point, and that so far everyone has been nice and supportive. SO FORTUNATE, because I know it's not like this for everyone.
Anyway, got through a bunch of the to do list yesterday, which was shocking and awesome at the same time. Didn't get a whole lot of school work done though, which I'm trying to rectify today. Of course the phone calls I did make turned into more phone calls, which I should try to make today. It seems none of this will end any time soon so I might as well get used to it.
Sigh.
The other day I was reading a book, resting the book on my stomach, and every so often a kick would make the book bounce ever so slightly. It's probably just foreshadowing of things to come, as in, "Mommy! Put down your book! Pay attention to me!"
I met with the MD-PhD program administrator today to tell her my news, and she was very happy and enthusiastic, and agreed with my overall plan. I just feel so fortunate that I have as much flexibility with my schedule as I do at this point, and that so far everyone has been nice and supportive. SO FORTUNATE, because I know it's not like this for everyone.
Anyway, got through a bunch of the to do list yesterday, which was shocking and awesome at the same time. Didn't get a whole lot of school work done though, which I'm trying to rectify today. Of course the phone calls I did make turned into more phone calls, which I should try to make today. It seems none of this will end any time soon so I might as well get used to it.
Sigh.
Monday, September 19, 2011
Ok guys?
If you're planning on having kids, particularly if you think you're going to be working or in school full time, please plan ahead re: childcare!
Of the 10 or so couples I've known recently who have had kids, not a single one of them planned in advance. Many of them thought that they'd be able to "write their dissertation while taking care of a baby" (to save $ I guess?). Others didn't realize that daycare in Philadelphia for a baby will run you $1200-$1500 per month. And then they realize that a full time sitter will likely be EVEN MORE expensive.
I've been told by many people that waiting lists for daycare in the West Philly area can be really really long.... like 18 months sometimes, so it behooves you to do this!
And I have to say, when I call the daycare centers to find out what their application procedure is, they all ask me how old my child is, and what date I want to start service. Can I tell you? The relief on the phone is PALPABLE when I tell them I'm not due until late January, and that my expected date of need is May 1st. Some of them still tell me that I may still have to wait, but it's soooooo much better than being told that now than say 9 months from now.
They probably get yelled at a lot by desperate people.
Not saying that I WILL actually get in by May 1st, I may still have to wait, but it has made me realize the importance of planning ahead.
PLAN AHEAD PEOPLE!! I can't be the only one!
Of the 10 or so couples I've known recently who have had kids, not a single one of them planned in advance. Many of them thought that they'd be able to "write their dissertation while taking care of a baby" (to save $ I guess?). Others didn't realize that daycare in Philadelphia for a baby will run you $1200-$1500 per month. And then they realize that a full time sitter will likely be EVEN MORE expensive.
I've been told by many people that waiting lists for daycare in the West Philly area can be really really long.... like 18 months sometimes, so it behooves you to do this!
And I have to say, when I call the daycare centers to find out what their application procedure is, they all ask me how old my child is, and what date I want to start service. Can I tell you? The relief on the phone is PALPABLE when I tell them I'm not due until late January, and that my expected date of need is May 1st. Some of them still tell me that I may still have to wait, but it's soooooo much better than being told that now than say 9 months from now.
They probably get yelled at a lot by desperate people.
Not saying that I WILL actually get in by May 1st, I may still have to wait, but it has made me realize the importance of planning ahead.
PLAN AHEAD PEOPLE!! I can't be the only one!
Sunday, September 18, 2011
House
This weekend, Luca and I decided to bite the bullet this weekend and clean out the office, which will shortly become the baby's room. Of course this also involved cleaning out the places where we had to put the stuff FROM the office also.
And let me just say, the amount of class materials -- books, papers, old exams, random documentation -- that I have accumulated from med school and PhD school over the last 5 years is quite remarkable. Even though I've made an effort to get rid of things as I go along.
We also bought primer and painting supplies, and moved a bunch of furniture. It was quite a productive day.
Of COURSE, as we're finishing up the project, I look up and see a spot on the ceiling. So I ask Luca, "Is that a water spot?"
"Oh no," he assures me, "There are lots of spots on the ceiling, and I've felt them and all of them are dry," he says as he reaches up to feel this one (which is why I asked him to do it -- sometimes it's nice to have a husband who is 6'5).
As he starts to touch it, I hear him bellow, "DIO CRISTO, MADONNA. PORCA PUTTANA. VACCA TROIA (etc. you get the idea)." Followed by a 5 hour full blown temper tantrum involving pouting, whining, refusal to do further work, and stomping around. Apparently this was a NEW spot, and is NOT dry.
And lo, our simple project (clean out the office and prime and paint the walls) mushroomed into a much bigger pain in the ass. Now instead of being able to finish next weekend, we will have to get the roof patched and resealed (the resealing we probably should have been doing anyway), AND we will have to do something with the ceilings.
And did I mention they are popcorn ceilings? They are totally hideous, so I made the executive decision that we are going to drywall these and cover them up so that we can paint them too and make the rooms look like they belong to the 21st century rather than the 1980s.
And behold, we illustrated one basic tenet of home ownership: If you dare to undertake a project (in particular a project that is designed to make the house look rather than function better) you will uncover several other expensive projects in the process that you will HAVE to do to keep the house from falling apart. Instead of crossing off items on your to do list, you will make the list LONGER. Woo!
