Post-Call Exhaustion

Did I really exalt post-call Mondays, not too far back?  Was that me?  Excited about the prospect of heading into another work week without a proper break?  I must have been smoking crack.  Luckily, this is a short week.

The weekend part of the call wasn't too bad really -- a full work day Saturday and a quick hour Sunday, but somehow I managed to incur the wrath of each of my family members inadvertently starting at about 3:30 a.m., and I've been fighting sleep all day.  When I got up at 5:00 to blow off some steam on the treadmill, which I had not intended to do, I was interrupted by early bird John sniffling barefoot on the concrete floor.  After having my sleep and run cut too short, my daughter waged World War III on me at breakfast this morning, when she noticed John got to watch a video before breakfast ("Sweetie he's been up for almost two hours - this was not done against you, I promise").  I finally reacted by slamming some cabinet drawers while cooking.  John thought it was a joke, and laughed.  Sicily continued to glare at me, unmoved.  I thought this mother-daughter hatred thing started at 13, not six!

After self-flagellating all the way to work for losing my cool, I reflected on the good parts of the call weekend.  There were some really good ones:

1)  Getting into the lap pool at the Raquet Club and swimming laps for the first time in, I don't know, 10 years.  Despite the fact that anyone peering down at my backstroke would have thought I was drunk and it took me a while to get the hang of breathing during freestyle -- it felt so good I snuck out at lunch today and bought a Nike swim suit for exercising.  I can't wait to do it again.

2)  Cooking the best Mexican chicken soup I have had in months with Ike Sunday night -- we chopped cilantro, chicken, mushrooms, tomatoes, onions, jalapenos, and corn - all in a chicken broth base.  We added some spices and garnished with sliced avocado and multi grain chips.  Homemade black beans were served on the side.  My mouth has been watering all day long thinking of leftovers tonight.

3)Taking Sicily up to work Sunday afternoon to read peripheral smears and showing her normal small intestinal epithelium vs. tumor (I'm still throwing antibodies at it trying to figure out what the heck it is - it is a mystery).  I taught her how to adjust the eyepieces on the microscope and compared the large, atypical mitoses in dividing tumor cells to stars.  She balked at my comparison.

"Give me a pen and paper mom.  I think I know what you want me to see.  Does it look like this?"

"No, Sicily, that is the enlarged nucleus with a prominent nucleolus.  A tumor cell, not a mitosis."  I noticed she drew petals around the tumor cell, and searched my memory in quiet surprise trying to find a tumor cell that looked like a flower.

She looked again, then drew.

"Does it look like this?"  She drew a perfect tripolar mitosis.

"Yes, that's it!  Isn't it beautiful?" 

"Nice, mom, but not a star."  

Maybe she had a point.  It did look more like an electrified peace sign.  I'm going to have to get a little more savvy in my descriptions, for her.  

I really hope she remembered the scope lesson at school today, and the chocolate milk from the doctor's lounge, instead of our fight this morning.

I Wish I Was the Moon Tonight . . .

Neko Case is an amazing artist.

"How will you know, if you find me at last?  Cause I'll be the one, be the one, be the one, with my heart in my lap.  I'm so tired.  I wish I was the moon tonight."

Check her out on youtube.

Book Club

You need to go out and read Olive Kitteridge.  That wasn't our book club book for Friday night, it was Free Food for Millionaires, which is a really good book, but Olive is much better.  There's not much more praise I can heap on top of a book after it won the Pulitzer Prize for fiction.

I kept getting biting my tongue back at dinner, trying not to talk about Olive, who the two other consistent readers had not read (but I think I convinced them to and passed it along to one of them just to make sure).  I have never read a novel that revealed a character quite like Elizabeth Strout did Olive - in beautiful short stories.  And the author's prose was so powerful that although I finished it a couple of weeks ago, phrases keep drifting in and out of my consciousness throughout the day.  The author's knowledge and expression of the depth and range of human emotion and empathy was staggering.  Sometimes the simple clarity of her words hit me over the head like a bludgeon.

Anyway, I won't write a review - you can read Louisa Thomas' excellent one at the New York Times if you goolge it because I still can't insert a darn link and I've got to go see my apheresis patient.

Whenever I read a novel that I love so much, I have trouble moving on, because anything new invariably sucks compared to the last one.  So rather than pick something that has any chance of hope for comparison, I wait a few days, and then intentionally stray toward something light and fluffy - brain candy.  Brain candy is also ideal after big tests, like medicine, residency, and fellowship boards.  It acts a bit like an eraser, to prepare me once again for substance.

So I won't tell you what I am reading this week - it's too embarrassing.  I won't be suggesting it for the next book club.

