Certified

A mere ten days had gone by since my nerve-wracking trip to Chicago when I received the e-mail that my oral board exams results had been posted. Reading the email, I was shaking almost as bad as I did on actual exam day.

The flood of relief at seeing a passing result on the screen was overwhelming. My emotions included a little joy and excitement of passing and becoming a fully board certified anesthesiologist, but mostly relief that I wouldn't have to undergo that painful hazing procedure again.

And just like that, I'm done. There is no next big exam looming in my immediate future. There will be recertification, but that's years and years from now. It's almost a little unnerving, the mental quiet that is inside my head. After over a decade of medical training, with the one career impacting exam after another hanging over me, always there in my thoughts, I'm finally done.

For the first time ever, my time is my time. When I come home after work, there is absolutely nothing else I should be doing except being home. There is no longer guilt and anxiety that all the time I'm playing with my kids, or watching a movie, or reading a book, that there is something else I should be doing. There is no studying I should be undertaking.

My time no longer belongs to the USMLE, or the ITE, or the AKT, or the ABA. My time belongs just to me. 

Just to keep everything unbiased, here is Monkey's view of the whole oral board process...

(I was so surprised my mom past a huge test in a month. My mom's legs were shaking. Then...my mom past. I was so surprised.)

Dear Bug, May 2014

Dear Bug,

Spending all your childhood watching you grow and change didn't prepare me for how our relationship would grow and change.

When you were a toddler and a small boy, every day, multiple times a day, I'd hear, "Play with me, Mommy!"

And that's what we did, every moment we had. Blocks, Legos, puzzles, board games, Hot Wheels, stuffed animals, hopscotch, train tracks, dinosaurs. Countless rounds of the fishing game, the battery operated wheel whirring around with the plastic fish opening and closing their mouths with funny little clicks while we both aimed flimsy fishing poles into their mouths.

Having you approach your teenage years has changed that "Play with me, Mommy!" into "Leave me alone, Mom."

I do my best to not take it personally. I understand that you still love me. This is just the start of the time when you need a little more independence, a little more elbow room to become your own person. I do my best to make sure I'm not hugging you in front of your friends, that I'm not picking out all your clothes, that I'm giving you just a little of the space that you need.

Bug, self portrait (because he does not take "selfies.")

Hopefully, you understand why I still plant a kiss on your forehead (while you are still shorter than I am and it's easy for me to do it), why I still insist that you be involved in family activities, why I still ask to do things with you. I'm used to being your playmate, your friend, used to joining you on your adventures.

Watching you set out on adventures, such as junior high, without me is scary. For both of us, I think. I'm trying to approach these adventures with the same level of excitement as you are, instead of pining for Candyland on the living room floor.

So much of parenting surprises me. Going from your best friend, your playmate, to a strictly parental figure has been a tough transition.

But luckily, you are still willing to sign off of your Minecraft game that you play over Skype with your friends, and watch an episode of Doctor Who, or play a game of Clue, or read a few chapters of a novel. I worry that as time goes by, you won't want to do even these things with me. But worrying about it won't change anything. So I'll enjoy every second that you do spend with me.

And refrain from that hug in front of the school.

Love,
Mom

Unrecognizable

My 20 year old self would not recognize my current self at all.

I'm quite a few pounds heavier from having three children. I'm finding wrinkles and gray hairs and wear dark undereye circles almost daily.

The physical changes aren't the reason. I'm doing things and thinking things that my younger self would have scoffed at.

I run and I love it. I'm willing to wake up at 4:30 am to fit in a run before the kids get up. I'm frustrated when my run is limited by my schedule. I scour the internet for races to join.  I understand that runner's high.

My younger self hated running.

I drink green smoothies daily. They are filled with spinach, flaxseed powder, greek yogurt. I think they look lovely and taste delicious. I constantly try to get my family to join in.

My younger self would have found green smoothies disgusting.

I drink apple cider vinegar with honey every day. Even though I know there is no good evidence around this (and believe me, I'm usually all about the evidence), I feel better. I'm less hungry, less gassy, and over all feel better.

My younger self would scoff at this and anyone else who did this.