The good news is that since my schedule is flexible, I can get quotes relatively easily if I stay home and do work (all day usually, since contractors and the like don't tend to come when they say they will). Arranging this would be somewhat less anxiety inducing if I didn't have a very full week next week, with several meeting times pending because SOME PEOPLE (ahem) cannot be bothered to respond to meeting requests in a timely fashion.
(As a side note, since when is a 1-2 week turnaround time for a meeting request ok? I realize people are busy, but doesn't it occur to anyone that the times I list as available two weeks ago may no longer be available when you get around to responding? This used to really stress me out. However I DO take response time into account when selecting mentors and other people to work with... so keep that in mind if you or your secretary is a slow responder.)
So now, for Monday:
1) Call outside drain cleaner people
2) Call roofer
3) Call contractor #1 to get quote about ceiling
4) Call electrician
5) Print out, fill out, and mail day care center wait list applications (after calling to find out what application process is)
6) Go to noon meeting
7) Submit manuscript (seriously -- FINALLY)
8) Go over problem set to prepare for office hours Tues AM
9) Start protocol for implicit review project
10) Start running analyses for paper #2 that is 1/2 done but that I haven't looked at since April
11) Work out? (haha)
And let me just say, the amount of class materials -- books, papers, old exams, random documentation -- that I have accumulated from med school and PhD school over the last 5 years is quite remarkable. Even though I've made an effort to get rid of things as I go along.
We also bought primer and painting supplies, and moved a bunch of furniture. It was quite a productive day.
Of COURSE, as we're finishing up the project, I look up and see a spot on the ceiling. So I ask Luca, "Is that a water spot?"
"Oh no," he assures me, "There are lots of spots on the ceiling, and I've felt them and all of them are dry," he says as he reaches up to feel this one (which is why I asked him to do it -- sometimes it's nice to have a husband who is 6'5).
As he starts to touch it, I hear him bellow, "DIO CRISTO, MADONNA. PORCA PUTTANA. VACCA TROIA (etc. you get the idea)." Followed by a 5 hour full blown temper tantrum involving pouting, whining, refusal to do further work, and stomping around. Apparently this was a NEW spot, and is NOT dry.
And lo, our simple project (clean out the office and prime and paint the walls) mushroomed into a much bigger pain in the ass. Now instead of being able to finish next weekend, we will have to get the roof patched and resealed (the resealing we probably should have been doing anyway), AND we will have to do something with the ceilings.
And did I mention they are popcorn ceilings? They are totally hideous, so I made the executive decision that we are going to drywall these and cover them up so that we can paint them too and make the rooms look like they belong to the 21st century rather than the 1980s.
And behold, we illustrated one basic tenet of home ownership: If you dare to undertake a project (in particular a project that is designed to make the house look rather than function better) you will uncover several other expensive projects in the process that you will HAVE to do to keep the house from falling apart. Instead of crossing off items on your to do list, you will make the list LONGER. Woo!
The good news is that since my schedule is flexible, I can get quotes relatively easily if I stay home and do work (all day usually, since contractors and the like don't tend to come when they say they will). Arranging this would be somewhat less anxiety inducing if I didn't have a very full week next week, with several meeting times pending because SOME PEOPLE (ahem) cannot be bothered to respond to meeting requests in a timely fashion.
(As a side note, since when is a 1-2 week turnaround time for a meeting request ok? I realize people are busy, but doesn't it occur to anyone that the times I list as available two weeks ago may no longer be available when you get around to responding? This used to really stress me out. However I DO take response time into account when selecting mentors and other people to work with... so keep that in mind if you or your secretary is a slow responder.)
So now, for Monday:
1) Call outside drain cleaner people
2) Call roofer
3) Call contractor #1 to get quote about ceiling
4) Call electrician
5) Print out, fill out, and mail day care center wait list applications (after calling to find out what application process is)
6) Go to noon meeting
7) Submit manuscript (seriously -- FINALLY)
8) Go over problem set to prepare for office hours Tues AM
9) Start protocol for implicit review project
10) Start running analyses for paper #2 that is 1/2 done but that I haven't looked at since April
11) Work out? (haha)
Friday, September 16, 2011
Anatomy
I had my anatomy scan a few days ago. Luca took the morning off from work to come with me so he could see the baby. I was glad to have him there. He has felt it kick a couple of times (I was reading a few nights ago, resting the book on my belly, and the book kept bouncing up and down), but I thought he might feel even more connected if he SAW it.
I was right. When we were looking at the head on the ultrasound, we saw it swallow several times. He said he almost cried.
My husband is so cute. :-)
Anyway, since there have been requests for pictures, I thought I would post one or two from that visit.
So, here's just a regular ultrasound pic:
DO NOT TELL ME WHAT THE GENDER IS IF YOU CAN TELL BY THIS PICTURE!!! (thanks)
And here's the 3D image that Luca convinced the dr to get for him (for grandma in Italy... he was very persuasive). You can see the baby's hand over his/her face and the lips and nose. Very cute in my totally unbiased opinion. :-)
Also happy to report that baby has all of his/her arms + legs, 4 chambers in the heart, and the intestines are where they should be. After med school my #1 neurotic fear was anencephaly. My #2 fear was aplastic left heart. So, fortunately neither of those things seem to have happened. Phew!
I was right. When we were looking at the head on the ultrasound, we saw it swallow several times. He said he almost cried.
My husband is so cute. :-)
Anyway, since there have been requests for pictures, I thought I would post one or two from that visit.