Highlight the Important Things

I was just making the kid's lunch and started cracking myself up at a series of inane conversations I have been having with Sicily over the past few days.  

Two new food products were introduced to my kids last week on vacation.  First, Aunt Esta brought out Oreo Cookie Cakesters for kid dessert a couple of nights - a sort of puffed up soft Michelin Man version of the original Oreo.  Sicily begged me to look for them at the grocery Sunday for their lunches this week, so I complied.  Second, on the way home in the airport, John picked out a gourmet version of a kid's meal with deli ham, crackers, different kinds of cheeses, and a creme de menthe - the adult version of the lunchable.  They loved them so much I also looked for that at the grocery, but could only come up with the kid version, so I bought a few to try out.  The introduction of both new terms to our food repertoire has brought confusion to the house.  For example:

"Mom, can I have a cakeable for dessert if I eat all my chicken?"

"It's not a cakeable Sicily.  It's a cakester."

"Oh.  I mean cakester.  Can I mom?"

And this:

"Mom, I really don't like the ham that comes in that lunchster.  Could you please add some deli ham so I can use that instead?"

"Sure, but it's not lunchster.  It's lunchable, remember?  Cakester, lunchable."

Here's another:

"Since John and Daddy got to go to the ice cone place can I have two cakeables for dessert instead of one (ever the budding lawyer)?"

"Cake-STER, Sicily.  Cake-STER."

Why do I even bother correcting her on these NON-words?  That's the ridiculous part of it all - me.

Anyway, after both kids rejected the lunchable soundly (as they should, but you sometimes get desperate when returning from vacation) we decided to get some fancy tupperware and create our own version of the lunchable.  Thin-sliced deli ham, whole wheat crackers, whole foods cheddar cheese, fruit (juice for Sicily), and maybe a cakeable for dessert.  I think I'll call it the lunchster.

Running

I just stepped inside from the back porch of this amazing beach house. A thunderstorm is brewing, and the streaks of lightning through the massive cloud shelves compete with the steady lights of the shrimp boats on the horizon. As the breeze cooled my sun burnt back, I thought about the highlights of this vacation.

I ran every day. I never really thought about myself as a runner, until this trip. I started running three years ago, when I realized that my body would no longer be immune to my daily tortures and consumption, and I desperately needed a healthy mind-altering state. As I ran on the three mile stretch of private beach, littered with shells and bordered by state parks, I thought of all the other places I ran over the last three years. I compared. This place took the cake.

The marshes that lie directly adjacent to the beach are sea turtle and bird sanctuaries, so it is not uncommon to see long-necked egrets standing in the grass, chains of pelicans diving into the ocean to feast on a school of fish, and seagulls wading among the oyster beds - fat and happy. The birds far outnumber the humans, of which there are rarely more than five or six. Mike's Aunt Esta informed me that the beaches, this week, are overcrowded.

I didn't see a turtle, but on the first day, Esta took Sicily and I on a golf cart tour of her beach, and she pointed to some turtle tracks that she and her husband John had seen on turtle patrol that morning. They found an egg - a rare but golden find, and it was buried and marked with a wooden stick flagged in bright orange. Sicily was disappointed that she couldn't see the egg, but she chose an exquisite glass baby loggerhead emerging from an egg as her serpentarium gift shop reward for behaving, so all was well. I wondered aloud how many turtles had emerged from the ocean to create this at least two foot span turtle track leading to the covered mound. Esta smiled knowingly - she and John have lived here for three years. "Just one."

Running along this private stretch of beach was a little difficult because of all the visual distractions - beautiful sea shells, giant horseshoe crabs, and man-o-wars. I was so excited to see the whale carcass that Ike's cousin Michael's wife Tara told me had been there for months; unfortunately it had been removed a few weeks prior to our visit. We hosted dinner for 12 last night. Ike's Uncle John pointed to two giant rib bones I hadn't noticed on the floor under a coffee table covered with seashells, anemones, and crabs. "Those are from the whale carcass. They sawed it apart and distributed the bones."

I ran morning, noon, and evening - so I was able to see the changes in the tide, which was more striking in distance than I might have imagined. My favorite run was this evening after dinner - the sun was setting and even though the wind had picked up, making it difficult on the way back, I delighted in reminiscing about college with all the Beastie Boys albums I gathered recently from my brother. Who knew that the Beastie Boys were such great running music? I've only ever partied to them.

