Buzz Killer

This is the conversation I overheard in the car yesterday:

Toby (age 4): "When I grow up I'm going to jump in puddles anytime I want to!"
Sam (age 7): "When you grow up you won't want to jump in puddles."
Toby: "Yes I will!"
Sam: "When you grow up you'll be so busy you won't have time to jump in puddles even if you want to."

What am I teaching my children??

My husband and I work hard so we can provide our children with a relatively carefree childhood...or so we thought.

Sam is our oldest and he is a typical oldest child. He is a pleaser and he's very precise and hard on himself. He follows the rules and expects everyone else to do the same. While he can be very goofy, he can also be very serious, so much so that at times I have to tell him to lighten up. He's a lot like me, I am also an oldest child.

After overhearing this conversation I resolved to try and show him the lighter side of adulthood. True, I no longer want to jump in puddles, but I do have fun and I want him to see that.

Then came this morning when I found myself snapping at him to come when I called him so I could give him hugs and kisses before I left for work.

????

I was yelling at my child so I could give him a hug and a kiss. What kind of sense does this make? I guess I need to lighten up myself before I can get him to lighten up. That minute he took to dawdle on his way to say goodbye wasn't going to make me late. I was just already so anxious about being late I couldn't let it go.

Mornings are tough. I didn't get up late, I just had a lot to do and I ended up a little squeezed for time. In the end I made it to work in plenty of time and now am stuck with the guilt of robbing the pleasantness from the morning. I wish I had just left when we were all watching the astronauts enter the space shuttle while parked on my bed and I finished feeding the baby. But I didn't.

I'm not raising my kids in an idealized world. They know bad things happen. Any illusions that this world was perfect were shattered when their beloved Uncle died. Still, I want them to be kids and experience the joy of childhood. I don't want them to worry about my stress and I don't want them to think that being an adult is all stress and no joy.

Something else for me to stress about.

Lazy

Have my iDevices killed the blogger in me?

It has been over a week since I have last blogged and it's not because I don't have anything to say. I have been having trouble finding the time to sit down and actually write. On days I don't work my dedicated computer time is over breakfast. I love having my coffee while checking my email and Facebook and maybe writing a blog or otherwise surfing. Since my birthday (roughly 2 weeks ago) when I got an iPad, I no longer use my laptop to do this. I use the iPad. And why wouldn't I? It's smaller, it powers on faster, it has a sleeker look and a more user friendly interface. But it isn't really conducive to typing. It's on-screen keyboard is really only good for a quick email reply or Facebook status update.

I anticipated this issue and got a wireless keyboard (which I am typing on now) to go with the iPad. What I didn't anticipate was that I would be too lazy to walk into another room and retrieve the keyboard and actually use it. Emails that require lengthy replies and blogging always seem to be things that I'll do later.

If you haven't heard from me lately, that's probably why.

I've also been a bit busier. It's summer and weekend barbecues and trips to the pool take precedence over inside computer time. At work my downtime is taken up by pumping.

So I'm still here, the baby loves the pool, the older boys are getting darker skin and lighter hair and Mike and I are remembering how much we love hosting our friends in the back yard with the grill going and the wine flowing. It just might be a while longer in between blogs. I blame these new-fangled devices.

When Did I Become Evil?

I think for my sanity I may have to stop reading the New York Times. Ok, so I know sticking my head in the sand isn't the answer, but an article I read this morning has my blood pressure up again. A few weeks ago I wrote an angry response to Dr. Karen Sibert's op-ed on women doctors. I have since read many other responses, some calmer and more thought out than mine. It is nice to know I am not alone in my belief that women can work part-time and still be good doctors.

This morning there was an article in the Times about government "mystery shoppers" who will be calling primary care physicians (pediatricians and ob/gyns included) to see if they are accepting new patients, if so how long it will take to get an appointment and if there are different answers depending on the type of insurance (private or medicare/medicaid) the patient has. If you would like to read the article you can find it here.

http://www.nytimes.com/2011/06/27/health/policy/27docs.html?nl=todaysheadlines&emc=tha24

I object to this on many levels.

The stated purpose of this survey is to see if there is a doctor shortage. Really? I'm pretty sure this is already known. It seems to me we can compare the number of doctors trained with the number of people in the US and figure this one out. It has nothing to do with how long it takes to get an appointment and if a doctor takes medicare.

They also say that all of the information will be kept confidential. Again, really? I don't trust the government to do this, do you? There will be leaks and some doctors will be penalized for not being able to book a patient in the window that some bureaucrat set.

What really bothers me though is the need the government feels to spy on doctors. Do they think that if we get a call from a new patient vs a call from someone who identifies themselves as a government survey taker we will change our answers?

I am tired of being maligned by my own government. Clearly, they think I will lie if asked directly so they feel a need to lie to me. They also think that I only order diagnostic tests for the money (even when I get none) and that I am quick to order or perform procedures, again for the money.

Most doctors in this country get paid based on the number of patients we see. It doesn't matter if we spend 10 minutes or 10 hours with that patient, we get the same amount of money. Because of this it is to our benefit to squeeze in as many patients as possible. I'll be surprised if any doctors on this production model have long waits. Salaried doctors may be another story, but...

Most doctors in this country and beyond went into medicine because they are genuinely caring people who want to serve their communities. Because of this, I'll be surprised if the patient mentioned in the above article who complains of coughing up blood and trouble breathing will be made to wait anywhere.

Doctors are not the problem in this system. Our rates are set by private insurance companies who take their cues from Medicare. We work hard to provide the best care we can within the limits we are given. We are not allowed to unionize or strike. When I contacted my government representatives and offered to help craft the new healthcare initiative I was given a thank you and a request for money.

I have many patients that I see who cannot afford to pay me and I see them anyway, because they need me. I am in a sub-specialty where it takes a long time to see a patient. It can take an hour or more for me to do a new patient consultation. And yet the government decided last year that I shouldn't get paid any more for that than I get for a ten minute patient exam.

I have three children and a mortgage. Somehow I need to earn a living.

There are bad apples in every profession. I am tired of my profession being vilified because of them and the misinformation that is out there. This attitude will keep people from going into medicine and drive others out. Surveys like this will only exacerbate the doctor shortage that it is supposedly trying to find.

No one goes into medicine for the money. It makes no sense. You spend the first four years paying or going into debt for medical school. You spend the next 3-7 or more years earning miminal salaries and working non-stop as residents. You then make it to attending status and have to see as many patients as possible to try and make enough money to pay your overhead, live, and eventually retire someday.

Doctors may make higher salaries than some professions, but we don't make as much as some others.

Since when did earning a salary become a crime?

Birthday Bliss

Yesterday was my birthday and it was great. The day started off when I woke, on my own, at 7:00 and groggily realized that I hadn't gotten up in the middle of the night to feed the baby. Thank you Drew for a great birthday present.

He woke up soon after I did and I fed him and then went on a walk all by myself. Thank you to my husband for that present.

After I walked I took the older boys to camp and they laughed and were happy the whole way. There was no aggravation, no fighting, it was totally smooth sailing. Thank you Sam and Toby for that present.

At this point it was 9:15 and I was already having an amazing day.

I got to go out to lunch with my husband (and the baby), get my nails done (fingers and toes) and get a facial (half price!). My sitter gave all of the boys baths and I got to hang out with them through and after dinner with minimal fussing and fighting.

It was wonderful. If you have to have a birthday and get older, this was the way to do it. And notice I haven't even mentioned any gifts or cake yet!!

I did get some great things, but the best thing of all was my day.

I'm going to try to hang on to that feeling when the baby wakes up at 1:30 and screams for an hour before going back to sleep (like he did this morning) or when I have to work or when the older boys are bickering and driving me nuts. It's nice to just know it's possible to have a lovely day and even better to have had one.

You Can't Stop Time

In two days I’ll officially be another year older.  Another year farther from my youth and closer to old age.  Birthdays are traditionally a time for celebration and reflection.  A time to look back at what you have accomplished and to look forward to what you have yet to do.  I remember when I looked forward to my birthday.  I was younger then.

This morning in the shower I felt slow and achy and I wondered if this is what it’s like to be getting old.  Or if it was because I had gotten up two hours earlier to feed the baby and spent the interim in that no-man’s land between awake and asleep.  Or both. 

I have accomplished a lot in the past year.  Most notably, I’ve had a baby.  I’ve also continued to raise my other two children, work, write a blog that I’m hoping to turn into a book and start this blog.  I’ve nurtured relationships with my husband, my family and my friends.  I’ve lost my grandmother and continued to mourn my brother.  I’ve continued to ride this roller coaster we call life.

I feel like my preface is over.  I’ve gone to school, earned my degrees, gotten married, started my career and my family.  I’m in the less rewarding stage of just keeping it all going now.  No graduation every four years, no pat on the back for a job well done.  Just the self satisfaction of going to sleep with the dishes done, the backpacks loaded and ready for the next day, the house relatively clean.  This is real life; making it through everyday just to face the next one; hoping that eventually we’ll save up enough, early enough to enjoy our old age before the end.  Hoping that we get to old age.

Life is not without its perks.  Seeing the baby smile makes everything better.  Listening to my older children have an actual conversation is a wonder to me.  Seeing the joy on their faces as they make a joke that is actually funny, or learn something new, or lose a tooth is amazing. 

This year my birthday wish is for time.  I wish for time to spend alone with my husband.  I wish for time to just hang out with my kids, with no place to be and no homework to get done.  I wish for time to slow down so the baby stays a baby as long as he can. 

I’m not going to be rich and famous.  I’m not going to change the whole world.  But I can have great influence on my little world and I wish for the time and energy and fortitude to do so.

Addendum to Yesterday's Open Letter

To the dad I saw this morning without shirt but with jogging stroller, bronze pecs and washboard abs exposed to the world, you and you alone, may continue running shirtless. 

But please wear plenty of sunscreen.

An Open Letter to Men Who Should Know Better

I am an unapologetic people watcher.  One of the best times to observe my fellow humans is when I am out walking in the neighborhood.  I find very little of which to disapprove, mostly I admire the variety and quantity of the species.  For the most part, if you are out there walking, jogging, biking, moving; I applaud you.  You can be with a single, double or triple stroller or infant in front carrier, with dog or dogs, in a gaggle or strutting solo and I am your fan.  Whether you are a young college student, young mother, young empty nester or young senior, we are all young when we are out there making the effort.  You can listen to music or listen to the birds.  You can wear the latest in trendy running fashions, or like me, be clad in old shorts and faded t-shirts left over from years ago and I am proud to be among you.  Whether your calves are hard as rocks or just a little (or a lot) softer, I welcome you.  There is however one member of our clan who should know better.

To the men who jog shirtless I ask, beg, plead with you to please put a shirt on.  Very few of you can carry this off in a way that is pleasing to the eye and even you shouldn’t be doing it with all that we know about skin cancer.  And to the 99.9% of men out there who can’t carry it off; we don’t want to see it.  I don’t want to see your pale skin reflecting the sun into my eyes.  I don’t want to see the rolls jiggling, the sweat dripping down from one to the other and finally to the sidewalk.  It’s hot, I get it, but the cotton of my old college t-shirt absorbs my sweat.  Or better yet get a moisture wicking shirt that promises to keep you cool and refreshed. 

I revel in the beauty of nature when I walk.  I watch the birds, the squirrels, the houses, the flowers, the trees and the people.  For the most part all of the people are beautiful because we’re all part of this neighborhood.  We make it what it is.  You are not beautiful.  You are unpleasant, but not unfixable.  Don’t stop running; don’t stop participating in the flow of this lovely community.  But please do it fully clothed.

Thank you.