Intervention Study

In my TA class a few weeks ago, the other TA and I led a discussion of Epi in the News. I really like the concept behind this part of the class, since there are SO MANY PROBLEMS with the way clinical research is covered by the news, and I think it's great for the students to talk about the problems with various studies, and how they're presented by the media.

The challenge though, has been getting the students to think more like scientists, and less like activists. I mean, it's great that you have a political viewpoint, and this study happens to agree or conflict with it. Tell us more. But while you're at it, please also tell us some of the problems with the actual methods that were used in the study. Thanks.

Case in point. One student (who is an excellent student, I might add) presented NYT coverage of an intervention study aimed at reducing perinatal deaths in African American women in Pittsburgh. I think it was covered a few weeks ago. Anyway, the study found that perinatal deaths went down after the initiation of the program, and the article (at least how it was presented in class) turned into this piece on how horrible it is that funding for the program is getting cut.

Ok fine.....

So I tried really hard to get them to think of alternative explanations for why perinatal mortality went down following the initiation of this intervention, besides, "The intervention caused the decline."

To their credit, the students were able to come up with a couple on their own, for instance, what if the control group was systematically different than the people in the intervention group? I thought this was a great start.

Then I threw in:

What if perinatal deaths were declining in that population for reasons that had nothing to do with the intervention?

What if perinatal mortality rates jump around such that the decline observed was just random variation?

What if the patients who received the intervention were not the same ones that the perinatal death rates declined in (since the study was ecological)?

Anyway, I felt like a total social conservative in saying these things to the class, and I wonder what they thought of me telling them these things. But come ON!! We are trying to train them to be scientists here, not knee jerk liberals or conservatives. Go ahead, have your political agenda, but make sure you know how to critically read a research study while you're at it.

And for the record, I think the idea for these types of programs is really solid. It's just that I just want to see them studied in a rigorous fashion. How else will we ever get good enough data on which to base our public policy?

Loulou

One of my readers sent me this link.*

http://theanthropologist.net/#/PhillipToledano

It was too fantastic to keep to myself. My husband loved it.

Thanks for sending it my way!


*Blogger doesn't embed anymore, sorry. Not sure what's up with that. You'll have to cut and paste the link.

Last Night

Is graduate school the new "college?"

Last night, our grad student neighbors had a Halloween party. Hey, at least this time they were kind enough to tell us in advance and "invite" us, though we all knew the invitation was a token only.

And it was really ok.... until people started going home at about 1AM. At which point their front door slammed ever 2-3 minutes or so, hard enough to shake our house, and people would linger outside our bedroom window chatting it up until they finally walked away into the night. It kept us awake for over an hour despite the fact that we had the noise machine going at full blast and the windows were closed.

And then, at about 2AM the party came outside, and a group started chatting loudly right below our window. After about 15 minutes of this (we figured we'd give them the chance to disperse or go back inside before we said anything), I stuck my head out and told them if they didn't go back inside, I'd call the cops.

Which they did, thank god.

They probably think I'm a total bitch.

They don't know how lucky they are. If I were my neighbor from across the street, I would have just called the cops with no warning to them first.

But seriously guys, WTF. It was 2AM! This isn't college anymore! You live on a block with other people who have jobs, obligations, things to do on the weekends besides nurse a hangover! I don't think I acted like that past age 21 or so, and then at least I lived in a dorm where staying out late was quasi-expected. These "kids" are 26 or 27 years old!

(Luca was thinking he might start leaving out the front door in the morning at 5AM when he goes to work, slamming the door repeatedly, and trying to coerce the dog to poo in a loud voice, but I said that just putting the baby room next to theirs and leaving the window open when we stop sleeping with him/her in our room would probably be sufficient revenge.)

I guess I'd mind less if it didn't take me so long to fall back to sleep these days, and if I didn't feel completely knocked out by any sort of activity. Putting in the lilies DESTROYED me on Friday. I was so winded, and after I came inside I had to sit quietly for about 20 minutes before I could muster the energy to go upstairs and shower. Then I walked back and forth to school for a meeting, and promptly passed out on the couch at 6PM.

It's starting to become difficult to find a comfortable position when I sit on the couch, which is only going to get worse over the next three months. This makes me cranky. Pretty much any activity requiring physical exertion has been curtailed above the bare minimum I have to do to do my work. Luca and I want to go to NYC to see an art exhibition at the Guggenheim that starts 11/4, but all I can think of is all the walking I'd have to do, and how exhausted I would feel. We'll really have to think about whether it's worth going.

Welcome to trimester #3 I guess!

Revise and Resubmit

Good news! I got a revise and resubmit from the relatively competitive journal I submitted my manuscript to about a month ago.

I was worried I'd just get a rejection. This is much better. And also, most of the points that the reviewers raise are addressable, though they may not like how we ultimately address them.....

The bad news is that it means more work for me....

And I have a committee meeting next week.

And an abstract to submit today.

And another paper I'm in the process of finishing up the analyses for.

Ah well, at least I'm done with class. Then I'd really be up shit creek.

We also finally got the electrician to finish the job. Luca had to stay home from work and crack the whip a bit, but it's done. And I have to say, WHY does it take the man cracking the whip to get things done? I feel like if I'd done what he did or said what he said, it would have been construed as "hysterical" or "overreacting" and I would have been blown off anyway.

And he also got BR #3 taped and primed, and BRs #1+2 touched up and de-plastic-ed yesterday. So over the weekend, maybe we'll paint BR #3? Then of course we still have the basement, and the basement bath to do.... but at least the 2nd floor of the house will be reclaimed.

As a side note, I just discovered that we're supposed to get 3-5" of SNOW in the next 48 hours.... so I guess I'll be planting my lily bulbs this afternoon instead of doing "real" work, since it seems I won't be able to tomorrow or Sunday.... WTF, Philadelphia. SNOW???? It's still freaking October! This isn't Chicago!

Really good at.....?

Today during a meeting with some project team members, we started talking about things we were really good at. This came up because one person mentioned that she didn't think our biostatistician was actually bad at anything.

(I said she must be. Everyone is bad at something.)

My biostatistician is really really smart and awesome. Also, she is a world Sudoku champion.

We then tried to come up with things that we are really good at. I must say, it was easier to come up with things I was bad at. Here are my top five:

1. Knitting , Sewing , Crafts of any kind
2. Seeing dirt
3. Sitting still
4. Being zen
5. Keeping my mouth shut

My goal in life has been to avoid any job where #2 is important. I had one of those once. What a fiasco that was! #3 was a problem the first year and a half of med school, but fortunately that time has passed. #4 and #5 are ongoing battles. Throughout my clerkships I had an ongoing monologue with myself that consisted of me repeating, "Shut up shut up shut up. It doesn't matter. Don't say anything. Shut up." It helped to a degree. I will never be a zen person.

Now for things I am good at...

1. I have an excellent sense of direction
2. I am great at making lists and checking off boxes
3. Telling if a research question is interesting / worth pursuing / adequately substantiated
4. Remembering random shit
5. Imagining what other people feel

It turns out #2 and #4 are very useful for med school. #3 is useful for PhD-land. #1 is useful in life (but only when my husband lets me drive). #5 is probably useful in life, but is also NOT useful because it also means that I worry too much about what other people think of me.

Ah well.

Any interesting talents among my readers?

How people in science see each other

A friend posted this on facebook, and Luca and I thought it was too funny not to post here as well....

The mushrooming of tasks

Six weeks ago, when I told the MD-PhD department about my pregnancy, I was assured that I didn't have to do ANYTHING (their exact words) about my maternity leave. An email would get sent to the financial people who manage my grant, the NIH would be notified, and I didn't have to worry. Everything would be taken care of.

Of course, that's not how it's worked out. An email did indeed get sent to the financial person at that time, but as far as I can tell, she did nothing.

Anyway, a few weeks later, the MD-PhD head dude told me to email her to ask about whether I could get my grant extended if I needed to, and to also ask her about maternity leave.

Lo and behold. I received a response.

In fact my grant could be extended -- maybe -- and by 4 months at most. But, btw could I send an official notification to persons X, Y, and Z here and at the NIH to inform them about my maternity leave? Thanks.

So, I sent the email.

I received this email back from some person at the NIH I've never heard of:

"Please send an official notification countersigned by the authorized business official to Ms. Otherperson Lastname, the current Grants Management Specialist assigned to this grant."

Ooookkkkkaaaayyyyy.....

What the hell does that even mean?

So I emailed the financial person at my institution who told me that all I need to do is I put your email into a Word document, sign and send back to her. E-signature too will be fine on this document, if I have one (I don't). Like my NRSA it will then need to be signed by a university official (which they will take care of).

So. For the record: "You don't need to do anything," has been translated literally as:

1. Send official emails to various people at this institution and at the NIH (also, find out who these people that you need to send these emails to are).
2. Write a formal document requesting maternity leave.
3. Sign electronically (whatever that means -- FIGURE IT OUT!!)
4. And send the formal documentation to whoever else needs this too.
5. Follow up (because nobody ever does anything unless a fire is lit under their ass).

It's not that it's so much work really, it's just the aggravation of thinking (repeatedly) that you have killed a particular task, only to have it spring back up and spit green crap in your eye.

(Kind of like what's going on with the electrician.... who is going to have to come back AGAIN on Thursday. Need I say more. Fortunately this time my husband is going to stay home from work that day to take care of it, since I have several unmovable meetings scheduled for that day, roughly from 9AM-4:30PM, and the electrician has proven that he needs to be supervised 100% of the time.)

Ah well. At least my protocols are getting written.

The Hunger Games are like crack

I read the first book while I was in Italy. It took about 48 hours to finish the whole thing.* I started book 2 of the series yesterday. The only reason I didn't get farther than 1/3 of the way through was that I also helped a) paint a room, and b) ran a bunch of models for my project on the computer, which was time consuming.

I sent a document on basic linear regression coefficient interpretation to one the fellows who just started working for the group, and today he commented that I was obviously hard at work this weekend.

I know he means nothing by it, but I never know what to say to these things. This time I said, "Yeah, I'm kind of always doing work these days..." which is true. Because I want to get as much done as possible before the arrival of the offspring so that I can actually graduate on time, (and also have a house that is not simultaneously leaking and falling apart).

One of the other fellows then commented -- good naturedly, "Haven't found that good work-life balance yet, huh?" (She was an anesthesiology fellow... interesting that I'd get a work life balance comment from her, right? I know, food for thought...)

And the answer to that is..... no ma'am, no work-life balance here! Not right now, anyway. See, I've found lately that if I work semi-constantly, I am able to get a prodigious amount done. And it's INTOXICATING. This phase of my life won't last forever, that I know. But while I'm still able to I feel like I ought to take advantage.



*I was very proud of this until I found out that it's technically classified as "Young Adult" fiction. Oh well.

Painted!

Does this look like a color that would only be appropriate for a boy's room to you?



See, I thought it was fairly gender neutral. And more importantly it looked nicest in the room we're painting this weekend out of all the other colors we looked at.

But several people have seen the color and said, "Oh, you must be having a boy." One woman even went so far as to accuse me of lying when I told her we didn't know the gender.

What's with these wacky people? It's not like I'm painting the room Thomas the Train blue and putting pictures of cars, footballs, and construction equipment on the walls. Besides that, cotton candy pink just seems like a silly, unattractive color to paint a room. Not that I would *never* do it (if I had a child who wanted a pink room, I suppose I would relent), but why would I do that by choice?

I have to wonder whether these people think that a baby girl who sleeps in a blue room will end up horribly "confused" and possibly GAY (oh no not that!!). One can only imagine the disapproval I would face had I chosen to paint the room pink, and ended up with a son.

Anyway, I had no idea that this was such a contentious issue. So weird.

Limp

The Boo is still limping, and now her toe is swollen too, so Luca is taking her to the vet this morning. Can I tell you how much it pains me to see her gimping around the house??

We couldn't get an appt at the ghetto vet we usually go to this AM, so Luca is taking her to the bougie vet in Ardmore that has the obnoxious staff. I think I've blogged bitching about them before, so I won't burden you with the details, but suffice to say that you do NOT win points with me by:

a) telling me that I MUST get a BP check done NOW on my dog for her new med
b) charging me $60 for it (just the BP check, not the visit -- that was $200)
c) refusing to give me the results in person -- or to even call me with them after a week
d) giving me attitude on the phone when I follow up myself for the results
and e) telling me that "doctor's offices work this way too" (they don't)

... to which I replied, "Yeah? Well I AM a doctor, and no office I've ever worked in has ever operated this way...." which kind of felt like heresy since I am still a mere med student. Therefore I vowed never to go back.

So we never did. Though we never really found an acceptable alternative from either there or the ghetto vet that have her doggie papilloma virus in her ear.

Anyway, Luca is taking her, and will report back when he's done. I figure it's good practice for when he has to take the offspring to the pediatrician because I will be at work (constantly).

In other news, we are painting today!! Progress is being made!

So, since I use this blog to complain about my life so much, I thought I'd list some GOOD things that are happening in my life.

1. My father read my post about them not visiting, and emailed me and APOLOGIZED. Now he and my mom are coming for lunch one day of their trip!! I am really excited to see them.

2. My work, though I have tons of it, is going really well. Lots is getting done, of course never quickly enough.... but let's not be picky.

3. I still haven't heard back from the Blue journal where I submitted my manuscript almost 4 weeks ago. So either they lost it, or they've decided to send it out for review. It could still get rejected, but at least it wouldn't be an OUTRIGHT rejection.

4. Things are slowly but surely getting accomplished around the house, therefore proving that stressing, ripping one's hair out, and being very very proactive CAN actually result in work getting accomplished. In fact, I'm not sure there's any other way.

5. It's FALL!! My favorite season. It's finally nice and cool out, and I sleep so much more soundly. The Boo has been coming up on the bed every morning after Luca leaves and curling up under the blankets with me. She's so CUTE!! And I know she just does it because she's cold/ because she owns me, but it makes me feel loved. Even when she beats me in the face with her tail.

6. Luca's job has calmed down -- he really likes his new boss. Can I tell you how much this has improved his mood?

7. The day lilies that I planted a few weeks ago are doing great.

8. The little kicker has been kicking up a storm, which can be *mildly* annoying when one is trying to go to sleep, but is mostly just really awesomely cool, and makes me feel all warm and fuzzy when he/she does it. He/she had the hiccups the other morning, so my entire abdomen shook. And so far so good with my health, and the baby's health this pregnancy (knock on wood). I told my NP yesterday how fortunate I felt that things had gone so smoothly thus far (knock on wood).

9. I am over 1/2 done with the grading I have to do this semester in my TA-ship. Though it still makes me cringe when I have to mark down certain students since I know they will complain to me about how unfair I am being (dear God I HATE that), and that I should give them back points, at least I know that I only have 1-2 assignments left to grade.

