Thursday, December 24, 2009

Merry Christmas Eve

It's already been a day (and a week) of ups and downs. Tuesday was a good day at work (minus a few frustrations): drew bloods myself on rats successfully, figured out a problem I've been having with my Western blots, and did a steroid knee injection on a patient (with supervision, of course). Wednesday involved a nice lunch with a friend but not a lot of sleep and a ton of anxiety, due to my sister's surgery.

Jen is doing much better today and should be discharged soon. I'm scheduled to take the evening shift with her, but that may be complicated. This morning, Sophie woke up vomiting. This is the second time since she's been born that she's thrown up--she did it once when she was six months old, and that's it. We've made up for it with respiratory stuff, but the GI's been pretty good (she didn't get that from me).

It hasn't been bile-y vomit--no need to go into a ton of detail, but I think it might be more that the house is dry and she has some drainage that is making her gag. No fever, she's very active and wants to play, and she just seems...fine.

Tim's going to stay with her tonight while I'm with Jen, just to be safe. He's not heartbroken about missing his family's Christmas--for once, the drama has been on his side of the family and not mine. We're really playing all of Christmas by ear. It all depends on how Jen and Sophie are doing.

I think Jen's surgery was even more serious than any of us expected. They actually took her top jaw, moved it forward, rotated it, and pulled it down in the back. They also did some work on her septum and lip, and they actually had to move the facial nerve a bit. She'll permanently have plates and screws, and she can't chew for six weeks, but since they didn't have to do the work on her lower jaw, she doesn't have to be wired shut.

I guess she is night and day compared to yesterday. I didn't get to see her yet, but I can't wait to spend some time with her. I was very relieved to get the update that things are going well. Not that there is anything I could've done, but that didn't stop me from worrying.

So, it may end up being a bit of a chaotic Christmas, but I think in a way it's really working to reinforce what's important: spending time with family. I'm looking forward to mass tomorrow to get back in tune with the reason for the season, but prioritizing around what is best for family makes Christmas seem even more important. As my mom said, this is one year. Next year we can be back to the usual. For now, we'll try and see extended family when we can, but if it can't happen at the big events, we'll make some personal visits over the next week and try to catch up.

It's been a good but exhausting week, and I'm sure that will continue for the next few days. I just want to say Merry Christmas, and I hope that this holiday brings you together with the people that are important in your life.

Sunday, December 20, 2009

Pictures, part 2

So I am even FARTHER behind in the picture department than I originally thought. I went to update the computer, and I haven't taken pictures off since August. Oops.

Lots happened between then and now, so I'll just give you two pics for now. One is from Halloween--I actually didn't have a lot of success with the posed pics this year, but here's the best of those:

And one from yesterday, before we went to dinner at my friend's house:Looking over the pictures, I can't believe how much she's changed over the last few months. I really need to keep up better. And it's not going to get easier with two (and then med school, and residency, and fellowship...)

Pictures, round 1

Way behind on blogging (as I am with most things in my life right now), but I did finally get scans into the computer. Here are a few of the pics from the recent ultrasound (minus the money shot, but trust me, it's a boy!) Some of them are grainy, thanks to the scanner I am using, but you get the idea.

I would like to introduce you to Joshua Timothy...

2-d ultrasound, profile shot.


Hard to see on this image, but the right and left feet and toes.


These views always look a little creepy, but it's as if he's looking at you (you can see the eye and nose openings).

I didn't realize we'd get a 3-D ultrasound, but once the doc came in, he just started getting pic after pic. Totally amazing. He didn't print them all, but it was so cool to see. This is the left hand (look in the mid-right bottom area).


In this one, you can see both his arms covering his face. You can just see his nose and mouth. He had his arms covering his face for most of the visit.

This is a 3-D profile, looking at the left side of his face. You can see his arm, hand, shoulder, ear, nose, and eye. This was even clearer on the screen when we were there, and the doctor could rotate the picture for us. Totally amazing (a word we used a lot).

The doctor kept trying to get us a clear face forward shot, but the baby kept moving his head. That's why the face looks a little elongated. But you can see part of his face, abdomen, and his leg curling up.

The doctor got some other shots, including this absolutely astounding reconstruction of the spine. He rotated it so you could count every vertebrae and rib. We were pretty cheesed at having to wait two hours to be seen, but the tech and doctor spend an hour and a half with us, so that made up for it. We saw the organs, including multiple amazing shots of the heart beating. I wish they took video here. I could watch it over and over.

There's lots to talk about regarding the baby, including my personal feelings on finding out it was a boy. That may have to wait till later this week when I have some time at home. For now, I'm going to head to the other computer to upload Sophie pictures (I haven't done it since before Halloween...)


Wednesday, December 09, 2009

Big ultrasound news

After waiting two hours to be seen, we got to see pictures of the baby. And it was totally worth it. I have a dinner to go to tonight, but I'll scan some pictures later. The big news is...

It's a boy!

No doubt about that one, either :)

Monday, December 07, 2009

Focus

I am completely distracted today. Sophie is home sick with a fever and nasty cough. However, I am not distracted because I am home with her. I am distracted because I am NOT home with her. My mom was kind enough to come up and watch Sophie so that Tim and I could go to work today. I have complete faith in my mom--she did deal with five different sick kids over the last thirty years. It's that I want to be the one home taking care of Sophie. I'm her mom.