As I ran, I thought of all the other times I have run over the past three years. Running leaves an indelible stamp on an experience - similar to art, music, and books. I thought back to my anniversary trip to Eureka - where I ran the last three miles of an 11 mile hike through the forest, feeling timeless. There, my distractions consisted of giant snail shells and fat black and yellow millipedes. I decided the snail shells were an impossible anomaly of our overly wet Arkansas spring. I also thought of all the treadmills I have graced at the pathology conferences I have attended - Chicago, Monterey, San Diego.

I started to run in residency because of my two best friends of that time period - Mel and Trishie. Both runners. Last week I called Mel to wish her a happy birthday. I reminded her of a phone conversation we had long ago, where she told me that she ran at home in her underwear and sports bra. I was studying the possibility of running in my head, and collected that information for future use. She laughed at the memory. "We should create a market. Rundies."

So that weekend, when I emerged from the basement in sports bra and underwear, sweaty and flushed, John and Sicily stared at me suspiciously. Sicily said, "Mommy, why do you run in your underpants?"

I adopted my best Wonder Woman pose (Oh I wanted to be her so bad when I was little), and said in a loud, commanding superhero voice, "These aren't my underpants! They're my RUN-DERPANTS!" Now I'm regretting it. They loved it so much, it has become a daily joke. One I miss, on occasion. But they remind me. Children have the memory of elephants.

Dreams

I just checked in on my kids, who are sleeping soundly. I wonder what they are dreaming about. Yesterday, I noticed an eyelash in the corner of John's eye.

"John, can I get that eylash?"

I pulled it out and placed it between my forefinger and thumb.

"Make a wish."

"Mommy, I wish that I could fly."

What a wonderful wish. I fudged, as I often do, checking to see which finger would hold the eyelash after a solid pressing. Looks like the thumb.

"John, take a guess. Which finger will hold the eyelash?"

He pointed at my thumb, and I granted his wish.

I remember when I was little, my most amazing dreams were flying dreams. I would wake up certain that with little effort, I could take flight.

Now my most wonderful dreams are nursing dreams. Yes, nursing carried lots of angst. Pain, blocked ducts covered with cabbage leaves, razor sharp cuts that brought tears to the corner of my eyes. But when you get it right, as I often did, it was the most amazing experience in the universe. The contraction of myoepithelial cells, followed by letdown, was a rush unlike any man-made drug on the planet.

When I decided to quit nursing John at eight months, because I was almost dried up and desperately needed to study for my boards, I spent the afternoon at my mother's house. I couldn't hold back my tears, which normally don't come easily to me. I knew this was probably my last kid - ergo my last nursing experience. The grief overwhelmed me.

"John, where are you going to fly?"

"Mommy, I want to go with you. You are so beautiful. Will you fly with me?"

Forever and always.

The Flip

I just got my new Flip Mino HD in the mail yesterday and I am so excited!  It looks cool (I passed up vintage designs, retro patterns, hello kitty, skulls, and chameleons for the basic black, to which I tend to gravitate) some proceeds went to charity, and I can finally catch up on all the kid videos we have missed over the past six years.  Best of all, it only took me about five minutes to read the instructions and voila, I was making videos.  

I promise I won't glut everyone with videos of my kids.  Only family -- not blogspot, just picasa.  Unless there is a particularly fabulous one.

I never thought making videos could be so technophobe-friendly.  This is right up my alley.  My only fear is that it is so little I might lose it on vacation, like the ishuffle.  

Birthdays and Bicycles

It's John's fourth birthday today, and we just wound down a family dinner with cupcakes and candles.  I can't believe it has been four years since my water broke six weeks early while I was walking on the treadmill.  It wasn't  a gushing, dramatic break like the one I witnessed when I was seven and my little brother was coming ("What is happening, mom?  Are you peeing on the floor?"  I whispered to my sister, " That's a LOT of pee") but a slow trickle that made me wonder if my bladder was betraying me.  Nope, pink-tinged serous fluid - it had to be amniotic.  

John was a scrawny five pounds, very unlike his sister, but he never left my side for more than an hour or two in the hospital and I took him home right away.  Luckily, my dad's pull as a neonatologist helped in that arena.  I spent almost my entire maternity leave lying in bed, chain reading, and nursing John.  At night he glowed under the eerie blue lights of the bili blanket that my dad smuggled home from the hospital when John was looking too yellow.  I felt like I was nurturing a tiny alien.  By his due date on July 5, I had doubled his weight to over 10 pounds.  I am more proud of that than anything I ever accomplished in school.

John's first outing came unexpectedly.  I was at home alone with John, and the phone rang.  I answered.

"Lizzie?  Is that you?"  The voice sounded frantic.  The only person that calls me Lizzie, in my adult life, is one of my best friends from residency, Trisha.  

