Ana posted a year in review over at her blog and I liked the idea so I decided to do the same here.
January -- Return from Christmas at my parents' house in CT. Find out I'm pregnant. Enjoy extra attention and affection showered on me from Luca. Get period a week later, and while I'm disappointed, see how devastated he is, which makes me feel worse. Start my final semester of full time class for my PhD, including a class on Outcomes Research which I love. Decide I want to focus my career on policy research. Put thesis project aside to start side project that my PI (temporarily) finds interesting.
February -- Get pregnant again! Finish side project, which PI no longer finds interesting, wondering out loud why I haven't made more progress on my thesis project. Grrr..... Luca is happy about the pregnancy news, but not as optimistic this time.
March -- Lose 2nd pregnancy. Really start hating class. Take Control Unleashed with the Boo, whose behavior improves immeasurably, at least in the class setting. Work on class, which takes up way more time than it should.
April -- Finish semester. Finally. Manage not to fail Operations research class and actually get an A, which in retrospect, it's an MBA class, why in heck was I worried, again?? Get pregnant again at the very end of the month, only this time I don't realize it.
May -- 34th birthday. Go to Outer Banks NC for "vacation" where I finish off my final projects for the semester and prepare a poster for the ATS conference I'm going to. Take pregnancy test which I swear is negative, but Luca thinks may be positive. I overrule him and have a margarita and raw oysters that night, and get my "period" the next day. I feel vindicated. I go to ATS the next week in Denver which goes swimmingly, but I feel like I've been knocked on my ass and retreat back to the hotel for a nap every day at 3PM. I attribute this exhaustion to jet lag and a cold I am getting over.
June -- I have my third positive pregnancy test, and then get my "period" three days later during the Department of Medicine Research Day. I take and finish the last class I hope to ever take for my PhD (crossing my fingers!) and start studying for my qualifying exams. And for real, get officially cracking on the first manuscript of my thesis, now that I've set aside the other "interesting" project that is no longer interesting. Luca and I start doing rock climbing on the weekends because we're bored with our exercise routines and I decide if I can't have a baby, then at least I'll get strong again.
July -- Almost finish manuscript but have to put it on hold to study for my qualifying exams. Study constantly for 4 weeks or so, and relearn a bunch of stuff that I never get tested on but which actually turns out to be quite useful. Go to see reproductive endocrinology because of 3 consecutive pregnancy losses. Wait for period so I can do day 3 labs. Period never arrives, and I conclude that I must be pregnant. It turns out I'm 13.5 weeks. Feel like the stupidest medical student ever. I call Luca to tell him the news. He is ecstatic, but never is as affectionate to me as he was after the first positive pregnancy test, and refuses to tell his parents because it could be bad luck.
August -- Studying for quals, prenatal labs and appointments out the wazoo, take qualifying exams (10 days of my life that I will never get back, and I don't think they even read the grant I had to write when they graded it -- we certainly didn't get any feedback on it if they did....). Go to St. Louis for my swim buddy's wedding, and have my first manicure and pedicure ever. Go to Italy for "vacation" while Luca has job crisis #2 on the year, and is a total basket case for the entire vacation. I hide in the bedroom and read 5 books.
September -- I return from vacation, finish my manuscript for thesis project #1 and submit it! I start TAing a class, which initially annoys me, but it turns out that I really like teaching undergrads. I start preparing my protocols for my oral candidacy exam.
October -- Revise and resubmit received for manuscript, which I am ecstatic about because all of the points are addressable. PI is more pessimistic. Keep working on my orals protocol. Belly really starts to pop at the beginning of the month and I feel fantastic. Things start going well with my PI and the rest of the project team, and at long last I feel I'm getting somewhere.
November -- Committee meeting goes well. Try to finish up analysis for previously abandoned paper, but then have to do revise and resubmit instead, and re-abandon previously abandoned paper. Submit IRB amendments for projects I ultimately will never do. I feel like I was working all the time that month but for the life of me I can't remember on what! Start and finish a bunch of projects on the house.
December -- Scrap third aim in the week before my oral candidacy exam protocol is due. Whip together other aim. Complete revise and resubmit. Submit continuing review documentation for grant with brand new aims and hope nobody at the NHLBI minds. Finish TAing. Catch two colds. Feel really enormous, and amazed at the same time how quickly time has flown since I found out I was pregnant. Think more about what I really want my life to be like and procrastinate by looking at real estate prices in various areas of the country on zillow.
Overall, I'd say the year improved steadily as it went along. Hopefully this trend will continue next year. I can't believe I only have 14 months of PhD-dom left, and then I'll return to med school. It's just crazy!
Saturday, December 31, 2011
New Years Eve
This year, Luca and I are planning on extending our 6 year long tradition of cooking a nice dinner (minus the wine this year) and going to bed by 10:30. Do you all have anything fun planned?
I woke up this morning and puked my guts out! It was mostly water. Otherwise I feel like my cold is finally going away. The baby's head is lower in my pelvis this morning and I can feel it when I'm sitting now, as well as when I stand up and walk around. Not comfy!
Luca immediately googled vomiting at 37 weeks and freaked out. "Oh my God you might be about to go into labor!!!" he said.
Yeah, right. At yesterday's appointment, my cervix was thinner, but still closed. In any case, the baby *better* not arrive until after my candidacy exam on Tuesday. I don't want to have to prepare for that all over again.
Which, incidentally, I have no idea what I need to be doing to prepare for this. I wrote my protocol, and of course will not receive any feedback on it before the exam. I literally have no idea what people are going to say or ask me, and frankly most of them have never administered a candidacy exam before, so in fact THEY probably don't really know either. I'm really only afraid of what my statistician will ask me since a) she is a statistician, and b) she has done this before.
I'm kind of anticipating a committee meeting on steroids.... and if this meeting goes as well as my last committee meeting in November went then I should be ok. But then again, most of them have never seem my third aim before. Add to the fact that my PI didn't want me to do it the way that I think it needs to be done based on what a more experienced investigator told me a few weeks back. So of course I had to write it up the way my PI wanted it. I'm anticipating that my other committee members may pounce on it as wrong. Good times.
So to prepare, I'm reviewing my protocol. Again. Going over my slide deck. Again. Reading through the literature (some more). Making sure that I've read all the papers my PI has forwarded to me over the past several months.
Convalescing.
It's been hard to get really motivated or stressed out about this exam. I mean, what would happen if I failed? I suppose I'd have a better idea of what to expect next time.... It's not as though my progress on any of these projects would stop. I'd simply give birth, re-prepare, and then re-present in 4-5 months, with (in theory) more completed work behind me, and more opportunities to receive guidance on what they think I should be doing differently. I have to have another committee meeting in 6 months ANYWAY, so would it really be that much more of a pain? I don't know. Of course I'd like to avoid that scenario....
As for New Year's Resolutions, I'm not so into them, but I'm hoping to strive for the following:
1. Continue trend of eating more salad and vegetables, which I started during pregnancy.
2. Keep up better with the literature in my field.
3. Sleep as much as possible.
Other than that, who knows what the next few months will even bring, so it seems silly to give myself a bunch of resolutions that may end up being completely unreasonable.
I woke up this morning and puked my guts out! It was mostly water. Otherwise I feel like my cold is finally going away. The baby's head is lower in my pelvis this morning and I can feel it when I'm sitting now, as well as when I stand up and walk around. Not comfy!
Luca immediately googled vomiting at 37 weeks and freaked out. "Oh my God you might be about to go into labor!!!" he said.
Yeah, right. At yesterday's appointment, my cervix was thinner, but still closed. In any case, the baby *better* not arrive until after my candidacy exam on Tuesday. I don't want to have to prepare for that all over again.
Which, incidentally, I have no idea what I need to be doing to prepare for this. I wrote my protocol, and of course will not receive any feedback on it before the exam. I literally have no idea what people are going to say or ask me, and frankly most of them have never administered a candidacy exam before, so in fact THEY probably don't really know either. I'm really only afraid of what my statistician will ask me since a) she is a statistician, and b) she has done this before.
I'm kind of anticipating a committee meeting on steroids.... and if this meeting goes as well as my last committee meeting in November went then I should be ok. But then again, most of them have never seem my third aim before. Add to the fact that my PI didn't want me to do it the way that I think it needs to be done based on what a more experienced investigator told me a few weeks back. So of course I had to write it up the way my PI wanted it. I'm anticipating that my other committee members may pounce on it as wrong. Good times.
So to prepare, I'm reviewing my protocol. Again. Going over my slide deck. Again. Reading through the literature (some more). Making sure that I've read all the papers my PI has forwarded to me over the past several months.
Convalescing.
It's been hard to get really motivated or stressed out about this exam. I mean, what would happen if I failed? I suppose I'd have a better idea of what to expect next time.... It's not as though my progress on any of these projects would stop. I'd simply give birth, re-prepare, and then re-present in 4-5 months, with (in theory) more completed work behind me, and more opportunities to receive guidance on what they think I should be doing differently. I have to have another committee meeting in 6 months ANYWAY, so would it really be that much more of a pain? I don't know. Of course I'd like to avoid that scenario....
As for New Year's Resolutions, I'm not so into them, but I'm hoping to strive for the following:
1. Continue trend of eating more salad and vegetables, which I started during pregnancy.
2. Keep up better with the literature in my field.
3. Sleep as much as possible.
Other than that, who knows what the next few months will even bring, so it seems silly to give myself a bunch of resolutions that may end up being completely unreasonable.
Thursday, December 29, 2011
Is it me? Does it matter?
Tomorrow is another Ob appointment. Hopefully this time will be ok. I only had a salad for dinner, and as of this AM, I'd only put on a pound since 2 weeks ago....
A couple of months back, I ran into an EM doctor and his wife at the clinic. One of my favorite EM doctors, if you must know. The person who made me think that maybe I wanted to do EM. But then also made me think that maybe I didn't. It's complicated. Anyway, he offered to give me a ride home from the clinic, which was especially nice since I live almost 2 miles away and the walk had started to suck in a third trimester kind of way.
I bring this up because one of the things we talked about was how I (and his wife) liked the practice. I said it was ok, but that it felt a bit like assembly line medicine. His wife didn't feel the same way (supposedly), and they recommended that I ask for specific providers when I came in so that I could develop a relationship with someone and would hopefully not feel that way anymore.
I haven't done that, and here's why:
1. The clinic seems to rotate who is "on" every month or so. So I don't think I'd end up having the option of seeing someone specific even if I did want to pick.
and
2. Probably more importantly, I'm not going to be able to choose who delivers my baby (see #1), so I feel like it behooves me to get to know as many of the providers as I can before I show up at the hospital in labor.
Still, I wondered if I was just being really hypersensitive about this whole thing. So I asked Luca after one of the visits he accompanied me to what his impression was.
He said: Well, she spent the entire time looking at her computer and typing. I can see why you feel like she doesn't care about you.
I hadn't really thought about that, and it is true. Usually, we have about a 15 second introduction, and then whomever it is goes straight to the computer to (presumably) read off whatever numbers they have on me.
But I think what bothers me is the lack of humanness in the interaction, beyond the computer. The introduction will always be something that I don't really know how to respond to like, "How's the baby doing." I don't think they've asked me how *I'VE* been feeling once. Or if they have, it's been in such a way that I can just tell a lecture or some empty platitudes will be forthcoming if I tell them, "I've been really exhausted," or, "I haven't taken a normal crap in a month," or, "I'm worried that my PI is taking all of my interesting projects away from me because I'm pregnant." Or if I do bring something up, they're likely to address me in a confrontational way, like the Dr did 2 weeks ago about my due dates.* It's like they've lost all ability or interest in interacting with me as a person, let alone a person who has a brain.
Several of you have suggested that I switch practices, and I really do wish I could. But the thing is, a lot of people I talk to say that they like this practice, and I wonder if the problem is really that my expectations for human interaction are too high. I know that I will get high quality medical care at this practice, and to me that's what matters the most. I also don't have confidence that anywhere else I go would be any better.
I guess I just wish I could have some of the touchy-feely sensitive doctor stuff as well. Is that really too much to ask?
****
*As a side note, I located my copy of NMS Ob/Gyn to make sure I was right about how one dates a pregnancy. The section on this was written by my very own Ob/Gyn preceptor from 4 years back, who -- wouldn't you know -- is a dr at the practice I am receiving my care at now. In fact, I could have seen her as a patient tomorrow, but I decided that would be awkward, especially since I always got the feeling that she wasn't very fond of me when I was her student.
And as it turns out, you're supposed to use the LMP unless the 1st trimester ultrasound is off by more than 7 days, or the second trimester ultrasound is off by more than 14 days. Since my LMP and ultrasound are discrepant by 3 days, that means we're supposed to be going by my LMP.
So there.
Anyhow, after I read this, I fantasized about bringing my textbook to the clinic tomorrow, and having a discussion with the Dr about it. Ha! I doubt that would have gone over very well.... but it was fun to think about, anyway.
God I must be a horrible patient.
:-)
A couple of months back, I ran into an EM doctor and his wife at the clinic. One of my favorite EM doctors, if you must know. The person who made me think that maybe I wanted to do EM. But then also made me think that maybe I didn't. It's complicated. Anyway, he offered to give me a ride home from the clinic, which was especially nice since I live almost 2 miles away and the walk had started to suck in a third trimester kind of way.
I bring this up because one of the things we talked about was how I (and his wife) liked the practice. I said it was ok, but that it felt a bit like assembly line medicine. His wife didn't feel the same way (supposedly), and they recommended that I ask for specific providers when I came in so that I could develop a relationship with someone and would hopefully not feel that way anymore.
I haven't done that, and here's why:
1. The clinic seems to rotate who is "on" every month or so. So I don't think I'd end up having the option of seeing someone specific even if I did want to pick.
and
2. Probably more importantly, I'm not going to be able to choose who delivers my baby (see #1), so I feel like it behooves me to get to know as many of the providers as I can before I show up at the hospital in labor.
Still, I wondered if I was just being really hypersensitive about this whole thing. So I asked Luca after one of the visits he accompanied me to what his impression was.
He said: Well, she spent the entire time looking at her computer and typing. I can see why you feel like she doesn't care about you.
I hadn't really thought about that, and it is true. Usually, we have about a 15 second introduction, and then whomever it is goes straight to the computer to (presumably) read off whatever numbers they have on me.
But I think what bothers me is the lack of humanness in the interaction, beyond the computer. The introduction will always be something that I don't really know how to respond to like, "How's the baby doing." I don't think they've asked me how *I'VE* been feeling once. Or if they have, it's been in such a way that I can just tell a lecture or some empty platitudes will be forthcoming if I tell them, "I've been really exhausted," or, "I haven't taken a normal crap in a month," or, "I'm worried that my PI is taking all of my interesting projects away from me because I'm pregnant." Or if I do bring something up, they're likely to address me in a confrontational way, like the Dr did 2 weeks ago about my due dates.* It's like they've lost all ability or interest in interacting with me as a person, let alone a person who has a brain.
Several of you have suggested that I switch practices, and I really do wish I could. But the thing is, a lot of people I talk to say that they like this practice, and I wonder if the problem is really that my expectations for human interaction are too high. I know that I will get high quality medical care at this practice, and to me that's what matters the most. I also don't have confidence that anywhere else I go would be any better.
I guess I just wish I could have some of the touchy-feely sensitive doctor stuff as well. Is that really too much to ask?
****
*As a side note, I located my copy of NMS Ob/Gyn to make sure I was right about how one dates a pregnancy. The section on this was written by my very own Ob/Gyn preceptor from 4 years back, who -- wouldn't you know -- is a dr at the practice I am receiving my care at now. In fact, I could have seen her as a patient tomorrow, but I decided that would be awkward, especially since I always got the feeling that she wasn't very fond of me when I was her student.
And as it turns out, you're supposed to use the LMP unless the 1st trimester ultrasound is off by more than 7 days, or the second trimester ultrasound is off by more than 14 days. Since my LMP and ultrasound are discrepant by 3 days, that means we're supposed to be going by my LMP.
So there.
Anyhow, after I read this, I fantasized about bringing my textbook to the clinic tomorrow, and having a discussion with the Dr about it. Ha! I doubt that would have gone over very well.... but it was fun to think about, anyway.
God I must be a horrible patient.
