After working Tuesday, Wednesday, Thursday 2pm-12am & then unsuspectingly showing up Friday morning to daycare

"Honey, why were the ladies in the infant room getting such a kick out of a picture of Gi-gi with a silly grin holding a $5 bill?"

"What did they tell you?"

"Something about you and strippers."

"Oh. Well… I showed up Tuesday night and told Graham it was just us boys for 3 nights and so Dada was gonna get them some strippers."

"Nice, honey. And the $5?"

"I gave it to him to stuff in the stippers' G-strings. At first I was going to hand him one-dollar bills, but that wasn’t enough for MY boy. The ladies thought it was hilarious and took a picture of him holding up the money."

"Right."

"What did you say to the daycare ladies when you saw the picture?"

"I told them to keep Gi-gi away from sex, drugs and alcohol."

"What did they say?"

"Just say no, Gi-gi! Just say NO!"

Hello, My name is Pain In The Ass.

Schedulers control my life, so I was glad when my ER’s new scheduler sent each of us an e-mail asking about our overall schedule preferences. I was all too eager to tell her exactly what works and what doesn’t work for me… So I answered her with a lengthy description, which I’d normally hold back for fear of seeming like a pain-in-the-ass, but Hey! -- She asked for it!

I chose to include it in my blog because it really sheds some light on the chaos that defines our family schedule.

Hi Michelle. Looking forward to working with you.

Thank you for asking about our scheduling preferences, because getting a schedule that works with my family has such a positive effect on our quality of life. I'm thrilled to tell you all about what I prefer. I'll start out by answering your fourth question ("What are your scheduling likes and dislikes"). Do you have kids? If so, you may understand a lot of this.

My ideal shifts are the 7a-5p shifts. I LOVE those. I especially love week day 7a-5p shifts. Generally, the more I get of those, the happier I am.

I have two baby boys -- 24 months and 8 months, and a husband who works full time 8-5 and no live-in nanny and no family in the immediate area (my parents are three hours away, so they at least can come in a pinch), so on a daily basis it is up to my husband and I to provide child care. The boys go to day care M-F 7-6, so the more I can work when they are in daycare, the better. It's very hard on my husband and typically a challenge to find childcare assistance when I work nights and weekends. I understand it's part of the job, but that is why I strongly favor 7a-5p shifts.

For similar reasons, when I have to work 9p-7a I prefer them to be anything other than Friday or Saturday, because there is no sleep to be had in my house on Saturday or Sunday with the two babies at home. Any other shift on Fri or Sat is preferred over 9-7.

Except for those Fri and Sat 9-7 shifts which I can never recover from because I can't really sleep, on Sun-Thurs I don't think nights are that bad because they allow me to be home for family time at night. On Sun-Thurs if I can't have 7-5 I'd prefer 9-7 (confused yet?), because then I can be home for dinner, putting kids to bed, etc. The worst shifts on weekdays for me are the 12-9, 2-12, 5-1 because I miss family time at home.

Obviously, like everyone, I don't like weekends. I'd like at least one weekend a month where I'm off the WHOLE weekend. (Lately I've been asking for specific weekends to ensure this, like I have for March.)

Those are my utopian preferences. I know reality and fairness interferes with what you are able to do about them, but I appreciate you at least asking.

Here's my answers to your other questions.
1) How many shifts do you prefer to be scheduled in a row?
I'm flexible here. By the fourth shift I get to be really tired, so three is probably enough. But, honestly, I'm not as concerned about how many shifts in a row as I am with getting the "right shifts" (see above.)
2) How many night shifts in a row?
Two seems to be just right for me, but again, I'm flexible. I'm more concerned with getting nights that aren't Fri or Sat.
3) How many shifts do you prefer to work each month?
130. Maybe throw in an extra shift when it's a 31 day month to make 140.
4) What are your scheduling likes and dislikes?
See above!
5) Anything else that I should know about you that would affect how you are scheduled?
My "boys" (Husband Dan, 2 year old Cole, 8 month old Graham) are the most important thing in the world to me and 99% of my scheduling requests revolve around them. Sometimes Dan has to go out of town for his work (He's a V.P. at Suntrust bank), and so sometimes I ask off for that.

