FreshMD

Bumped.

I've been sorting my photos from 2011, Year of Ilia Tove. It's taken me this long to get some perspective so that I can go in and prune some of the hundreds of newborn pictures.

It does break my heart a little to see Ariana in these images, newly ejected from her long-held position as beloved baby girl. She took it graciously, and seriously; and yet on so many pictures she looks sidelined.

 

There was this, though, and lots of it:

That sweet face. I hope I didn't do wrong by you.

The shapes of stories

I work with refugees, and many come with horrific stories of rape, kidnapping, imprisonment, torture. None of us at the clinic work full-time; we wouldn't last.

Vicarious traumatization is a term coined by McCann and Pearlman in 1990 to describe the psychological response of those who work with victims of trauma, including "long-term alteration in the therapist's own cognitive schemas, or beliefs, expectations and assumptions about self and others." And this from Wikipedia: "Its hallmark is disrupted spirituality, or a disruption in the trauma workers' perceived meaning and hope."

I've noticed lately that it's less the details of the trauma, and more the trajectory of the overarching patient story that affects me most. As per Kurt Vonnegut's graph below, good stories end with an upswing. It's the curves that angle downward, with no hint at even a modest recovery, that get me. 

Little bombs of revelation

And how do these creative thoughts come? They come in a slow way. It is the little bomb of revelation bursting inside you. I found I never took a long, solitary walk without some of these silent, inward bombs bursting quietly: "I see. I understand that now!" and a feeling of happiness.  - Brenda Ueland, If You Want to Write, 1938

Those little bombs. Nothing makes me happier, especially when they're set off by pulling on a thread that runs from parenting to medicine to theology to everything else. And this is what ignites them:

[T]he imagination needs moodling,- long, inefficient, happy idling, dawdling and puttering. These people who are always briskly doing something and as busy as waltzing mice, they have little, sharp, stacatto ideas, such as: "I see where I can make an annual cut of $3.47 in my meat budget." But they have no slow, big ideas. And the fewer consoling, noble, shining, free, jovial, magnanimous ideas that come, the more nervously and desperately they rush and run from office to office and up and downstairs, thinking by action at last to make life have some warmth and meaning. 

This is one of the reasons I work part-time. My days at home with the (almost two-year-old) baby are for a kind of idleness. Two days of this a week yields good ideas. Three days led to rumination and meagreness. There's a fine line with these things.

Testing the waters.

Twin Lakes, Bend, Oregon. August 2012.

Feelings of loss post-partum

When Ilia was a few weeks old, Pete asked, and said it so casually from the couch where he was reading after dinner, "Do you miss our old life?" . . . continued.

Kindness

Last spring, my experience as physician, mother and patient intersected through a calamitous pregnancy loss. A few weeks ago (days after I delivered my daughter), my reflections on those events were published in CMAJ. As on-line access requires sign-in, I requested permission to post the entire article at Mothers in Medicine.

Ilia Tove Scholtens

February 26 at 1:22 AM

7 lbs 8 oz

More here.

One clinic day, three responses to my pregnancy

I dislike that pregnancy forces me to bring my personal life into the office. I don't have pictures of my kids on my desk, I am vague when curious patients ask where I live and on Monday mornings I never volunteer my weekend activities to the staff.

But this pregnant belly, no matter how discreetly swathed in muted professional clothes, begs comment from everybody.

* * *

A patient comes to see me for follow-up after a miscarriage. I am acutely aware of how difficult it might be for her to see her doctor pregnant . . . continued at Mothers in Medicine.

Ten guidelines for medicine-life balance

Right now, this month, seven years out of residency with a part-time position at the refugee clinic and three and three-quarters children, I have work-life balance. It's somewhat precarious, something that could be toppled by illness or an unbearable colleague or a newborn, but I would rate my current satisfaction with both career and home life as high. Here are some philosophical and practical guidelines that I follow:

1. Accept that you can't have it all - at least not at once - but you can have a life that is rich and full and satisfying. I watch resignedly as other (childless) physicians at my clinic leave to spend months working in Afghanistan and Peru. I'm the mother that arrives late to the preschool Christmas potluck and sets a box of mandarin oranges next to the homemade cheesy noodle casseroles. My son's school uniform pants are embarrassingly short and I couldn't make a recent cross-cultural mental health conference because I'm home with my daughter on Thursdays. But I have kind, secure children and what is arguably the most delightful, rewarding patient population in the city. It's enough.

Continue reading at Mothers in Medicine.

Number four

The immediate, unmistakable second pink line on the test laid on the bathroom counter - oh, the power of that pink line. The possibility that it stands for, the hope for a healthy pregnancy and a perfect newborn and another loved child. One slim line that releases a cascade of happy plans . . .

Continue reading.

Metablogging

It's Metablogging Week at Mothers in Medicine. Click here for my post on hate mail, non-anonymous blogging and a favourite comment.

I don't look twenty-two anymore

And I'm fine with that (@ Mothers in Medicine).

What can still make a physician-mother squeamish

New post up at Mothers in Medicine.

A day in the life

The topic of the week at Mothers in Medicine is "A Day in the Life." Check out the typical day of a neurologist, pediatrician and internist. I describe a typical Tuesday at the refugee clinic here.

The antidote: knitting

Post up at Mothers in Medicine on why I consider knitting the perfect antidote to medicine and parenting.

I put an embryo on a daycare waitlist

September 2001

One year and three months into a two-year residency, I give birth to my daughter. I am eligible for one year of maternity leave, and have every intention of staying home with my sweet, big-eyed Saskia for all fifty-two weeks. Pete and I haven't yet decided what we'll do for childcare when the year is up, but daycare isn't even on the table. I grew up understanding that daycare was for the unfortunate children of selfish mothers. It was fact, just as neighbours who mowed their lawns on Sundays could not be Christians.

January 2002

I sit at the desk in our loft, looking at a list of home daycares. The nine remaining months of residency loom over my days with my infant daughter. I have an irrational fear that I will have a series of consecutive pregnancies - defying all contraceptive measures - causing a perma-maternity leave and precluding any possibility of ever finishing residency. I am desperate to be done with it . . .

Post continued here. The topic today at Mothers in Medicine is childcare, where fifteen of us weigh in with our experiences.

Looming deadline for professional success: age 40?

The effective, moving, vitalizing work of the world is done between the ages of twenty-five and forty.

- William Osler (1849-1919), renowned Canadian physician

I turned thirty-five last month, and what struck me most was how odd it is that it's been thirteen years since I was twenty-two. But apparently what I should have been impressed by is the five short years remaining in which to make a significant professional contribution to the world. I find this idea disconcerting, as I'm waist-deep in raising kids and was banking on my next decade to make some strides career-wise.

More here at Mothers in Medicine.

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.)