10. You all have been so supportive of me these past few weeks, and I really do appreciate your kind words and your advice. It really has been immensely helpful to me.

You know you're old when

The prospect of getting a new (usable) toilet in the basement excites you.

The plumber will be here in 30-60 minutes. Hopefully this will go more smoothly than the electrician did. Still waiting to hear back from him, but I'm not THAT worried since we are withholding $3000* until he fixes the problem.



PS -- I weighed myself again this morning and was 139.6 -- 1.2 lbs more than yesterday morning. Uh oh I'm in trouble now. That's a total of 4.5 lbs this past month!!!** And I will get weighed in the afternoon (after eating) with clothes on, so it will probably be worse on their scale. I'm definitely getting a lecture.

PPS -- Good news: only up 3 lbs from the last visit! No anemia! And no lectures! Woo! Also, the roofer AND electrician say they'll come on Monday. Now all we have to do is make sure Miss. Boo's toenail doesn't get infected (did I mention she partially tore one on her front paw at its base) and we will be golden. Hopefully the fact that my default insurance somehow got erroneously "switched" to the shitty student health insurance rather than my husband's good insurance won't result in a huge bill for the lab work I got yesterday, but I am not optimistic..... Nothing to do on that one I guess but wait and see.



*Welcome to the joys of homeownership where what you consider "expensive" now has three zeros rather than two.
**This is meant to be sarcastic

Dear God

Why can nothing ever go smoothly?

Yesterday the electrician finally finished the work on the house. After he left, Luca and I went around testing outlets to make sure they all worked and that they were all grounded.

It turned out that three of the four new outlets that were all supposed to be on a new circuit were not grounded, which I'm guessing means either they "forgot" to do the work, or f-ed it up. So I contacted the electrician and reported the problem.

Of course he tried to tell me that the outlets only APPEARED old, but in fact they were on a new circuit.

Then I told him that they weren't grounded and he said, "Oh."

Fortunately, we have not paid him yet, so he at least has an incentive to come back and fix the problem.

Unfortunately, it means that I have to work from home another day next week.

Argh!! Why can nothing ever go smoothly????

Anyway, I'm not THAT upset because I wasn't expecting things to work the first time, so jaded I have become about hiring people to work on the house.

In other news I had my 15th syphilis test for this pregnancy. Oh and also my GCT. It wasn't so bad, really. I did avoid eating anything at all before the test even though technically the test does not have to be done fasting since if I'm going to fail and have to take the GTT, I don't want it to be because I ate cereal for breakfast that morning. That would be truly annoying.

I'm trying to imagine a worse fate than having gestational diabetes and having the NPs even farther up my ass each time I visit them about my food intake, but at the moment I'm at a loss. For the record, I have gained 3.3 lbs since my last visit 4 weeks ago, so they can go and suck it. For now anyway.

Picking Baby Names

Picking a name for our bundle of joy has been a challenge! On one hand, you want to pick something somewhat unique. On the other, you don't want something completely wacky that will get the kid made fun of or that you will regret two years later.

Then there's also public opinion. My friend was telling me that she and her husband asked their friends what they thought of various names, and every single one, some friend had an issue with it. Ultimately they had to stop asking because they started feeling bad about all the names they liked.

Luca and I opted NOT to go down that road. I am well aware that some people may think our baby's name is stupid, but at least after the kid is born and the ink is dry on the birth certificate, most people have the tact to keep their mouths shut. Hence, we are telling nobody before the big day.

I will disclose this:
We are doing 4 names (I have 4 names too, so think twice before you mock).
The last name is Luca's last name.
The second to last name is my last name.
And, we have two candidate complete names for girls.

But oh man, the boy names are so hard to come up with! We found one we liked the other day that seemed like the perfect combination of manly yet sensitive, and we wikipedia-ed it? Turns out it's the name of some hell demon who, "Teaches those whom he favors to kill their enemies, masters and servants. He stirs up trouble and dissension."

Clearly this will not work. (Though I have to admit the part about stirring up trouble and dissent sounded a bit like me.... heh.)

Then we found another one we liked, and noticed that it has become increasingly popular over the last 5 years (don't worry, I would never name my child Aiden), and we worry it might break the top 20 this year, so we (I) nixed it.

Of course there are always family names.... but I just don't like most of those names, and the rest are really generic. Though Luca and I joked that we could name the offspring "Daniel Robert" after an ancestor of mine. He went by D.R. How many rude comments do you think THAT moniker would get, given my profession.

Ha.

So we continue to search for the perfect name. I'm hoping that we come up with something soon, because I'm starting to worry.

My electrician commutes in from Reading to work on my house in Philadelphia on a daily basis

Which is another reason I can't fathom why my parents feel it's, "too out of the way," to stop in Philadelphia for lunch/overnight on their vacation. Since they're spending a day in Reading on the way back from NC to CT. Since they'll most likely have to drive through King of Prussia anyway to get back to CT.

My parents' excuses:
1. Well, I didn't get to see Daniel Boone's place of birth on last year's vacation (when they also did not visit, even though they were invited), and I really wanted to this year.

Wait, seeing the house that Daniel Boone was born in is more important than seeing your pregnant daughter? Who will not be pregnant forever (unlike the house which will still be there next year)?

2. My parents weren't at all interested in MY pregnancy.

Nice.

3. Your father doesn't want to miss church on Sunday.

Wait, you're not willing to miss ONE SUNDAY to see your pregnant daughter? You do know they have churches in Philadelphia too, right?

4. We don't want to impose on you.

Um, didn't I just INVITE you?

5. You're completely irrational.

You're not helping your case here.

6. We're too busy.

You are RETIRED. You have nowhere else to be that weekend (except church).

7. I don't know what's wrong with you. It is completely unreasonable to be upset about this.

Again, this doesn't do much for your case.

I also pointed out that NORMAL parents would be thrilled that their offspring had invited them to visit. Because most parents actually wish they saw their kids more than 3 days per year.

So, for the record:
A) My parents don't give a shit about me or my pregnancy.
B) Well, if they do, it's less than they give a shit about church or Daniel Boone's place of birth.
C) It is "irrational" and "selfish" of me to be upset about them blowing me off (repeatedly) because -- since it's not important to THEM that they see me, it shouldn't be important to me either.

Being afraid that others will be annoyed with me

Yesterday the other TA asked me at 8:15AM whether I could cover for her 9AM office hours. I was at home waiting for the electrician to arrive, and honestly? Even if I had been at school, it would have been a giant time suck for me. So I said no.

Then I felt irritated at her for asking me to cover for her. Actually, I'm still a little annoyed. I think it's that I feel anxious about not being able to say yes, and thereby making HER annoyed with ME. As in OMDG, you are SO INFLEXIBLE!! Come on, haven't we all heard that line when we say no to people before? Even if their requests are completely last minute and/or outlandish?

And then today a student emailed me to find out if she could just swing by my office hours -- an hour and a half before they started. First off, I don't have an "office." Office hours are held in this little alcove outside the prof's office. Second, NO! I don't have time to just hang out all day answering questions from drop-ins. Sheesh! If it's so important, can't you email us?

So again I was annoyed. This time because -- what if the professor decides that I'm being inflexible and is annoyed with me. Because if you really want to know, yeah, I could come to school early and sit there and wait all day for students to show up. I don't have an actual conflict with her request in the form of another meeting. It's just I won't get anything else done today if I do that.