Thanks again for asking those questions and allowing me to voice my preferences, Michelle. Just so you know, we are having a minor logistical crisis in the Simons household, because Dan's work just mandated that he go to Atlanta for 2 or 3 days every week for the next 8 weeks! This is not typical and is NOT going to extend beyond 8 weeks (if it does... either he or I will be looking for a new job, because you can imagine the logistical nightmare.) I don't know if or how this will affect my schedule requests. We are looking into finding someway to get childcare the evenings he's gone. The only reason I'm telling you now is that I may have a few more schedule requests for March. I'll let you know soon if there are.

Thanks again.

Hopefully she’ll be kind.

No He DIDN’T!

Next time you visit your local ER, please remember your doctor is human and try not to be a jerk. The other day the jerk-to-reasonable person ratio in the ER was astronomically high. Everyone thought they were the only patient, and I was the only doctor for all 20 of them. I was getting slammed and the shit was flying.

The older docs I work with reminisce about the times when doctors were treated with some respect. I’ve never known those times and just have accepted that being an ER doc and getting bitched at go hand-in-hand. Usually it doesn’t phase me; partly because I do understand that whatever brought people to the ER is stressing them out, but more so because when you get bitched at everyday, you have to find a way to ignore it if you want to stay sane. But the other day this guy somehow managed to get under my skin so much that even the next morning in the shower I was still fuming about what an asshole he was.

His wife came into the ER by ambulance after a minor fender-bender and went straight to room 6, not even realizing she had bypassed the 4+ hour wait time for patients who did not come by ambulance. My first clue that she wasn’t too seriously hurt was that her biggest complaints were related to being immobilized in a cervical collar on the backboard. I understand those things are not particularly comfortable, so to the extent possible I try to get to such patients as soon as I can and get them off the backboard. Maybe I took a little longer with this lady because there were so many REALLY sick people who came in at the same time, but I explained and apologized as soon as I walked into her room.

As I examined her, she never jumped or winced but complained of tenderness EVERYWHERE (another clue she wasn’t too seriously hurt, because pain will usually localize at least to a general organ system if there’s a serious conditions). When I went to clear her out of the c-collar, she said her mid c-spine was tender right in the center, but unfortunately the one place she wasn't tender was on the sides of her spine where the paraspinal muscles run (which maybe would have allowed me to chalk it up to just a sprain / strain or spasm). I doubted the lady broke her neck , but I ordered x-rays to cover my OWN neck.

Then, not too worried about her, I left her in the room, ordered her some pain meds, ordered her x-rays and went about my business… which – I should mention – at that moment happened to include intubating and stabilizing a nice lady with lung cancer in acute respiratory failure. By then, it was around the time the cafeteria closes, and I was starving because of my new diet. So once I knew everyone was at least stabilized, I ran to the cafeteria and grabbed some food and brought it straight back to the nurse’s station, holding it in my hand as I checked a few things. Then I disappeared for 5 minutes to wolf down a bit.

When I emerged, the administrative head of the ER found me to ask what the delay was in bed 6. Generally she shows up only when people ask to speak to "whoever is in charge." The fender-bender woman hadn’t even physically been in the ER for 2 hours at this point! (I’ve had SCHEDULED non-emergent OB appointments longer than that!) I told the administrator that I hadn’t checked the x-ray yet because I was taking care of sicker patients, and she went off to her room to smooth things over.

Not too long afterwards I checked her x-ray, which, of course, was negative, and then I went to discharge her. I AGAIN apologized for the delay, and no sooner had the words come out of my mouth than a grumpy old man growled from the foot of the bed an extremely accusing and sarcastic, "How was DINNER?!"

My jaw hit the floor. The nerve of some people. I mustered a smile and made a joke out of it, trying to keep it light… "Don’t even give me grief for eating," I teased. "You don’t want a doctor taking care of her who doesn’t have any fuel in her brain!"

He became less growling and less accusing, but still continued, "I wish WE could eat."

"You can."

"The cafeteria’s CLOSED now," he snapped, like somehow I have control over the cafeteria hours, or the fact that he wasn’t resourceful enough to run down there when they were open and bring something back.

"Well, there’s a subway just across the parking lot and that’s probably better than our cafeteria food anyway."

"Well, WE’VE been hungry for hours." He gave me a how-dare-you-feed-yourself-when-my-wife-is-waiting glare.