I've elimated many chemicals from my house. I primarily clean with water, baking soda, vinegar, Norwex, and a little Mrs Meyers. I feel better about what I have around my kids, worry less about when they eat things off the floor (they were going to eat those Cheerios anyways, but now at least it's chemical free.)

 

My younger self wouldn't have cared about this at all.

I'm researching rain barrels and composting containers and urban chickens. I spend weekends at the farmers market and try to buy as much local food as possible. I contemplate returning to my vegetarian diet.

My younger self would be so confused about all of this.

Standing in the dark kitchen, mixing up a kale-grapefruit-banana smoothie while still sweaty from a morning run, I almost don't myself now.

Who is this increasingly crunchy girl, trying to rack up the miles on the road and eat cleaner and live better? Is it getting older, leaving behind that youthful feeling of invincibility, that is making me focus on things that might keep me healthier? Is it having children that makes me care about these things? Is it my work, days spent caring for people in poor health, that has changed my attitudes?

I'm not sure. I don't really care the reason, because I feel great.

And I'm sure my younger self would at least appreciate that, even if she wouldn't recognize me.

This feeling isn't unique, right? We all make changes that surprise us, right? Would your younger self recognize you and the choices you've made?

In Defense of Books

I tend to drag my feet when it comes to new technology. Sometimes I feel silly about this, because I'm supposed to be a member of the generation that is comfortable with the lightening fast changes technology throws at us. After all, I've been through the birth of the internet, the development of email, mp3s, texting, smart phones. 

Somehow, I always find myself dragging my feet in the back of the line when it comes to new things. I don't want to be a cautionary tale, trying to figure out what to do with my collection of laser discs or HD DVDs.

Also, I'm never quite convinced that latest and greatest could ever actually be that great. I had a film camera for years after digital cameras started coming on the market, because I hated the pixelated look of the digital cameras. Nothing would ever be as good as film. 

Umm, yeah.

When I started seeing Nooks, and Kindles, and other e-readers hit the market, I had an even more exaggerated response. Because it wasn't just another new technology.  It seemed that these devices were taking away the very soul of reading: sitting quietly, cracking the cover, turning the pages.

After an extended trip where I lugged around 3 huge novels in my carry on, I began to see the advantage of an e-reader. When I stayed up late on vacation and finished my book and had nothing the read on the return journey, I felt myself warming up to the idea even more. 

Turns out, I'm not completely against them.  I've read a couple of books on my tablet and it's just fine.

However, and maybe this is me just being me and continuing to drag my feet in the face of technological advancement, e-readers are not going to replace books in my house.

My family struggles with screen time. We set time limits and make rules and do the best we can to keep the time our children are sitting in front of a screen as minimal as possible. But then we get tired, or have bad days, or it's cold outside, and it's just easier to put on a movie or let them play Angry Birds or Minecraft. I'm always harping on my kids to get off the computer, put down the iPad, turn off the TV and do something else. Play outside! Build a puzzle! Read a book!

If books are all electronic, how can I continue to help my children see the difference between unhealthy screen time habits and healthy book reading habits?

I'm a voracious reader. Once I start a book, I have a hard time putting it down until I've finished the entire story. I always have a long list of books I want to read. I buy books and then keep them forever, unwilling to part with stories and characters I love.

So, I felt completely sucker punched when I commented a few weeks ago to my eldest that I loved seeing him enjoy reading as much as I do, and he replied in shock, "What?  I never see you reading!"

Sitting in front of a screen, my children can't differentiate if I'm skimming Facebook or absorbed in my favorite dystopian novel. They don't see me as a reader, no matter how many books are on my Kindle.

So that's why I'm going to continue to defend books. Good old fashioned, paper paged books. We will still make Sunday afternoon trips to the libraries. We will hold a physical book during bedtime family story time.  I will continue to tell my children to put down the tablet and pick up a book.


What are your thoughts on e-readers, electronic books, and making your children readers?

I Want My Kids to Scare Me

I want my kids to scare me.  Actually, every parental impulse I have doesn't want my kids to scare me. I want my kids to be safe, protected, to never be hurt. I want the same things that all parents want for their kids. 

However, childhood is full of risk and adventure, as it should be. Following my urge to protect my children from every little thing doesn't do them any favors.

Yes, my heart lurches up right under my jaw when I catch Monkey balancing on the backyard fence. My stomach flip flops when I watch Bug launch himself out of the play ground swing.

