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Someone left a comment on an old post of ours, and it made me smile. Thank you, whoever you are, and I hope you find your friend. (Click Roach Wars and scroll to last comment.)
A number of years ago, Eric sat down in a chair and his mom taught Rachel the art of the haircut, thus passing the glorious torch that she had held on to the next generation. Over the past 3-4 years, she has gotten quite adept.
And apparently more trusting, since she was willing to go for a role reversal. Letting your husband cut your hair is daring. When your husband hasn't so much as brushed his own hair is well near a decade, it is especially laudable. But thus is Rachel. And so, she carefully held up a mirror, and guided Eric step by step through his first hair-cutting experiment. The result: not too bad (I hope).
During the fall of my third year of medical school, I was on a psychiatry rotation, which we all affectionately referred to as "Psych-ation." Basically meaning that you'd go in to work for a few hours a day and have the rest of the day off. I got rather bored during this time and decided to develop some new hobbies. I read Robert Jordan's Wheel of Time series in its entirety (those of you who have read this epic series know it's a significant time investment), and decided to teach myself how to crochet. Not wanting to start a small project (of course not) I jumped right in with deciding to crochet an afghan. Why not? Now remember, this was 5 1/2 years ago. And to my credit, in the interim I've crocheted 2 scarfs and 2 baby blankets. The afghan travelled from California to Michigan with me at the start of residency, and proceeded to sit in two different closets until, the momentous event occured last weekend, and I finished the afghan! If I were to sell it and I billed my current hourly rate as a resident (which is somewhere around $10/hour, so I could probably do better working at McDonalds), I think this afghan would probably go for about $500 or more. Any takers?
Sometimes in the Michigan winters, one can get complacent and neglect opportunities that still persist all around you. My first couple years in Michigan, I visited everywhere within a 5-hour radius of Ann Arbor, and now after 7 years, I have to fight the temptation to become one of those people who have never been to some interesting place, even though it's been 30 minutes away all this time.
Now that we've been there, we sort of understand why, though if a local were showing us around, I'm sure we would have found more places of interest. Our first stop was to the Islamic Center of America, which might be the largest mosque in the US. We have only visited old world mosques in various other countries, and so this was interesting. Big, but not really ornate. And it bore a number of resemblences to modern American megachurches (including coffee shop, gift shop, and fellowship halls). Maybe these similarities are the parts not intrinsic to either religion, just to America. 
Yes, in general, we are among those who exult in not observing Valentine's Day. Even better is observing it in a tasty yet mocking way. So we made a heart-shaped pizza, and we would have had a home brew to go with it, but the fact that this picture is of two women, and not just one, precluded that.
The four books I read all center on relationships. The first book, I Do Again, is by Cheryl and Jeff Scruggs. This is a couple who got married, divorced after several years, became Christians, and remarried. It's less an advice on marriages book and more an autobiography of their story. But Cheryl, the primary author, has reflected on where things went wrong, and how things got made right again, and will hopefully offer encouragement to people contemplating divorce, are already divorced, or even someone who's considering marriage (better to fix things before marriage rather than after). It was an interesting story, and maybe a resource to offer to people, but thankfully not needed by me and Eric. :)
I didn't get a chance to read the final book, "Love as a Way of Life devotional," although I did read and review its companion book by Dr. Gary Chapman here several months ago. This is a brief description that was given to me: "Each devotional entry showcases biblical truths that guide a life of love, offering fresh insight and practical guidance in how to make love a lasting habit. Over the course of three months, readers will learn to follow God’s lead as they practice the characteristics of a loving person: kindness, patience, forgiveness, courtesy, humility, generosity, and honesty." I have a short list of the 3 things I dislike the most about doctoring:
1. Narcotic pain med management
2. Reviewing my dictations before signing them
3. Filling out disability paperwork
I had a bit of an epiphany regarding disability a few months ago. It is (in my opinion) an unfortunate part of our jobs that we certify disability. I prefer the forms where I just get to write what I see/know from a medical standpoint, and someone else decides whether that means they can hold a job, but often times I'm the one making the call, which is always with a large degree of uncertainty.
My epiphany came when a women came in for an annual examination. She is in her late 30s and is in a wheelchair due to a genetic condition called spinal muscular atrophy. The important point is that she has very limited use of all her extremities. She also was born without an essential enzyme to help with everyday energy production, and certain amino acids will make her incredibly sick. It's called phenylketonuria, and you can check out a warning to her and other with her disease in the small print on the back of your Diet Coke. All this, and she's just here for an annual exam. No worries. She has a husband and kids and runs a small business just north of the Ohio state line.
Later that day (maybe the next day), I saw a woman about her same age, sitting in the room with her daughters, neck rigid with debilitating pain that has gone on for over 4 years. I (and numerous other specialists) have tried and tried to find anything wrong with her bones, muscles, nerves, or any other part of her body, and all of it appears totally normal. No medicine helps. No therapy helps. I wish I could say this case was unique. She came in that day to get forms for disability filled out, so that she could get some cash assistance. So I filled them out. "What physical findings support this disability?" Well, none. "What tests and exams support this?" Also, none. "What is her diagnosis?" Just 'neck pain'. "Can she hold any job at all?" Now, why did they have to go and ask me that? Taking it all together, I would have to say that no, she can't. I don't know why, but I know from interacting with her that it's not going to work.
So, what makes for disability? I'm convinced that emotional well-being is really where it originates. The first lady taught me that almost no physical disability can't be overcome is the rest of one's person is well-functioning. And the second woman (and dozens like her) just reinforces that nothing may be physically wrong, but the emotional/social/spiritual health of a person is easily enough to push them into a state where even a basic job will probably not be doable.