So, here's just a regular ultrasound pic:
DO NOT TELL ME WHAT THE GENDER IS IF YOU CAN TELL BY THIS PICTURE!!! (thanks)
And here's the 3D image that Luca convinced the dr to get for him (for grandma in Italy... he was very persuasive). You can see the baby's hand over his/her face and the lips and nose. Very cute in my totally unbiased opinion. :-)
Also happy to report that baby has all of his/her arms + legs, 4 chambers in the heart, and the intestines are where they should be. After med school my #1 neurotic fear was anencephaly. My #2 fear was aplastic left heart. So, fortunately neither of those things seem to have happened. Phew!
Thursday, September 15, 2011
Telling
I told my mentor about my pregnancy yesterday at our team meeting. In front of the other team members, just in case (I'm paranoid like that). And he responded with genuine sounding congratulations.
And today we met one on one to talk about my project and what I should be working on right now, and AGAIN he offered sincere congratulations, said it was a great time to have a kid, and offered childcare advice(!). It was very helpful childcare advice if you must know. His wife also works full time, and they are both very busy. They use daycare, but since both of them have to be out of the house so early, they also pay someone to do morning dropoffs for them.
Interesting.
Anyway.... whew!! Bullet dodged! And he totally endorsed not attempting to do anything at all the first 4 weeks, and then slowly easing back into things. And liked my characterization of children as "money suckers."
Now word is spreading around the department. Today someone asked me if I'd planned on telling ANYONE, or if I was just planning on walking my pregnant self around the department to see if anyone would say something. In truth, I mostly wanted to tell my mentor first (out of respect) before I blabbed to the rest of the world so that he'd get to hear it from me and not third hand.
Anyway, what a relief!
And today we met one on one to talk about my project and what I should be working on right now, and AGAIN he offered sincere congratulations, said it was a great time to have a kid, and offered childcare advice(!). It was very helpful childcare advice if you must know. His wife also works full time, and they are both very busy. They use daycare, but since both of them have to be out of the house so early, they also pay someone to do morning dropoffs for them.
Interesting.
Anyway.... whew!! Bullet dodged! And he totally endorsed not attempting to do anything at all the first 4 weeks, and then slowly easing back into things. And liked my characterization of children as "money suckers."
Now word is spreading around the department. Today someone asked me if I'd planned on telling ANYONE, or if I was just planning on walking my pregnant self around the department to see if anyone would say something. In truth, I mostly wanted to tell my mentor first (out of respect) before I blabbed to the rest of the world so that he'd get to hear it from me and not third hand.
Anyway, what a relief!
Wednesday, September 14, 2011
How to respond when someone tells you they've had a pregnancy loss
Fizzy had a comment in my last post that I wanted to expand upon. She said that women don't usually talk about their early pregnancy losses, but they are very common.
Her experience has been somewhat different from mine in this regard, or at least so I gathered from her comment. She says a lot of women she talks to will tell her that they had a loss too. Perhaps it's because most of the women in my circle have never tried to have a child, but that was not my experience.
In my experience, people said the following to me if I ever mentioned it at all:
"Maybe it's because you do X."
"Maybe it's because you are too thin."
"Maybe it's because you exercise."
"Maybe it's because you are stressed out." (my personal favorite)
"You can always adopt."
"Maybe it's because you're a bad person and this is karma."
"Maybe it's something YOU DID."
"This is your fault, you know that don't you? This would never happen to me."
(Ok the last three are made up, but it kind of felt like that was where they were going with some of their comments.)
Occasionally I'd also hear the following:
"This happens to lots of people. I'm sure the next time will work out. [changes subject]."
"My mother had problems conceiving. She did XYZ and it worked out. Maybe you should try XYZ."
"It probably was genetically screwed up anyway. You're better off this way."
"Oh thank goodness, now you can have that mammogram I wanted to order for you last time you were here."
"I don't know why you're complaining. *I* tried to get pregnant for a FULL YEAR before we had any success. You don't have it nearly as bad as I did."
"You should really shut up. It took me and my husband 10 years and 5 cycles of IVF to have a child. You have nothing to be upset about."
"[Changes the subject immediately]."
(I actually DID get every single one of those comments practically verbatim.)
Look, I know it's hard to know what to say when someone tells you something bad has happened to them. Maybe this is the first time someone has told you something like that, and you don't know the appropriate way to respond.
So here's what you do:
You say, "I am so sorry. That sounds very difficult/painful. Do you want to talk about it more?" and then you listen.
I didn't tell many of my friends at all (some of the really bad comments were from drs and nps I've seen in the past 6 months for other problems -- woo!), but when a friend responded that way, and sounded sincere? I wanted to hug her. She was just perfect. And I really did feel a little better.
I really wish it was easier to talk about these things candidly because I feel that sometimes just knowing you're not alone can make all the difference in your outlook. It's too bad so many people need a lesson in social skills.
Her experience has been somewhat different from mine in this regard, or at least so I gathered from her comment. She says a lot of women she talks to will tell her that they had a loss too. Perhaps it's because most of the women in my circle have never tried to have a child, but that was not my experience.
In my experience, people said the following to me if I ever mentioned it at all:
"Maybe it's because you do X."
"Maybe it's because you are too thin."
"Maybe it's because you exercise."
"Maybe it's because you are stressed out." (my personal favorite)
"You can always adopt."
"Maybe it's because you're a bad person and this is karma."
"Maybe it's something YOU DID."
"This is your fault, you know that don't you? This would never happen to me."
(Ok the last three are made up, but it kind of felt like that was where they were going with some of their comments.)
Occasionally I'd also hear the following:
"This happens to lots of people. I'm sure the next time will work out. [changes subject]."
