FreshMD

Dandelion poetry

Thank you for all your kind comments and well wishes on the last post. As suggested, I plan to link to my Mothers in Medicine posts from here. There's a new one up today.

Finished

When I began blogging, a family member unfamiliar with blogs looked over this site and said politely, "It looks nice. Is it almost finished?" 

Well, now it is. 

I feel hamstrung by the mix of personal and professional anecdotes under my real name in the face of increasing readership. I find myself censoring and second-guessing myself and that really dilutes the pleasure of blogging.

I started this blog for the satisfaction of crafting bits of my chaotic days at home and work into a tidy package. But now my domestic and clinical days have settled into a relatively unruffled routine and I'm eager to pursue other projects. Any creative energy (and time) not exhausted by children or patients is in short supply, not enough to slather over multiple projects.

And so I need to absolve myself of this blog. I'm not sure if I'm euthanizing it or inducing an indefinite coma. The site will remain up but expect this post to greet you for the foreseeable future.

I'll still be active at Mothers in Medicine, Twitter and Flickr. 

Thank you to my little band of readers, especially those who commented or emailed over the last year and a half.

Baby names

I have a post up at Mothers in Medicine on the medical implications of baby names, including my own close call with the name Claudia.

(If you've been reading this blog since the beginning, you might remember I did another post on the topic way back here.)

The R-word

There's been a move afoot recently to stamp out the R-word. 

While I agree that the use of retarded as a derogatory term is offensive, I can't help wondering: Why aren't paraplegics protesting the slang use of lame? Why aren't families of schizophrenics fighting the word psycho? 

There are scores of medical words indicating impairment that are used disparagingly in every day speech: Dumb. Idiot. Blind. Imbecile. Moron. 

Some insults are used with no recognition of their medical origins. Cretin is someone who suffers from congenital hypothyroidism, but I've never heard the word used in that context outside of medical school.

I suppose the degree of offensiveness of these words depends on where your sensitivities lie. I cringe when people bandy about terms like brain-dead and on crack; light references to head trauma and addiction bother me as much as the slang use of retarded.

 

I don't oppose efforts to eliminate the R-word. But to be consistent, better ban the L-word, too. And the D-word, the I-word . . .

Island

On the way home as we round one of the final bends before our place, we pass Grey Rocks Island. It's privately owned with a house tucked into the stand of trees. I've never seen any comings or goings; it's always completely still. I imagine the inhabitants lying on the couch reading novels all day. 

As we swing by in the minivan, it almost makes me feel a bit gritty and common, having neighbours and a driveway and a mailbox and all. 

Devils are not real

I took inventory of Saskia's beliefs recently. I asked her to answer 'real' or 'not real' to various characters and she enthusiastically complied.

"Santa?" I suggested.

"Not real!" Said with seven-year-old pride.

"Easter bunny?"

"Not real!"

"Jesus?" 

"Real."

"Tooth fairy?" 

"Not real." (A surprise to me, this was followed by a brief discussion to identify my underminer. Pete.)

"Monsters?"

"Not real."

"Giant whales in the sea?" 

"Real." (What about dolphins, interjected Leif. Are they real?)

"Fairies?" 

"Not real." Said regretfully.

"Angels?" 

"Real." In a soft voice, utterly convinced.

"Devils?" 

"Not real." Said with equal conviction, laughing at the ridiculousness of the idea. "Let's do more!" she urged.

But I was too moved by the last two answers to continue.

Sanatorium

One of my favourite photos in the album from my grandmother is this one, of her brother in a sanatorium in Harderwijk, the Netherlands in the 40's: 

Sanatorium sounds psychiatric, suggesting a place where one's sanity is restored, but it's an institution for medically supervised recuperation from disease, usually tuberculosis. From a medical and a literary perspective, I was admittedly pleased to discover that a relative had suffered from consumption.