The next step would be then to work more towards this model of holistic health for people. Unfortunately, I don't really think we're all too good at that. Not in medicine. Most of that health has to come from elsewhere.
After 3 years of Rachel's amazing academic accomplishments getting us a free dinner at The Chop House, one of Ann Arbor's premier yummy spots, Eric was able to chip in a bit. Larson Financial, a financial planning firm that only works for physicians, was hosting a free dinner there, in exchange for hearing a talk on financial planning. It was a good time, and though there was no lobster bisque, the filet and the tuna were excellent as always. A couple quirky observations:
1. The founder and head of Larson financial just happened to be the best man in a wedding where Rachel was the maid of honor. Small world.
2. Our server bore an uncanny resemblance to Stephen Fry playing the role of P.G. Wodehouse's genius valet Jeeves. Certainly the black suit and the impeccable service helped the resemblance, but the predominant impression was the somewhat prominent chin and his way of surveying the room with a slight nod of "everything in its place". Right-o Jeeves...
Behold, the answer to America's fuel shortage ills: The Peel 50, the world's smallest road-legal car, sits parked between two vans in London's Piccadilly Circus.Today marks the first day of my third (and last) trimester. As an OB, I feel like this is a very important milestone (mostly in terms of fetal status--long term outcomes are much better for the baby if they are delivered after this point). It's been an interesting time, being pregnant and in my last year of OB-GYN training, like a double edged sword. Most people think it must be great, since I would know everything that's going on. Maybe my obstetrician thinks it's great, because I never have to ask any questions at my OB appointments. :)
The flip side is of course that I also know of all the potential complications that can occur during a pregnancy, and I've thought of them all over these past six months. Medicine is a superstitious profession, and many think that doctors and nurses are usually subject to the most medical complications, the weird diagnoses, the rare problems. Starting with my positive pregnancy test at 4 1/2 weeks (yeah, yeah), I thought about the risk of miscarriage. And bleeding. And molar pregnancies, which can lead to cancer. I saw the first heartbeat on an ultrasound that I did myself around seven weeks, which was somewhat reassuring, but I knew there was still a chance of miscarriage. You'd think I would have relaxed at 12 weeks then, the end of the first trimester. But no...several weeks later there was a string of patients coming in to labor and delivery with an "IUFD" (intrauterine fetal demise, or pregnancy loss) between 14-17 weeks. One day in clinic, my first patient was due 2 days before me. She came in at 17 weeks, still unable to feel the baby move. I told her that was normal, thinking to myself, I haven't felt my baby move, either. But then I couldn't find the baby's heartbeat on the ultrasound, and had to tell her that her baby had died. I left the room, shaken, and immediately grabbed a monitor to reassure myself that my little one still had a heartbeat.
Starting at 23 weeks, the good news would have been that the baby was now "peri-viable," or technically able to survive outside the womb. The bad news is that there's a better than 50% chance of death, and an 80-90% chance of long term disability. What if I'd deliver now? That might be the worst possible scenario! But I didn't. And now, week by week goes by and every week is a little better for the baby's long term outcome. But still--IUFDs, preterm labor, rising blood pressures, so many things could still go wrong! Honestly, my pregnancy has been as smooth as possible so far. Minimal morning sickness, no contractions, normal weight gain, minimal discomfort. I'm grateful for that! And I am glad to know that when I do come in in labor, I'll know what to expect, who's taking care of me, what the baby's heartrate patterns mean, what happens if I need an epidural, or a C-section, or whatever.
I haven't been losing sleep over any of the above issues, either, but I have had time to reflect on what it means when a doctor turns into a patient. I'm sure there are correlations to other professions, but doctors have a unique place in all of this. Going through this experience gives me some insight into what my patients talk about every day. Granted, it's not like I'm going through a diagnosis of cancer and a chemotherapy regimen, it's a much happier and more common occurrence. But still. Now that my patients can see that I'm obviously pregnant, I feel like there is an easier bond there. They trust my reassurance more (I have that same pain sometimes...it's normal!). I have some extra personal insights. Sometimes I inwardly roll my eyes at their complaints. The glucola test didn't taste that bad. You can't be all that uncomfortable since I'm not. I need to recognize that every pregnancy is different, and increase my compassion accordingly.
And finally, there is a special kind of joy in being pregnant that has been fun to experience as well. The first movement. All the subsequent movements, in the middle of a surgery or during rounds, that no one else knows about, that bring a smile to my face. Seeing my little girl on ultrasound for the first time. And the second, and third, and....(and all the benefits of being able to do as many ultrasounds as I want). Wondering what she'll look like, and what she's act like, and what name we'll finally pick for her, and if she'll really grow up to marry one of our friends' little boys who have all been born recently (probably not, but it's a fun thought!). So I know that in the end, things will probably be fine. And unless an incredibly rare complication occurs, which is unlikely, no matter how my labor goes, I will go home in the end and be a mommy for the first time, with a beautiful new life to take care of. Shock and awe. And gratitude. And wonder, that though I may have learned many things over the years, some thing are still wonderful and mysterious and defy comprehension.
No news is good news, but the absence of any news lately makes me feel the need to post a pregnancy update: Yes, Rachel is still pregnant. Tomorrow is 28 weeks. She drank the glucola sugar water and does NOT have diabetes. And it didn't taste as bad as all her pregnant patients had made it out to be. She does not waddle. She goes to all her prenatal appointments, even though it's brief and there's nothing for them to talk about. All is well, and our little girl moves like crazy. We're slowly narrowing our list of names, but won't be telling anyone until she arrives.