I exercised a great deal of control and instead of going off (I won’t even put into writing all the things I wanted to say to him), I politely and pleasantly said, "Well, then, let’s get you discharged so all of you can get out of here and go get some food." I couldn’t get out yet another apology for the delay… even though I could tell they wanted one. (This asshole wouldn’t have been happy unless I knelt down and spit-shined his shoes while groveling.) As I fled room 6, they were right on my heels, chasing down the nurse for her portion of the discharge papers. Then they hovered around the nurse’s station, just glaring at everyone until her nurse succumbed and stopped in the middle of doing something for one of the other sicker patients to give them their papers so they could finally leave. I was so relieved to see them walk out of the ER.

Ever since then I’ve been eating in stealth, hiding out in the doctors’ lunge. I’ve learned my lesson – I don’t dare let my patients know that I actually stop to pee… and sometimes I even EAT!

Graham's Symphony

Mark my words. Graham is going to be musically inclined. My little man sings and coos to me like a little bird, or sometimes like a little dolphin baby. He loves the sound of his own voice and takes great pleasure in chirping to himself in varying intonations, as if he’s trying to find his favorite melody. He even provides dinner music – a deeply contented medley of "mmm-mmmm-mmmmm"s and "aaaahhh"s as we shovel in the baby food. And then, when he’s had enough, it’s the raspberry – "ppfftt," which started out meaning "I’m done, Mama" but has recently been extrapolated to just about any time he’s feeling displeased: "Get me out of this high chair" or Get me out of the car seat" or "Get me out of my crib" or "No, not formula! I want SOLIDS." For someone who doesn’t know any words, he sure is vocal.

Not only is baby G making noise with his voice, he’s found all the kiddy musical instruments in the house. He won’t leave Cole’s Sunshine Drum alone.

At daycare, his favorite toy is the maraca. He will fight the other little babies for it and shake, shake, SHAKE his little heart out. In fact, he will repeatedly shake or clank anything that might have even the remotest chance of making some noise. Some sounds in Graham's Symphony:

• His fingernails scratching across the lining of his car seat,
• Two of Cole’s building blocks clanking into each other,
• The wrist button on his dress shirt tapping against the kitchen table as he repeatedly slams his fat little hand down,
• The tinkling of his multiple rattles,
• The crinkling of paper as he balls it into his tiny fist,
• The clap of his stackable plastic cups knocking against each other.

I bought him a Little Tykes Piano for Christmas, and he takes it VERY seriously – pounding away like a little virtuoso. And that’s just a warm-up… then he steps it up a notch and steals his brother’s toy keyboard and makes music on that. He truly is a musical little baby.

Look out American Idol 2025!

What It Means To Be A Parent

Usually I blog about being a doctor or being a mom (I didn’t title this blog "Doctor Mom" for nothing), but I take exception for exceptional circumstances. Today’s blog is about parenting… PHENOMENAL parenting, but not by me.

I haven’t written about this because it’s not something that can easily be summed up in a blog entry or two. For the last 8 months, our thoughts and prayers have been with the Fish family, who’ve been going through very difficult times, to say the least. Fish is Dan’s oldest and best friend. (Here are Dan and Fish with their new babies, Graham and Ian.)


Fish’s oldest son, Kyle, was 5 this past May when he was diagnosed with Myelodysplastic syndrome with monosomy 7, a rare form of leukemia. Sine then, their world has been turned upside down. We’ve been following along vicariously, trying to empathize but not really being able to even fathom the hell of having a child get so sick.

There’s no bright side to the situation, even for me, a glass-half-full kind of person, but there is a lot of inspiration in the way the Fish family fought so valiantly – inspiration about the phenomenal strength of little kids and the true devotion of parents.

After being diagnosed, Kyle was rushed to Yale and then spent May through December in the hospital, first at Yale and then at Duke, after Fish’s relentless search for the best care for Kyle’s condition led him to doctors in Durham. The feedback from his medical staff was that there wasn’t a stronger child than Kyle. He was a model patient. I’ve seen grown-ups melt down over a needle-stick, but not Kyle. He underwent what seemed like umpteen million medical procedures (some so uncommon that even I had to look them up) with more tenacity than the bravest, toughest man. Fish, ever the golf fanatic, said he couldn’t have been more proud of Kyle, "even if he won the Masters, US Open, and the British all in one year." It’s hard for me to even type how Kyle’s battle ended, but sweet little Kyle died late December after the most valiant of fights.