"My mother had problems conceiving. She did XYZ and it worked out. Maybe you should try XYZ."
"It probably was genetically screwed up anyway. You're better off this way."
"Oh thank goodness, now you can have that mammogram I wanted to order for you last time you were here."
"I don't know why you're complaining. *I* tried to get pregnant for a FULL YEAR before we had any success. You don't have it nearly as bad as I did."
"You should really shut up. It took me and my husband 10 years and 5 cycles of IVF to have a child. You have nothing to be upset about."
"[Changes the subject immediately]."
(I actually DID get every single one of those comments practically verbatim.)
Look, I know it's hard to know what to say when someone tells you something bad has happened to them. Maybe this is the first time someone has told you something like that, and you don't know the appropriate way to respond.
So here's what you do:
You say, "I am so sorry. That sounds very difficult/painful. Do you want to talk about it more?" and then you listen.
I didn't tell many of my friends at all (some of the really bad comments were from drs and nps I've seen in the past 6 months for other problems -- woo!), but when a friend responded that way, and sounded sincere? I wanted to hug her. She was just perfect. And I really did feel a little better.
I really wish it was easier to talk about these things candidly because I feel that sometimes just knowing you're not alone can make all the difference in your outlook. It's too bad so many people need a lesson in social skills.
Tuesday, September 13, 2011
13
I've received several inquiries about how it was possible that I didn't know I was pregnant until 13 weeks + had gone by. I've gone back and forth about whether or not to share this story because, really? Who wants to read about my menstrual history on the internet. Gross.
On the other hand, it is somewhat educational from a medical standpoint.... and an interesting story (at least *I* think so), so I'm a bit torn.
So, you'll be getting the abridged version.
For starters, in medical school they tell us that it's not uncommon at all for someone not to know they are pregnant for up to 3 months. The typical woman this happens to has PCOS with irregular periods, often skipping periods entirely. In medical school, they told us about these types of patients, and everyone still thought that only a total idiot wouldn't know she was pregnant. I dunno, maybe it's because a lot of PCOS patients are obese, it's assumed that they are also stupid.
I do not have PCOS.
I don't even have irregular periods, just very very light ones.
And let's just say that things like implantation bleeding (which can occur after a negative pregnancy test -- trust me on this), and first trimester bleeding, can both look a lot like a very light period. Especially when they happen somewhere between 24 and 31 days apart from one another. It might be especially confusing if you've already had an early loss somewhere along the way, and you think that's what's going on again. Also remember that it takes up to 2 weeks for a pregnancy test to be negative after an early loss. And I didn't get nauseated or feel especially tired during the first trimester, at all really.
And that's about all the detail I care to share, dear internet.
Anyway, the long and the short of it is that Luca and I started trying in December, and ended up with a pregnancy by April, and for that I feel extremely fortunate regardless of whatever else happened along the way.
One more thing: If you're a student trying to get pregnant, I STRONGLY urge you to seek out a real Ob/Gyn early on, as I quickly exceeded the scope of knowledge of the nurse practitioners I dealt with at student health. Even scarier was that they did not acknowledge this fact to me (I'm not even sure they recognized this fact themselves), and did not even suggest a referral. I should have been given a type & screen along with other prenatal labs in January at least, and they totally dropped the ball. Fortunately everything turned out fine in the end though, so that's another thing I can be thankful for.
On the other hand, it is somewhat educational from a medical standpoint.... and an interesting story (at least *I* think so), so I'm a bit torn.
So, you'll be getting the abridged version.
For starters, in medical school they tell us that it's not uncommon at all for someone not to know they are pregnant for up to 3 months. The typical woman this happens to has PCOS with irregular periods, often skipping periods entirely. In medical school, they told us about these types of patients, and everyone still thought that only a total idiot wouldn't know she was pregnant. I dunno, maybe it's because a lot of PCOS patients are obese, it's assumed that they are also stupid.
I do not have PCOS.
I don't even have irregular periods, just very very light ones.
And let's just say that things like implantation bleeding (which can occur after a negative pregnancy test -- trust me on this), and first trimester bleeding, can both look a lot like a very light period. Especially when they happen somewhere between 24 and 31 days apart from one another. It might be especially confusing if you've already had an early loss somewhere along the way, and you think that's what's going on again. Also remember that it takes up to 2 weeks for a pregnancy test to be negative after an early loss. And I didn't get nauseated or feel especially tired during the first trimester, at all really.
And that's about all the detail I care to share, dear internet.
Anyway, the long and the short of it is that Luca and I started trying in December, and ended up with a pregnancy by April, and for that I feel extremely fortunate regardless of whatever else happened along the way.
One more thing: If you're a student trying to get pregnant, I STRONGLY urge you to seek out a real Ob/Gyn early on, as I quickly exceeded the scope of knowledge of the nurse practitioners I dealt with at student health. Even scarier was that they did not acknowledge this fact to me (I'm not even sure they recognized this fact themselves), and did not even suggest a referral. I should have been given a type & screen along with other prenatal labs in January at least, and they totally dropped the ball. Fortunately everything turned out fine in the end though, so that's another thing I can be thankful for.
Monday, September 12, 2011
Being pregnant in Italy
A friend of mine warned me that if I didn't want my husband's family all up in my business during our vacation, that I'd be best off if we waited to tell them about the pregnancy until after our return.
It didn't quite work out that way for obvious reasons. First, there is NO WAY at this point that I could disguise this. Second, my parents in law are nice people who tend to err on the side of not getting in Luca's and my way. I felt pretty comfortable that things would be fine if we told them.