:-)
Wednesday, December 28, 2011
Baby Game
Ok guys, this isn't typically my sort of thing... but I thought it might be fun to conduct a little contest wherein you try to guess the baby's:
1. Birthday
2. Sex
3. Weight
The person who guesses closest in each category will receive.... um.... nothing? Mention by name (with link if you have your own blog) on this blog? Same for the person who gets closest overall, plus my eternal admiration of your psychic powers?
(Any suggestions on non-sucky prizes would be appreciated since I don't have any idea how these things usually work.)
Now, to level the playing field a bit, some disclosures:
LMP: 4/16/2011
Due date by LMP: 1/21/2012
Due date by 13.5 week ultrasound: 1/24/2012
Typical cycle length: 24-28 days
I weighed 7lbs 10oz when I was born, but my mom smoked. She weighed 9 lbs 6 oz when she was born. I have gained somewhere in the vicinity of 24 to 29 lbs so far, depending on whether you believe that I didn't put on any weight in my first trimester. My GCT was 117 fasted.
Looking forward to hearing your guesses!
Now I'm off to pack my hospital bag.
1. Birthday
2. Sex
3. Weight
The person who guesses closest in each category will receive.... um.... nothing? Mention by name (with link if you have your own blog) on this blog? Same for the person who gets closest overall, plus my eternal admiration of your psychic powers?
(Any suggestions on non-sucky prizes would be appreciated since I don't have any idea how these things usually work.)
Now, to level the playing field a bit, some disclosures:
LMP: 4/16/2011
Due date by LMP: 1/21/2012
Due date by 13.5 week ultrasound: 1/24/2012
Typical cycle length: 24-28 days
I weighed 7lbs 10oz when I was born, but my mom smoked. She weighed 9 lbs 6 oz when she was born. I have gained somewhere in the vicinity of 24 to 29 lbs so far, depending on whether you believe that I didn't put on any weight in my first trimester. My GCT was 117 fasted.
Looking forward to hearing your guesses!
Now I'm off to pack my hospital bag.
Not zero
One of the things that annoyed me most when I worked in business was the insistence of upper management that we achieve an error rate of zero.
First of all, such a rate is *actually* unachievable (something about calculus and limits and asymptotes and all that) though possibly achievable theoretically.
Second of all, if you were to try to achieve an error rate of zero, you'd expend an inordinate amount of resources doing so that would be most likely better spent on something else.
And finally, in trying to achieve an error rate of zero, you'll create perverse incentives, which may cause people to partake in other unattractive behaviors in order to game the system.
(Sorry this is so unscientifically phrased.... it's been a while since I tried to speak econ.)
The problem was, if you raised any of these points in a business environment, and suggested deciding on what the optimum error rate should be, some doof manager would decide you were just lazy and "not a team player" and that would be it for you.
And now you're wondering how this is related to my research.
I went to a talk on hospital readmissions last week, and there it was again. A guy was talking about ways to reduce the 30 day hospital readmission rate to zero. They were identifying patients who had a "high" probability of being readmitted using available hospital admission data, and "targeting" them in order to reduce readmissions. He'd come up with a model that had a sensitivity of (drum roll please) 25%, which basically means that you cannot identify these patients using his data. And he'd "designed" a fancy Excel spreadsheet tool (oooooohhhhhhhh!!!!) that allowed him to fiddle with the numbers in an expedient way in order to determine whether or not an intervention program would save money.
(As a side note, lesson #1 in my career was that many managers are easily impressed by things like one's ability to manipulate an Excel spreadsheet. No, not by your novel thoughts, but by your ability to make Excel dance. Yes, that is disdain you are picking up upon.)
Ok, let's put aside the fact that he wasn't even looking at cost-effectiveness, and that there were no confidence intervals around the numbers he was producing, or the fact that his model could not predict shit. What disturbed me the most was when the only economist in the room (who is a brilliant brilliant man) said, "The optimum readmission rate isn't zero," and this guy replied, "The optimum PREVENTABLE readmission rate is at zero."
I swear, it was like talking to a wall.
Which made me realize that the guy giving the presentation truly had no idea what he was doing. Or if he did, he had been so steamrolled by some moron manager he worked for that he was actually unable to understand the point the economist was trying to make, or at least felt he couldn't acknowledge such a point in public for fear of angering some higher-up.
It also gave me a chance to reflect on the fact that several people have recommended this guy's career trajectory to ME, and made me want to cry just slightly. I'd much rather be thought of like the economist....
Anyway, none of this is to say that quality improvement is a bad thing, or that we shouldn't try to do better. It IS to say that there is a reason (actually reasonS) that I ran screaming from the business world.
And also, I'm wondering whether a six sigma approach might work as alternative.
First of all, such a rate is *actually* unachievable (something about calculus and limits and asymptotes and all that) though possibly achievable theoretically.
Second of all, if you were to try to achieve an error rate of zero, you'd expend an inordinate amount of resources doing so that would be most likely better spent on something else.
And finally, in trying to achieve an error rate of zero, you'll create perverse incentives, which may cause people to partake in other unattractive behaviors in order to game the system.
(Sorry this is so unscientifically phrased.... it's been a while since I tried to speak econ.)
The problem was, if you raised any of these points in a business environment, and suggested deciding on what the optimum error rate should be, some doof manager would decide you were just lazy and "not a team player" and that would be it for you.
And now you're wondering how this is related to my research.
I went to a talk on hospital readmissions last week, and there it was again. A guy was talking about ways to reduce the 30 day hospital readmission rate to zero. They were identifying patients who had a "high" probability of being readmitted using available hospital admission data, and "targeting" them in order to reduce readmissions. He'd come up with a model that had a sensitivity of (drum roll please) 25%, which basically means that you cannot identify these patients using his data. And he'd "designed" a fancy Excel spreadsheet tool (oooooohhhhhhhh!!!!) that allowed him to fiddle with the numbers in an expedient way in order to determine whether or not an intervention program would save money.
(As a side note, lesson #1 in my career was that many managers are easily impressed by things like one's ability to manipulate an Excel spreadsheet. No, not by your novel thoughts, but by your ability to make Excel dance. Yes, that is disdain you are picking up upon.)
Ok, let's put aside the fact that he wasn't even looking at cost-effectiveness, and that there were no confidence intervals around the numbers he was producing, or the fact that his model could not predict shit. What disturbed me the most was when the only economist in the room (who is a brilliant brilliant man) said, "The optimum readmission rate isn't zero," and this guy replied, "The optimum PREVENTABLE readmission rate is at zero."
I swear, it was like talking to a wall.
Which made me realize that the guy giving the presentation truly had no idea what he was doing. Or if he did, he had been so steamrolled by some moron manager he worked for that he was actually unable to understand the point the economist was trying to make, or at least felt he couldn't acknowledge such a point in public for fear of angering some higher-up.
It also gave me a chance to reflect on the fact that several people have recommended this guy's career trajectory to ME, and made me want to cry just slightly. I'd much rather be thought of like the economist....
Anyway, none of this is to say that quality improvement is a bad thing, or that we shouldn't try to do better. It IS to say that there is a reason (actually reasonS) that I ran screaming from the business world.
And also, I'm wondering whether a six sigma approach might work as alternative.
Tuesday, December 27, 2011
Snot disease -- BE GONE!!
I am really hoping I'll be able to sleep for more than 60 minutes at a time tonight. Last night between the pregnancy induced night sweats and subsequent sheet changes (x2), peeing every 1-2 hours, and stuffed up head + cough, even though I was in bed for 12 hours officially, I still felt like I'd been hit by a train when I got up this morning.
I did finally start putting together my slide deck for my orals next week though. It sucks, but it's just a first draft so it will get better.
And tonight -- Benadryl. Even if it just knocks me out and dries up my nose just a little, it will still hopefully be better than the last few nights have been.
I feel shitty that Luca has this week off, and he has spent it playing host to my parents and nurse to me. I wish I were better company for him. Hopefully things will improve over the next couple of days. This cold has made the last one I had a few weeks back look like NOTHING. I hope I don't give it to him, though given the amount of snot I've produced I would be amazed if he doesn't succumb.
Fortunately, the offspring seems unfazed (said as I receive a couple of good solid kicks to the liver). Just 25 days until my due date (28 if you go by the week 13 ultrasound). Crazy!
I did finally start putting together my slide deck for my orals next week though. It sucks, but it's just a first draft so it will get better.
And tonight -- Benadryl. Even if it just knocks me out and dries up my nose just a little, it will still hopefully be better than the last few nights have been.
I feel shitty that Luca has this week off, and he has spent it playing host to my parents and nurse to me. I wish I were better company for him. Hopefully things will improve over the next couple of days. This cold has made the last one I had a few weeks back look like NOTHING. I hope I don't give it to him, though given the amount of snot I've produced I would be amazed if he doesn't succumb.
Fortunately, the offspring seems unfazed (said as I receive a couple of good solid kicks to the liver). Just 25 days until my due date (28 if you go by the week 13 ultrasound). Crazy!
Monday, December 26, 2011
36 and counting
My parents were visiting for the weekend, and just left. It was nice seeing them!
For some reason we argue less when they're here than when I visit them. I think I've observed this before. This was even the case this weekend despite the fact that I came down with a bad cold AGAIN (second cold in three weeks -- awesome), and Luca had to do a lot of the food prep. Fortunately, we went considerably less elaborate than over Thanksgiving. Also, Luca is a great host/nurse, and gets along well with my parents. I am very fortunate to have him.
Also fortunately, we still have abundant leftovers which means less work on cooking this week.
Since we finished painting the basement (FINALLY) hopefully we'll be able to put some of our stuff back down there this week, including all my med school books, epi books, and the chest freezer that came with the house.
We're also hoping to inventory the stuff we already have for the baby, and compare it to a list of stuff we're told that we need, and fix the discrepancies.
Luca is also insisting that I pack my hospital bag, which I believe to be an absolute guarantee that I will not give birth for another 5.5 weeks. To a 10 lb baby.
Also, I need to create the slide deck for my oral candidacy exam next week, and remind myself of the projects I wrote about planning to do. Not to mention the methods I said I'd be using. Sobel test? What is that again? I think I may hold off on starting that for another day or so, or at least until I can remain upright without feeling like I want to lie down again for more than 5 minutes at a time.
Stupid cold.
For some reason we argue less when they're here than when I visit them. I think I've observed this before. This was even the case this weekend despite the fact that I came down with a bad cold AGAIN (second cold in three weeks -- awesome), and Luca had to do a lot of the food prep. Fortunately, we went considerably less elaborate than over Thanksgiving. Also, Luca is a great host/nurse, and gets along well with my parents. I am very fortunate to have him.
Also fortunately, we still have abundant leftovers which means less work on cooking this week.
Since we finished painting the basement (FINALLY) hopefully we'll be able to put some of our stuff back down there this week, including all my med school books, epi books, and the chest freezer that came with the house.
We're also hoping to inventory the stuff we already have for the baby, and compare it to a list of stuff we're told that we need, and fix the discrepancies.
Luca is also insisting that I pack my hospital bag, which I believe to be an absolute guarantee that I will not give birth for another 5.5 weeks. To a 10 lb baby.
Also, I need to create the slide deck for my oral candidacy exam next week, and remind myself of the projects I wrote about planning to do. Not to mention the methods I said I'd be using. Sobel test? What is that again? I think I may hold off on starting that for another day or so, or at least until I can remain upright without feeling like I want to lie down again for more than 5 minutes at a time.
Stupid cold.
Saturday, December 24, 2011
Sleep
My parents are visiting for Christmas. I actually really like it when they come see me in Philly. For some reason we seem to fight less than when I go to see them in CT. Perhaps I regress less to my adolescent self. Haha.
Last night my mom told me that she was a 9 lb 6 ounce baby. My grandma was neither a) obese, or b) diabetic, so this was all genetics. I was only 7 lbs 10 oz, but MY mother smoked throughout her pregnancy with me. If she hadn't maybe I would have been a 10 pounder myself.
So last night I went to bed at 10, and then at 2AM I woke up and just lay there paralyzed with fear thinking about having to squeeze a 10 lb baby out of my vagina. Without an epidural (if my platelets are too low that day). I lay there awake until 6AM.
It sucked.
Fortunately I got to take a nap today. Thank goodness that after my orals in a week (a week!) I'll have a relatively low key couple of weeks before I (hopefully) give birth to a (NOT TEN POUND FOR GOD'S SAKE) healthy baby. I know I'll sleep less after the baby arrives, but at least then I won't be lying there paralyzed by anxiety about my future fecal and urinary continence.
Last night my mom told me that she was a 9 lb 6 ounce baby. My grandma was neither a) obese, or b) diabetic, so this was all genetics. I was only 7 lbs 10 oz, but MY mother smoked throughout her pregnancy with me. If she hadn't maybe I would have been a 10 pounder myself.
So last night I went to bed at 10, and then at 2AM I woke up and just lay there paralyzed with fear thinking about having to squeeze a 10 lb baby out of my vagina. Without an epidural (if my platelets are too low that day). I lay there awake until 6AM.
It sucked.
Fortunately I got to take a nap today. Thank goodness that after my orals in a week (a week!) I'll have a relatively low key couple of weeks before I (hopefully) give birth to a (NOT TEN POUND FOR GOD'S SAKE) healthy baby. I know I'll sleep less after the baby arrives, but at least then I won't be lying there paralyzed by anxiety about my future fecal and urinary continence.
Have you hugged a med student today?
Now I'll grant you, some med students (like some people in general) are entitled little snots who think that they know more, deserve more than they do. I'd like to think students like this are the exception rather than the rule, but what do I know anyway. I mean, I don't think *I'm* an entitled snot.... yet I've met people who assume I must be based on the fact that I grew up in Manhattan, or because I attend medical school.
But I digress.
Anyway, there was an article in the NYT about how Vanderbilt is trying to make med school more humane byforcing med students to partake in team building activities being more like "Hogwarts." They're trying to prevent burnout from setting in. Which.... is basically impossible.
A bunch of doctors and med students wrote comments saying that the problem with med school was the workload. That drinking out of the firehose of information to cram into your head for 4 years was what made med school hard.
I call their bullshit.
What makes med school hard is that it's the first time in your life that you're treated as less than a person. On a consistent basis. Over at least a year, and probably longer if it continues into residency.*
And I can tell you, I've worked some pretty dehumanizing shitty jobs in the past, but NOWHERE else have I worked where it is ok to pretend you don't know, or not bother to learn the name of someone who has been on your team for four weeks.
I was talking to a 4th year that I'm doing research consulting for yesterday, and he told me that he realized how low his expectations for being treated like a person were when an attending he'd been working under said to him, "Good morning John! How are you doing today," and he was completely shocked. He said it felt amazing.
That's so fucking pathetic, I don't even know where to begin.
I remember on my Ob/Gyn rotation, asking the resident what cytotec was (we'd learned it as misoprostol in didactics, and that's what all the textbooks said, so how the heck should I know!), and the resident said to me, "Oh my GOD I can't believe you don't know what that is. What are you, stupid or something???" scoffed loudly, stomped out of the room, and then would not acknowledge my presence for the rest of the week. The WEEK! Did I mention that the room was full of other people? Yeah, she was a gem. (Hi Candace!!)**
I eventually did find out what cytotec was. Not that it mattered since I was never permitted near a patient on that rotation.
So the next week, I had a different team, and one of the residents took me aside and started explaining how an induction worked, and actually said the words, "We use cytotec to ripen the cervix. Cytotec is just misoprostol." I literally almost teared up at this person taking the time to talk to me like a person, taking the time to explain things. I wanted to hug him and thank him. But of course you can't because that would be weird. What would you even say? "Thank you for taking the time to say one sentence to me like a normal person?"
I wrote him a good eval anyway. Not sure these things even matter.
So I guess my point is, you don't need Hogwarts-like contests between contrived teams to make med school a more positive experience. All you really need to do is to say hi once in a while and address the med student by name. Once per week maybe.
Or maybe just once ever.
*I'll let you know about that one, but from what I've heard, it does.
**Her real name.
But I digress.
Anyway, there was an article in the NYT about how Vanderbilt is trying to make med school more humane by
A bunch of doctors and med students wrote comments saying that the problem with med school was the workload. That drinking out of the firehose of information to cram into your head for 4 years was what made med school hard.
I call their bullshit.