I think being afraid that others will be annoyed with me (and will talk about me behind my back or evaluate me poorly) is one of the main reasons I don't ask for favors myself, and I think I really need to get over this. Who really cares if someone else is annoyed at me for asking? Just like, who really cares if someone else is irrationally annoyed at me for saying no?

I have to protect my time as much as anyone else, and why is my time less important than the other TAs? You don't get points for being Mrs. Nice Lady if you're helping out other people so much you can't do as good as job on your own work. Plus, if you always say yes, then people learn that they can get what they want by asking you, so the requests actually increase. This was one of the lessons conveyed at the failure panel last year, and wow -- SO USEFUL.

Big day around the house

Yesterday I worked on school stuff all morning and until about 2:30. I'd wanted Luca to start on some house projects, but instead he lay on the couch watching videos. Around 2:30 this started making me really cranky, so I began nagging him to action.

And we actually made some real progress in the form of actual decisions!

1. We decided that since our basement toilet is hopelessly old and lacks a water shutoff valve, we would just hire the plumber to replace it. We were quoted $275 for both the toilet and the labor for this, which isn't that bad all things considered. We KNOW that it's "easy," but all the instructions we've been able to find on this start with, "Turn off water to toilet using shut off valve," and sometimes it's easier to make things someone else's problem rather than do them yourself. Then when the plumber's here, we can ask him about a quote for replacing the sink in there as well.

2. We decided what electrical work we wanted to have done. This was huge. The crew is coming Monday (minus the main electrician since he is recovering from getting cardiac stents placed last week -- yikes!), and I know NOTHING about electricity. We decided that 1/2 the job needed to happen now, and 1/2 could wait until a later date. This saves us between $2400-$3000 now, which we will probably have to spend later.... but it's not urgent.

3. We decided to take the Boo to daycare on Tuesday and Wednesday so that she wouldn't get in the way when the electricians are working upstairs. You have no idea how much better this makes me feel, since I'm going to have to be out of the house for several hours both days.

4. We decided NOT to cover the popcorn ceilings. Upon closer inspection the ceilings in the BRs look ok and are not peeling. Only the ceiling in the hall really needs to be replaced, and we can do that later. This means that we will not have to undertake the massive and horrible project of moving all the furniture out of those rooms to the basement and then back again.

5. As a result of 4, we decided to go ahead and paint the guest BRs. We FINALLY hung paint swatches, and picked out SEVEN colors. None of them were quite right, so we made a second trip to Home Depot and picked out three more. And.... I think we may have a winner! Though we still need to see what the colors look like midday just to make sure.

6. We also picked out paint colors for the basement.

7. And decided to nix the idea of new baseboard for the basement, at least for the time being, since the current baseboard appears to be glued to the wall rather than nailed, and I don't want to deal with replastering if chunks of wall come off during its removal. We can tackle that later if necessary.

8. We also decided in the basement bath to put new flooring OVER the existing floor rather than to remove the old floor. I think the effect should still look decent.

9. And we decided on the type of cabinet we want to put in the breakfast room, and not only that, but where we want to put the wire rack that it will be replacing.

Woo!

On top of that, I (almost) finished creating my "final" models for my icu length of stay variables. I just need to add one more variable that I removed from my dataset a year ago because I wasn't using it.... but that my PI all of a sudden re-decided was important.

AND I read through the protocol for the second aim of my dissertation, and it is beginning to suck less. The intro/background still needs work, but that's the sort of thing that develops over time.

Hallelujah!

Today we're taking the dog for a walk, and doing the monthly epic trip to the grocery stores in the suburbs where we stock up on staples. Then we'll pick out final paint colors and buy paint, so we can paint next weekend. I hope to get my hospital LOS models built today too. Wish me luck on getting it all to happen!

As a side note, I had a moderately irritating conversation with my dad wherein I told him that while we could come to visit for Thanksgiving, Xmas was more or less out of the question. They live in rural CT about 5 hours away, and the nearest hospital (30 min from their house) sucks ass and I'm not sure it has an inpatient Ob department. He couldn't understand why. Hello! I will be 36 weeks pregnant over Xmas! That's why! (Thank you mom for backing me up on this one.)

Anyway, he then told me that they could come Xmas day but NOT Xmas eve because (god forbid) they would have to miss their church Xmas concert. Now, I know church is very important to my dad (not for religious reasons mind you, it's just he can't handle any mild perturbation in his routine), but I'm not really interested in celebrating Xmas at 5PM on Xmas day, and I'd think that missing that concert ONE TIME in 34 years would not be too much to ask. But apparently it is, so they will now not be coming at all. Frankly, it's not that we *can't* have them the following week, though we probably will be working and it would be more difficult for us. It's more the principle. I.e. that my father's church concert should not be more important than the family being together on Xmas.

Why having a dog walker has made me wary about hiring an in home babysitter

When we got the Boo two years ago, we knew that on some days we'd have to leave her at home alone in the house, and hire a dog walker to do a noon-ish walk.

So that's what we did. We hired this dog walker based on the recommendation of our next door neighbor. And it turns out she is good friends with a friend of a friend of our other neighbor as well.

And you know something? She is a total flake. But the problem is, I'm not sure I'm going to be able to do better since a) all the dog walkers in the area appear to know each other, and b) I know one of the other walkers and actively dislike her and believe her to be incompetent (she goes to the dog park).

So what's the problem? About once every 2 months she f-s something up. Something kind of important. Allow me to list these things here:

1. She locked herself out of the house during a walk. Then she called me at work and demanded I come home right away so she could be let in. When I said I couldn't since I was in a meeting, she acted pissy towards ME. Yes, she offered to comp me for that walk, but I worried that if I took her up on the offer, she'd treat my dog worse. This fear has been borne out in other situations.

2. She has failed to come at least 5 times that she has been scheduled in the past 18 months because of a scheduling SNAFU. The dog then has to hold her pee for 10 hours. Not the BIGGEST deal in the world, but also not great either.

3. She lost my keys, offered to comp me for replacing the locks on my house, but then said that she didn't see what the big deal was since my keys didn't have our address tag on them (they did when we gave them to her, so I don't really believe her). I took her up on the offer to comp me since replacing my locks cost $150. We put that amount towards future walks. However, walks are supposed to be at least 30 minutes, and we noticed during the time when she wasn't getting paid by us that she didn't even bother to lie to us about giving the dog 30 minutes (which we assume that she normally does). She went right ahead and wrote down 15-25 minutes for each walk during that time. Fortunately this ended once the $150 was comped, but it seemed pretty unprofessional of her.

4. She lost her phone with all of her customer information in it, including our address and alarm code. No apologies given. It was just assumed that everything would be fine, and that we'd give her our contact info again, no questions asked, since she didn't have this information backed up anywhere.

5. Even though we've given her our alarm code repeatedly, she doesn't seem to be able to handle turning it off when we set it. This has resulted in 4 visits by the police in the past 18 months, with a $75 fine each time. Not to mention the frantic phone calls to me and Luca freaking out and requesting the code when this happens. Luca had to come home twice from work because of calls from the security company.

6. Last week, I didn't see a note so I assumed that she'd forgotten to come again. I sent her an email to that effect, and she *insisted* that she'd been there and left a note. It just wasn't on a new page like it usually was since she's trying to save paper (for the environment!). I checked the next day, and lo! There was a note, but I have no idea whether she just wrote a note during the following visit to cover her ass.

7. And that same day, she failed to lock my door when she left. I have no idea whether this was retribution or incompetence.

8. Even though Miss. Boo chases cats and we've told her not to let Boo near them, she continues to think it's cute. Two weeks ago, Boo got scratched on the nose, and it's bad enough that she may end up with a scar.

9. She continues to allow Boo to play with other dogs on her visits even though we've told her not to (liability concerns). At first it seemed like it would be an ok idea, but now I am worried that we'll get sued if something bad happens because she has not exercised good judgement.

So. Our dog walker sucks big time. And even if a babysitter was 1/4th the flake our dog walker is, that would still be too much. In some ways, while I don't like the idea of daycare for little babies because of the germs, at least you know that if they are licensed that they are inspected by outside people every so often, and at least there are regulations they're SUPPOSED to follow. Plus, there are some really good daycares out there.

I do know that there are some excellent babysitters as well, but how on earth do you find one? And they cost so much money! It's totally insane. I feel like we're likely to have to go through several before we find one that we like, and between each one we would have to go through the hiring process over again, which would be stressful. And God, if we ended up with one like our dog walker.... just shoot me now.

Anyway, those are my thoughts.

Failure Panel

Last year, for the women's MD-PhD organization, I helped organize this talk that we nicknamed "The Failure Panel." It was held in early January. It was supposed to be where successful physician scientists told us how they had overcome adversity and dark times during their careers, and had ultimately triumphed by doing XYZ.

Unfortunately, none of our panelists would admit to having had so much as a single setback. Perhaps we didn't phrase the question well enough, perhaps people just aren't comfortable discussing these things in front of strangers, or perhaps our panelists were actually perfect human beings. However despite this, the panel was very well attended and a big success.

This year, our organization has new leaders. The former leaders tried really really hard to get me to head the group this year, but I felt that given my impending "life changes" (so to speak) this was not going to be the best year to undertake more extracurricular leadership positions. So other people were eventually coerced into doing this. I also mentioned that I didn't think I'd be able to help with the event this year for a variety of reasons. I didn't actually say the word "pregnancy" though, so perhaps what happened next was really my bad.

Yesterday I got an email requesting the following, "OMDG! We're planning on holding the failure panel again this year on January 10th and were hoping you could organize the event!!"

Um, no.

I replied that I could not, seeing as I had my oral candidacy exam scheduled for the week before, and I planned to be giving birth right around that time (I believe January 10th will be week 38 for me). But I gave them the names of the people I'd contacted in my department the year before to see if they wanted to be panelists this year.

I kind of expected a response.

I got crickets.

Maybe she thought that "giving birth" was a euphemism for something else?

Anyway. I thought it was kind of funny.

As a side note, when I was in Target last week, I noticed that the aisle containing the breast pumps was labelled the "natural feeding" aisle. I guess the word breast is considered too PG-13 for the Target audience? Oh Target.

Shirt

I have made the transition to maternity jeans.... but many of my old t-shirts still fit. Well, actually just the ones I got at Target in the pajama section.

But I have to ask, why does EVERY SINGLE SHIRT marked "maternity" have a plunging neckline? Really? Does the entire world need to see my cleavage?

As if being obviously pregnant weren't enough to keep one from being taken seriously....

And also, some not terrible useful advice from my mother yesterday:
Her: You seem very stressed out.
Me: I wouldn't say I'm more stressed out than usual....
Her: It's not good for the baby for you to be so stressed out.
Me: That's not especially helpful mom.
Her: I was HAPPY when I was pregnant with YOU.
Me: Uh huh, sure you were.
Her: I was. Really!
Me (to self): You were working 80 hours a week as an investment banker when you were pregnant with me. Do not try to tell me that you weren't stressed out. Also, you smoked your entire pregnancy. I really think you need to shut up now.
Me (out loud): I'm not unhappy. This is not a contest.

OMG I need to work harder!

She types as she should be writing her protocol.

I went to on my first daycare center interview today removing from my life most of the morning. I really liked the place, though I think we'd have to get a second car if we got in since it is three miles away from my house, and there's no super convenient public transportation way to get there. The bus + mile walk today took 45 min this morning, which is ok, but not good enough for a place that's only three miles away! And would probably take longer with offspring in tow + gear.

Of course it's the most expensive place on my list. But! They have 1% turnover(!!!!) and my next door neighbor is a former board member who assures me that it is the best daycare in Philadelphia. And I really like and respect her. Plus, it's not [my institution] affiliated, which I consider a bit of a plus. I don't know.... all of the doctors I know who use [my institution] daycare seem thrilled about the hierarchy and structure at those programs (which, they're doctors -- is this really surprising?), but I suspect my parenting philosophy will be a little more laid back. I dunno, we'll see.

(As a side note, I was completely flabbergasted that two of the other applicants had young infants, and were expecting to apply and get into a daycare within A WEEK OR TWO????? One said her in-laws were leaving next week -- not unexpectedly, mind you, and the other one was going back to work in like two weeks and hadn't applied anywhere yet. There was one other pregnant woman on the tour, but I was honestly surprised that the "norm" seems to be people who put this off until the last possible moment. I guess I shouldn't be surprised.... since that's all I've seen so far. What's up with this phenomenon? Are people just in denial about the need to hand off the childcare to someone else so you can go back to work? Or in denial in general about having to return to work?)

Anyhow.

I was at our project team meeting right after that, which went really well actually. And I found myself thinking about all the different projects that one of the fellows was working on. And then thinking about how yes, I am working on a bunch of stuff too.... but I've been around 2 years longer than he has. And then thinking, oh shit, I should really step up my game if this is who I have to "compete" with.

Sigh. I think I'm supposed to feel this way. Self comparison is supposed to motivate me to work harder! But it really sucks, feeling like you constantly have to sprint in order to stay caught up. I've been very busy lately, but I just can't work late into the night, and over the weekends, well, because I have other shit to do. Like buy groceries. And make sure the electrician comes (who, btw just had a HEART ATTACK -- and he's a young guy too. WTF? Who's going to rewire my house now??). And walk the dog.

She says as she hits "Publish Post" and goes back to working on her protocol.

The Boo and The Pregnancy

Among all the other things that people now ask me, now that I'm pregnant, possibly the most entertaining for me and Luca are when people ask me how we're going to deal with the dog once the baby is born. She is a pit bull mix, and while a complete sweetie, we understand that a lot of people think all pits are vicious baby-eaters. Fortunately nobody has asked us if we're planning on getting rid of her. THAT taboo apparently exists. Thank God.

So I thought I'd post a couple of FAQs along with our typical responses.

Q: Does Boo know you're pregnant?
A: I don't know, let's ask her. Miss. Boo? Did you know Mommy is pregnant? Oh you didn't? Look at you playing dead for a treat. Sorry sweetie, Mommy doesn't have a treat...... I don't think she knows.

Q: Is Boo good with children?
A: Hahahahaha. No. She is terrible with children. Not in an attack-them kind of way, but she thinks children are dogs, in particular when they scream or move fast. Then she chases them, jumps up, or herds them.

Q: What are you going to do with the Boo when you have the baby?
A: Walk her? Actually, this is an excellent question. Since the baby is due in January, I expect the sidewalks will be impassible with a stroller for at least several weeks early on. So, we're on the lookout for impromptu dog walking help. I met one of my new neighbors the other day, who declared he was a dog person, so I may see if he's willing to exchange cash for walks.