I was right. In fact, the first words out of my father-in-law's mouth were, "She's not being all psychotic about what she eats now, is she?" Or words to that effect.
I love my father-in-law.
Though I will say it was a little annoying not to be able to drink wine, eat salami, or eat any of the listeria laden unpasteurized dairy products at the malghe in Alta Lessinia, since aren't those some of the reasons to even GO to Italy?
At least I had an excuse to avoid huge amounts of coffee though. Whenever I go I feel like I am constantly being asked if I want coffee, and it upsets my stomach when I have a lot of it. I like it in the morning, but that's about it, and now I had a good reason to refuse! It was nice. :-)
The other relatives were ok. I received a great many uninvited pats to the stomach, which were fine I guess, and a lot of congratulations. I got to sit in the front seat of the car whenever we went anywhere, and thus avoided car sickness. A highlight of the trip occurred during the last night we were there at dinner, I requested some mayonnaise, and my brother-in-law asked whether I was allowed to eat some commercially made mayonnaise since it had raw eggs in it (I am). Except he asked the *rest* of the family in Italian, I think because he thought I couldn't understand, which I found really annoying. But I understood well enough to respond anyway.
So there. Bite me.
My sister and brother in-law were also very interested in how much weight I had gained, and asked me repeatedly. I guess this is a thing over there? My doctor hasn't even mentioned weight gain so my guess is that I am fine (who am I kidding, I know I am fine), but perhaps women get hassled about it more over there?
Otherwise it was fine. Jobs are required to give Italian women (but not men) 12 months of maternity leave for each child paid at 50%, which is obviously not an option for me. So I was expecting shock and horror when I told them I'd be taking 2-3 months most likely (if I get what I want), and that my parents were 70 and most likely not going to be able to help out. I'm used to this sort of thing anyway since everyone always reacts with shock and horror when we tell them how little vacation we get in the US.
Anyway, it's good to be back. We picked up the Boo from Central Bark yesterday and spent a bunch of quality time with her, playing her favorite game, obedience school. Then we went to sleep at 7.
It didn't quite work out that way for obvious reasons. First, there is NO WAY at this point that I could disguise this. Second, my parents in law are nice people who tend to err on the side of not getting in Luca's and my way. I felt pretty comfortable that things would be fine if we told them.
I was right. In fact, the first words out of my father-in-law's mouth were, "She's not being all psychotic about what she eats now, is she?" Or words to that effect.
I love my father-in-law.
Though I will say it was a little annoying not to be able to drink wine, eat salami, or eat any of the listeria laden unpasteurized dairy products at the malghe in Alta Lessinia, since aren't those some of the reasons to even GO to Italy?
At least I had an excuse to avoid huge amounts of coffee though. Whenever I go I feel like I am constantly being asked if I want coffee, and it upsets my stomach when I have a lot of it. I like it in the morning, but that's about it, and now I had a good reason to refuse! It was nice. :-)
The other relatives were ok. I received a great many uninvited pats to the stomach, which were fine I guess, and a lot of congratulations. I got to sit in the front seat of the car whenever we went anywhere, and thus avoided car sickness. A highlight of the trip occurred during the last night we were there at dinner, I requested some mayonnaise, and my brother-in-law asked whether I was allowed to eat some commercially made mayonnaise since it had raw eggs in it (I am). Except he asked the *rest* of the family in Italian, I think because he thought I couldn't understand, which I found really annoying. But I understood well enough to respond anyway.
So there. Bite me.
My sister and brother in-law were also very interested in how much weight I had gained, and asked me repeatedly. I guess this is a thing over there? My doctor hasn't even mentioned weight gain so my guess is that I am fine (who am I kidding, I know I am fine), but perhaps women get hassled about it more over there?
Otherwise it was fine. Jobs are required to give Italian women (but not men) 12 months of maternity leave for each child paid at 50%, which is obviously not an option for me. So I was expecting shock and horror when I told them I'd be taking 2-3 months most likely (if I get what I want), and that my parents were 70 and most likely not going to be able to help out. I'm used to this sort of thing anyway since everyone always reacts with shock and horror when we tell them how little vacation we get in the US.
Anyway, it's good to be back. We picked up the Boo from Central Bark yesterday and spent a bunch of quality time with her, playing her favorite game, obedience school. Then we went to sleep at 7.
Friday, September 09, 2011
Dear Internet
I have an announcement to make*:
FAQs:
Q: When are you due?
A: January 21, 2012. That puts me at almost 21 weeks.
Q: Do you know the sex?
A: Luca and I would like to be surprised.
Q: How much time are you taking off?
A: I don't know, whatever I can get. 2-3 months? I hope?
Q: Was this planned?
A: Yes.
Q: Did you use IVF?
A: No.
Q: What did your mentor say?
A: We haven't discussed it yet. I haven't seen him in 6 weeks, and we wanted to wait to tell him until after our quad screen.
Q: Does this mean you'll need to take an extra year in your program?
A: Hopefully not, but it could. My projects could also get stuck, causing me to take an extra year for that reason too.
Q: Are your parents coming to help you?
A: My parents are 70. So... no. My in-laws have told us they'll come.
Q: Have you been sick?
A: I didn't even know until week 13. So, no.
Q: Any other symptoms?
A: Besides feeling enormous? My skin cleared up, which has been nice.
Q: What does Luca think?
A: He is excited.
Q: Do your clothes still fit?
A: Thank god for elastic waistbands.
*Photo of my father-in-law's pancia was posted with his consent.