What makes med school hard is that it's the first time in your life that you're treated as less than a person. On a consistent basis. Over at least a year, and probably longer if it continues into residency.*
And I can tell you, I've worked some pretty dehumanizing shitty jobs in the past, but NOWHERE else have I worked where it is ok to pretend you don't know, or not bother to learn the name of someone who has been on your team for four weeks.
I was talking to a 4th year that I'm doing research consulting for yesterday, and he told me that he realized how low his expectations for being treated like a person were when an attending he'd been working under said to him, "Good morning John! How are you doing today," and he was completely shocked. He said it felt amazing.
That's so fucking pathetic, I don't even know where to begin.
I remember on my Ob/Gyn rotation, asking the resident what cytotec was (we'd learned it as misoprostol in didactics, and that's what all the textbooks said, so how the heck should I know!), and the resident said to me, "Oh my GOD I can't believe you don't know what that is. What are you, stupid or something???" scoffed loudly, stomped out of the room, and then would not acknowledge my presence for the rest of the week. The WEEK! Did I mention that the room was full of other people? Yeah, she was a gem. (Hi Candace!!)**
I eventually did find out what cytotec was. Not that it mattered since I was never permitted near a patient on that rotation.
So the next week, I had a different team, and one of the residents took me aside and started explaining how an induction worked, and actually said the words, "We use cytotec to ripen the cervix. Cytotec is just misoprostol." I literally almost teared up at this person taking the time to talk to me like a person, taking the time to explain things. I wanted to hug him and thank him. But of course you can't because that would be weird. What would you even say? "Thank you for taking the time to say one sentence to me like a normal person?"
I wrote him a good eval anyway. Not sure these things even matter.
So I guess my point is, you don't need Hogwarts-like contests between contrived teams to make med school a more positive experience. All you really need to do is to say hi once in a while and address the med student by name. Once per week maybe.
Or maybe just once ever.
*I'll let you know about that one, but from what I've heard, it does.
**Her real name.
Friday, December 23, 2011
The hardest thing about med school
For me, anyway, is realizing that nobody cares about your opinion. Even if you're right. ESPECIALLY if you're right.
In the hospital I could take it. At least there I knew that I didn't know what I was doing. Of course then your attendings tell you to be more assertive, to state what you think and why. So you practice doing that. And then you get a new attending who tells you that you're arrogant for stating what you think and why. Who thinks medical students are better seen and not heard. But even that I could deal with since the hierarchy is so entrenched on the wards.
Now I'm in PhD-land.
I sit in meetings several times a week with doctors talking about health care policy. This is a field in which I am getting my PhD, and in which many of them have no experience at all. And they still they assume that they must know more than I do, when I've been doing research longer than many of them have even been doctors.
Because all they see is that they are fellows. To them, I am still a mere know-nothing medical student.
And people: I am good at what I do. This policy thing? It's my calling.
A couple of them listen. Generally these are the fellows and attendings who have been around for at least a year or two, doing this research along side of me. It's a joy to work with them. A real pleasure.
It's the others that make me want to put my head through a wall.
I used to try to give constructive feedback on their projects, which is the entire point of having these meetings. So they can get feedback so that their projects stop sucking. And in general, they'd smile and make some patronizing comment to me like, "Thanks for your input little medical student!" in a voice like they were speaking to a small child.
Once one of the fellows said he'd really like to talk with someone more advanced who'd made a career in translational research work. I suggested he talk to a specific person who has a reputation for being a great mentor, has been a great mentor to me, and who is a rising star in his field. The fellow did the body language equivalent of the pat on the head, and then he turned away as though I wasn't standing right there giving him the information of a valuable contact.
So now I just sit back in these meetings and listen to them as they design utter crap research. Why should I share my ideas with them if they're going to blow me off like that? They'll just remember the idea 6 months from now, and think it was their own anyway.
I might as well keep the ideas for myself, for my future R01s.
In the hospital I could take it. At least there I knew that I didn't know what I was doing. Of course then your attendings tell you to be more assertive, to state what you think and why. So you practice doing that. And then you get a new attending who tells you that you're arrogant for stating what you think and why. Who thinks medical students are better seen and not heard. But even that I could deal with since the hierarchy is so entrenched on the wards.
Now I'm in PhD-land.
I sit in meetings several times a week with doctors talking about health care policy. This is a field in which I am getting my PhD, and in which many of them have no experience at all. And they still they assume that they must know more than I do, when I've been doing research longer than many of them have even been doctors.
Because all they see is that they are fellows. To them, I am still a mere know-nothing medical student.
And people: I am good at what I do. This policy thing? It's my calling.
A couple of them listen. Generally these are the fellows and attendings who have been around for at least a year or two, doing this research along side of me. It's a joy to work with them. A real pleasure.
It's the others that make me want to put my head through a wall.
I used to try to give constructive feedback on their projects, which is the entire point of having these meetings. So they can get feedback so that their projects stop sucking. And in general, they'd smile and make some patronizing comment to me like, "Thanks for your input little medical student!" in a voice like they were speaking to a small child.
Once one of the fellows said he'd really like to talk with someone more advanced who'd made a career in translational research work. I suggested he talk to a specific person who has a reputation for being a great mentor, has been a great mentor to me, and who is a rising star in his field. The fellow did the body language equivalent of the pat on the head, and then he turned away as though I wasn't standing right there giving him the information of a valuable contact.
So now I just sit back in these meetings and listen to them as they design utter crap research. Why should I share my ideas with them if they're going to blow me off like that? They'll just remember the idea 6 months from now, and think it was their own anyway.
I might as well keep the ideas for myself, for my future R01s.
Thursday, December 22, 2011
No I am not praying
The bus stop on my street pretty much has a sign, but not much else. No shelter, and certainly no bench. So, as revolting as it may sound, I've taken to kneeling on the sidewalk while I wait for the bus.
What! If I stand for long periods (i.e. more than 30 seconds) my heart rate starts to go up and I feel like I want to pass out. And there's not even anywhere to lean really, and even if there were, kneeling works so much better. Increased venous return and all that.
I've been doing this for the past month, and very few people have said anything at all to me. Well, there was this one woman who asked if I was ok, and I said thanks for asking, but yes I was fine.
Until this morning, when not one, but TWO people asked me if I was praying.
Come to think of it, I was facing west.
Anyway, I assured them I was not praying, but was just very pregnant and didn't want to pass out.
Ha. I must look pretty ridiculous kneeling there on the sidewalk.
Oh well. It's better than the alternative.
What! If I stand for long periods (i.e. more than 30 seconds) my heart rate starts to go up and I feel like I want to pass out. And there's not even anywhere to lean really, and even if there were, kneeling works so much better. Increased venous return and all that.
I've been doing this for the past month, and very few people have said anything at all to me. Well, there was this one woman who asked if I was ok, and I said thanks for asking, but yes I was fine.
Until this morning, when not one, but TWO people asked me if I was praying.
Come to think of it, I was facing west.
Anyway, I assured them I was not praying, but was just very pregnant and didn't want to pass out.
Ha. I must look pretty ridiculous kneeling there on the sidewalk.
Oh well. It's better than the alternative.
Wednesday, December 21, 2011
We got new sheets!
Luca and I don't really exchange gifts at Christmas, per se. Mostly I compile a list of stuff I/we want but wouldn't normally buy for ourselves because we consider it too indulgent, or because we are too lazy or cheap to just buy it when we think of it.
A good example of this would be a new camera. We'd really like to get one before the offspring arrives, since our current camera takes like 60 seconds to recharge every time you use the flash. (Unacceptable!!) But it seems really indulgent to buy a new one since we already have one that works. We haven't gotten one yet, but may see about it after Christmas is over.
But we did get new sheets! And they arrived today. Fancy percale (whatever that means) sheets that are pink with polka dots. Luca picked the color. I can't WAIT to try them out. And we got a new bathmat that will hopefully match my bathroom tile a little better than the current one.
Who knew I'd ever be a person who would get excited about bedding.
For Miss Boo, we got her a "fancy" squeaky toy with -- count them -- TWELVE squeakers. I am looking forward to Christmas just so I can watch her destroy it. It's gonna be awesome.
A good example of this would be a new camera. We'd really like to get one before the offspring arrives, since our current camera takes like 60 seconds to recharge every time you use the flash. (Unacceptable!!) But it seems really indulgent to buy a new one since we already have one that works. We haven't gotten one yet, but may see about it after Christmas is over.
But we did get new sheets! And they arrived today. Fancy percale (whatever that means) sheets that are pink with polka dots. Luca picked the color. I can't WAIT to try them out. And we got a new bathmat that will hopefully match my bathroom tile a little better than the current one.
Who knew I'd ever be a person who would get excited about bedding.
For Miss Boo, we got her a "fancy" squeaky toy with -- count them -- TWELVE squeakers. I am looking forward to Christmas just so I can watch her destroy it. It's gonna be awesome.
Crabby Crab
These past few days I've been a giant crabby bitch.
I know, I was in a good mood Friday - Sunday. But things change.
There are two reasons for this change.
1. I turned in my oral candidacy exam proposal, and though I have more work I could be doing, I DON'T WANNA DO IT!! (stamps foot)
2. I stopped sleeping well. Again.
You may recall that about a month ago, I was feeling really worn down. Ever since I got pregnant I've been getting up to pee 3-4 times a night. Usually I've been able to fall back to sleep no problem. Then there came a time, right around the 6 month mark, where I'd start waking up and couldn't fall back to sleep. For 2, sometimes 3 hours.
Now, it's not like this never happened to me in the past. I suppose it probably happens to everyone. But when it happens to you 3-4 nights in a row, and then you ALSO start having problems falling asleep, it gets to be kind of unpleasant.
So in order to compensate, I started going to bed earlier and sleeping later. Lately, my typical sleep pattern has been as follows:
Bed 10PM
Wake up 12:00
Wake up 2:00
Wake up 4:00
Wake up 5:20 (Luca's alarm)
Wake up 7:00
Get up 8:00
Sometimes if I could, I'd stay in bed even later. It helped, but not enough. Not as much as uninterrupted sleep would have helped. And if it was one of those nights when I couldn't fall back to sleep, that would usually happen between 2 and 5AM.
But then, last week, I found myself sleeping from 12-4:30 completely uninterrupted. I honestly can't explain why this happened, since after all, I'm getting bigger, not smaller. But I did. And it was glorious.
So I set about telling my friends, all childless, about how awesome I felt and how great my sleep had been that week. I found myself uttering phrases I never in my whole life expected to escape my lips like, "I slept 4.5 hours IN A ROW, five WHOLE DAYS in a row, and it was GLORIOUS!!"
What was their reaction?
Every single one recoiled in horror. It's worth pointing out that one of said friends is a second year resident, and she was *still* horrified. I have to say it made me feel better. It also made me realize how f-ed up my sleeping had gotten, and that I was tired -- not because I was getting fat -- but because I was sleeping like crap.*
Of course my streak ended this Saturday night. The first night wasn't so bad. It never is. Even the second night was ok. But by the third night, I was getting seriously cranky. I felt so tired when I went to bed, but somehow, still couldn't manage to get comfortable or sleep for more than 1-2 hours.
Anyway, last night I was finally back to my old sleeping pattern. Still no 4.5 hour marathons, but at least I had no problems falling back to sleep. And I feel so much better. So, please excuse my crabby nature over the past few days. That's what happens when I don't sleep enough.
*I'm sure I will get some comment that says one of the following things:
"I haven't slept more than 4.5 hours total in the past 5 years. You have no idea how good you have it. You should stop complaining."
"You are so screwed for residency. When I was a resident......"
"Just wait until you have the baby. I remember when I....."
"How on earth did you make it through medical school. I only sleep 4 hours per night, and I am fine."
Please note that these sort of comments will not be appreciated, and may be deleted.
Thanks!
The Management
I know, I was in a good mood Friday - Sunday. But things change.
There are two reasons for this change.
1. I turned in my oral candidacy exam proposal, and though I have more work I could be doing, I DON'T WANNA DO IT!! (stamps foot)
2. I stopped sleeping well. Again.
You may recall that about a month ago, I was feeling really worn down. Ever since I got pregnant I've been getting up to pee 3-4 times a night. Usually I've been able to fall back to sleep no problem. Then there came a time, right around the 6 month mark, where I'd start waking up and couldn't fall back to sleep. For 2, sometimes 3 hours.
Now, it's not like this never happened to me in the past. I suppose it probably happens to everyone. But when it happens to you 3-4 nights in a row, and then you ALSO start having problems falling asleep, it gets to be kind of unpleasant.
So in order to compensate, I started going to bed earlier and sleeping later. Lately, my typical sleep pattern has been as follows:
Bed 10PM
Wake up 12:00
Wake up 2:00
Wake up 4:00
Wake up 5:20 (Luca's alarm)
Wake up 7:00
Get up 8:00
Sometimes if I could, I'd stay in bed even later. It helped, but not enough. Not as much as uninterrupted sleep would have helped. And if it was one of those nights when I couldn't fall back to sleep, that would usually happen between 2 and 5AM.
But then, last week, I found myself sleeping from 12-4:30 completely uninterrupted. I honestly can't explain why this happened, since after all, I'm getting bigger, not smaller. But I did. And it was glorious.
So I set about telling my friends, all childless, about how awesome I felt and how great my sleep had been that week. I found myself uttering phrases I never in my whole life expected to escape my lips like, "I slept 4.5 hours IN A ROW, five WHOLE DAYS in a row, and it was GLORIOUS!!"
What was their reaction?
Every single one recoiled in horror. It's worth pointing out that one of said friends is a second year resident, and she was *still* horrified. I have to say it made me feel better. It also made me realize how f-ed up my sleeping had gotten, and that I was tired -- not because I was getting fat -- but because I was sleeping like crap.*
Of course my streak ended this Saturday night. The first night wasn't so bad. It never is. Even the second night was ok. But by the third night, I was getting seriously cranky. I felt so tired when I went to bed, but somehow, still couldn't manage to get comfortable or sleep for more than 1-2 hours.
Anyway, last night I was finally back to my old sleeping pattern. Still no 4.5 hour marathons, but at least I had no problems falling back to sleep. And I feel so much better. So, please excuse my crabby nature over the past few days. That's what happens when I don't sleep enough.
*I'm sure I will get some comment that says one of the following things:
"I haven't slept more than 4.5 hours total in the past 5 years. You have no idea how good you have it. You should stop complaining."
"You are so screwed for residency. When I was a resident......"
"Just wait until you have the baby. I remember when I....."
"How on earth did you make it through medical school. I only sleep 4 hours per night, and I am fine."
Please note that these sort of comments will not be appreciated, and may be deleted.
Thanks!
The Management
Tuesday, December 20, 2011
Can I say?
I'm really tired of people assuming that the Gentle Leader is a muzzle. It's bad enough that I have a pit mix -- I get tons of nasty looks and a wide berth on the street under normal circumstances when I walk her. But the gentle leader seems to provoke actual negative commentary.
So today we went to the vet, and since I figured that we'd be sitting in a waiting room with a variety of other animals, I figured that the Gentle Leader was a prudent choice under those circumstances.
Today there were FIVE kitties in carriers waiting to be seen by the vet as well. FIVE. in basically a 12'x12' waiting room. For 40 minutes. Miss Boo is really bad with cats. I think she would eat them if given the opportunity (fortunately most cats are too smart for this to happen). So of course she got really worked up and tried to lunge at the kitty carriers, and panted and cried, and was generally difficult to handle.
And I will admit that when she pants with the gentle leader on she makes this snorting noise. Unfortunately, many people mistake this for a growl, and have a tendency to comment to that effect. Which is really awesome.
One lady (with three cats) decided that it would be appropriate to have a loud conversation about how awful pit bulls were right next to me.
Another lady with a standard poodle mix of some kind (Miss Boo actually did growl at him at one point when he stared at her and started getting too close to me), was clearly freaked out by her. She practically tripped over her own feet trying to get out of the way as we were leaving the office. I think she was afraid the Boo was going to attack her dog, but for the record, the Boo completely ignored him. She was way more interested in the cats.
I'm just imagining the commentary that ensued after we left.
Anyway, other dog owners: Do you find that people ask you whether the gentle leader is a muzzle, or whether your dog bites when you walk him/her using one? I used to try and educate people when they asked me this, but I've gotten REALLY tired of explaining over and over to a group of people who is just going to think I'm making excuses for my vicious dog anyway. I'm tempted to just start telling them, "Yes she bites.* STAY AWAY," and then moving on but I'm afraid that would just make things worse.