Yesterday actually brought me a lot of comfort--I hope it did for Sophie too. Just being still and doing nothing but being with Sophie helped me get my priorities in line a bit. Sophie, Tim, and I never really made it out of pajamas. Tim and I took turns holding Sophie and taking care of her. That's the entirety of what we accomplished yesterday. For as bad as I feel for Sophie when she is sick, it's so wonderful to be able to take care of her and know that she wants to be snuggled and comforted. All she wanted was to be by Tim and me.

And then to be able to call my mom last night and have her come up today--it reminded me why it's so nice being near family.

I have a ton to do this week at work, as does Tim, which is why we asked my mom to come up in the first place. But being here completely goes against what I remembered is important yesterday--family. I know Sophie is in good hands. I want them to be my hands.

This has been a serendipitous week for me. At the same time that I've been debating what I personally want from my life, I've come across a lot of papers and editorials talking about women physician scientists. The theme is that they are funded much less frequently than men (although when they are funded, they are funded for more money). The fundamental question is: are women funded less often because they are not capable, or is it because they are choosing not to pursue the same path as men physician scientists? Overwhelmingly, the consensus has been that it is choice. The fact that funded women are funded at a higher amount than men would suggest that they are equally competent, if not more so. All of the personal accounts seem to suggest it is a choice made by women to have a career that allows them to also have a personal life.

I see myself moving toward that trend. In college, I had every expectation of completing my MD/PhD program, getting a high powered residency/fellowship, starting a lab, and striving to be successful at a well respected academic institution.

I've seen myself change. My personal lab experiences have led me to move away from wanting to fund and run my own lab. Starting a family has made me re-evaluate the goal of a career. Do I want to be the best, to receive recognition from people in my field? Or do I want to do well but be content with a smaller contribution to my field?

Part of the reason I chose to do an MD/PhD program in the first place was to set myself up for option #1 above. I told myself that, as a clinician, I could help individual patients, but as a researcher, I could change the course of a disease for millions of people. Yes, that is a naive statement, but fundamentally, I think it is true. The issue is that most research isn't geared towards breakthroughs. People pick a problem, or a protein, or some small piece that they want to study and be the expert on. They publish, they get funding, but only rarely is it important to anyone outside of their niche. True valuable translational research is hard to do. It doesn't always work. And you have to be comfortable moving to whatever technique you need to do to answer a question. It's tough. But it's important.

Of the three labs I've been in, my current project has the most translational value. Even then, it is years, maybe decades, away from actually impacting patients. IF I could find a way to do more translational research, I might consider running a lab. But right now, despite my earlier desire to help millions of patients instead of a few thousand, I'm leaning towards clinical practice.

And if clinical is the way I want to go, getting the absolute best residency/fellowship is less of a "have to" and more of a bonus. I don't want to take a step down--I'm currently in a top 25 med school, and I'd like to stay around there ranking-wise for residency. But do I need to do the absolute best? I don't think so. I need to be trained well. But if clinic is my focus, my patients won't pick me based on where I did residency or fellowship (ok, some might, but most won't). I'll attract patients and find jobs based on my skills and my referrals.

It all comes back to my goals. If I wanted to follow my original path and be a well recognized lab, I would go for it. I'm stubborn--I'll try anything if I have my heart set on it. But I know the sacrifice that would take. And I'm not sure that the personal satisfaction of research can equal the satisfaction I get from my family. That's just me.

Having said that, I also couldn't give up a career entirely. That's also me. I've said it before--more power to stay at home moms, but that's not who I am. I want a career, and I love science and medicine. As long as I can have a family life and a career, I want both.

I understand I have a little under a year left of the PhD, two years of med school, three years of residency, and probably three years of fellowship left. A lot can change in that time. But for where I am right now in my life, I feel as though I owe it to Sophie and baby #2 to try and balance family and career as much as I can. If that means staying near family for a while, that's fine. I know people do residencies with kids in cities where they know no one. I give them a lot of credit. But if I have the option to stay in Cleveland for some of my training, I'm not going to turn it down just to tell people that I did things the hard way and succeeded. A lot of people don't have that option. I'm lucky enough to be someone that does.

I still think the best chance for us to move out of town is for fellowship. Depending on what I decide to specialize in, moving may be the only option. That's still at least six years down the road. We'll see where I am in my life then. Having moved a lot as a school age child, I can tell you that wherever we move, I want to get a job there. I don't want to be yanking kids out of school every few years to find another place for training/employment. There's another reason to not have a lab--I'd like some control over my geography.

Anyway, Tim and I had a few conversations this weekend that went along with the idea of focusing on what is best for our family. Maybe I'll get to those sometime this week. It was just a very clarifying weekend for me. I feel like I'm more sure of what is important and what is not.

And one of those important things is home sick. But I'm trying to focus on how appreciative I am that we have family that can take care of her, how important it is that I finish what I need to do in lab so I can move on with my training, and how quickly today will go.

I may not have accomplished much physically this weekend, but mentally, it was good for me. Now, if I could have an equally productive weekend with my to-do list, I might someday be caught up!

Tuesday, December 01, 2009

On a more upbeat note...

I can't credit the source of this pic, since I got it through an email forward, but I thought it was funny:

How Pumpkin Pies are Made: