Monday, January 20, 2014

trust but verify

(This post was inspired by, but not directly related to, Mandi's post over at Messy Wife, Blessed Life.) 

Pediatricians and parents are in a partnership when it comes to the health of children. I would venture to say neither one is the ultimate boss in the partnership-- parents of course have the final say in many things, but not if their decision will cause blatant harm to their child (e.g. refusing oxygen for a previously healthy child with pneumonia, or insisting on feeding a preemie whose intestines aren't mature enough).  They each have different roles.  Parents know more about their child, and pediatricians know more about medicine.  (That's not meant to be an insult; it's just a statement of fact. Lawyers know more about law. Literature professors know more about literature. Statisticians know more about statistics.  Why even go to a doctor if they don't know more than you about medicine?)

Sometimes-- not often, but sometimes-- parents will get very defensive and upset if their pediatrician wants to check something that the parent doesn't feel is a problem.  "What about our partnership?!" they're thinking.  "Why don't you trust me?  Do you think I'm irresponsible? Do you think I don't know what I'm talking about?"

It's not that we, the pediatricians, don't trust you, the parents.  But we don't really know you that well-- certainly not well enough to say "they would NEVER do that."  And we've seen so many bad things happen to kids, even kids whose parents seem trustworthy.  Toddlers who were shaken until they bled into their brains.  Babies who developed herpes meningitis despite their moms' insistence that they couldn't possibly have herpes. Preschoolers whose teeth have literally rotted away because their parents didn't bother to brush them or take them to the dentist.  Kids who fractured their skulls in car accidents because they weren't buckled in properly.  Ex-preemies who became severely anemic because their parents didn't give them iron supplements.  3-year-olds who don't know how to talk because their parents didn't realize that was a problem and didn't take them to their check-ups.  Kids who ended up on ventilators because their parents didn't give them their asthma medications.  I could go on and on.  Pediatrics is usually a happy field of medicine, but when it's sad, it's REALLY sad.

So we worry.  We worry about the newborn whose mom declined prenatal HIV testing, because we don't know her from Adam (or Eve), and maybe SHE knows she can't possibly have HIV, but WE don't know.  We worry about the slightly-underweight child who missed his follow up for a weight check, because probably his parents are feeding him a perfectly normal diet, but what if there's something wrong?  It's not that we don't trust our patients' parents, but stranger things have happened, and we've been wrong about people before.

Now, obviously there is healthy skepticism and concern, and then there is blatant patronizing rudeness.  But if you find yourself asking, "Why doesn't she trust me?" about a pediatrician you otherwise like, give her the benefit of the doubt.  It's not that she doesn't believe you, she just wants to be sure because she cares about your child.  As one of my adolescent medicine attendings used to say, "Trust but verify."  (Now, she was usually talking about whether or not to run STD tests on teenage girls with pelvic pain who swore up and down they'd never had sex-- and whaddaya know, some of them had chlamydia-- but the point still stands.)

Think about it this way:  if your child got hurt while being cared for by your babysitter, you'd want to hear your child's version of how it happened, right?  That doesn't mean you don't trust the babysitter.  You just want to be sure.  (Obviously I'm not saying parents are to pediatricians as babysitters are to parents-- it's not a perfect analogy, just another "trust but verify" example.)

And of course, "trust but verify" works the other direction too. You're perfectly justified in wanting to double-check that what your pediatrician says is accurate, and any doctor who isn't willing or able to explain his or her reasoning is not a good doctor.  (Though please, I beg you, make sure you're using a reputable source when you double-check-- not Dr. Google or your Facebook friends. For a good explanation of what makes scientific literature valid and "peer reviewed," read this.  This article/post is specifically about vaccines-- which I'm not going to go into, but I'm sure you can guess where I stand-- but the part about peer-review applies to anything.)

If you feel like your pediatrician never listens to you, then it's time to find a new pediatrician.  But if he sometimes apologetically wants to "make sure" of something, and you're wondering whether or not to feel offended, put yourself in his shoes.  Most parents are good parents, but some aren't, and it's sometimes hard to tell the difference in a 15-minute appointment. 

Friday, January 17, 2014

seven quick takes - ed. 13

1. My thirteenth Seven Quick Takes! I love 13.  I was born on a Friday the 13th, so I joked all through my childhood that traditionally "unlucky" superstitions were lucky for me. And I always feel as if Friday the 13ths (no matter the month) are sort of an honorary birthday for me.

2. With the big 3-0 rapidly looming (!!!), I recently decided it was time to start wearing Grown-Up-Lady makeup.  Because, I mean, wearing only concealer + cherry Chapstick may have worked in college, but that was (gulp) ten years ago.

So here's me with my Grown-Up Lady face. 

I made a conscious decision to go with actual red lipstick (well, this is my newly-dubbed Work Lipstick so it's sort of peachy-red), which is against my every instinct. But I realized that whenever I see a woman wearing red lipstick I think "I LOVE IT SHE LOOKS GREAT."  And after the shock of seeing it on my own face has worn off, I do love it.

3. Faith has been copying EVERYTHING we say lately. We've been trying to teach her not to interrupt by saying, "Faith, I'm talking to Daddy right now. It'll be your turn in a minute." Recently she began tossing that right back at us. "No, Daddy, I talkin' to Mama!" Or, more hilariously, when she's talking aloud to herself while she's playing, "Mama, shh! I talkin' to Faify!"

4. Short but sweet article that my pediatrician self can't help sharing:  Fever in Children: 5 Facts You Must Know.  I wish this could be required reading for parents of young kids.

5. Recently an old friend of mine was debating which attachment to put on a Swiss Army knife she was ordering-- a Phillip's head screwdriver or a corkscrew. (You can already tell she's way cooler than I am, because the knife is for her. She's also an architect and lives in NYC. See what I mean?)  Her reasoning was that theoretically the Phillip's head would be more practical in a pinch... but then again, you could probably use the flathead screwdriver attachment in a Phillip's head screw if necessary, but if you want to open a bottle of wine and don't have a corkscrew, you're SOL.


I so need to try this.

6. Josie has been getting super grabby and pinchy... especially when she's nursing.  When I wear a tank top it looks like I've got sun freckles on my chest, but they're actually tiny bruises from tiny baby fingers.  Ouch.  So I channelled my inner crunchy-granola mama and ordered a couple of nursing necklaces from this Etsy seller.  Hopefully it helps! Anyone have any experience with this type of baby-distraction?  

7. Apparently there's an ongoing measles epidemic in the Philippines, with over 1500 people infected and 21 dead over the course of 2013.  With the Philippines being the closest major land mass to Guam, and with an impressive 25% of Guam's population being Filipino, there's a lot of travel between here and there. As a result, the local public health department is asking all physicians on the island to keep their eyes out for any possible cases.  This is pretty crazy.  I've never seen a case of measles in my life-- it was declared to be eliminated in the US back in 2000 thanks to widespread vaccination.  (Note that, in epidemiology, "eliminated" doesn't mean "gone completely;" rather it means that measles is no longer present continuously, but only in discrete outbreaks-- thanks to those who don't vaccinate.)  I hope to go my whole career without having to diagnose it... but we'll see.

On that lighthearted note... go see Jen at Conversion Diary for more Quick Takes!

Wednesday, January 15, 2014

see: shape, comma, out of

Allow me to let you in on a little secret:  I've been super out- of-shape for the past, like, 20 years. I can sort of fool people because I've never had a weight problem (thanks for the genes, dad!)... but a paragon of fitness I am not.

All this to lead into the fact that I joined a workout group! The first time I could make it was yesterday, and you guys... I. Am. Dying. I'm so sore today. Which is good. But painful. But good.

The great thing about the group is that it's all moms with young kids, and everyone brings the kids along with jogging strollers. Which is great for a number of reasons-- first, just the fact that it's a GROUP provides some feeling of accountability. For me at least, that's huge. I'm one of those people who (almost) never skipped class in college... I'm generally what you'd call a Rule Follower. So having the feeling that "I'm expected to be there" makes me more likely to do something than just telling myself "I really ought to."

The second great thing is that, frankly, it's hard to exercise when you have little kids.  I don't mean physically (though there is that... babies aren't exactly harbingers of well-restedness), but just from a practical standpoint.  If you try to do it at home, they're all up in your business. If you try to go to the gym, you've got to find childcare. It's just a huge hassle. A group that welcomes and accommodates kids makes it that much easier.

Third, there are all different fitness levels in the group. I wasn't even one of the last ones in the jogging section, amazingly (and I HATE running, y'all).  I can't tell you how happy that made me-- not in a "ha ha, I'm faster than you" way, but in an "I'm not completely hopeless after all" way.  I tend to get really discouraged when I'm clearly not good at something, and instead of motivating me to work harder, it just makes me want to quit... which I know is a serious character flaw, and one that's shared by many first-born achiever types (or pseudo-first-borns like me).  It's something I definitely need to work on.  But not if it's too hard, because then I'll just quit.  (Haha, see what I did there?)

Anyway, I won't bore you with constant updates, but I'll let you know how it goes!

Monday, January 13, 2014

book list for 2014

Re-posting in order to join Haley's linkup!

Here follows, in no particular order, the books I intend to read in the coming year:

The Mysterious Benedict Society by Trenton Lee Stewart

Mansfield Park by Jane Austen (already started)

Miracles by C.S. Lewis (already started)

The No. 1 Ladies' Detective Agency by Alexander McCall Smith

Carpe Jugulum by Terry Pratchett

The Ruins of Gorlan by John Flanagan.  Ordered this by accident via Kindle after reading a review... meant to add it to my wish list but hit "one click order" by mistake... so might as well read it!  (Hey, at least the review was good.)

Small Steps for Catholic Moms:  Your Daily Call to Think, Pray, and Act by Danielle Bean

Style, Sex, and Substance:  10 Catholic Women Consider the Things that Really Matter by Hallie Lord

The Tipping Point:  How Little Things Can Make a Big Difference by Malcolm Gladwell.  I read another book of his, Blink, in 2013 and loved it!

Into the Still Blue by Veronica Rossi (on pre-order, comes out this month).  I'm also planning on re-reading the first two books of the trilogy before it comes out.

Something Other Than God:  How I Passionately Sought Happiness and Accidentally Found It by Jennifer Fulwiler (on pre-order, comes out in April)

Watership Down by Richard Adams

Simplicity Parenting:  Using the Extraordinary Power of Less to Raise Calmer, Happier, and More Secure Kids by Kim John Payne

Strange Gods:  Unmasking the Idols in Everyday Life by Elizabeth Scalia

The Creative Family:  How to Encourage Imagination and Nurture Family Connections by Amanda Blake Soule

Quiet:  The Power of Introverts in a World that Can't Stop Talking by Susan Cain

A Book of Saints for Catholic Moms by Lisa M. Hendey

Behold Your Queen!  A Story of Esther by Gladys Malvern

Cranford by Elizabeth Gaskell

To the Field of Stars:  A Pilgrim's Journey to Santiago de Compostela by Kevin A. Codd

A Hidden Magic by Vivian Vande Velde

The Heart of Motherhood: Finding Holiness in the Catholic Home by Donna-Marie Cooper O'Boyle

The Island of the Colorblind by Oliver Sacks

Feast!: Real Food, Reflections, and Simple Living for the Christian Year by Haley and Daniel Stewart

Pope Awesome and Other Stories by Cari Donaldson

Lady of Avalon by Marion Zimmer Bradley.  (This is a novel that was given to me as a gift and has been lingering unread on my shelves for YEARS.  Time to knock it out.)

The Maze Runner by James Dashner

The Ocean at the End of the Lane by Neil Gaiman

The Catechism of the Catholic Church (I'm doing that "Read the Catechism in a Year" via email thing.  It started in December, so if you'd like to join in, there's not TOO much catching up to do!)

That's an average of about one book every two weeks (not counting the Catechism).  Think I can do it?

Thursday, January 9, 2014

theme thursday: bare

On Guam, there aren't any starkly lovely bare winter trees. While the eastern half of the United States is gasping through the coldest temperatures in decades, we're going to the beach and eating popsicles in the air conditioning.

But you know what that does mean? Bare feet. Bare shoulders. And bare babies!

My roly-poly Josie posy (or Ro Po Jo Po, when I want to sound like the Judoon) in all her rolled and dimpled glory. The cuddliest baby ever.

Head over to Clan Donaldson for more bare pictures!