Q: Are you going to keep doing agility with her?
A: No. We don't have time. We really like dog school for her, but we don't have the space to train at home, and it's a big time commitment to go every week. We may try a tricks class, since she seems to like that sort of thing.

Q: Are you going to take the baby to the dog park?
A: Hells No!! I get jumped on every time I go to that place, and it's just not a good idea. Maybe if Luca carried the baby, since he's 6'5 and out or jumping range, but otherwise no.

Q: Are you going to do anything to make the Boo feel more comfortable with the baby?
A: I don't know.... do you have any suggestions? I hear they sound like cats when they cry when they're first born, and this could be a problem (Boo chases cats like it's her job), so any thoughts readers might have on this subject would be most appreciated.

I'm sure there are others. Suggestions on introducing the dog to the baby would be most appreciated though!

Sleep

I've been having trouble sleeping lately, and last night was the worst it's been in a while. I woke up at about 1:30 and finally went back to sleep at about 4:30.

Now I know some of you are going to be unable to resist the impulse to comment something like the following, "When *I* was pregnant, I had insomnia too. Here, let me tell you all about it, and what you should do. WARM MILK!! HOT BATHS!! SOME OTHER BULLSHIT!! And while I'm being especially annoying, I'll throw in some charming tidbit about how the insomnia now is preparing you for later when 'the little one' arrives, and oh isn't life beautiful."

If you were thinking of leaving that comment, please take your annoying self to a real mommy blog. Because I'm getting ready to talk about WORK here, not babies.

The thing is, I actually don't think the insomnia has much to do with the physical discomforts of pregnancy than with the enormous amount of anxiety I've been experiencing lately. And no, this isn't anxiety about whether I will be a good mother (even though I'm not going to teach my child Italian) or how I'm going to cope with things once junior arrives.

It's more anxiety about being taken seriously at school and later on in life.

The thing is, this was a problem in my department before I became pregnant, it's just that it's become magnified now.

First, there is the fact that although my mentor was initially supportive of my pregnancy (hi mentor!), he has made a number of comments subsequent to learning about it that lead me to believe that he is highly concerned about my ability to graduate on time. Of course, he would never, ever, admit to this (if he did it would be because he is a wonderful CONCERNED person who CARES about me -- haha yeah right), but even though he hasn't used the actual word "pregnancy," he has used words like, "events that will transpire next January...." in the same way. Kind of like it used to be illegal to say "pregnant" on tv.

Then there are the other people in my department, virtually all of whom are 45-65 year old white men with stay at home wives. Prior to becoming pregnant, I was involved in conversations with several of them that went something like this:

We'll be talking about my research and then out of nowhere....
Them: OMDG, why do so many women FAIL out of academic medicine.
Me: I think many of them opt out (in my head.... because they don't want to deal with assholes like you, maybe?)
Them: They ALL HAVE BABIES during fellowship. I think you can determine whether or not a woman is going to seriously pursue a career in academic medicine by whether she does this.
Me: Maybe their priorities change. Anyway, I was saying about my research....
Them: As a woman, what do you think of this? Are you planning on becoming a breeder and failing out of academic medicine too? Are you going to waste your education, not to mention the department's money, getting a degree that you will do nothing with?
Me: I think I should leave now. Bye.

See previously, all they were able to see when they talked to me was a woman, not a future colleague. Now I'm just a pregnant woman, which is even worse.

Thus, whenever I run into one of these people now, I want to run away. Last Thursday before conference I saw one of them waiting for the elevator, and I rushed by and took the stairs before he could say anything to me so that I wouldn't have to talk to him. I almost passed out going up seven flights, but it was worth not being trapped in the elevator with him!

The week before, one faculty member was riding the elevator with me, and I swear he looked abdomen to face three times, asking expectantly me each time if "anything new" was going on in my life. I said that I'd taken my quals (2 months ago), and was waiting for them to be graded and skipped off the elevator. I have no desire to repeat that conversation.

It's fine really, while talking to my friends, or other people who I don't work with. But when I'm talking to the white male geezers in my department, I feel their thoughts about how I'm not serious about my career, and how I'm wasting the department's money* press down on me. It's like my belly is this big elephant in the room that they want to comment on, that they can't resist commenting on, and that I no longer have a brain to speak of.

The irony is that my work has never gone better. I just worry that it won't matter because everyone expects that I will drop off the face of the earth when I deliver, and even if I bust my ass extra hard and produce great work, it won't matter because everyone will EXPECT that my work will be meager and sucky, and that's what they'll see without looking instead.

Now I think I understand why a lot of women drop the academic medicine career path. It's not that they can't do it, it's that they're rolling the boulder up a mountain of expectations that they can't, and after a while they think, Fuck. This. Shit. I am busting my ass and doing this great work, and all anyone thinks about when they see me is that I am pregnant. Maybe I should just go and practice medicine. I'll make more money there anyway.


*If you want to get all technical about it, it's MY money, since you know, I got that grant to pay for myself.

Italy and the baby

When I was on "vacation" in Italy about a month ago (otherwise known as the trip from hell where I was forced to interact with relatives for several hours every single day), that was when the questions about how I was going to raise the baby started.

First were the questions about how much maternity leave I would get (practically none), to which most reacted with shock and horror. This didn't really bother me, since I'm used to such reactions when I tell them how many hours residents work, or how much vacation we get in a year.

Then were the questions about whether my family mother would be coming to help with the baby. Apparently, if you are a woman in Italy, one of the unspoken duties in life you must fulfill is to provide free childcare for your grandchildren. I can tell you that my mother would not have been into performing that function even if she hadn't had two craniotomies and could still walk decently. However rather than say that, I'd just say my mom was 70 and in no position to help care for my baby. Which is also true.

And of course there were the comments about whether *I* was going to quit my program since, well, obviously I had "more important" things to worry about now. This comment in particular irked me because it came from not an elderly relative, but a friend of Luca's with 2 kids himself whose wife had just finished telling us how she couldn't wait to go back to work since she hated being a SAHM.

This actually underscores a general irritation I have about Italy and my in-laws. They have NEVER been interested in my career or what I do for a living. They do NOT appreciate how hard I work, except in so far as they think I work too hard, am too stressed out, and (I'm assuming) should just give it all up to care for my husband and future offspring who are more important anyway. They ONLY ever talk about the work the various males in the family do. This includes my sister-in-law who a lawyer is about 1000x more career motivated than my brother-in-law. And it's always, "Poor [male person]! They work so hard!!!" That has always driven me a little nuts, and it's only going to get worse now.

Anyhow, I don't typically have to deal with this kind of bullshit in the US. Thank God. Instead in the U.S. I get the following questions:

"Are you going to give your child an Italian name?"
and
"Are you going to teach your child Italian?"
and
"Are you going to do cute Italian cultural things in your house?"

And the answer is.....

HELLS NO!!

First off, most Italian names for boys (other than Luca, of course) sound stupid in English. I'm sorry, I am not naming any son of mine Lorenzo, Fabio, or Maurizio. Some of the girl's names are pretty, but they're usually really frilly and girly, and really? I'm way more into the strong woman names. Big surprise, I know. We considered for a while doing an Americanized version of a couple relatives' names, but ultimately just didn't like the way the names sounded. The only criteria we have settled on is that they must be pronounceable by an Italian, which honestly I don't even care that much about since they have never been able to pronounce my name anyway.

Luca's ok with this because he doesn't want people to assume the kid is an immigrant from looking at his/her name. This is another fact that sometimes horrifies people. Not sure why it does, but it really shouldn't be that surprising that people sometimes treat him like shit because he has an accent, and he'd like to prevent such assumptions from being made about his offspring.

As for speaking Italian, I think we established a while ago that while I speak well enough to get by, it is far from easy for me to do. I would probably be harming my child's IQ if I chose to speak to him/her in Italian, in fact, since, aren't you supposed to speak to the kid in the language you're best at?

Anyhow, Luca's English is excellent, but if he wants to speak to the kid in Italian or northeastern dialect, he is free to do what he wants. I am not going to stress out about this. As for caring about whether my child grows up bilingual? I don't. I have no intention of sending him/her to baby language classes, and while there is a French immersion school in Philadelphia, I am pretty sure that Luca would veto that choice on principle.*

I might feel differently about this if Italian was even remotely a useful language.... but it's not. So there it is.

As for raising them in Italian culture, I've yet to see elements of "Italian culture" are so amazingly wonderful and unique to Italy that I must do them in my home as well. I have no intention of sending my offspring to swimming lessons in a full bathrobe for instance, serving primi and secondi for dinner, or avoiding peanut butter and barbeque sauce. I intend to keep using air conditioning in the summer, and am not going to buy a manual shift car. However, if the kid wants to play soccer, I won't say no.

The nice thing is that most people over here are just trying to make conversation when they ask me these things, and merely smile and nod at my responses (I try not to be antagonistic which probably helps). Occasionally I find a person who reacts with shock.... and I tuck that info into the back of my brain -- as in, "Psycho person just DOESN'T GET IT," -- for later reference.




*Italians hate French people. At the last world cup Luca didn't care how Italy did, as long as they beat the French. Which they did.

Crystal Ball

I love when policy researchers draw moronic conclusions from study results. There's a new study out that shows that 1/3 of medicare patients have surgery in the last year of life, and 1/10 have it in the last week.

They are arguing that we are too aggressive with these patients and we should be focusing on palliation instead.

Do you want to know why people who are going to die in a year or less have surgery? They have it because they are sick. And guess what, when you get old, you get sick, and you eventually die. It is often a long process with a sometimes uphill and sometimes downhill trajectory.

Here's the problem -- Nobody has a crystal ball. Do the doctors know the patient is going to die in a short amount of time? No. Many many studies have highlighted the difficulties in prognostication. Do the patients know they're going to die either? No.

Do we have data on the patients who received surgery but did NOT die? Well yes, but the authors didn't actually do that study. And anyway if you did do that study, you'd have confounding by indication -- i.e. sick people get surgery, and sick people are also more likely to die. Still, when you look only at the patients who died, you are severely biasing the way you'll end up interpreting your data.

And don't even get me started on the part about regional variation. There are many many reasons we can have regional variation in practice patterns including differences in the underlying population of patients and providers and differences in patient preferences. It doesn't necessarily mean that someone is screwing up, cheating the system, or performing unnecessary procedures.

Of COURSE some surgeries probably shouldn't be done and that don't ultimately end up benefiting the patient. Of COURSE some doctors (and patients and families) exercise unrealistic judgement. But to jump up and down and claim that we're torturing old people before they're about to die, and oh also we can save money by withholding care from this population who OBVIOUSLY did not benefit from surgery is short sighted and actually kinda stupid. That's how policies that limit care get implemented and you end up killing people who might have survived (with decent QOL) before. Do people really want that?

Anyway.

Flu Shot

I got my flu shot today -- Yay!!! One more thing on the to-do list crossed off. It's required for all employees at my institution now, which I think is absolutely fantastic. I hate the flu. God, what an unpleasant disease.

I found out though that a friend of mine who does not have direct patient contact (and is therefore not required to get it) who is pregnant does not plan to get her flu shot now or ever because of "concerns about vaccines in general."

I try to withhold judgement about people as much as I can since there are many things in life where being dogmatic is just silly. Vaccination is not one of those areas. Can I just say? When I find out people think this way, my opinion of them declines.

Appreciably.

Does she not know that pregnant women are one of those groups especially encouraged to get the vaccine? Apparently if she knows that, she doesn't think that means her.

Anyhow just more proof that having a PhD in one subject does not make you an expert in everything. Even though lots of people think it does.

In other news, you'll be happy to hear, dear readers, that my husband and I have decided to HIRE someone to help when I go back to school 8 weeks after my child is born. No more in-laws! We decided that they and we would be much happier with a social visit a couple of months later.

I feel so much more relaxed! I feel back to being excited and happy about my pregnancy! Aside from being pretty sleepy (which could be partly due to Fall as well as the pregnancy since I always feel sleepy this time of year), I feel great. And my projects are progressing well, at school and on the house. Yay! Thank you all for your suggestions about this. It has really meant a lot to me, and some of the advice has been really fantastic.

Now, if only I could convince everyone that a 1 week visit and a hotel would be optimal. We'd even pay for the hotel. This might be a tough sell though. We'll see. Wish me luck!

Babysitter

Luca and I talked last night. I think the primary thing that is stressing me out (besides the vast quantities of work I must accomplish and construction projects around the house that must be completed) is the idea that the in-laws are coming for a MONTH. The original idea was that they would come during weeks 8-12 so that I could start working on my dissertation again, and that would give us a cushion to find more permanent childcare.

The thing is, the last time they visited, I had to have a beer before I interacted with them every single day. Like medicine. Luca's hours at his job are even worse than they were then, and this time, I'm not going to have the option of hiding in my bedroom to avoid contact. Plus, they have proven time and again that they are not able to follow directions given by me without a) a lot of extra questions, or b) refusing to do what I ask, so I'm worried that their presence will fall into the "burdensome" category rather than the helpful one.

But what would we do instead? How do people find babysitters? So, I procrastinated spent about an hour on Craigslist, where my (really uptight) neighbor said she found her's to take a look. I figured if SHE could find someone acceptable there, perhaps I could too?

Well anyway, it's not just individuals that advertise there, but agencies. And I was duly relieved. Yes, I'd still have to screen and hire one. And yes, it would be expensive, but I WILL be able to find something. It may not be "ideal" (God knows what that even is), but as long as she doesn't shoot heroin in the house, or kidnap/abandon the baby, really? Well, let's just say that there are plenty of moms who aren't "ideal" either.

Anyway I was feeling better about this, so I talked to Luca, and you know what his response was? "I had babysitters growing up, and one was so awful. She drank juice directly out of the container without using a glass. Can you believe it??? My mother had to fire her." (Yet another reason why I don't want my MIL living here for a month....)

As he told me this, I removed my spoon from the ice cream container and backed away from it slowly (kidding, though not really).

Fortunately I was in the process of falling asleep when he let loose this particular gem, so I didn't have the opportunity to WTF this particular comment. That happened this morning, and he apologized.

In truth, MY first babysitter, though fabulous with me, was in debt to the loan shark. She also ate about $100 of food per week (that's 1977 dollars, folks) and sat out all of my parents' furniture.... but they were willing to live with that because she was so good with me. They did unfortunately have to let her go when they found out about the loan shark.

And THAT is a reasonable reason to fire a babysitter, not because they drink juice directly out of the container.

Anyway.

I also discovered that there was a daycare center in West Philly that did not have an 18 month waiting list. I asked a woman at school with kids about this and she told me that she had several friends who weren't happy with it.

Why? I wanted to know.