FAQs:
Q: When are you due?
A: January 21, 2012. That puts me at almost 21 weeks.
Q: Do you know the sex?
A: Luca and I would like to be surprised.
Q: How much time are you taking off?
A: I don't know, whatever I can get. 2-3 months? I hope?
Q: Was this planned?
A: Yes.
Q: Did you use IVF?
A: No.
Q: What did your mentor say?
A: We haven't discussed it yet. I haven't seen him in 6 weeks, and we wanted to wait to tell him until after our quad screen.
Q: Does this mean you'll need to take an extra year in your program?
A: Hopefully not, but it could. My projects could also get stuck, causing me to take an extra year for that reason too.
Q: Are your parents coming to help you?
A: My parents are 70. So... no. My in-laws have told us they'll come.
Q: Have you been sick?
A: I didn't even know until week 13. So, no.
Q: Any other symptoms?
A: Besides feeling enormous? My skin cleared up, which has been nice.
Q: What does Luca think?
A: He is excited.
Q: Do your clothes still fit?
A: Thank god for elastic waistbands.
*Photo of my father-in-law's pancia was posted with his consent.
Thursday, September 08, 2011
Primary Care
There's an article in the NYT about how Orthopedic surgeons and Primary Care doctors in the US get paid a lot more than in other countries. I thought it was interesting.
The problem with these studies though, is that nobody ever stops to consider that the cost of living differs substantially between these countries. For instance in Verona Italy, sure you might pay the same amount in rent as you would in Philadelphia, and perhaps more for food and tvs and things like that. However you do NOT have to pay for your own health care, retirement, or your kids' college education. Oh wait, tuition at the University of Padua, the most competitive university in the country, is about 1500 Euros/year now. The horror.
Yes, taxes are lower in the US (assuming that people in Italy actually PAY all their taxes -- which they do not), but even after taking that into account, people in the US still have to shell out a lot of money for health care, retirement, and college tuition for their kids. And let's not forget that med school tuition + room and board can run over 250K. Plus college tuition. Compare that with 6x1500 = 9000 Euro for a medical education in Europe. Sure, it's more if you live away from home, but most kids -- at least in Italy -- do not.
Alternative career choices are not so abundant in Italy either, so you don't actually have to pay doctors very well to get smart people to go into medicine. There is currently a dr surplus in Italy, in fact. This is not the case in the US. We have to import our doctors so that there are enough.
Anyway, before we start crying that Primary Care doctors in the US are overpaid, I think we should at least consider those facts. And you KNOW nobody will when they start taking the axe to dr salaries. Again.
The problem with these studies though, is that nobody ever stops to consider that the cost of living differs substantially between these countries. For instance in Verona Italy, sure you might pay the same amount in rent as you would in Philadelphia, and perhaps more for food and tvs and things like that. However you do NOT have to pay for your own health care, retirement, or your kids' college education. Oh wait, tuition at the University of Padua, the most competitive university in the country, is about 1500 Euros/year now. The horror.
Yes, taxes are lower in the US (assuming that people in Italy actually PAY all their taxes -- which they do not), but even after taking that into account, people in the US still have to shell out a lot of money for health care, retirement, and college tuition for their kids. And let's not forget that med school tuition + room and board can run over 250K. Plus college tuition. Compare that with 6x1500 = 9000 Euro for a medical education in Europe. Sure, it's more if you live away from home, but most kids -- at least in Italy -- do not.
Alternative career choices are not so abundant in Italy either, so you don't actually have to pay doctors very well to get smart people to go into medicine. There is currently a dr surplus in Italy, in fact. This is not the case in the US. We have to import our doctors so that there are enough.
Anyway, before we start crying that Primary Care doctors in the US are overpaid, I think we should at least consider those facts. And you KNOW nobody will when they start taking the axe to dr salaries. Again.
Wednesday, September 07, 2011
Lessinia
Unfortunately it rained 3/4 days we were going to spend in Cortina, so Luca and I decided to hang around the in-laws house in Verona instead. Then nonna broke her hip and is in the hospital now, so it's probably a good thing we didn't go. Of course staying in Verona means an endless stream of visits with the relatives. And I do mean endless.
Which would be more ok if I didn't get so exhausted having to speak Italian all the freaking time. Oh! And if they didn't just drop by unannounced and expect us to be all bright eyed and bushy tailed to see them.
Woo.
Tuesday we went to Padova for a day trip, where Luca went to college and did his PhD. I got to see the collegio where he lived for 4 years, and we walked around the town while he reminisced. We went to see Palazzo del Bo, which is where they used to do gross anatomy class way back when. When med students graduate, they defend in this building, and the law school still has classes there. It's kind of cool that the University has been around for almost 1000 years!
We did get to go hiking in alta Lessinia. Twice. Which is the high plain just north of Verona that comes before the Alps. I'm attaching some pictures from one of of the hikes.
The pictures are kind of small, so if you want to see them in detail, just click. They look better full size anyway.
Cows and cars.
Osservatorio. The big ditch behind me is actually a WWI trench.
Luca thinks of scenes like this and gets all nostalgic for his childhood.
Some of the rock formations kind of remind me of the badlands in South Dakota.
This is Trento. According to Luca, all people from Trento are assholes (as are all people from Brescia and all people from Vicenza). People from Verona are just crazy.
Luca is so cute.