Thoughts?
*She's never bitten anyone I know, but that's besides the point.
*****
In other news, this is the vet that gave her doggy papilloma virus with a non-sterile cautery tool. We only use him for routine vaccinations and care since he is really cheap. Otherwise we go to the expensive bougie vet in Ardmore. They have better hours, and don't tend to give me lectures on "wasting money" on my dog. Haha.
So today, I asked for some acepromazine for long car trips since the Boo pukes in the car on trips over 60 minutes. He wanted to know where we were going, and I said, nowhere at the moment, it's for later in the year. I'll probably go to my parents' at some point at least once. And he was reluctant to give me any! Did he want me to come back for another visit I wonder?
And then the front desk lady refused to give me a copy of her vaccination record, saying that she could fax the kennel or day care or what have you a copy if they needed it. It was total bullshit! All sorts of services require this sort of documentation, and this vet is not always open. What a pain it's going to be to have to call them up to have them send a fucking fax every time we need it!
I wondered if they were afraid that people were going to defect to other vets, who invariably require the vaccination record.
So, today I told Luca I was done with them, and that from now on we're going to Ardmore for everything. Period. The end. Bye bye Dr. Littlejohn!
So today we went to the vet, and since I figured that we'd be sitting in a waiting room with a variety of other animals, I figured that the Gentle Leader was a prudent choice under those circumstances.
Today there were FIVE kitties in carriers waiting to be seen by the vet as well. FIVE. in basically a 12'x12' waiting room. For 40 minutes. Miss Boo is really bad with cats. I think she would eat them if given the opportunity (fortunately most cats are too smart for this to happen). So of course she got really worked up and tried to lunge at the kitty carriers, and panted and cried, and was generally difficult to handle.
And I will admit that when she pants with the gentle leader on she makes this snorting noise. Unfortunately, many people mistake this for a growl, and have a tendency to comment to that effect. Which is really awesome.
One lady (with three cats) decided that it would be appropriate to have a loud conversation about how awful pit bulls were right next to me.
Another lady with a standard poodle mix of some kind (Miss Boo actually did growl at him at one point when he stared at her and started getting too close to me), was clearly freaked out by her. She practically tripped over her own feet trying to get out of the way as we were leaving the office. I think she was afraid the Boo was going to attack her dog, but for the record, the Boo completely ignored him. She was way more interested in the cats.
I'm just imagining the commentary that ensued after we left.
Anyway, other dog owners: Do you find that people ask you whether the gentle leader is a muzzle, or whether your dog bites when you walk him/her using one? I used to try and educate people when they asked me this, but I've gotten REALLY tired of explaining over and over to a group of people who is just going to think I'm making excuses for my vicious dog anyway. I'm tempted to just start telling them, "Yes she bites.* STAY AWAY," and then moving on but I'm afraid that would just make things worse.
Thoughts?
*She's never bitten anyone I know, but that's besides the point.
*****
In other news, this is the vet that gave her doggy papilloma virus with a non-sterile cautery tool. We only use him for routine vaccinations and care since he is really cheap. Otherwise we go to the expensive bougie vet in Ardmore. They have better hours, and don't tend to give me lectures on "wasting money" on my dog. Haha.
So today, I asked for some acepromazine for long car trips since the Boo pukes in the car on trips over 60 minutes. He wanted to know where we were going, and I said, nowhere at the moment, it's for later in the year. I'll probably go to my parents' at some point at least once. And he was reluctant to give me any! Did he want me to come back for another visit I wonder?
And then the front desk lady refused to give me a copy of her vaccination record, saying that she could fax the kennel or day care or what have you a copy if they needed it. It was total bullshit! All sorts of services require this sort of documentation, and this vet is not always open. What a pain it's going to be to have to call them up to have them send a fucking fax every time we need it!
I wondered if they were afraid that people were going to defect to other vets, who invariably require the vaccination record.
So, today I told Luca I was done with them, and that from now on we're going to Ardmore for everything. Period. The end. Bye bye Dr. Littlejohn!
Monday, December 19, 2011
Study
A couple of people asked about the research study I signed up for on Friday. I went in for my first visit this morning* to sign consent forms and give urine and blood samples. From what I gather, it's looking at how mode of feeding (breastmilk, cow based formula, or soy based formula) affects endocrine development of babies.
So, my participation requirements:
1. 3rd trimester urine and blood
2. Urine collection in 2 days to be FedExed in
3. Birth visit while in hospital (more urine and blood + questionnaires)
4. 2 week visit (breast milk sample, questionnaires)
5. 12 week visit (more breast milk, questionnaires)
In exchange I get up to $155 to compensate me for travel, time, and bodily fluids.
My baby also participates. Most visits require some or all of the following:
Body measurements, physical exam, urine, blood, swabs of genital area, ultrasound of thyroid, ovaries, testes.
And there are a bunch of visits.
1. Birth visit
2. 2 week visit
3. 4 week visit
4. 6 week visit
5. 8 week visit
6. 12 week visit
7. 16 week visit
8. 20 week visit
9. 24 week visit
10. 28 week visit (final visit for boys)
11. 32 week visit
12. 36 week visit (final visit for girls)
In exchange you get all the formula you need to feed your baby if you're in one of the formula arms, or a breast pump if you're in the breast feeding arm.
You also get "an allotment" of diapers if you're in the breastfeeding arm. I was told that I should expect several large packages, and that I'd need a car to get them all home.
You also get $875 in cash for your visits if you have a girl, and $725 for boys.
*As a side note, when I went to the security desk to get my visitor's badge this morning, even though I said I was a visitor here for a research study, the guard asked me if I had a hospital ID. I said yes, and then she confiscated it! Fortunately, I basically never go to that hospital and plan on doing mostly adult medicine electives in the future, but in theory I could sign up to do some sort of clinical activity there at any time that would require my ID. Plus, it was my best picture out of all my hospital IDs, so I was a little annoyed that she took it. It's not as though it would work anyway. Good thing I'm not planning on doing peds! Otherwise I'd have to get a new ID, and that would be a giant PIA!
So, my participation requirements:
1. 3rd trimester urine and blood
2. Urine collection in 2 days to be FedExed in
3. Birth visit while in hospital (more urine and blood + questionnaires)
4. 2 week visit (breast milk sample, questionnaires)
5. 12 week visit (more breast milk, questionnaires)
In exchange I get up to $155 to compensate me for travel, time, and bodily fluids.
My baby also participates. Most visits require some or all of the following:
Body measurements, physical exam, urine, blood, swabs of genital area, ultrasound of thyroid, ovaries, testes.
And there are a bunch of visits.
1. Birth visit
2. 2 week visit
3. 4 week visit
4. 6 week visit
5. 8 week visit
6. 12 week visit
7. 16 week visit
8. 20 week visit
9. 24 week visit
10. 28 week visit (final visit for boys)
11. 32 week visit
12. 36 week visit (final visit for girls)
In exchange you get all the formula you need to feed your baby if you're in one of the formula arms, or a breast pump if you're in the breast feeding arm.
You also get "an allotment" of diapers if you're in the breastfeeding arm. I was told that I should expect several large packages, and that I'd need a car to get them all home.
You also get $875 in cash for your visits if you have a girl, and $725 for boys.
*As a side note, when I went to the security desk to get my visitor's badge this morning, even though I said I was a visitor here for a research study, the guard asked me if I had a hospital ID. I said yes, and then she confiscated it! Fortunately, I basically never go to that hospital and plan on doing mostly adult medicine electives in the future, but in theory I could sign up to do some sort of clinical activity there at any time that would require my ID. Plus, it was my best picture out of all my hospital IDs, so I was a little annoyed that she took it. It's not as though it would work anyway. Good thing I'm not planning on doing peds! Otherwise I'd have to get a new ID, and that would be a giant PIA!
Sunday, December 18, 2011
More Baby Name Stuff
Also, last night Luca and I watched "Cat on a Hot Tin Roof," which had been unavailable on Netflix for years, and then finally appeared in my instant queue about 6 months ago I think. Anyway, it was AWESOME. Luca had some trouble understanding the heavy southern accents, but he managed to stay awake for the whole movie, which I think means he liked it too.
We briefly considered naming the offspring "Brick" after the Paul Newman character. They just don't make movies like this anymore these days, and well, I think it's not a bad name. It's better than Aiden anyway....
We then toyed (again, briefly) with naming the offspring after one of the University of Chicago Nobel Prize winning economists. Fogel, perhaps. Or Milton. We decided Coase wasn't that pretty, but August was nice for a boy or a girl. Then there were Simon, Arrow, Prescott, Sargent, and Lucas, or even Ted. I vetoed Becker though because I thought it sounded too much like "Pecker." When I suggested Levitt (even though he hasn't won a Nobel Prize), but Luca said he was too big an ass. To which I replied, "All economists are asses. That's what I like about them!"
Anyhow, all this is related to the movie we saw last night because after we moved on from economists, we thought we could go *extra* snooty and do playwrights instead. Which is where we ended up.
Our poor offspring! Hopefully he/she will like the name we saddle him/her with. We've at least put a lot of thought into it!
Sorry for totally geeking out on you all here. Sometimes I just have to get back to my UChicago roots, is all.
We briefly considered naming the offspring "Brick" after the Paul Newman character. They just don't make movies like this anymore these days, and well, I think it's not a bad name. It's better than Aiden anyway....
We then toyed (again, briefly) with naming the offspring after one of the University of Chicago Nobel Prize winning economists. Fogel, perhaps. Or Milton. We decided Coase wasn't that pretty, but August was nice for a boy or a girl. Then there were Simon, Arrow, Prescott, Sargent, and Lucas, or even Ted. I vetoed Becker though because I thought it sounded too much like "Pecker." When I suggested Levitt (even though he hasn't won a Nobel Prize), but Luca said he was too big an ass. To which I replied, "All economists are asses. That's what I like about them!"
Anyhow, all this is related to the movie we saw last night because after we moved on from economists, we thought we could go *extra* snooty and do playwrights instead. Which is where we ended up.
Our poor offspring! Hopefully he/she will like the name we saddle him/her with. We've at least put a lot of thought into it!
Sorry for totally geeking out on you all here. Sometimes I just have to get back to my UChicago roots, is all.
Oral Candidacy Proposal....
SUBMITTED!!!
I celebrated by helping Luca paint the basement.
Next:
(1) Create Power Point presentation for meeting on 1/3.
(2) Finish manuscript I've been sitting on for 6 months.
Then I'll actually be able to start the projects I've outlined in my proposal. Isn't that crazy?
I'm also hoping that over the next week or so, Luca and I can finish the basement, and then reorganize all the crap we have stashed all over the house. End goal: to get the house organized enough so that we can hire housecleaners to come and clean before the baby arrives.
And we have to meal plan and grocery shop for my parents' arrival on Friday. I think my dad is bringing the ham that we were originally planning on having over Thanksgiving had we gone to CT then. Don't worry, dear internet, it's been frozen this past month. At least I hope it has been.
It has been, right dad? If you're NOT bringing the ham, can you please let me know!
Also, I'd like to make some Christmas cookies.
But yay! I can back off the gas at school for a couple of days. Whee!
I celebrated by helping Luca paint the basement.
Next:
(1) Create Power Point presentation for meeting on 1/3.
(2) Finish manuscript I've been sitting on for 6 months.
Then I'll actually be able to start the projects I've outlined in my proposal. Isn't that crazy?
I'm also hoping that over the next week or so, Luca and I can finish the basement, and then reorganize all the crap we have stashed all over the house. End goal: to get the house organized enough so that we can hire housecleaners to come and clean before the baby arrives.
And we have to meal plan and grocery shop for my parents' arrival on Friday. I think my dad is bringing the ham that we were originally planning on having over Thanksgiving had we gone to CT then. Don't worry, dear internet, it's been frozen this past month. At least I hope it has been.
It has been, right dad? If you're NOT bringing the ham, can you please let me know!
Also, I'd like to make some Christmas cookies.
But yay! I can back off the gas at school for a couple of days. Whee!
Discoveries
This morning it was 30 degrees out. So, while Luca read over my oral candidacy exam proposal, I took the dog for a walk. And since it was cold (and since I am too enormous to wear my own coat), I wore Luca's coat.
It is a marvelous coat. It is so light and fluffy, but still warm and cozy. And is a man's XL. I don't even want to think about what I must look like in it.
And lo, I discovered that I could still run! Very slowly at first. It was more like trotting. I would trot 1 short block, and then walk 1 short block. I'd forgotten how much I like doing aerobic exercise in the cold. And it was low intensity enough that I didn't really even get winded, and the abdominal/pelvic bouncing was kept to a minimum. Not sure how well the baby liked it. It definitely woke up and squirmed around a bunch during the walking segments.
Unfortunately, the bouncing was not so minimal as to prevent my keys and phone from being jostled out of my pocket somewhere along the way. And of course I was wearing my hat and could not hear when it happened. I didn't discover this until I got home, and then (I think understandably) I freaked out.
Fortunately, Luca was home, so we used his phone to call my phone, and it turned out some lady had picked them up on her way to church. So we ran. All the way to the church on 50th and Baltimore, to go get them from her.
Damn we were lucky.
It was at this time that I discovered that not only can I still run, I can still run FAST. The jostling is minimized if I run on my toes and take lots of little steps. Isn't this was the Vibram 5 fingers shoes are supposed to do to your stride? Who knew you could get a similar effect from pregnancy!
It felt GREAT. Also, because I freaked out and yelled, the Boo was scared into submission, and didn't pull on the leash the entire way. Good Boo!
Perhaps I will have to try this more often. Or not. We'll see.
UPDATE: My shin splints are now back with a vengeance. Dammit! I suppose this is evidence that the athletic trainer in high school was right: The only way to make shin splints better is via rest. :-P
It is a marvelous coat. It is so light and fluffy, but still warm and cozy. And is a man's XL. I don't even want to think about what I must look like in it.
And lo, I discovered that I could still run! Very slowly at first. It was more like trotting. I would trot 1 short block, and then walk 1 short block. I'd forgotten how much I like doing aerobic exercise in the cold. And it was low intensity enough that I didn't really even get winded, and the abdominal/pelvic bouncing was kept to a minimum. Not sure how well the baby liked it. It definitely woke up and squirmed around a bunch during the walking segments.
Unfortunately, the bouncing was not so minimal as to prevent my keys and phone from being jostled out of my pocket somewhere along the way. And of course I was wearing my hat and could not hear when it happened. I didn't discover this until I got home, and then (I think understandably) I freaked out.
Fortunately, Luca was home, so we used his phone to call my phone, and it turned out some lady had picked them up on her way to church. So we ran. All the way to the church on 50th and Baltimore, to go get them from her.
Damn we were lucky.
It was at this time that I discovered that not only can I still run, I can still run FAST. The jostling is minimized if I run on my toes and take lots of little steps. Isn't this was the Vibram 5 fingers shoes are supposed to do to your stride? Who knew you could get a similar effect from pregnancy!
It felt GREAT. Also, because I freaked out and yelled, the Boo was scared into submission, and didn't pull on the leash the entire way. Good Boo!
Perhaps I will have to try this more often. Or not. We'll see.
UPDATE: My shin splints are now back with a vengeance. Dammit! I suppose this is evidence that the athletic trainer in high school was right: The only way to make shin splints better is via rest. :-P
My Law and Order addiction can be useful sometimes
Every so often, I start looking at boy baby names. Again. Because I can't seem to find one that I like.
Today I came across this one: Ryker.
Now come on people. I know you were probably going for tough and manly with a dash of sensitive. But did you HAVE to name your child after New York's main jail complex? Now I'll grant you, that is spelled with an "i", but it's still a bit like naming your son Alcatraz. Or Folsom.
Today I came across this one: Ryker.
Now come on people. I know you were probably going for tough and manly with a dash of sensitive. But did you HAVE to name your child after New York's main jail complex? Now I'll grant you, that is spelled with an "i", but it's still a bit like naming your son Alcatraz. Or Folsom.
Saturday, December 17, 2011
Today as I dragged Luca for our walk
As he whined about the cold, and about the dog's behavior (which actually was quite good today -- thank you gentle leader!!), and about how dirty the house was, etc.