 

I love the button-up pyjamas, the drape of the bed sheets, the sun behind the curtains in the high windows and - most of all - the perplexing X where Oma marked her brother in ballpoint pen.

Album

I visited my grandparents the other day, and when the coffee had been served in decades-old flowered teacups and the pastries set out in a ring around the coffee table, Oma shuffled over with a photo album. She settled next to me on the couch and turned to the first page. 

"This is my oldest sister," she said happily, a bejeweled finger resting on a wedding picture. And in the same contented tone: "She died of a heart problem." Her finger slid down to the next photo. "And that is my oldest brother. He died of pneumonia." 

My grandmother had sixteen siblings, a corresponding massive extended family and a slew of friends, and their images were tucked into the book in black and white, in faded vintage tones, on thick matte paper and on Polaroid squares. She paged through the album, briefly remarking on each picture. Every observation included the cause of death. 

"Her husband died in the doctor's office when he was thirty-nine," she said of her niece. "She had five children." Flip. "My brother was in a sanatorium for TB. He was there for a year. He got better but then he died in a boating accident." Flip. "That is the husband of my sister. He died of a heart attack in 1981." 

Half-way through the album, and not one person in the photos was still living. And the strange thing was, Oma kept recounting their relationship to her and how they died in a cheerful, matter-of-fact way. I could smell her sweet old-person breath as she leaned closer to identify a blurred face, and I could tell she was enjoying herself immensely. 

I recognized almost no one in the pictures, save my grandparents and some of their siblings, marked by family resemblances: the small, pretty vandenHoven nose and chin; the full Byl cheeks and red hair. 

She closed the album and gave it to me. I took the book, heavy and oblong with a faded blue fabric cover, and realized that she had just paged through it for the last time.

"You can throw out the pictures of the people you don't know," she suggested. "You can just keep the pictures that you like." 

And so there is an album of dead strangers, of Oma's treasured people, on my desk. One day I'll probably sort and rearrange it, but for now I haven't the heart to disturb those photos' resting place.

A walk to the village for Honey's donuts

My aptitude for family medicine: poor, apparently

I did the University of Virginia medical specialty aptitude test purely for sport recently and was startled to learn that of 36 medical specialties, the one I am least suited for is family medicine. 

I'm not surprised that family medicine did not rank first. I chose it only partially because of any natural inclination toward it, and mostly because the training and practice of it meshed best with other priorities in my life, particularly raising a family. What did take me aback was that it occupied the very last spot on the list.

Pathology and radiology ranked at the top. 

From time to time I flirt with the idea of returning to residency, but what it comes down to is that I would rank my current job satisfaction as a family physician at a 9/10. Is a chance at boosting that to a perfect score worth three more years of residency, a massive reorganization of family roles, a significant reduction in my time spent with the kids and a hefty kick in the pocketbook? I don't know.

William Maxwell, fiction editor of the New Yorker from 1936 to 1975, said upon retirement: "For nearly forty years I have shaved with pleasure in the thought that I was about to come to this job." How I love that quote. What a gift, such perfect happiness with one's work. 

Of course, while he was shaving his wife Emmy was likely frying up the breakfast bacon, readying their daughters for school, preparing for a day of housework and granting him the enviable ability to be single-minded. 

That is what I find most difficult about mixing medicine and motherhood: the diffusion of focus. 

My work in refugee medicine is profoundly rewarding; raising three little ones even more so. The two have proven to be compatible. And yet at some point the efforts put into one require sacrifices made of the other. There simply are not enough hours in the day for me to invest what I wish I could into both spheres. I have erred on the side of mothering, and while I do good work at the clinic, my career trajectory has been modest.

I say this cheerfully. So far, I don't regret any decisions I've made. And every day presents an opportunity for new and different choices. Maybe one day, when the kids are a little older, I'll alter my career track or return to residency.

But for now, and maybe forever, a 9/10 is good enough.

(Cross-posted at Mothers in Medicine.)