And lastly, because I haven't posted a picture of Miss. Ferocious in a while, here's one of the Boo from a few months back. Normally she likes to lie UNDER my legs on the couch. She is in the kennel at Central Bark now and we miss her. :-(
Which would be more ok if I didn't get so exhausted having to speak Italian all the freaking time. Oh! And if they didn't just drop by unannounced and expect us to be all bright eyed and bushy tailed to see them.
Woo.
Tuesday we went to Padova for a day trip, where Luca went to college and did his PhD. I got to see the collegio where he lived for 4 years, and we walked around the town while he reminisced. We went to see Palazzo del Bo, which is where they used to do gross anatomy class way back when. When med students graduate, they defend in this building, and the law school still has classes there. It's kind of cool that the University has been around for almost 1000 years!
We did get to go hiking in alta Lessinia. Twice. Which is the high plain just north of Verona that comes before the Alps. I'm attaching some pictures from one of of the hikes.
The pictures are kind of small, so if you want to see them in detail, just click. They look better full size anyway.
Cows and cars.
Osservatorio. The big ditch behind me is actually a WWI trench.
Luca thinks of scenes like this and gets all nostalgic for his childhood.
Some of the rock formations kind of remind me of the badlands in South Dakota.
This is Trento. According to Luca, all people from Trento are assholes (as are all people from Brescia and all people from Vicenza). People from Verona are just crazy.
Luca is so cute.
And lastly, because I haven't posted a picture of Miss. Ferocious in a while, here's one of the Boo from a few months back. Normally she likes to lie UNDER my legs on the couch. She is in the kennel at Central Bark now and we miss her. :-(
Monday, September 05, 2011
Medicine: A good career for a woman?
One of my biggest pet peeves is when people tell me that it's wonderful that I chose to go to medical school because being a doctor is such a great career..... for a woman.
And I hear it all the f-ing time!
We all know what this means: I can pick a "family friendly" specialty and go "part time" when I have kids. Unlike in a lot of other careers. And! If I pick something like Anesthesiology, I will work shifts, and be able to be home at a predictable time every day! Which will enable me to prepare dinner and tuck my children and husband into bed. Because we all know that's the most important thing to keep in mind -- FOR A WOMAN -- when she chooses her career.
I might even make enough money for it to be worth my while to keep working. Then I can even contribute to my children's college tuition in the future. Now there's a novel concept!
It makes me snicker. I'm going to be a physician scientist, which is most definitely NOT "family friendly" though most people have no idea what this is. The hours are horrible AND the pay is low (for a doctor), and you have very little job security. True though, you can leave in the middle of the day to pick up your kids.... but then you can go right back to work when you get home.
30, 40, 50 years ago women were told that nursing was a good career "for a woman" because she could take care of other people (at work too!), take orders from men, and hopefully meet a doctor who would marry her. Then she could do as God intended and quit her job and stay home with the kids. Teaching offered similar promise, only without the same opportunities to meet a high earning husband. A woman could also be a secretary or flight attendant. Woo!
It's also the implication that I'm only working to support my family, not because I have any passion for what I do, and that my true calling (as a woman) is to have kids and spend as much time with them as possible. If I don't realize that having children will be my true passion, I will, don't worry. And that if I have any passion for my job, when I have kids I will give all of that up because that is more important than anything else. For me though. Not my husband. Because *I* am a woman.
It's sexist. It implies I am not serious about what I do, and that my career is not important. It implies that having babies is (or should be) more important for me (as a woman) than anything else ever could be.
Look, there's nothing wrong with wanting career stability, a good salary, and not horrible working hours. There's also nothing wrong with having kids and wanting to see them, or even with being a SAHM. It's also not unreasonable to find out about different career trajectories that you can take once you become a doctor.
However none of those reasons are why ANYONE (including men) should choose to go to medical school.
You should go to medical school because you can't see yourself doing anything else besides being a doctor.
Then if you decide you want to work less later on, do that. Because working less than 60 - 70 hours a week is a laudable goal for ANYONE. But don't go into it with the plan that it's a great career for a woman *because* you can go part time later to take care of the kids.
I just really want to stop hearing that phrase -- "Medicine is a great career for a woman." It cheapens what I'm doing. It's a great career PERIOD. For ME. Because I am a PERSON who loves science and research and patients.
And I hear it all the f-ing time!
We all know what this means: I can pick a "family friendly" specialty and go "part time" when I have kids. Unlike in a lot of other careers. And! If I pick something like Anesthesiology, I will work shifts, and be able to be home at a predictable time every day! Which will enable me to prepare dinner and tuck my children and husband into bed. Because we all know that's the most important thing to keep in mind -- FOR A WOMAN -- when she chooses her career.
I might even make enough money for it to be worth my while to keep working. Then I can even contribute to my children's college tuition in the future. Now there's a novel concept!
It makes me snicker. I'm going to be a physician scientist, which is most definitely NOT "family friendly" though most people have no idea what this is. The hours are horrible AND the pay is low (for a doctor), and you have very little job security. True though, you can leave in the middle of the day to pick up your kids.... but then you can go right back to work when you get home.
30, 40, 50 years ago women were told that nursing was a good career "for a woman" because she could take care of other people (at work too!), take orders from men, and hopefully meet a doctor who would marry her. Then she could do as God intended and quit her job and stay home with the kids. Teaching offered similar promise, only without the same opportunities to meet a high earning husband. A woman could also be a secretary or flight attendant. Woo!
It's also the implication that I'm only working to support my family, not because I have any passion for what I do, and that my true calling (as a woman) is to have kids and spend as much time with them as possible. If I don't realize that having children will be my true passion, I will, don't worry. And that if I have any passion for my job, when I have kids I will give all of that up because that is more important than anything else. For me though. Not my husband. Because *I* am a woman.