I said, "Look honey, do you WANT me to have to push a 10 lb baby out of my vagina? Do you want me to be able to shi!t normally ever again in my life? And more important perhaps, do you want me to have a really really floppy vagina? No? So quit yer bitchin'."
So, he did.
(This, by the way, is why I married him. I don't think I could stand being married to some prudish man whom I couldn't say these things to. You're awesome, honey!!)
I said, "Look honey, do you WANT me to have to push a 10 lb baby out of my vagina? Do you want me to be able to shi!t normally ever again in my life? And more important perhaps, do you want me to have a really really floppy vagina? No? So quit yer bitchin'."
So, he did.
(This, by the way, is why I married him. I don't think I could stand being married to some prudish man whom I couldn't say these things to. You're awesome, honey!!)
A Visit From the Goon Squad
I also recently finished A Visit From the Goon Squad by Jennifer Egan. Her book, Look at Me, is one of my all time favorites, though probably a bit dated at this point. I liked Goon Squad too, but not as much, which is probably as much my fault as anything else.
The book reads like a series of short stories about different characters, that are all linked together. A minor character in one story will be the main character in the next story. And all in all I found that each story was highly readable, well written, and entertaining. There was great character development. I like the way she writes.
The problem for me was that, since I only have time to read for maybe 30 minutes a day (on a good day), I found myself not being able to remember the context in which characters had appeared in previous chapters, and what their significance had been, and thinking, "I really should go back and re-read that section, because I think this part might make more sense if I did," but then not really feeling like doing it.
Also, the power points that go along with the story don't come across super well on the Kindle. I wish they'd done a better job with that. The power points really seemed to bring things together. I just kept feeling like I was missing the bigger picture of Goon Squad as I read it.
I do feel like I'd want to re-read it if I had the time. If or when that will ever happen, I do not know. *Sigh*
At least I felt like I was reading "high quality" literature for a change.
:-)
It was definitely higher quality than the Hunger Games anyway, which don't get me wrong -- I LOVED that series. But Goon Squad was more like a fine red wine, whereas the Hunger Games are more like crack.
Next: Cutting For Stone, at the recommendation of Amy and ABB. It's a doctor book (which normally I eschew), but I've heard such good things about it, I decided to give it a try anyway.
The book reads like a series of short stories about different characters, that are all linked together. A minor character in one story will be the main character in the next story. And all in all I found that each story was highly readable, well written, and entertaining. There was great character development. I like the way she writes.
The problem for me was that, since I only have time to read for maybe 30 minutes a day (on a good day), I found myself not being able to remember the context in which characters had appeared in previous chapters, and what their significance had been, and thinking, "I really should go back and re-read that section, because I think this part might make more sense if I did," but then not really feeling like doing it.
Also, the power points that go along with the story don't come across super well on the Kindle. I wish they'd done a better job with that. The power points really seemed to bring things together. I just kept feeling like I was missing the bigger picture of Goon Squad as I read it.
I do feel like I'd want to re-read it if I had the time. If or when that will ever happen, I do not know. *Sigh*
At least I felt like I was reading "high quality" literature for a change.
:-)
It was definitely higher quality than the Hunger Games anyway, which don't get me wrong -- I LOVED that series. But Goon Squad was more like a fine red wine, whereas the Hunger Games are more like crack.
Next: Cutting For Stone, at the recommendation of Amy and ABB. It's a doctor book (which normally I eschew), but I've heard such good things about it, I decided to give it a try anyway.
Harry Potter
Luca and I stayed up last night to watch the last Harry Potter movie. While neither of us ever read the books (and never will), we found at least the first couple of movies in the series to be entertaining.
This last one was.... meh. Luca basically predicted what was going to happen in the first 5 minutes, and was completely right. So it was predictable. Also, Luca liked the special effects, but those kinds of things have never really done it for me anyway. Maybe my meh-ness has more to do with me not being able to sit still for 2 hr movie anymore in general, but in any case I found myself wanting to turn it off 1/2 through so I could go to bed.
Which is to say, I guess I'm glad I saw it so that I know what happens, but it was far from awesome.
In other news, yesterday the Ob told us that we needed to watch all of our adult movies before the baby arrived, because after that all we'd be able to see would be kids movies. It took a moment for us to realize that she meant that because of the cursing and adult content in regular movies. This hadn't really occurred to me. Do people really worry about this??
Good thing I've mostly stopped watching movies anyway.
As we were leaving I said to Luca, "Well, at least she didn't recommend that we go out to eat for date night!" That would have really annoyed me.
:-)
As a side note, we've been watching "How the Earth was Made," on Netflix recently. It's been pretty educational, probably because I know nothing about geology. (I'm just imagining a series called, "How your body works," and finding it to be horrifyingly oversimplified and wrong.) Also, I think I like it because each episode is about 45 minutes long, and you can totally not pay attention during most of it, and still get the main points.
Perfect!!
This last one was.... meh. Luca basically predicted what was going to happen in the first 5 minutes, and was completely right. So it was predictable. Also, Luca liked the special effects, but those kinds of things have never really done it for me anyway. Maybe my meh-ness has more to do with me not being able to sit still for 2 hr movie anymore in general, but in any case I found myself wanting to turn it off 1/2 through so I could go to bed.
Which is to say, I guess I'm glad I saw it so that I know what happens, but it was far from awesome.
In other news, yesterday the Ob told us that we needed to watch all of our adult movies before the baby arrived, because after that all we'd be able to see would be kids movies. It took a moment for us to realize that she meant that because of the cursing and adult content in regular movies. This hadn't really occurred to me. Do people really worry about this??
Good thing I've mostly stopped watching movies anyway.
As we were leaving I said to Luca, "Well, at least she didn't recommend that we go out to eat for date night!" That would have really annoyed me.
:-)
As a side note, we've been watching "How the Earth was Made," on Netflix recently. It's been pretty educational, probably because I know nothing about geology. (I'm just imagining a series called, "How your body works," and finding it to be horrifyingly oversimplified and wrong.) Also, I think I like it because each episode is about 45 minutes long, and you can totally not pay attention during most of it, and still get the main points.
Perfect!!
Friday, December 16, 2011
I'm in a good mood today
Luca stayed home with me for my prenatal appointment, and he finished painting the basement while I did some online Xmas shopping. I know, the pinnacle of productivity I am, with the writeup for my orals supposedly due at the end of today. Soooooooo not going to happen. But! It will happen over the weekend.
It's always nice to have him home with me during the day, even if it's only for a couple of hours.
While I was at the appointment I signed up for a research study on breastfeeding. I am (tentatively) in the "exclusive breastfeeding" group based on what I hope to be able to do, although who the heck knows what's going to happen in reality. In exchange for blood and urine from me and my baby, and something like 9-12 visits over the next 10 months, I get free diapers (lots of them) and a breast pump. Sweet!
Honestly though, I'm not doing this for the loot. I'm doing this because a) I like participating in research, and b) I consider it good karma to be a subject in other PIs' studies. Plus, I really should have the time to do this study over the next year, and it sounds kind of cool. I mean, it's still totally flawed in the sense that people who are *able* to exclusively breastfeed for 6 months are by definition different than those who wind up giving formula, so any result will be biased in this way. But I'll try not to put my Epidemiologist hat on too much. Plus, it's hard to say no to a free breast pump and diapers.
And then, we had the appointment. I knew today it would go well since Luca came with me. He told me that I was good, and it was impossible to tell how angry the doctor had made me at the last visit. (This was probably because I wasn't feeling angry at this visit....) We had a long conversation about due dates.
So, by LMP I am 35 weeks 6 days.
But! By ultrasound I am 35 weeks 3 days.
And I am measuring 36 cm up from 33 cm last visit.
I think she was expecting a fight over the 3 day discrepancy. I basically told the doctor that it didn't really matter to me much which set of dates they used, and if they needed to schedule a c-section or induce me, I would just go by what they thought would be best. I think she liked that.
:-)
I gained a mere pound in the last 2 weeks, which I think helped. Don't ask me how this is possible, because I. Don't. Know. It's not like I changed anything about my diet or activity level. Though, I did make sure *not* to have Chipotle (or anything else super salty) to eat for four days leading up to this appointment. Ha.
And now I should really get to work.
Thanks for all the helpful tips about choosing electives. Really, super helpful guys!
It's always nice to have him home with me during the day, even if it's only for a couple of hours.
While I was at the appointment I signed up for a research study on breastfeeding. I am (tentatively) in the "exclusive breastfeeding" group based on what I hope to be able to do, although who the heck knows what's going to happen in reality. In exchange for blood and urine from me and my baby, and something like 9-12 visits over the next 10 months, I get free diapers (lots of them) and a breast pump. Sweet!
Honestly though, I'm not doing this for the loot. I'm doing this because a) I like participating in research, and b) I consider it good karma to be a subject in other PIs' studies. Plus, I really should have the time to do this study over the next year, and it sounds kind of cool. I mean, it's still totally flawed in the sense that people who are *able* to exclusively breastfeed for 6 months are by definition different than those who wind up giving formula, so any result will be biased in this way. But I'll try not to put my Epidemiologist hat on too much. Plus, it's hard to say no to a free breast pump and diapers.
And then, we had the appointment. I knew today it would go well since Luca came with me. He told me that I was good, and it was impossible to tell how angry the doctor had made me at the last visit. (This was probably because I wasn't feeling angry at this visit....) We had a long conversation about due dates.
So, by LMP I am 35 weeks 6 days.
But! By ultrasound I am 35 weeks 3 days.
And I am measuring 36 cm up from 33 cm last visit.
I think she was expecting a fight over the 3 day discrepancy. I basically told the doctor that it didn't really matter to me much which set of dates they used, and if they needed to schedule a c-section or induce me, I would just go by what they thought would be best. I think she liked that.
:-)
I gained a mere pound in the last 2 weeks, which I think helped. Don't ask me how this is possible, because I. Don't. Know. It's not like I changed anything about my diet or activity level. Though, I did make sure *not* to have Chipotle (or anything else super salty) to eat for four days leading up to this appointment. Ha.
And now I should really get to work.
Thanks for all the helpful tips about choosing electives. Really, super helpful guys!
Thursday, December 15, 2011
Electives
When I go back to med school in 15 months(!) or so from now, I'm going to have a limited amount of time to a) remember how not to kill people, and b) decide what field I want to do. Since currently I do critical care outcomes research, and since I loved my medicine sub-i, obviously Internal Medicine is at the top of the list.
However I also really enjoy procedures and being in the OR. I especially liked rounding on the post-op trauma patients when I did that rotation (I know this is not normal), so therefore Anesthesia is on my radar as well.
(Not sure why I never considered Peds, even though I really liked that rotation.... but I never did. And in some ways it seems too late to go back.)
(I also like Neurology a lot, but I'm not so into outpatient medicine, and I want to do policy research, which is a better fit for IM or Anes. If I became a Neurologist, I worry that I'd have a hard time getting any of them to see the value of my non-basic science research, and honestly at this point in my life I'm tired of fighting that battle.)
(I like psychiatry too, but if I want to do policy I think it will be important to do a specialty that already has some cred in that area.)
Anyway, so I was thinking about what rotations I should do to get back in the swing of things. The following came to mind:
- Cardiology
- Possibly a second IM sub-i
- MICU or CCU (or SICU if I decided to go the Anes. route)
- Anesthesiology
- Internal Med Procedure Service (if that is actually an elective, which I'm not sure about)
- Pulmonary
- Renal
- Infectious Disease
- If I do IM, I should probably do an outpatient month also (barf)
You get the idea. Useful stuff. But then I was thinking about the kinds of electives that sounded FUN, probably in part because I know little to nothing about them. Like that I might do after I apply to residencies but before the match because I'd never really get the chance to see them again. So, I started coming up with THAT list too.
- Autopsy
- Neonatal ICU
- Neuro ICU (which I could actually do as an Anesthesiologist)
- Derm
And I wanted to open up the floor to your suggestions, dear readers.
A) What electives did you find most useful to you when you started residency?
and
B) What electives (if any) did you think were fun?
and
C) Would you advise eschewing the "fun" for the "useful"?
However I also really enjoy procedures and being in the OR. I especially liked rounding on the post-op trauma patients when I did that rotation (I know this is not normal), so therefore Anesthesia is on my radar as well.
(Not sure why I never considered Peds, even though I really liked that rotation.... but I never did. And in some ways it seems too late to go back.)
(I also like Neurology a lot, but I'm not so into outpatient medicine, and I want to do policy research, which is a better fit for IM or Anes. If I became a Neurologist, I worry that I'd have a hard time getting any of them to see the value of my non-basic science research, and honestly at this point in my life I'm tired of fighting that battle.)
(I like psychiatry too, but if I want to do policy I think it will be important to do a specialty that already has some cred in that area.)
Anyway, so I was thinking about what rotations I should do to get back in the swing of things. The following came to mind:
- Cardiology
- Possibly a second IM sub-i
- MICU or CCU (or SICU if I decided to go the Anes. route)
- Anesthesiology
- Internal Med Procedure Service (if that is actually an elective, which I'm not sure about)
- Pulmonary
- Renal
- Infectious Disease
- If I do IM, I should probably do an outpatient month also (barf)
You get the idea. Useful stuff. But then I was thinking about the kinds of electives that sounded FUN, probably in part because I know little to nothing about them. Like that I might do after I apply to residencies but before the match because I'd never really get the chance to see them again. So, I started coming up with THAT list too.
- Autopsy
- Neonatal ICU
- Neuro ICU (which I could actually do as an Anesthesiologist)
- Derm
And I wanted to open up the floor to your suggestions, dear readers.
A) What electives did you find most useful to you when you started residency?
and
B) What electives (if any) did you think were fun?
and
C) Would you advise eschewing the "fun" for the "useful"?
Med students at your delivery
The high maintenance mom at my childbirth classes (who never mellowed out AT ALL) went on a tirade about how there was no way she was going to allow medical students at her delivery during one of the classes.
I was curious, so I asked her why. I mean, she's entitled to her preference, but some people have very strange ideas about the role of med students at a delivery.
She told me that she didn't want to expose her babies to unnecessary cervical exams during delivery. Actually, this was a big thing for her since apparently she objected even to the cervical exams she was receiving at her 35+ week ob appointments when she was pregnant with TWINS. But I digress.
I don't think I laughed in her face, but I could have. I think during my entire 6 week Ob rotation at this hospital I did ONE cervical *or* pelvic exam (including on surgical patients) the entire rotation. And since her delivery was likely to be on the complex side, sure, they'd probably let the med student stand in a corner of the OR. But participate in any way? Hahahahaha.
I did tell her that she had very little to worry about re: med students violating her cervix, but whatever, if she didn't want them it was her prerogative. She sounded like a really bad patient to see as a med student anyway. Really confrontational, really ignorant (but thought she was educated), and really distrustful. As if a med student doesn't already have enough people being shitty to them on that rotation. They'd be better off with a multip who was more mellow about the whole process.
I was curious, so I asked her why. I mean, she's entitled to her preference, but some people have very strange ideas about the role of med students at a delivery.
She told me that she didn't want to expose her babies to unnecessary cervical exams during delivery. Actually, this was a big thing for her since apparently she objected even to the cervical exams she was receiving at her 35+ week ob appointments when she was pregnant with TWINS. But I digress.
I don't think I laughed in her face, but I could have. I think during my entire 6 week Ob rotation at this hospital I did ONE cervical *or* pelvic exam (including on surgical patients) the entire rotation. And since her delivery was likely to be on the complex side, sure, they'd probably let the med student stand in a corner of the OR. But participate in any way? Hahahahaha.
I did tell her that she had very little to worry about re: med students violating her cervix, but whatever, if she didn't want them it was her prerogative. She sounded like a really bad patient to see as a med student anyway. Really confrontational, really ignorant (but thought she was educated), and really distrustful. As if a med student doesn't already have enough people being shitty to them on that rotation. They'd be better off with a multip who was more mellow about the whole process.
Wednesday, December 14, 2011
Public
I was reading a blog post at another site I frequent, and I noticed a post with a very familiar story. As I kept reading, I realized that I knew this person in real life. I wondered if she realized how non-anonymous she was, and wondered whether she wanted the whole internet (and real world) to know what she was blogging about.
It made me think about my own (lack of) anonymity. As I get further along in my professional career, I start to worry about how this blog might be seen by future employers. I wonder how many people read it and hate me. I know that there are bloggers that *I* read whom I find to be less than appealing, definitely, and whom I probably wouldn't hire based on what I've read about them. I'd be naive to think that some people don't feel the same way about me and my blog.