Sometimes I have to close my eyes and go back inside to prevent myself from shouting for them to be safe.

My kids need these moments to realize that they are brave, risk taking, healthy, normal children. They need to climb as high as they can up the front yard tree. They need to practice riding their bikes with no hands. They need to cannon ball into the pool instead of just timidly entering from the shallow end.

I still insist on helmets and sunscreen and swimming lessons and seat belts and looking both ways.  Adventure should never be an excuse to abandon common sense.

But I'm working just letting them have the childhood they deserve. I let them make homemade bow and arrows and target practice in the back yard. I let them carve with pocket knives. I let them be pirates and ninjas and superheroes. I don't worry about the grass stains or the mud.

I want to keep my children safe. But I'd much rather kiss bumps and bruises and apply bandaids and neosporyn to scraped knees and elbows, than have my boys rolled in bubble wrap, safely on the couch.

I never want to see my children get hurt. But I'd rather them be brave, invincible, adventerous boys that occasionally fall down than have them cautiously living vicariously through a computer screen.

I want my kids to scare me.

Surfacing

As we all know, life has a way of coming at us in waves and sometimes all the extraneous things must be let go of, so all effort can be focused on not being swept out to sea.  After all that effort, it feels wonderful to surface again.

Last Friday, I took my anesthesia oral boards. Should I pass, this will have been my last exam and I can finally be board certified. There are people who just sail through the stress and preparation of the exams. I am not one of those people. Every thing surrounding this exam overwhelmed me. It crept into every aspect of my life. I couldn't focus on family activities. I was overwhelmed with small tasks, such as meal preparation and cleaning. I didn't sleep well for weeks.

I didn't use to be like this. I'm not sure if it's due to being a little bit older and not having the mental resilience of a 20 year old. Maybe the last decade of accumuated stress and sleep deprivation has impaired my coping mechanisms. As an undergraduate, I scheduled my MCAT exam on the same day as I was supposed to be moved out of my apartment, which was the weekend after I finished spring semester finals. I don't remember being overwhelmed by this or thinking it was a bad idea. I just did it. Everything got done and there was no crying.

The last few months were completely different. Showering suddenly felt like a huge drain on my energy reserves. I scaled back family meals to be all easy to prepare items, but sometimes even putting frozen burritos in the oven felt overwhelmingly taxing.

One of the questions I was asked frequently when I interviewed for residency was "How do you cope with stress?" I'm not sure the answer I gave then, but it was probably like vague and standard like doing outdoor activities, spending time with my family, or doing yoga. My answer definitely was with how I deal with stress now, which is shutting myself in my closet with a bag of chocolates while having a good cry and avoiding real responsibility.

The oral board exam itself was horrid. I was warned before hand that I would feel terrible when the exam was over and to prepare myself for that. Even with that heads up, how bad I felt afterwards was unexpected. It's one thing to sit in front of a computer, doing multiple choice questions, knowing that the answer is somewhere in on the screen, and if I'm unsure I can always come back and readdress the question. It is quite another thing to sit in front of two ABA physicians, getting grilled about multiple aspects of diagnosis, treatment, and ongoing complication management, and have all my professional shortcomings laid out in front of me, like a murder scene where my education and training is the victim.

I have moments, even now, days after the exam, where a wave of panic engulfs me as I think about the possibility of failing and having to do the whole process again.

But for now, it is done and there is nothing to do except breathe in, breathe out, reenter my daily life, and wait the six weeks for the result.

Add to all this, Hubster is in the most challenging portion of dental school. He frequently is in the lab until late at night, sometimes coming home for dinner and then returning to school and working long past when the children have gone to bed. He's tired and stressed.

In the past, one of us as always had the energy reserves to pick up the slack when the other was overwhelmed. These last few months, with both us pushed all out. The loose ends have just been left loose. The house plants wilted and the floors went uncleaned and there were more fast food meals than anyone wants to admit.

But just as winter is finally leaving and spring is starting to show herself, hopefully this is also a time for me to start fresh, leaving all the stress behind.

It's nice to be back.

When You Don't Have a Village

We've all heard the saying that it takes a village to raise a child.