It's sexist. It implies I am not serious about what I do, and that my career is not important. It implies that having babies is (or should be) more important for me (as a woman) than anything else ever could be.
Look, there's nothing wrong with wanting career stability, a good salary, and not horrible working hours. There's also nothing wrong with having kids and wanting to see them, or even with being a SAHM. It's also not unreasonable to find out about different career trajectories that you can take once you become a doctor.
However none of those reasons are why ANYONE (including men) should choose to go to medical school.
You should go to medical school because you can't see yourself doing anything else besides being a doctor.
Then if you decide you want to work less later on, do that. Because working less than 60 - 70 hours a week is a laudable goal for ANYONE. But don't go into it with the plan that it's a great career for a woman *because* you can go part time later to take care of the kids.
I just really want to stop hearing that phrase -- "Medicine is a great career for a woman." It cheapens what I'm doing. It's a great career PERIOD. For ME. Because I am a PERSON who loves science and research and patients.
Saturday, September 03, 2011
Marriage
I was at a wedding last weekend. While I was there I got to talk with several friends of the bride. They were mostly 24 or 25 years old, just starting out in their careers, and are bright and attractive young women with promising futures.
The thing is, many of them didn't see it this way because they weren't a) already married, or b) in a serious relationship.
In the same vein, I find myself often receiving emails about whether or not someone should put off medical school because they might not find a husband.
Look. I understand how much it can suck to be alone. How lonely you can get and how desperate things can feel. How destructive it is when men when you dump tell you what a picky bitch you are and that should feel lucky to have them grace your presence, and how when they dump you tell you everything about yourself that you should fix because you are that unattractive a person.
It all makes me very sad. Sad because these women have so much, but think that because they are single that they have so little.
I am very happy that I found my husband. I feel very fortunate. But he was WORTH THE WAIT. I can also tell you that I would be better off single than with someone not as awesome as he is.
The thing is, all you can control is yourself. You can't make other people like you. All you can do is make yourself the best person you can be. To follow your dreams. Yes, go on dates, meet lots of people, be nice to others, all that too. But the more confident you can be in yourself, the happier you will be. Ironically the happier and more confident you are, the more attractive others will find you.
And to answer a question I often get, when I started my post-bac I had not met Luca yet. We didn't start dating until a year or so after I started, when I was 27. It was clear from the beginning that he would follow me when I went to med school, not the other way around. It's not that his career is not important, it is VERY important, and he is very good at it. But my career is also very important to me, and I had a chance to get into a really great MD-PhD program that was exactly what I'd been working towards for years. Luca and I are a team and we work together to make things work for both of us. Maybe things will be harder for us in the future, but we will deal with that when the time comes.
There are a few messages I want to convey with this post:
1) You can't make other people like you. All you can do is make yourself the best you can be.
2) 25 is not old!! Neither is 30! Life can take all kinds of different paths, and you don't have to be married with three kids by age 35 to be a happy and fulfilled person. The happiest people seize the opportunities that present themselves and accept that life can be wonderful even if it doesn't turn out exactly as you planned.
3) You are not a failure if you do not get married and have kids. Even if your family is telling you otherwise.
4) If you become a doctor, you are likely to eventually have the means to support a family yourself, i.e. you won't need a man. You will be more free to choose the life you want rather than have someone else choose it for you.
The thing is, many of them didn't see it this way because they weren't a) already married, or b) in a serious relationship.
In the same vein, I find myself often receiving emails about whether or not someone should put off medical school because they might not find a husband.
Look. I understand how much it can suck to be alone. How lonely you can get and how desperate things can feel. How destructive it is when men when you dump tell you what a picky bitch you are and that should feel lucky to have them grace your presence, and how when they dump you tell you everything about yourself that you should fix because you are that unattractive a person.
It all makes me very sad. Sad because these women have so much, but think that because they are single that they have so little.
I am very happy that I found my husband. I feel very fortunate. But he was WORTH THE WAIT. I can also tell you that I would be better off single than with someone not as awesome as he is.
The thing is, all you can control is yourself. You can't make other people like you. All you can do is make yourself the best person you can be. To follow your dreams. Yes, go on dates, meet lots of people, be nice to others, all that too. But the more confident you can be in yourself, the happier you will be. Ironically the happier and more confident you are, the more attractive others will find you.
And to answer a question I often get, when I started my post-bac I had not met Luca yet. We didn't start dating until a year or so after I started, when I was 27. It was clear from the beginning that he would follow me when I went to med school, not the other way around. It's not that his career is not important, it is VERY important, and he is very good at it. But my career is also very important to me, and I had a chance to get into a really great MD-PhD program that was exactly what I'd been working towards for years. Luca and I are a team and we work together to make things work for both of us. Maybe things will be harder for us in the future, but we will deal with that when the time comes.
There are a few messages I want to convey with this post:
1) You can't make other people like you. All you can do is make yourself the best you can be.
2) 25 is not old!! Neither is 30! Life can take all kinds of different paths, and you don't have to be married with three kids by age 35 to be a happy and fulfilled person. The happiest people seize the opportunities that present themselves and accept that life can be wonderful even if it doesn't turn out exactly as you planned.
3) You are not a failure if you do not get married and have kids. Even if your family is telling you otherwise.
4) If you become a doctor, you are likely to eventually have the means to support a family yourself, i.e. you won't need a man. You will be more free to choose the life you want rather than have someone else choose it for you.
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