On the other hand, I really like my blog community. It's been especially helpful for getting advice and support about first the dog, and now the pregnancy, and hopefully (soon) the baby also. It's also great therapy for me. I'd hate to give up blogging and lose that. Writing in a diary just isn't the same.
For the moment I tell myself that the benefits outweigh the costs. I wonder how long that will continue to be true.
I also wonder how much time I waste in a given day on the internet and if I'd be better off doing something more productive.
Things to consider....
I just don't know.
It made me think about my own (lack of) anonymity. As I get further along in my professional career, I start to worry about how this blog might be seen by future employers. I wonder how many people read it and hate me. I know that there are bloggers that *I* read whom I find to be less than appealing, definitely, and whom I probably wouldn't hire based on what I've read about them. I'd be naive to think that some people don't feel the same way about me and my blog.
On the other hand, I really like my blog community. It's been especially helpful for getting advice and support about first the dog, and now the pregnancy, and hopefully (soon) the baby also. It's also great therapy for me. I'd hate to give up blogging and lose that. Writing in a diary just isn't the same.
For the moment I tell myself that the benefits outweigh the costs. I wonder how long that will continue to be true.
I also wonder how much time I waste in a given day on the internet and if I'd be better off doing something more productive.
Things to consider....
I just don't know.
Monday, December 12, 2011
Oral Candidacy Exam
I received an email from one of the secretaries of my committee members that I *must* send my proposal for my oral candidacy exam by 12/19 OR ELSE. It's not as though I wasn't planning on doing that anyway since everyone else wants it by the end of this week. She just had to be the one to send the snarky email.
I don't know what this woman's particular deal is.... When I had my last meeting, the night before I sent out my agenda and got a SCATHING email about how her boss could not possibly be expected to go over documentation prior to the meeting on such short notice. I pointed out that it was an agenda, and that prior review was unnecessary.... and I never heard back. It's all very ironic since I'm not actually even planning on doing the project that this person's expertise was required for anymore, but I don't think I'm going to say anything this time either.
But I digress.
The hard deadline of 12/19 (or this Friday if you're going to get particular about things) means that AFTER 12/19 things should get a little easier. As in, I should have time to a) finish writing up this other manuscript that I've been working on, b) work on the slide deck I'll be presenting for my committee meeting, and c) get everything else in my life done that I haven't been able to in the past month and a half due to pregnancy exhaustion and otherwork. Did I mention that TAing ends the 19th as well? Can I tell you how glorious that will be?
Things I want to do....
1) Get haircut (it's been 4 months, and we all know it ain't happening for a while once the kiddo is born)
2) Take the Boolet to the vet for her checkup and some new Interceptor
3) Get people stuff for Christmas (actually, I've been thinking that online shopping would be a fantastic way to procrastinate this week while I get all this writing done)
4) Do inordinate amounts of laundry
5) Clean the house (ha)
6) Finish painting the basement trim (Luca did the walls this weekend, and it looks fantastic)
7) Organize the upstairs bedrooms that have been serving as storage areas for the basement since we *intended* to paint it 2 months ago, but never got around to it.
8) Pack my hospital bag
Not to mention all the Christmas-y things I *want* to do, but know that I won't have time for (cookies, decorating, meal planning for Christmas dinner, etc.)
We'll see if any of this actually gets done.
I'll just be happy to get my proposal out of the way. Cross your fingers that it happens for me in time!
I don't know what this woman's particular deal is.... When I had my last meeting, the night before I sent out my agenda and got a SCATHING email about how her boss could not possibly be expected to go over documentation prior to the meeting on such short notice. I pointed out that it was an agenda, and that prior review was unnecessary.... and I never heard back. It's all very ironic since I'm not actually even planning on doing the project that this person's expertise was required for anymore, but I don't think I'm going to say anything this time either.
But I digress.
The hard deadline of 12/19 (or this Friday if you're going to get particular about things) means that AFTER 12/19 things should get a little easier. As in, I should have time to a) finish writing up this other manuscript that I've been working on, b) work on the slide deck I'll be presenting for my committee meeting, and c) get everything else in my life done that I haven't been able to in the past month and a half due to pregnancy exhaustion and otherwork. Did I mention that TAing ends the 19th as well? Can I tell you how glorious that will be?
Things I want to do....
1) Get haircut (it's been 4 months, and we all know it ain't happening for a while once the kiddo is born)
2) Take the Boolet to the vet for her checkup and some new Interceptor
3) Get people stuff for Christmas (actually, I've been thinking that online shopping would be a fantastic way to procrastinate this week while I get all this writing done)
4) Do inordinate amounts of laundry
5) Clean the house (ha)
6) Finish painting the basement trim (Luca did the walls this weekend, and it looks fantastic)
7) Organize the upstairs bedrooms that have been serving as storage areas for the basement since we *intended* to paint it 2 months ago, but never got around to it.
8) Pack my hospital bag
Not to mention all the Christmas-y things I *want* to do, but know that I won't have time for (cookies, decorating, meal planning for Christmas dinner, etc.)
We'll see if any of this actually gets done.
I'll just be happy to get my proposal out of the way. Cross your fingers that it happens for me in time!
Saturday, December 10, 2011
Dear MD PhD Applicants in Epi
My department has an MD-PhD applicant this year!
I have always found it amusing that my department aggressively tries to manage our image by ONLY introducing the students to the applicant as a group, and while under the supervision of faculty members in our department. They know that most of us won't say anything that might garner the disapproval of our superiors, and that they will be able toperpetuate lies convey the image they want in this context. Plus, there are currently a lot of us because in one year they decided to admit 4-5 students at once, so it will look like we are a robust, well established department.
DO NOT BE FOOLED.
So. Here's the deal.
First, the cons:
1. Most MD-PhD students at my school are funded by a combination of MSTP funds and R01s that their PI have secured. This R01 funding more or less does not happen in my department. The powers that be do nothing to encourage faculty to write funding for PhD students into their grants, and as such only 2-3 faculty members in the *entire department* are able to fund you by this mechanism. The PhD director has applied for a training grant for PhD students, but so far we have not received one yet.
2. If you happen to be interested in working with one of these 2-3 faculty members (and how could you possibly even know that at this point -- you haven't even started med school yet, how can you possibly REALLY know what you want to do), you MUST get some sort of written documentation guaranteeing that they will pay for you while you are their student. Or else by the time you are their student, they will likely "forget" this promise and screw you over. I've seen this happen.
3. One other alternative source of funding exists: pharmacoepi. However they will only fund you for 1 year, and then they will require you to apply for your own grants. Plus, this particular funding source more or less requires that you promise you will devote your entire career to doing pharmacoepi research. Maybe some med students are willing to commit to this line of work that early in their career, but I was not.
4. If none of the above work for you, you will be required to get your own grant. The most common funding mechanism is the F30, but not all NIH departments have one, so you could end up SOL on this front as well. Even if there is an F30 for you to apply to, know that they are a giant pain in the ass/time suck. You'll most likely need to budget at least 2 months at 50% time to do a good job on this. You'll at least be in the fortunate position of not having to be the first person in the department to apply to this (that was me -- you're welcome -- and you really don't want to know how much that sucked), but it still a total time suck, and is not even guaranteed $. So you may have to apply more than once. Joy.
5. Technically as an MSTP student, you are "guaranteed" funding for up to 10 years here. You could try to press your luck and just not bother to apply for grants, but you will piss everyone off if you do this. The Epi department will try to force the MSTP program to pay for you, and the MSTP program will try to force the Epi department to pay for you. You will be caught in the middle. You will end up applying for a grant anyway, but only after everyone has already labeled you as difficult.
6. There are a TON of required courses. Some of them are awesome (i.e. any and all biostats offerings, advanced epi, outcomes research, clinical economics, and probably some other courses that I haven't taken also), but about 40% of them suck. And by suck I mean a) they require inordinate amounts of your time via class time and busywork assignments, b) they teach you very little, c) they make you want to put your head through a brick wall. Don't say I didn't warn you.
7. PhD students are not a department priority. Master's level students are their priority, and for the most part these are clinical fellows who will have little to no interest in you, your research, the fact that you are going to know more about research than they do. They will most likely see you, and treat you, as a medical student first and foremost. Which is to say that it is likely that they will default to completely ignoring you, or being outwardly rude to you until they realize that you aren't a moron after all.
8. Because of all the required coursework and grant writing, this program really will take you 8 years.
9. We are a very small, new PhD program, with all the problems that can bring with it.
The pros:
1. The MSTP program at my institution takes care of its students so well it's not even funny.
2. They really want you to succeed, and want you to graduate within a reasonable amount of time (7-8 years). If you think it is like this everywhere, PLEASE think again. I know an attending in my field who did an ELEVEN year MD-PhD at my old institution. This problem tends to be worse when the PhD and MD programs are less integrated, and worse with social science departments.
3. If you are a PhD student in the biological or physical sciences, typically the stipend is a lot better than it is in the social sciences (30K per year compared with 18K or some such, and social science depts may not cover health insurance either). When you go to PhD-land, some schools will make up the difference in stipend so that you get paid the same as the other students, others will not. My school DOES make up this difference. I can't even imagine trying to live in Philadelphia in a non-slum on 18K per year, though I suppose people must do it.
4. Grant writing sucks, but getting a grant as a PhD student looks awesome on your CV. Also, it's what you'll be doing for the rest of your life if you go into academic medicine, so you might as well figure out if you like it now.
5. You can totally customize your training program to get exactly the kind of training you want, that is specific to your research interests.
6. The researchers here are some of the best in their fields. Some of them are even good mentors too.
7. The med school here is amazing. The MD-PhD office does a great job integrating the PhD part with the MD part as best as it can.
8. I really do feel like I've gotten the training I need to be a successful researcher in the future.
9. You won't be the first student to do MD-PhD in Epi (that was me), and you can benefit from advice / path-clearing from the people who came ahead of you.
10. Most students in my dept end up with a ton of publications.
11. A lot of the work you do is going to be very self directed since nobody has time to work closely with you on any sort of consistent basis. You will figure out very quickly if research is for you in this way.
12. The biostats department is amazing.
13. Fundamentally, despite all my bitching and moaning, I am happy I came here. I will have great options for my career when I finally finish this thing -- even better options than I would have had if I'd done basic science instead.
So, I have no idea whether this post will reach any of the people it needs to reach, but this is the scoop. I hope it's useful! And for those people applying in other non-trad MD-PhD fields, a lot of the points I raised will most likely be useful for you as well.
Good luck! And perhaps I'll see you on the interview circuit.
I have always found it amusing that my department aggressively tries to manage our image by ONLY introducing the students to the applicant as a group, and while under the supervision of faculty members in our department. They know that most of us won't say anything that might garner the disapproval of our superiors, and that they will be able to
DO NOT BE FOOLED.
So. Here's the deal.
First, the cons:
1. Most MD-PhD students at my school are funded by a combination of MSTP funds and R01s that their PI have secured. This R01 funding more or less does not happen in my department. The powers that be do nothing to encourage faculty to write funding for PhD students into their grants, and as such only 2-3 faculty members in the *entire department* are able to fund you by this mechanism. The PhD director has applied for a training grant for PhD students, but so far we have not received one yet.
2. If you happen to be interested in working with one of these 2-3 faculty members (and how could you possibly even know that at this point -- you haven't even started med school yet, how can you possibly REALLY know what you want to do), you MUST get some sort of written documentation guaranteeing that they will pay for you while you are their student. Or else by the time you are their student, they will likely "forget" this promise and screw you over. I've seen this happen.
3. One other alternative source of funding exists: pharmacoepi. However they will only fund you for 1 year, and then they will require you to apply for your own grants. Plus, this particular funding source more or less requires that you promise you will devote your entire career to doing pharmacoepi research. Maybe some med students are willing to commit to this line of work that early in their career, but I was not.
4. If none of the above work for you, you will be required to get your own grant. The most common funding mechanism is the F30, but not all NIH departments have one, so you could end up SOL on this front as well. Even if there is an F30 for you to apply to, know that they are a giant pain in the ass/time suck. You'll most likely need to budget at least 2 months at 50% time to do a good job on this. You'll at least be in the fortunate position of not having to be the first person in the department to apply to this (that was me -- you're welcome -- and you really don't want to know how much that sucked), but it still a total time suck, and is not even guaranteed $. So you may have to apply more than once. Joy.
5. Technically as an MSTP student, you are "guaranteed" funding for up to 10 years here. You could try to press your luck and just not bother to apply for grants, but you will piss everyone off if you do this. The Epi department will try to force the MSTP program to pay for you, and the MSTP program will try to force the Epi department to pay for you. You will be caught in the middle. You will end up applying for a grant anyway, but only after everyone has already labeled you as difficult.
6. There are a TON of required courses. Some of them are awesome (i.e. any and all biostats offerings, advanced epi, outcomes research, clinical economics, and probably some other courses that I haven't taken also), but about 40% of them suck. And by suck I mean a) they require inordinate amounts of your time via class time and busywork assignments, b) they teach you very little, c) they make you want to put your head through a brick wall. Don't say I didn't warn you.
7. PhD students are not a department priority. Master's level students are their priority, and for the most part these are clinical fellows who will have little to no interest in you, your research, the fact that you are going to know more about research than they do. They will most likely see you, and treat you, as a medical student first and foremost. Which is to say that it is likely that they will default to completely ignoring you, or being outwardly rude to you until they realize that you aren't a moron after all.
8. Because of all the required coursework and grant writing, this program really will take you 8 years.
9. We are a very small, new PhD program, with all the problems that can bring with it.
The pros:
1. The MSTP program at my institution takes care of its students so well it's not even funny.
2. They really want you to succeed, and want you to graduate within a reasonable amount of time (7-8 years). If you think it is like this everywhere, PLEASE think again. I know an attending in my field who did an ELEVEN year MD-PhD at my old institution. This problem tends to be worse when the PhD and MD programs are less integrated, and worse with social science departments.
3. If you are a PhD student in the biological or physical sciences, typically the stipend is a lot better than it is in the social sciences (30K per year compared with 18K or some such, and social science depts may not cover health insurance either). When you go to PhD-land, some schools will make up the difference in stipend so that you get paid the same as the other students, others will not. My school DOES make up this difference. I can't even imagine trying to live in Philadelphia in a non-slum on 18K per year, though I suppose people must do it.
4. Grant writing sucks, but getting a grant as a PhD student looks awesome on your CV. Also, it's what you'll be doing for the rest of your life if you go into academic medicine, so you might as well figure out if you like it now.
5. You can totally customize your training program to get exactly the kind of training you want, that is specific to your research interests.
6. The researchers here are some of the best in their fields. Some of them are even good mentors too.
7. The med school here is amazing. The MD-PhD office does a great job integrating the PhD part with the MD part as best as it can.
8. I really do feel like I've gotten the training I need to be a successful researcher in the future.
9. You won't be the first student to do MD-PhD in Epi (that was me), and you can benefit from advice / path-clearing from the people who came ahead of you.
10. Most students in my dept end up with a ton of publications.
11. A lot of the work you do is going to be very self directed since nobody has time to work closely with you on any sort of consistent basis. You will figure out very quickly if research is for you in this way.
12. The biostats department is amazing.
13. Fundamentally, despite all my bitching and moaning, I am happy I came here. I will have great options for my career when I finally finish this thing -- even better options than I would have had if I'd done basic science instead.
So, I have no idea whether this post will reach any of the people it needs to reach, but this is the scoop. I hope it's useful! And for those people applying in other non-trad MD-PhD fields, a lot of the points I raised will most likely be useful for you as well.
Good luck! And perhaps I'll see you on the interview circuit.
Race
This morning, instead of working on my protocol, I decided to a) give my husband a haircut, b) wash the dog, and c) wash myself. While I was doing this, my mind drifted to policy.
So, one of the ways in which hospitals are currently rated is based on their observed/expected mortality ratio. Ratios > 1 are bad. Ratios < 1 are good. Way back when in the early 90s or something, they didn't used to adjust for patient mix, but now they do. This is important because different hospitals serve different patient populations, and policy people didn't want to penalize hospitals that had complicated patients who might do worse through no fault of their own.