Sitting with my girl friends at brunch a few weekends ago, I listened to a few of them that have children talk about the support they have raising their children. Occasionally, they had to create that village on their own with a great deal of monetary expense. Regardless of the method, the fact remained: they had a village.

I don't have a village. I have Hubster and I have me.

I'm not saying that we have done everything on our own. That would be selfish and naive to assume that we have been and are completely self sufficient. My mother watched Bug on a daily basis for a few months after he was born while I continued my college degree. We had a few family members help out with child care in the past. We've had some friends take the boys for the day when we've had school closures. We've had people we could swap baby sitting with. We've had a day cares and after school programs that we trust and have done wonderful jobs providing care for our children while we continued our education and gone to work.

But, because of course there's a but...But I've never felt that there was someone else who was in this with us. Hubster and I have scrambled and agonized and worked for every bit of it.  While we have been able to find people to help out, there isn't anyone invested or dedicated to making sure we are successful. From the very beginning, it has felt that it was Hubster and I together against the world.

Usually it feels that things are day to day. Much the way too many people live paycheck to paycheck, we live alarm clock to alarm clock, only one fever, one cough, one episode of diarrhea, one injury, one snow day, away from chaos. Each bout of illness uncoils our tightly wound plans. Who should stay home, who stayed on last time, how long is the child going to be sick from school? With very limited sick time available, each day required at home amount to significant consequences. If Hubster misses a day, he potentially could have to repeat an entire section of school. If I miss a day, I don't get paid. Even small things, like late starts or early outs for school can cause feelings of panic. Doctor's appointments and recreational outings are planned months in advance.

Each day is a tight rope walk without a safety net.

Recently, I had to use a sick day at work because my children had a snow day at school. Hubster had covered that last two days that required someone at home and it was my turn. Upon returning to work the following day, I was berated for calling in sick due to a lack of child care. I was told that I should have arrangements for emergency back up child care. My only response was to ask the person if they were volunteering.

It took us a long time to find the child care circumstances we have now. My children spent a year and a half on the wait list for their elementary school's before and after school program, and we used a nanny during that time (accruing more debt to afford the nanny.) I started looking at day cares for Duck when I was 10 weeks pregnant; we finally received a spot in a day care when he was 3 months old.  It was hard to find regular child care. Emergency child care?  Seriously?

My nearest family member lives 2000 miles away. All my friends work or have their own busy house holds to take care of. There is no one to just drop things and suddenly be available when the schools close or the baby has a fever. There's just us.

And do you know what?  I don't resent anyone for this. I don't resent my family for living far away. After all, we are the ones who moved to Iowa to continue my training. My parents give me emotional support and words of encouragement. I'm not expecting them to drop what they have going on in their lives to come and help out with my kids. I don't resent my friends who do have their safety net, their village, helping them out on a daily basis.

I've made all these decisions.

There are plenty of hypotheticals that would fix all my problems.  I could have opted at any time to not work. But after 4 years of medical school and 4 years of residency and thousands of dollars in student loans, I'm pretty pot-committed to my career. And I'm finally at a point where my hours are more reasonable, my income more secure, and the options for my family are opening up. Also, if I didn't work, it would have been impossible for Hubster to go back to school and go to dental school. If I had chosen to not work, we would most likely have spent another 10 years in a miserable apartment in a bad neighborhood, scraping by on a paycheck to paycheck existence. Because that's what we were doing before all this.

I could have always opted to not have children. That's one way to deal with child care. However, it is just not possible for me to look at my three boys and regret them in any way.

So what do you do when you don't have a village?

Here's what I do, sans village:

I continue with my tight rope walking routine, carefully balancing multiple schedules, and juggling any balls that get thrown my way.

I continue to worry daily if I am adequately covering all the bases, if my children are getting enough attention, if I'm living a well balanced life, if I'm staying on top of the things, if I'm remembering to come up for air.

And eventually, I start to notice exactly how amazing my children, how they are normal and happy and well adjusted and adored and loved. I start to stop caring what other standards people have set for how my schedule is supposed to run, how my house is supposed to look, how my life is supposed to be. We do what works for us.

It's hard. It's a lot of work. But I just want anyone else out there, anyone else who is villageless, who knows that feeling of you against the world, that it's completely doable.

I'm okay. The kids are okay. And that's what matters.