Tuesday, January 7, 2014

saint of the year

So I joined the crowd with the Saint's Name Generator... and got someone I'd never heard of.

St. Paul Miki was a Japanese Jesuit in the 1500s known for his eloquent preaching, and became one of the 26 Martyrs of Japan (whose feast day is February 6th) when he was forced to march 600 miles and then crucified (!!) for his beliefs in 1597 at the age of 35.  Legend has it that he preached his last sermon from the cross and forgave his executioners before he died.

Preached his last sermon from the cross?! Talk about inner peace in the midst of chaos!  Can you imagine?!  And I act like my trials are so difficult.

St. Paul Miki, pray for us.

Monday, January 6, 2014

supermom wannabe + word of the year

Do you ever look around and think, "Oh yeah, I got this"?  (Yeah, me neither.)  Or at least "I think this is actually going to work and then life will be AWESOME"?  And you have this amazing plan to organize your entire life, so that your prayer life will be deepened, your marriage will be perfect and fulfilling with nary an argument, your house will be clean, your budget will be flawless, your children will be polite and precocious, your parties (oh yes, you'll throw parties) will be gorgeous, your plan to get in shape will actually happen, and you'll finally get around to reading all of Shakespeare.  Those plans always work out exactly the way you anticipate... right?

Any Myers-Briggs aficionados out there? Yeah. INTJ here.  I'm always trying to come up with an overarching solution, a master plan that will solve and organize everything.  And while I do actually enjoy planning and scheming and such, it can be frustrating when those plans don't come to fruition.

(Pinterest recipes, anyone?)

Cari at Clan Donaldson posted recently about asking the Holy Spirit to help you discern a word of the year-- a word to meditate on and try to build your life toward.  I thought this was a lovely idea, but I was a bit skeptical that I would be able to come up with such a word. And if I did, how could I be sure it was the one God wanted me to discern?

Enter New Year's Eve.  The prior two nights had been full of late-night rocking, fussy babies, and multiple awakenings. I already knew there was no way I was going to make it to midnight. I felt like I was post-call in residency again-- that nauseous, dizzy, please-I-will-give-you-money-if-I-can-just-lie-down feeling.  And then Josie, my poor teething runny-nosed baby, was refusing to go to sleep. I was deliriously tired (at like 9:30pm, haha) so I gave in and just brought her into bed with me.  Now, we're not really co-sleepers. She's been in her own room for months. Normally I would feel like this was backsliding, and beat myself up with Mothering Angst. But as I drifted off into blessed sleep, the word that popped into my head was "peace."

Peace with this situation. Peace with things not being perfect.  Peace with a little mess in my life-- not as if everything must be all peace, all the time.  I remember a story I read once about a king who held a contest for all the artists in the kingdom to illustrate the concept of peace. Most of the artists painted scenes such as beautiful landscapes of blue skies, green fields, and calm lakes.  But the winner's painting depicted a thundering waterfall crashing over a cliff in the midst of a raging storm-- with a mother bird sitting contentedly on her nest behind the falls.  Peace in the midst of chaos.  It's easy to feel peaceful when everything in your life is going right, but that's not the test of true peace.

I do struggle with the idea of how to keep a balance-- how do I make peace with where I am without becoming complacent, or just plain lazy?  I mean, I don't want to be unreasonably hard on myself, but we should all of us strive to be better than we are, right?

Maybe it's more about letting go of frustration. Not so much thinking that problems don't need to be fixed, but accepting that they don't need to be fixed right now.  Realizing that it's okay to stop and take a breath.

Wishing you peace in 2014.

(PS- I don't know why this post initially appeared way down at 12/27, since I wrote it long after that.  Editing in the hopes that it will now appear in the correct order.)

Saturday, January 4, 2014

13 from '13

I know it's not 2013 anymore, but that doesn't mean I can't do a year-end review or, more importantly, JOIN THE LINKUP!


We visited our families in Ohio for New Year's, aka Let's-Pretend-It's-Christmas-Because-We-Had-To-Work-On-Christmas-Because-Stupid-Residency. Faith got gastroenteritis and freaked out on the plane. Good times.