The adjustment isn't perfect, and for (most likely) political reasons, the ranking system is set up so that it doesn't "unfairly" punish small or community hospitals or reward big teaching hospitals. The end result is that more or less all hospitals look the same according to this metric. Woo! Just think of how much money has been poured into developing a ranking system that does exactly nothing.
In the severity adjustment, they adjust for patient severity of illness, comorbidities, age, and a variety of other things that are supposed to reflect the probability that you will die.
Do you think they should also adjust for race?
I don't, and here's why:
If you adjust for something in a statistical model, that means that you will end up making your comparisons across other hospitals with like characteristics. For instance, if you adjust for gender, you'll make one set of comparisons among women, and another among men. If you adjust for race (black or not black just to make things simple for now), you will make comparisons among hospitals that serve a lot of black patients and separate comparisons among hospitals that serve primarily non-black patients.
What's the problem with that, you're wondering. Don't we know that black patients have worse outcomes, even after we severity adjust? (Yes, this is true.) Wouldn't you be encouraging hospitals to turn away black patients if you didn't adjust for that? (Maybe.)
But the problem is, if you adjust for race, you're giving hospitals a free pass to do a worse job caring for black people, for no other reason than that they're black. And is it because some patients are black that they have worse outcomes? Or are there other underlying factors that are associated with being black that causes this population to have worse outcomes? I would argue that the latter is the more accurate picture.
Could you adjust for insurance status instead, so that hospitals that serve a lot of underserved patients aren't penalized for that? I'm not sure. The incentives would end up being similar, except now hospitals would get a "free pass" if they did a bad job caring for uninsured patients. At least you don't wear your insurance status on your skin though, and it would be harder to consciously or sub-consciously treat these patients worse.
Insurance status is a bit of a moot point anyway, since all of these models are based on Medicare data, where everyone has Medicare for insurance already! All that damage from being uninsured before you got on Medicare has already been done.
Anyway, these are the things I think about when I wash the dog.
So, one of the ways in which hospitals are currently rated is based on their observed/expected mortality ratio. Ratios > 1 are bad. Ratios < 1 are good. Way back when in the early 90s or something, they didn't used to adjust for patient mix, but now they do. This is important because different hospitals serve different patient populations, and policy people didn't want to penalize hospitals that had complicated patients who might do worse through no fault of their own.
The adjustment isn't perfect, and for (most likely) political reasons, the ranking system is set up so that it doesn't "unfairly" punish small or community hospitals or reward big teaching hospitals. The end result is that more or less all hospitals look the same according to this metric. Woo! Just think of how much money has been poured into developing a ranking system that does exactly nothing.
In the severity adjustment, they adjust for patient severity of illness, comorbidities, age, and a variety of other things that are supposed to reflect the probability that you will die.
Do you think they should also adjust for race?
I don't, and here's why:
If you adjust for something in a statistical model, that means that you will end up making your comparisons across other hospitals with like characteristics. For instance, if you adjust for gender, you'll make one set of comparisons among women, and another among men. If you adjust for race (black or not black just to make things simple for now), you will make comparisons among hospitals that serve a lot of black patients and separate comparisons among hospitals that serve primarily non-black patients.
What's the problem with that, you're wondering. Don't we know that black patients have worse outcomes, even after we severity adjust? (Yes, this is true.) Wouldn't you be encouraging hospitals to turn away black patients if you didn't adjust for that? (Maybe.)
But the problem is, if you adjust for race, you're giving hospitals a free pass to do a worse job caring for black people, for no other reason than that they're black. And is it because some patients are black that they have worse outcomes? Or are there other underlying factors that are associated with being black that causes this population to have worse outcomes? I would argue that the latter is the more accurate picture.
Could you adjust for insurance status instead, so that hospitals that serve a lot of underserved patients aren't penalized for that? I'm not sure. The incentives would end up being similar, except now hospitals would get a "free pass" if they did a bad job caring for uninsured patients. At least you don't wear your insurance status on your skin though, and it would be harder to consciously or sub-consciously treat these patients worse.
Insurance status is a bit of a moot point anyway, since all of these models are based on Medicare data, where everyone has Medicare for insurance already! All that damage from being uninsured before you got on Medicare has already been done.
Anyway, these are the things I think about when I wash the dog.
Friday, December 09, 2011
The snot disease
Ok this is going to be really whiny, but my husband gave me his cold and I feel soooooo gross!!! No fever or anything dramatic, but there is just so much snot! I've been trying to sleep as much as I can at night in an effort to eradicate this thing, but I fear I'm just going to have to wait it out.
Of course my husband has fully recovered. Damn him and his immune system of steel. I've been eating clementines and drinking grapefruit juice, and they definitely help. I'm going to attempt walking to school this morning again in the hopes that the cool air will help as well.
Just saying, it is not fun to come down with a cold ever. But it is especially not fun when you have the written part of your oral candidacy exam to do within the week, and all you want to do is lie on the couch, but instead you're stuck sitting at your kitchen table doing lit reviews and power calculations.
:-P
Of course my husband has fully recovered. Damn him and his immune system of steel. I've been eating clementines and drinking grapefruit juice, and they definitely help. I'm going to attempt walking to school this morning again in the hopes that the cool air will help as well.
Just saying, it is not fun to come down with a cold ever. But it is especially not fun when you have the written part of your oral candidacy exam to do within the week, and all you want to do is lie on the couch, but instead you're stuck sitting at your kitchen table doing lit reviews and power calculations.
:-P
Thursday, December 08, 2011
Med students on ob
I found out last night that one of my MD-PhD classmates is going to be doing his Ob/Gyn rotation at the hospital I'm delivering at during the month I am delivering.
Nice guy. Well liked. But also he was the guy who wore the cadaver's omentum as a wig during anatomy lab 5 years ago. The kind of guy who makes inappropriate jokes that are really funny, but that are not ok for girls to make. You know what I mean.
So it appears that my prohibition on med students in the delivery room was well thought out.
We all had quite a good laugh about this.
Nice guy. Well liked. But also he was the guy who wore the cadaver's omentum as a wig during anatomy lab 5 years ago. The kind of guy who makes inappropriate jokes that are really funny, but that are not ok for girls to make. You know what I mean.
So it appears that my prohibition on med students in the delivery room was well thought out.
We all had quite a good laugh about this.
Wednesday, December 07, 2011
Woo!
Last childbirth class was last night, and as a bonus, they couldn't get the video to work so we got to leave 30 minutes early!
Yay!!!
I really haven't enjoyed these classes. I'm not disputing their usefulness. It's just.... they leave me with a sense of dread about the whole having a baby process.
They had a mom come in last night to tell us what the process of giving birth and breastfeeding was like, and she was really really trying to be perky. And.... she was really really not succeeding in convincing me that she was happy. And I swear, if someone tells me about another item I MUST buy or else my life will be ruined. Sheesh.
So internet, I have a question for you: how soon after you gave birth were you able to start working out again (running, swimming, walking even, etc.)? What were the main barriers, and how do you suggest overcoming them? All I can think about these days is how badly I want to go for a run. And while I know that it's going to be at least several weeks before I'm able to after I give birth, any tips would be most appreciated!
Yay!!!
I really haven't enjoyed these classes. I'm not disputing their usefulness. It's just.... they leave me with a sense of dread about the whole having a baby process.
They had a mom come in last night to tell us what the process of giving birth and breastfeeding was like, and she was really really trying to be perky. And.... she was really really not succeeding in convincing me that she was happy. And I swear, if someone tells me about another item I MUST buy or else my life will be ruined. Sheesh.
So internet, I have a question for you: how soon after you gave birth were you able to start working out again (running, swimming, walking even, etc.)? What were the main barriers, and how do you suggest overcoming them? All I can think about these days is how badly I want to go for a run. And while I know that it's going to be at least several weeks before I'm able to after I give birth, any tips would be most appreciated!
Tuesday, December 06, 2011
Nerds
Yesterday I was talking with someone who has a penchant for boring me to tears with his obsession with fantasy football about someone else in my department.
"But he's such a NERD!" said Fantasy Football. It was clear by the way he said it that he didn't think the term "nerd" was complimentary.
He continued, "All he's ever able to talk about is his own research! It's so boring! And he's so arrogant!"
"Yeah, but he's usually right, even if that fact is sometimes annoying. And plus I kind of like listening to his stories about his work, even if he does have a high opinion of himself. He's really smart," I said.
"Ugh, but he's such a NERD!!" Fantasy Football exclaimed again.
"Well, maybe I'm just used to that kind of person. That's what pretty much everyone is like at the University of Chicago," I said, leaving out that I usually like nerdy people and find them interesting. Heck, one of the things that drew me to Luca was his knowledge of Latin poets (no I am not kidding). Nerdy is hot.
I thought to myself that I hadn't heard the word "nerd" used so pejoratively in quite some time. And what's so different about an inability to talk about anything but fantasy football, really? Except that fantasy football is not interesting to me, and this guy's work is.
Different strokes for different folks, I guess.
*Sigh*
Sometimes I really miss the University of Chicago.
"But he's such a NERD!" said Fantasy Football. It was clear by the way he said it that he didn't think the term "nerd" was complimentary.
He continued, "All he's ever able to talk about is his own research! It's so boring! And he's so arrogant!"
"Yeah, but he's usually right, even if that fact is sometimes annoying. And plus I kind of like listening to his stories about his work, even if he does have a high opinion of himself. He's really smart," I said.
"Ugh, but he's such a NERD!!" Fantasy Football exclaimed again.
"Well, maybe I'm just used to that kind of person. That's what pretty much everyone is like at the University of Chicago," I said, leaving out that I usually like nerdy people and find them interesting. Heck, one of the things that drew me to Luca was his knowledge of Latin poets (no I am not kidding). Nerdy is hot.
I thought to myself that I hadn't heard the word "nerd" used so pejoratively in quite some time. And what's so different about an inability to talk about anything but fantasy football, really? Except that fantasy football is not interesting to me, and this guy's work is.
Different strokes for different folks, I guess.
*Sigh*
Sometimes I really miss the University of Chicago.
Monday, December 05, 2011
Of course
Of course, right in the middle of writing up my protocols for my oral candidacy exam, I have to complete renewal documentation for my F30.
So I get the documents from the grant administrator at my school with a bunch of barely literate instructions. She sent that to me last Thursday with instructions to have it back to her by this coming Friday. Complete with signatures from my department chair and my sponsor. And let's be clear: electronic signatures will not do. I must print out said document, and hand carry it to these individuals' offices which are all over campus, wait for them to sign it, collect the document, and then hand carry it to the next individual.
It's annoying, is all I am saying.
Add to the fact that they are both very busy and are unlikely to be around. Both of them have goddesses for admins, but there's only so much that even they can do.
Did I mention that the person who filled out the form put in the wrong sponsor as well? When I asked her to correct it she just said, "Why don't you just white out the fields and change them yourself?"
Well, I could, but since those particular fields comprise about 50% of the fields on the document, it's going to look pretty sloppy. And on that particular document I can't edit it electronically, so yeah, it really would be me and a bottle of white out and a blue pen. Yeah: SLOPPY. (And really, how hard is it to get this information right? How lazy do you have to be not to look that up? Or at least send me a form that I can modify electronically. Is this really asking too much?)
Did I mention that the other documents are not savable with changes? So basically, I have to put in my information, and then print the documents out immediately. Which can't happen at my house since I don't have a printer here that is high enough quality for this.
Don't you love the administrative hurdles one must leap in the name of science?
I have no idea what will happen when I give this to her late. Oh well. Since she hasn't seen fit to reply to my emails about that, then it's just going to get turned in when it gets turned in. Too freaking bad.
Grumble grumble grumble.....
So I get the documents from the grant administrator at my school with a bunch of barely literate instructions. She sent that to me last Thursday with instructions to have it back to her by this coming Friday. Complete with signatures from my department chair and my sponsor. And let's be clear: electronic signatures will not do. I must print out said document, and hand carry it to these individuals' offices which are all over campus, wait for them to sign it, collect the document, and then hand carry it to the next individual.
It's annoying, is all I am saying.
Add to the fact that they are both very busy and are unlikely to be around. Both of them have goddesses for admins, but there's only so much that even they can do.
Did I mention that the person who filled out the form put in the wrong sponsor as well? When I asked her to correct it she just said, "Why don't you just white out the fields and change them yourself?"
Well, I could, but since those particular fields comprise about 50% of the fields on the document, it's going to look pretty sloppy. And on that particular document I can't edit it electronically, so yeah, it really would be me and a bottle of white out and a blue pen. Yeah: SLOPPY. (And really, how hard is it to get this information right? How lazy do you have to be not to look that up? Or at least send me a form that I can modify electronically. Is this really asking too much?)
Did I mention that the other documents are not savable with changes? So basically, I have to put in my information, and then print the documents out immediately. Which can't happen at my house since I don't have a printer here that is high enough quality for this.
Don't you love the administrative hurdles one must leap in the name of science?
I have no idea what will happen when I give this to her late. Oh well. Since she hasn't seen fit to reply to my emails about that, then it's just going to get turned in when it gets turned in. Too freaking bad.
Grumble grumble grumble.....
Sunday, December 04, 2011
Swim Attire
I hear swimming is supposed to be some kind of divine exercise for pregnant women. Unfortunately, my one pieces stopped fitting a while ago (serves me right for buying the indestructible polyester suits). In addition I developed this fear that I would run into someone from my department, and be forced to have an awkward conversation about my pregnancy while I was practically naked and shivering in my bathing suit.
I've since gotten over that fear. Those conversations? Already been (awkwardly) had in the elevator. And it is So. Much. Easier. to end them when it's your floor and the door closes behind you as you exit halfway through some (awkward) sentence.
Also, I can't see, much less shave, my bikini line, and didn't want to give the kids a faceful o' bush because I didn't know it was sticking out.
Also, the pool is cold.
Anyway, last week Luca suggested that I wear one of my athletic bikinis (I have a small rack so "athletic" is the only kind of bikini that works on me). His rationale was my mentor's wife wore a bikini while 7 months pregnant at the department picnic, and our friend wore one while 8 months pregnant to a July 4th barbeque at the neighborhood pool. And both ladies looked fantastic. Well, a lot more fantastic than they would have in a maternity suit anyway.
I was still apprehensive given the bikini line issue. Also, I was worried that the bottom wouldn't fully cover my crack (which is why they have maternity underwear in case you didn't know). So tonight, we tried it out to see if it would be a disaster.
Below are the results.
I think I like the last one the best, and yes I had to lean forward so that I could capture my toes peeking out from underneath my immenseness.
And while I'm certainly no Heidi Klum, I'd like to think confidence goes a long way. Or so I am telling myself. Now, if I could only get my behind out of bed in the morning early enough to get to the pool.....
If I go I will keep you posted.
I've since gotten over that fear. Those conversations? Already been (awkwardly) had in the elevator. And it is So. Much. Easier. to end them when it's your floor and the door closes behind you as you exit halfway through some (awkward) sentence.
Also, I can't see, much less shave, my bikini line, and didn't want to give the kids a faceful o' bush because I didn't know it was sticking out.
Also, the pool is cold.
Anyway, last week Luca suggested that I wear one of my athletic bikinis (I have a small rack so "athletic" is the only kind of bikini that works on me). His rationale was my mentor's wife wore a bikini while 7 months pregnant at the department picnic, and our friend wore one while 8 months pregnant to a July 4th barbeque at the neighborhood pool. And both ladies looked fantastic. Well, a lot more fantastic than they would have in a maternity suit anyway.
I was still apprehensive given the bikini line issue. Also, I was worried that the bottom wouldn't fully cover my crack (which is why they have maternity underwear in case you didn't know). So tonight, we tried it out to see if it would be a disaster.
Below are the results.
I think I like the last one the best, and yes I had to lean forward so that I could capture my toes peeking out from underneath my immenseness.
And while I'm certainly no Heidi Klum, I'd like to think confidence goes a long way. Or so I am telling myself. Now, if I could only get my behind out of bed in the morning early enough to get to the pool.....
If I go I will keep you posted.
Baby Center -- Birth Plan
As per my friend's suggestion, I signed up to get the weekly Baby Center updates. They send a cute email every week that tells you what your baby's development is up to and what to expect with how you feel. It's been nice. They also have a decent baby names search engine. I could do without the articles like, "Danger foods to avoid around the holiday season," but I suppose no internet service is perfect.