The reality of losing such a pure and innocent child who, as his father told us, just wanted to make it downstairs to the gift shop, literally makes me sick to my stomach. I thought being a doctor and dealing with death at work made me strong, but I’ve never had this same kind of visceral gut-wrenching reaction at work… Partly because, no matter how moving the circumstances, I’m always the doctor… And partly because I see my patients for only a handful of hours on one given day in the ER and don’t have the same degree of emotional investment. When it’s personal it is infinitely more devastating. I think about Kyle every day. His fight inspires me to live in the moment and to appreciate every single breath. Needless to say, I’m giving Cole and Graham many more hugs, kisses and snuggles lately, inspired by Kyle.

I also think about Kyle’s parents every day. What they have done the last 8 months has been a beautiful example of parental love. There can be nothing worse for a parent than not only losing a child, but first watching him suffer, not knowing if he can ever get better. Yet they somehow stayed strong, because their baby needed them. Every time I talked to Fish throughout the last 8 months I was overwhelmed by his strength. I must have said to Dan more than 100 times, "Fish is a Rock." If you believe people are defined by how they deal with adversity (which I do), then Fish has shown himself to be a pillar of strength and love.

From the moment Kyle was diagnosed, Fish put all of his New York-style pushiness to good use. If there’s anyone more aggressive and more outspoken than Dan, it’s his best friend Fish. When we first heard of Kyle’s illness, one of our first responses was that Kyle was lucky to have Fish as his advocate, because if there was any possible way for Kyle to get better, Fish would make it happen. As expected, Fish went on a relentless search for the best doc with the best track record for Kyle’s diagnosis, which was how Kyle ended up at Duke. Fish then left his home and his support network in Connecticut behind, moved to Durham into Kyle’s hospital room, and rarely left the hospital until Kyle died. It was Fish who was keeping the doctors on their toes and speaking for Kyle when he couldn’t speak for himself. I know this helped, because I’ve been the one on the other end having to deal with concerned and over-attentive families of patients, and I know that if a doc has 10 things to do (in the absence of any medical reason to prioritize), she’ll take care of the most vocal people first to get them off her back. Thankfully, persistent Fish was probably one of the squeakiest wheels that hospital ever saw.

The real reason Fish never left Kyle’s side, though, was because all he wanted was for Kyle to enjoy his time in the hospital. He gave up everything else (probably even eating, as evidenced by his new 30-lb-lighter physique) to be there playing games on the computer, drawing, going to activities (art, science class, bingo, etc.) Dan was able to get to Duke several times and always said that Kyle seemed like a normal kid – happy and playing—thanks, for the most part, to his devoted Dad. And then when Kyle got too sick to play, Fish was there remaining optimistic and keeping Kyle surrounded by the positive thoughts he needed. Fish was a rock.

Meanwhile, Donna (Mrs. Fish) was back and forth between CT and NC taking care of their second son, Evan, and GIVING BIRTH to their third son, Ian. Yes, that’s right… Donna was late in her pregnancy when Kyle was diagnosed. (As was I; and, needless to say, it gave me a lot of perspective about what REALLY constitutes a rough pregnancy and significantly curbed my own pregnant whining.) Throughout the 8 month ordeal we didn’t keep up with Donna as much as we did with Fish, but she made a huge impression on me in one single day with what she found the strength to do at Kyle’s funeral. In the middle of the ceremony, in front of a huge church-full of 5 or 6 HUNDRED people, Donna got up in her orange (Kyle’s favorite color) sweater and spoke for Kyle. It was amazing that her legs even carried her up there. The second she stood up several people around me gasped in disbelief. It was more amazing that she got through her entire tribute with only one little crack in her voice at the very end. She and Fish had asked several people to speak, and each one declined for fear they wouldn’t get through it. But Donna had no fear. He was her baby, and she was going to speak for him if no one else would. Her display of maternal love touched me so deeply that I will never forget it.