Faith turned two and gorged herself on cake. She also started talking more, working on overcoming her speech delay thanks to her wonderful speech therapist, Miss Betsy.


Still preggo. Fortunately I passed the dreaded glucose tolerance test this time-- when I was pregnant with Faith I just barely failed and had to come in to do the three-hour test on one of my few Saturdays off.  Shoot me.


Presented my research, "An Analysis of Infant Deaths and Injuries Associated with Swaddle Wraps and Sleep Sacks" at a poster presentation and won a (very local) award for it!  (Also, I turned 29. Yikes.)


Faith enjoyed her last month as an only child as we got ready for Josie's arrival.  I finished up almost all of my clinical experience as a resident, as I had cleverly arranged my schedule to have my final, baby-birthing month be a "board study" month only, with just a couple half-days of continuity clinic remaining.

Jack and I both finished residency!  Here's me (looking enormous) with almost my whole residency class on our end-of-residency party/boat trip.  Look how happy we all are to be DONE WITH RESIDENCY!!!

June gets the bonus picture!

Josie was born at the end of a super-quick 5.5-hour labor.  Seriously, I started having contractions as we headed out to lunch at Panera, and by dinnertime I had a baby.  It was basically drug-free (not on purpose... I respect ladies who want to go au natural but I'm not one of them) because it was ridiculously fast. They got the epidural in-- and the IV, which I was supposed to have much earlier for antibiotics due to screening positive for GBS-- JUUUUST in time for me to push.  Then it was like 3 pushes and hello baby!


Omg, you guys, we moved to Guam!!  The heck?!


We finally moved into our house after being on Guam almost a month.  So amazing after living in hotels for weeks on end.  Also, Jack turned 31... officially "in his thirties." Crazy!


I started work as a real-life attending pediatrician! Double crazy!


Faith was the cutest Red Riding Hood EVER for Halloween.


Cooked my first (teeny, under 10 pounds) turkey successfully!


Christmas on Guam. Surreal. Happy, though.

I could do with a few years quite a bit LESS eventful than 2013. You know?

Linking up with Dwija at House Unseen, Life Unscripted!

Friday, January 3, 2014

seven quick takes friday - ed. 12

1. Yesterday I worked "locum tenens"-- which is like being a substitute teacher, but for doctors. It was fine, but kind of weird. I felt like I wasn't sure what I was "allowed" to do-- for instance, I prescribe fluoride supplements to all my patients (which is the official recommendation for kids in areas where the tap water isn't fluoridated), but the docs I was covering for, it seems, don't.  So I didn't.  Some of medicine is cut-and-dry, black-and-white, but much of it varies with each physician's "style."

2. I'm planning on giving Faith a dollhouse for her third birthday (next month!) and omg, you guys, have you seen the Plan Toys dollhouse furniture? I can't get over how cute they are in their simple, sturdy way.

Sorry this picture is so blur-tastic.  It was the only (okay, the first) one I found with multiple sets in one photo.

3. Faith is cracking me up recently. The latest thing she says, "Oh my dosh!"  (She doesn't really say her Gs yet, so it's extra cute.)   As in, "Oh my dosh, why you sad, Josie?" or "Oh no, dropped it!  Oh my dosh!  Need help, mama!"

4.  Ever wanted to become a Ring Wraith? Look no further!

5. Has anyone ever made any of these "microwave [insert food here] in a mug" things?  The pictures always look delicious, but I'm a little skeptical.  Very tempted, but skeptical.  Although, I guess, what's the worst that could happen, right?  It's not like it's a big time investment.

6. On New Year's Day we went to mass at the base chapel.  The priest made an interesting point during the homily made an interesting point:  most New Year's resolutions are actually wishes-- to lose weight, to be a better spouse, to read more, exercise more, eat better, draw closer to God, whatever.  A real resolution would be to say "every Monday, Wednesday, and Friday I will jog for 30 minutes" or "I will set my alarm 15 minutes earlier and use that time for prayer" or "I will wash the dishes in the evenings without complaining to my husband."  That way you're actually resolving to do something-- a specific action-- to achieve your goal.

7. With that in mind, I hereby make a resolution to blog at least 3 times a week, AND to comment on others' blogs at least that often as well.

Happy New Year!  Go see more Quick Takes at Conversion Diary!