Anyway, I was clicking around the site today, and noticed that they recommended writing a birth plan. Now, in the past I've always thought birth plans were asinine, and typically written by granola women who wanted more control than is possible during birth, avoiding all interventions, eating their placentas, etc. However I was surprised to find this template to be very useful.
I won't go through every item on the list, but let's just say that not only were there things that I DID want, but that I actually felt quite adamant about them.
For instance:
- Only Luca is allowed in the room with me. No other relatives. Also, he is not allowed to leave. Ever. (Except to pee and maybe get food for himself.) I might allow a friend of mine who is a resident there to visit while I'm in labor depending on how things are going, but that's the only exception.
- His job is to take pictures and keep the nurse/drs under control. I've found that his mere presence helps with that sort of thing. They tend to lecture less and talk to me like an adult rather than a little girl when he is there.
- I do want to be able to walk around as much as I want. I realize that if I get an epidural, they won't let me. They tried to skirt around this during the anesthesia talk during childbirth class, and I recognize it's a liability issue for them, but I think that being confined to bed for a long time will make me nuts. Therefore I plan to defer the epidural as long as I can.
- I don't really care if I eat or drink as long as I have my Aquaphor.
- It would be nice to have intermittent fetal monitoring so that I can walk around, though I don't know if that will be permitted (which is where having Luca there might end up being helpful).
- I'd prefer to not have my labor be augmented if possible. If it needs to be augmented, then I want an epidural BEFORE that happens.
- I do not want to be coached while pushing.
- Specifically, I have instructed Luca that if the resident / nurse / attending says anything like the following: "I don't want to hear you scream / grunt/ make any noise while you push!! Any noise you make is less energy directed out of your vagina!" as I heard said MANY times during my Ob/Gyn rotation, he is to ask them not to say that. If that doesn't work, he is to ask them whether they think grunting makes Serena Williams hit the tennis ball less forcefully. And if they still can't control themselves, he is to kick them out of the room.*
- NO MEDICAL STUDENTS. These are people I am going to be graduating with, and there is quite simply no need. If I could not have residents at this hospital, I'd do that too, since I haven't met a single senior (female) Ob/Gyn resident that I have not found to be highly unpleasant. However, I doubt I will have that option.
- It would be awesome if Luca is allowed to help catch the baby. I don't know if they'd permit that, but I don't really see why not since they let jackass 1st year "watch a birth" med students who know nothing catch from time to time (though interestingly not actual clerkship students who might be interested in going into Ob/Gyn.... Not that I know anything about that.)
- It might actually be kind of cool to touch the baby's head as it crowns.
- If I have a c-section, I'd like to be able to see the baby be delivered over the blue screen if possible. Also, Luca must be present.
- It might be nice to donate the cord blood, though I'm not paying to do it.
- I want to room in with the baby after delivery 24h per day, and if I can't be there then Luca has to be.
One thing that has struck me as I wrote this is that I realized that I don't trust that I will be listened to when I'm in labor. My guess is that this is related to the fact that I AM NOT actually listened to (or treated like a person, much less an adult) at my prenatal appointments. Hm.
I guess I just don't like being treated like a patient on an assembly line. I never realized how important this was to me before this experience. Perhaps this doesn't bother other people, but it definitely bothers me.
*This wasn't actually on the birth plan checklist, but I remember vividly them talking to patients like this.
Anyway, I was clicking around the site today, and noticed that they recommended writing a birth plan. Now, in the past I've always thought birth plans were asinine, and typically written by granola women who wanted more control than is possible during birth, avoiding all interventions, eating their placentas, etc. However I was surprised to find this template to be very useful.
I won't go through every item on the list, but let's just say that not only were there things that I DID want, but that I actually felt quite adamant about them.
For instance:
- Only Luca is allowed in the room with me. No other relatives. Also, he is not allowed to leave. Ever. (Except to pee and maybe get food for himself.) I might allow a friend of mine who is a resident there to visit while I'm in labor depending on how things are going, but that's the only exception.
- His job is to take pictures and keep the nurse/drs under control. I've found that his mere presence helps with that sort of thing. They tend to lecture less and talk to me like an adult rather than a little girl when he is there.
- I do want to be able to walk around as much as I want. I realize that if I get an epidural, they won't let me. They tried to skirt around this during the anesthesia talk during childbirth class, and I recognize it's a liability issue for them, but I think that being confined to bed for a long time will make me nuts. Therefore I plan to defer the epidural as long as I can.
- I don't really care if I eat or drink as long as I have my Aquaphor.
- It would be nice to have intermittent fetal monitoring so that I can walk around, though I don't know if that will be permitted (which is where having Luca there might end up being helpful).
- I'd prefer to not have my labor be augmented if possible. If it needs to be augmented, then I want an epidural BEFORE that happens.
- I do not want to be coached while pushing.
- Specifically, I have instructed Luca that if the resident / nurse / attending says anything like the following: "I don't want to hear you scream / grunt/ make any noise while you push!! Any noise you make is less energy directed out of your vagina!" as I heard said MANY times during my Ob/Gyn rotation, he is to ask them not to say that. If that doesn't work, he is to ask them whether they think grunting makes Serena Williams hit the tennis ball less forcefully. And if they still can't control themselves, he is to kick them out of the room.*
- NO MEDICAL STUDENTS. These are people I am going to be graduating with, and there is quite simply no need. If I could not have residents at this hospital, I'd do that too, since I haven't met a single senior (female) Ob/Gyn resident that I have not found to be highly unpleasant. However, I doubt I will have that option.
- It would be awesome if Luca is allowed to help catch the baby. I don't know if they'd permit that, but I don't really see why not since they let jackass 1st year "watch a birth" med students who know nothing catch from time to time (though interestingly not actual clerkship students who might be interested in going into Ob/Gyn.... Not that I know anything about that.)
- It might actually be kind of cool to touch the baby's head as it crowns.
- If I have a c-section, I'd like to be able to see the baby be delivered over the blue screen if possible. Also, Luca must be present.
- It might be nice to donate the cord blood, though I'm not paying to do it.
- I want to room in with the baby after delivery 24h per day, and if I can't be there then Luca has to be.
One thing that has struck me as I wrote this is that I realized that I don't trust that I will be listened to when I'm in labor. My guess is that this is related to the fact that I AM NOT actually listened to (or treated like a person, much less an adult) at my prenatal appointments. Hm.
I guess I just don't like being treated like a patient on an assembly line. I never realized how important this was to me before this experience. Perhaps this doesn't bother other people, but it definitely bothers me.
*This wasn't actually on the birth plan checklist, but I remember vividly them talking to patients like this.
Friday, December 02, 2011
All ObGyns are bitches and deserve to die
Ok, not ALL of them. I ran into my REI Ob in the elevator today on the way to my prenatal appointment, and she remembered me from 6 months ago, and was so nice to me. I think she's amazing.
It's all those other ones.
So, I am currently 32 weeks and 6 days. My weight gain has been 22.9 lbs as of 7:30 this morning according to my scale (baseline weight 125 lbs, current weight 147.9 lbs). Since my last visit 2 weeks ago, I gained 1.5 lbs, (146.4 two weeks ago, and 147.9 this morning). I haven't been walking *as much* lately because it makes me so freaking exhausted -- I get winded walking up any sort of incline, my shins hurt, my abdomen hurts and I get really uncomfortable pelvic pressure, and if I have to stand, I get REALLY winded and feel like I want to pass out.... but! I've still been walking about 1-2 miles every day. It just sucks having to do it carrying a computer on my back.
Well, according to the Ob I saw today, the reason I get so tired walking is because of how fat I am! Isn't that fantastic? I'm glad she is such a smart doctor, and was able to tell me that. Actually, her exact words were, "You have gained 28 lbs this pregnancy, and 3 lbs in the last 2 weeks. That's probably why you're so tired."
I'm sure it has nothing to do with the fact that I sleep like shit these days. It's just my obvious obesity.
Then the lectures started*.
- I need to keep the weight gain to 1 lb per week.
- I need to do at least 30 minutes of physical activity a day.
- I need to make sure I only ever sleep on my left side (not sure where this came from, but I only sleep on my left or right sides, and if they really expect me not to roll over when I sleep, they need to put down the crack pipe).
The only thing I hate more.... scratch that, there is NOTHING I hate more than getting lectures I don't deserve. NOTHING. Especially when I know that if I say anything I will be a) blown off**, and b) possibly labeled as "difficult" or "uncooperative." It makes me fucking insane.
And to think I'd finally relaxed about the whole weight issue and stopped feeling so anxious all the time. Well shame on me for not neurotically bringing my own chart where I've been tracking my own weight at home to every appointment. That will teach me to let my guard down!
I walked out of that bitch's office and bawled the whole walk home. All 1.8 miles of it. I was so upset that for the first time in a month my shins didn't even bother me.
I talked to Luca and we decided that he will be coming with me to all of my appointments from now on. Either that or I won't go at all.
For all of you who can't understand why I find this so upsetting, and wonder why I just can't let things like this roll off my back, and desire to leave comments to that effect (along with a note about how you *only* gained 20 lbs when *you* were pregnant -- you know who you are), please note that I think you are an asshole. That is all.
*If ONLY the lectures consisted of these single sentences! But no, they consisted of several minutes of her talking and me sitting there seething.
**I hate being blown off almost as much.
It's all those other ones.
So, I am currently 32 weeks and 6 days. My weight gain has been 22.9 lbs as of 7:30 this morning according to my scale (baseline weight 125 lbs, current weight 147.9 lbs). Since my last visit 2 weeks ago, I gained 1.5 lbs, (146.4 two weeks ago, and 147.9 this morning). I haven't been walking *as much* lately because it makes me so freaking exhausted -- I get winded walking up any sort of incline, my shins hurt, my abdomen hurts and I get really uncomfortable pelvic pressure, and if I have to stand, I get REALLY winded and feel like I want to pass out.... but! I've still been walking about 1-2 miles every day. It just sucks having to do it carrying a computer on my back.
Well, according to the Ob I saw today, the reason I get so tired walking is because of how fat I am! Isn't that fantastic? I'm glad she is such a smart doctor, and was able to tell me that. Actually, her exact words were, "You have gained 28 lbs this pregnancy, and 3 lbs in the last 2 weeks. That's probably why you're so tired."
I'm sure it has nothing to do with the fact that I sleep like shit these days. It's just my obvious obesity.
Then the lectures started*.
- I need to keep the weight gain to 1 lb per week.
- I need to do at least 30 minutes of physical activity a day.
- I need to make sure I only ever sleep on my left side (not sure where this came from, but I only sleep on my left or right sides, and if they really expect me not to roll over when I sleep, they need to put down the crack pipe).
The only thing I hate more.... scratch that, there is NOTHING I hate more than getting lectures I don't deserve. NOTHING. Especially when I know that if I say anything I will be a) blown off**, and b) possibly labeled as "difficult" or "uncooperative." It makes me fucking insane.
And to think I'd finally relaxed about the whole weight issue and stopped feeling so anxious all the time. Well shame on me for not neurotically bringing my own chart where I've been tracking my own weight at home to every appointment. That will teach me to let my guard down!
I walked out of that bitch's office and bawled the whole walk home. All 1.8 miles of it. I was so upset that for the first time in a month my shins didn't even bother me.
I talked to Luca and we decided that he will be coming with me to all of my appointments from now on. Either that or I won't go at all.
For all of you who can't understand why I find this so upsetting, and wonder why I just can't let things like this roll off my back, and desire to leave comments to that effect (along with a note about how you *only* gained 20 lbs when *you* were pregnant -- you know who you are), please note that I think you are an asshole. That is all.
*If ONLY the lectures consisted of these single sentences! But no, they consisted of several minutes of her talking and me sitting there seething.
**I hate being blown off almost as much.
Thursday, December 01, 2011
Dear proud papas
Dear Proud Papas,
First off, congratulations on becoming a parent! I can tell how happy you are post the birth of your child, and how proud you are of your wife and impressed with how she coped with labor. You're probably feeling a mixture of amazement of the birth process, and thankfulness that you are a man and will never have to go through that yourselves. And I understand your desire to share these sentiments with the rest of the world.
However, there are some things that the world really does not need to know about, and the resilience / stretchiness of your wife's perineum are at the top of that list. Maybe you don't realize that's what people think when you share these stories, but.... it is. Well, at least it's what *I* think. And I know I don't want my husband sharing these types of things with other people when my baby is born, so I thought I'd just throw it out there.
For instance, there is no need to share with the world how your wife gave birth to a 10 lb baby vaginally without an epidural -- without tearing. I know you want people to think she's really tough, and that you're amazed that she was able to do this. But really it makes me think that she has a really loose / stretchy vagina, and perhaps a congenital connective tissue disorder also. And I am 100% positive that your wife does not want people thinking that about her.
Similarly, there is no need to tell us how proud you are that your wife completed a 100 mile bike ride a mere four weeks post-partum. It doesn't make me think she's tough, it make me think, "Wow, she must have had a really easy birth with minimal tearing." Again, not something that I (as a woman) would want other people thinking about me. Perhaps we can chat off line later so I can find out who her obstetrician is, though.
On a related note, I know you think that the colorful things your wife said to you during her delivery are funny. Perhaps the two of you even joke about it now in the privacy of your home. However, as a woman, I would not want my husband sharing the things I said while I was in agony with people I don't know. Maybe your wife is cooler than I am, and doesn't mind.... I'm just saying that *I* would, and that's what I think when you share these stories with me.
And finally, as a woman I find it rather irritating to hear you tell me about what an involved father you are in one breath, and then 10 seconds later you're telling me about how you went out drinking all night with your buddies 5 days after your child was born, leaving your wife at home to tend your three children under the age of 4. You just keep deluding yourself that you "equally share" childcare responsibilities. Not cool dude, not cool.**
Anyway, congratulations again on your bundle of joy. And keep being proud of your wife! Just maybe find other ways of sharing that pride with the rest of the world.
That is all.
**Alternatively, and equally annoying, is when the male faculty members say how awesome it is that their wives are giving birth so that their tenure clock gets extended by 6 more months. And then they act like they do equal parenting.
First off, congratulations on becoming a parent! I can tell how happy you are post the birth of your child, and how proud you are of your wife and impressed with how she coped with labor. You're probably feeling a mixture of amazement of the birth process, and thankfulness that you are a man and will never have to go through that yourselves. And I understand your desire to share these sentiments with the rest of the world.
However, there are some things that the world really does not need to know about, and the resilience / stretchiness of your wife's perineum are at the top of that list. Maybe you don't realize that's what people think when you share these stories, but.... it is. Well, at least it's what *I* think. And I know I don't want my husband sharing these types of things with other people when my baby is born, so I thought I'd just throw it out there.
For instance, there is no need to share with the world how your wife gave birth to a 10 lb baby vaginally without an epidural -- without tearing. I know you want people to think she's really tough, and that you're amazed that she was able to do this. But really it makes me think that she has a really loose / stretchy vagina, and perhaps a congenital connective tissue disorder also. And I am 100% positive that your wife does not want people thinking that about her.
Similarly, there is no need to tell us how proud you are that your wife completed a 100 mile bike ride a mere four weeks post-partum. It doesn't make me think she's tough, it make me think, "Wow, she must have had a really easy birth with minimal tearing." Again, not something that I (as a woman) would want other people thinking about me. Perhaps we can chat off line later so I can find out who her obstetrician is, though.
On a related note, I know you think that the colorful things your wife said to you during her delivery are funny. Perhaps the two of you even joke about it now in the privacy of your home. However, as a woman, I would not want my husband sharing the things I said while I was in agony with people I don't know. Maybe your wife is cooler than I am, and doesn't mind.... I'm just saying that *I* would, and that's what I think when you share these stories with me.
And finally, as a woman I find it rather irritating to hear you tell me about what an involved father you are in one breath, and then 10 seconds later you're telling me about how you went out drinking all night with your buddies 5 days after your child was born, leaving your wife at home to tend your three children under the age of 4. You just keep deluding yourself that you "equally share" childcare responsibilities. Not cool dude, not cool.**
Anyway, congratulations again on your bundle of joy. And keep being proud of your wife! Just maybe find other ways of sharing that pride with the rest of the world.
That is all.
**Alternatively, and equally annoying, is when the male faculty members say how awesome it is that their wives are giving birth so that their tenure clock gets extended by 6 more months. And then they act like they do equal parenting.
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