Kyle’s funeral was 2 weeks ago today. It was an unspeakably hard day. The Catholic Priest did say one thing that provided some comfort – when children die they automatically become Saints. So Saint Kyle is now up there watching out for his amazing Mommy and Daddy. They need his help right now. I cannot imagine their overwhelming grief. I know, though, that years from now as they heal more and more, they will look back and be proud – proud of themselves and their inspirational devotion as parents, and especially proud of Kyle.

Happy Birthday Cole!

Dear Cole,

New Year’s Eve you turned 2. Your first two years have given me more happiness than I’d ever known before you. From the very beginning, you met the world with more vitality than we expected from a newborn, rolling from your back to your side just out of the birth canal to check out the cute nurses as they cleaned your little wienie, and then lifting your head up the next morning, at just 1 day old, to look around the hospital room.

Since then you’ve continued to do everything full-throttle with your characteristic zeal. You kept us up crying countless hours your first 4 months with one of the most severe cases of colic I’ve heard of, just so we’d figure out that you ruled the house. One particularly bad night your dad was beyond exasperation and screamed at both of us, "Something’s wrong with this baby! We have to take him to the Emergency Room!"
"Honey," I reminded him, "I AM the Emergency Room." I know you were amused at that one.

You find ridiculous amounts of amusement in every little thing. Take your newborn baths, for example. You kicked, kicked, KICKED with a spastic fervor that would send fountains of water all over the bathtub and usually whoever was bathing you, while simultaneously slapping the water violently with both hands. And this wasn’t just every now and then; this was the entire time you were in the tub, every single bath you got. No wonder you are such a good sleeper, considering the boundless energy you expend every second you are awake.

It is spectacular to watch you grow and discover. Last year you hardly knew what to do with the humongous piece of birthday cake we put in front of you.

This year you surprised us by blowing on the candles like an old pro as soon as they got within breathing distance, just like you saw Dada do on his birthday a few weeks earlier.
It is amazing how you pick everything up this way, like a little sponge, without us having to even teach you. Here’s another example: Saturday was your birthday party. (We rented out The Little Gym – GREAT place!) After getting you all fired up about the party in the preceding days, I asked you the night before the big day, "Cole, do you know what’s happening tomorrow?"
"Happy to you!" you said, remembering what was sung to you with your cake on New Year’s Ever.

At your birthday party all I wanted to do was watch your face light up into a huge "I’m so proud of myself" grin as you ran around from uneven bars to balance beam to moonbounce mat. You jumped right into everything without fear or hesitation, with your signature uninhibited zealousness. It’s probably the only party a lot of parents had been to where the birthday boy stands up and vigorously punches the helium balloons tied to his party chair like a punching bag instead of sitting down for one minute and eating his cake.

It’s fun to see that you inherited at least a little bit of my "spaz" qualities, but when it comes to being a wild man, you are definitely your father’s child. In my wedding vows I told him, "You are my handful, my crazy-man, my laughing source." Well, Cole, you are my handful junior, my crazy-man junior, my laughing source junior.
You fill every moment with sweet (and sometimes not-so-sweet) surprises. It is a joy and privilege to be your mom. Each day with you is truly a gift.

Happy Birthday to my perfect little man.

I love you!

Love,
Mama

P.S. Check out the lyrics to "My Wish" by Rascal Flatts. I think of you and Graham whenever I hear this song.

"Go Potty"

It’s the first day back to "normal" life after a very busy holiday season. I’m home trying to organize a little bit, and I just came across a special message on one of Cole’s Toddler Daily Activity Reports from The Goddard School, dated 01/02/07 (2 days after his 2nd birthday):

"Cole asked Ms. Shari ‘Go Potty’ and he did. What a big boy."

I immediately called Goddard to clarify what this meant. We’ve done NO potty training with him, so I was about to be floored if he managed to get any pee or poop in the potty on his first crack at it. What he did was SIT (not shit) on the potty. I guess all his friends are doing it and now he wants to do it to. This marks the first time Cole has ever sat on a potty. Santa brought him a potty for Christmas, which is all set up in our bathroom ready to go, so we’re going to have to encourage him to get on it (instead of just throwing his balls in it). Guess he’s officially TWO now.

P.S. While I’m recording milestones, December was the month in which Graham learned to sit-up (at 6 months of age). Go G! My babies are getting so big!