Well, apparently, her friends found the environment "insufficiently enriching" for a child. Now, I'm still not a parent yet, but really? Can someone please tell me what kind of "enrichment" an 2 month old baby needs? 'Cause I thought they basically didn't do much besides eat, sleep, and shit at that age. If the baby were at home, would I be playing it Mozart and showing it flashcards? No. They need to be held -- at least that was my understanding -- and as long as THAT happens, I'm not sure I care how enriching the environment is. I decided I'd have to take a look at it myself.

So, my big lessons of the day were:

1. Babysitters are plentiful (though finding a good one may take some work).
2. My husband has ideas about ideal childcare that apparently I cannot even live up to.
3. There are an awful lot of psychotic parents out there reading to their infants in Mandarin.

The Undulating Abdomen

Luca took this video... a week and a half ago I think? I think it's from week 22 anyway. If you can't see anything, the action starts right after I take the deep breath, just to the left of my navel. It's a little subtle on video, but not when you're trying to sleep at night!



For some reason the sound didn't come through when we compressed it, but it's probably better that way since we were watching tv at the time.

Thanks for all your kind comments on my last post, and your helpful suggestions. They really did make me feel a bit better. Still not sure about what I'm going to do about the in-laws and the basement though. I suppose if the house doesn't get fixed before that then they won't have a choice.

Hah.

Rant

Yesterday Luca and I went to see some friends of ours who had a baby 5 weeks ago. They are really great, and share a lot of the same values / concerns we have about offspring, and we like them a lot. They are also holding up remarkably well.

Still, I feel kind of like visiting them was a colossal mistake.

First, they have had a lot of help. They also told us that every bit of help, even the help from the not-favorite in-laws, was useful. I've been dreading having my in-laws come and stay with us from weeks 8-12, and every so often we think of asking them not to come. But now I realize that the wise choice is to suck it up and have them come. And the thought makes me want to vomit.

I hate having them in our house. HATE it. I hate having to whisper to Luca in my own bedroom. I hate having no privacy. I hate that they require constant attention. We've thought about fixing up the basement for them so that there will be some separation, but I know my MIL is going to have a shit-fit about being in the basement, no matter how nice we make it and will insist on being on the 2nd floor with us, of course within earshot at all times. I hate the fact that they think every time I yell at Luca that I am just a bitch, and poor poor Luca who has to put up with such a shrew. They can't understand me, and he's their baby, so of course he can't do any wrong.

Also, I became aware of how much it's going to suck to breastfeed. My friend was telling me about how you basically have to sit there doing nothing for at least 30 minutes, when all you want to do is go to sleep. Every 2 hours or so. I am not capable of sitting still for 30 minutes for ANY reason now. Please, can someone just pull out each fingernail one by one instead? Because that sounds preferable.

And then there is the deprivation of adult contact. When we called, they practically begged us to come over. We'd been worried that we'd be imposing, but that just wasn't the case. I think they were thrilled to be talking to someone other than relatives, their infant, or each other. I can't stand being in the house by myself for 24 hours. With an infant I see this stretching into days and weeks and MONTHS. And I KNOW none of my friends who are local are going to think to visit, and if they do they will feel awkward and put out that all we talk about is the baby. Most of them are in their mid-20s and not even close to thinking about kids, and just don't get it. I feel depressed just thinking of the sleep deprivation combined with essentially the elimination of adult social interaction from my life.

And then there are the expectations that school will place on me. I've had a bit of foreshadowing of this already. Last week my mentor FREAKED OUT at me when he found out that I wouldn't be permitted to finish my PhD after returning to med school in 2013. It was really fun to be on the receiving end of that one.

Suffice to say that despite the fact that there could very well be MANY other things beyond my control and inherent to the research process that may prevent me from graduating on time, this pregnancy/child is at the front of everyone's mind as the main reason. Of course.

Why did he freak out? Well, even though I've come up with funding sources for myself twice already, that will run out in 2013, and if I can't finish on time, my department will have to find another way to pay for me. Let me just say that while yes, my school is contractually obligated to cover my tuition and stipend for 10 years, that has not stopped them from making it MY problem to pay for myself. I'm kind of at the point where if they try to make it my problem again, I may just refuse to do anything about it. They will have to pay me regardless, and really, what are they going to do, kick me out of the program when I have 2 years left? That's not going to happen. Still, it's bound to be an unpleasant process.

And I'm sick of running into new people who I don't especially like or care about who want to ask me about my pregnancy. Last week there was this faculty member in the elevator with me whom I'm not especially close with or fond of who kept staring at my abdomen and asked me THREE TIMES over the span of 9 floors if there was "anything new" going on in my life. Seriously dude? F-off.

Then there's the fattie bullshit that that f-ing nurse practitioner brought up last week. I hate her. I've never been someone who has worried about her weight very much, and now I feel like I have to keep track of everything I put into my mouth. It makes me want to cry. I can't imagine being someone who has to struggle with this all the time. I think I would rather shove a pencil in my own eyeball repeatedly. It seriously takes all the joy out of food.

I hate exercising now. The eliptical trainer makes my feet go numb, and last Friday at the pool (staring notwithstanding) I almost ran into one of my professors -- one who I think is a total asshole -- while in my bathing suit. I really didn't want to talk to him while I was practically naked, especially since the conversation would have inevitably turned to my pregnancy (really, how could it not?). I would have imagined him talking with my mentor behind my back (since they are best buds) about how I'm going to ruin my career and must not be a very serious student, and how are they going to pay for me?

And I hate walking. Anything over a mile or so, my back starts to ache. It really sucks. And I have to walk 4-5 miles every day just to take care of the dog and walk to and from school. If the NP suggests more exercise on my next visit, I may well have to tell her to shove it up her ass.

Other reasons I hate the NP. Well, during my week 18 visit she told me I might start feeling the baby move in the next couple of weeks after I told her I'd felt it the previous week, and she nodded at me like an idiot. Then this visit, she told me I might start feeling it move more often, and I told her that it already moves all the time, especially at night, that my husband can feel it move if he puts his hand on my belly, and that we took a video of the undulations beneath my abdominal skin that it makes when it kicks. Her response, "Well, that's awfully early for all of that."

Really lady? Do you think I'm making this up? F. You.

She has totally sucked all of the joy out of being pregnant. And I wasn't even minding being pregnant before. I've been so lucky with my pregnancy! Why can't she just let me enjoy it?

So the positive side of visiting my friends and their baby was that I got to see Luca hold their baby. He seemed really interested in her, and good with her. I was much more interested in talking to the adults. He's excited about being a father, which is great!

But I also think that it's much easier to be excited about it when YOU aren't the one who leaks pee. Who is kept awake all night by the baby kicking. Who will have to do all the work with the baby. Who gets to leave the house during the day to talk to adults and get things accomplished, and gets to come home to (the horror) a diaper change or two. Who will get to sleep at night, since I will likely feel too guilty to make him do anything at night because I want him to be rested for his job so that he doesn't get laid off (and let me tell you, lay offs are happening left and right at his company -- of course).

I wish he could take the maternity leave and that *I* could go back to work. Sadly, unless we want to be without his salary, that just won't be possible. He keeps trying to tell me that it won't be so bad, and I keep telling him that he doesn't know what he's talking about. And my reasoning sounds a lot more plausible than his. Too bad, because I really wish he was right.

So basically, while previously I was able to put my concerns about what actually having a baby will be like in the back of my mind before, seeing my friends brought all of that to the front. I wish we hadn't seen them yesterday because now I am dreading this.