"This is Jim.  Trisha's husband.  I'm out of town on business, and Trish is in the ER at St. Vincent's.  It was a bike accident.  Can you please go be with her?  I can't catch a flight for a couple of hours."

I packed John up in the infant seat - he was only a few days old and it dwarfed his premature body.  I drove to the ER, which is only about a mile from my house, and wandered around until I found her in a cubicle.  She was sitting upright in a hospital bed wearing a t -shirt and biking shorts.  Her slender athletic body was slumped and defeated, and her eyes were a little glazed.  Her golden hair was wet on one side and matted with blood.  Trish can outrun/outbike almost everyone I know, including guys.  She's also incredibly competent in the morgue and gross room.  This was the first time I had ever seen her look fragile.  I rushed over and gave her a hug.

"Trish!  Are you ok?  What happened?"

She was rounding a corner and hit a slick spot - flew off of her bike.  I asked her if she was wearing a helmet.  She replied that it had completely busted in the accident.  If she had not been wearing a helmet, her head would likely have suffered its fate.

After she told the story, I decided I needed to distract her.  I talked about my excruciating four days in the hospital, and told her about how I became so depressed I called around one afternoon and found someone who would give me a pedicure.  She did hair and feet for all the ladies in Baptist re-hab, and she was prematurely aged in the way that only a heavy smoking habit can do to a person.  I worried so much about her having to sit on the floor to paint my nails that I struggled to enjoy the experience, and tipped her heavily.

As I told the story, I stared at Trish's shirt.  It was so cool - like a pink/orange organic tie-dye.  I decided I wanted one, so I complimented it and asked her where she got it.  

"Lizzie, this t-shirt is plain white.  The blood did that."  We laughed so hard her head started hurting and we struggled vainly to stop, like little girls at a sleepover after lights out.  Another blond moment.  We both can be scatterbrained on occasion, and some of the more memorable stories are frequently passed down in resident lore.

She kept asking me if she looked all right, and I assured her that she looked fabulous, as always, like a supermodel, just with a head wound.  

"Do you remember that Stephen King movie, Carrie?  When she was all dressed up for the prom and then the pig's blood got dumped on her head?  You could be her, Trish!"

It took a while for the doctor to get there, and after I sat awkwardly on the stainless steel counter and covered myself with a blanket to nurse John, I jumped down, put him in the car seat, and warmed a washcloth with tap water.  I cleaned the dried blood from her face and neck, taking care to avoid the gaping wound.  She wasn't feeling great, so we spent a lot of time not talking.  Finally the doctor arrived, shaved her head around the wound, and stitched her up.  I held her hand at first, but she didn't need it after a minute or two.  

The other day Trish e-mailed me about anxieties of leaving her toddler daughter for a four day trip to Boston for a conference.  She is pregnant with her second child, a son, and I find it endlessly amusing that she is slightly freaked out that there is a penis growing inside of her.  I never really thought of it that way, when I was pregnant with John.  I e-mailed her back.

What?  You are afraid of planes, but you still bike?  Crazy, T!

Where the Rivers Meet the Ocean

That's where we are flying this Saturday, for a whole week!  Edisto Island, South Carolina.  To a small community called Jeremy Cay.  The island's population is a little over 2100.  There is one grocery store, a Piggly Wiggly.  We get to stay in a big beach house for a whopping $250 for the whole week, because Ike's Aunt Esta knows the owners, and lives next door.  She promises early morning turtle watching on the shore, and sent pictures of giant Man-O-Wars that wash up on the beach.  I've never been to the beach in South Carolina, and this one boasts a rich history, on the website.  There is also a serpentarium!  

Edisto Island was the vacation spot of choice for the rich South Carolina plantation owners who wanted to beat the heat and mosquitoes pre-civil war.  The Edisto people gained their riches by producing slave-picked cotton that rivaled Egyptian threads.  Their cotton was exported around the world, and was even used to adorn the pope.  An exclusive community was created, with fancy beach houses, a posh hotel, and the all important saloon.  All of this was destroyed in the Civil War, with the help of a few natural disasters, and the remnants of the by-gone era continue to wash up on the shore:  bricks, plates, and other physical manifestations of history.

I had never heard of Edisto Island, but have mentioned our journey to a few friends who recognize the name as being the best vacation spot in South Carolina.  I tried to buy a book about it today, called Tales of Edisto, but it's not at Barnes & Noble or Wordsworth - my two most frequent haunts.  Oh well.  I have enough books to read.  And I remember being enthralled, as a teenager, with everything Pat Conroy wrote, including his non-fiction.  So I have high hopes for Low Country - can't wait to see the large Oaks draped in Spanish moss and breathtaking sunsets - where the rivers meet the ocean.