Children Keep Dancing…

There are a million things to say about Kenya which I can’t even begin to process

Today I started my peds ortho away with my childhood doctor. For starters there are ghosts, memories, hopes, dreams, sleepless nights, screaming, pain, sweat, blood and tears behind every corner even with the remodel of the hospital the worst and yes even some of the best of my childhood is contained within these walls. I tred carefully for as has been the theme of the last week I stand on sacred ground.

As I child I feared/loved my doctor and he haunted my steps at times, made me think before I lept. Now he is my attending. A strange change of power….its odd for him too. About half the time he introduces me as his former patient, the other half as a random med student.  He teaches me quite passionately and patiently. he is far more patient with me sitting in the OR or struggling with my sewing than any surgery attending I have ever had. Of course he is. But I am wary with him,  its awkward a lot but it works best when he is teaching me as my attending and not trying to process the oddness of me at 25 grown up, on my own and not his patient.

There are strange moments though where its very hard for me to sit back and play med student.  I scrubbed in on a Cervical fusion today (ha!). The induction took a looooooooooong time. It was a skeletal dysplasia kid, one of my kin.  The neurosurgeon made several jabs about how my doctor’s “population” always took this long.  I bristled, my face was hot. hey buddy, those are my people.  I remember once there was a ENT who made several really unnecessary comments about Chinese  students with a Chinese student sitting right there.   I remember thinking what an idiot for not even noticing the med student was Chinese for crying out loud. But here I was pierre robin in all siting there staring at this highly educated doctor and I realized that he had no clue.

In a way it made me happy. Sometimes I forget that I can do this. Blend in if I am sitting. Later in the case he starts to inquire what a good Southern girl n from such a good school was doing in Delaware.  I told him I was referred here as a child, he looks at me and still doesn’t see it. Finally my doctor rescues him, she has Kniest…she is just tall.

Good for her, neurosurgeon says

Not good for her orthopod says

Honestly its all I have known I am neutral on it at the worst, I say really not wanting to debate my perspective on losing/winning the genetic lottery for the whole OR.

then they go talking about how people with conditions go into what they know.

I was glad more than anything that the secret was out I felt so much more at home among my people than I did in the blue scrubs.

The things we tell ourselves…

I have whiplash from this week.  Last Friday I went to my mailbox and was surprised to see my Peds AI grade sheet three weeks early.  I was even more surprised to see an negative comment on my evaluation after getting nothing but positive feedback. I panicked, my residency application was pending, my Dean’s letter. I was also convinced for a variety of reasons that the comment most likely came from the Chairman of the Peds Dept who had been my attending for three days. at the very end of my rotation. I freaked and drove in the pouring rain to Blacksburg to visit Jessica and cry my bloody eyes out over the ridiculousness. I appealed the comment t of course.  My pent of anxiety of my Sept TO DO LIST: apply to residency, have a hip replacement, learn to walk again for literally the 8th time, turn 25 (Oct 4) and make it back to school by Oct 5th overwhelmed me that night.  I cried and cired the whole drive up there and the first hour of being there. I needed to cry, I needed to for a moment not be strong, to let down the facade that I am holding everything together.

Child Pysch exploded this week with the start of school. We got a new attending and new third years and one of the acting interns went a-wall. We had three sexual abuse cases that nearly had us all in tears.  I got my NICU grade which contradicted my negative comment. I submitted my residency application after agonizing over whether to wait for the comment appeal.

My pain doubled from the stress and from what seems to be ever worsening hip health. Sleep is difficult and I keep having wild dreams from the pysch floor, the surgery and the general state of upheaval of my life.

There was strange good moments like James’ brilliant debut of his two new shows and Corinne’s beautiful new baby boy who seemed to whisper to my soul why that God is faithful and why I signed up for this insane profession.  The comment appeal went through and the comment will not be included in my letters. It will never leave Wake.

By Friday I was just grateful that it was over. That I could just get on with this surgery and the rest of my life. I was sitting waiting for my research adviser when it came.  AN RESIDENCY INTERVIEW INVITATION at Emory in Atlanta, GA. I had heard that peds got early interviews BUT STILL. In four days?!?!?!?!  I sat there and was ecstatically happy and grateful.  Not so much that I had an interview but just that there was forward motion. God saying HERE WE GO.

hold on to your hats. Sept is going to be bonkers.

The view from ZSR 6th floor on the eve of the rest of my life…

7 years is a long time.

I am sitting curled up in one of my favorite places in the world. The ZSR library on the Wake Forest ugrad campus. Its nooks and crannies and huge windows and high callings have facilitated my studies, my imagination and my dreams for the past 7 years.  It was here I studied for my first real exam EVER, memorized latin poetry, poured over novels, drew out organic mechanisms, took MCAT practice tests, discovered libreation theology, painstaking dissected the New Testament and the Koran and eastern European folklore. I learned EKGs and neuroanatomy on the 6th floor. I learned Rheumatology and Endocrinology over in the new wing.  I dreamed of traveling and medical school and later medical missions.  And like most young women day dreamed occasionally about boys and the future and all that is to come.  This place is full of friendly ghosts that remind me of where I have been, who I am and where I am going. Its not just nostalgia and books that live here but a sliver of my identity and the woman I have become will always find a home here.  Of all the places on the Wake Forest campus I think its the place i will miss the most when I finally physically leave Winston in May.

And that is about to come to a head. Tomorrow it begins.  I submit to the powers that be my residency application. Countless cups of tea, late nights, long hours, books, papers, notebooks, itunes, sutures, progress notes and surgeries.  seven years, six pages of resume and essay, five agonizing standardized board/admission exams, four summers loving Eastern Europe and four babies delivered, three years of med school (1 to go), 1.5 degrees, it all been for tomorrow so I can go get a job somewhere in the United States that wants a gimpy pediatrician to be with a strange love for all things from the Black Sea to the North Pole, a more than passionate obsession with disability rights who is in love with children, Jesus and comparative religion.

up, up and away.

Childhood is Sacred

Inpatient Child Pysch is a cross between Jerry Springer and a Jodi Piccoult novel.  It can be a very dark place filled with hopeless situations, broken families and gross abuse and neglect of children. I have learned about the gang wars of Winston-Salem, the myriad ways to get high off crack, marijuana, XTC, acid, glue, you name it. I listened as parents cuss their children out and their children cuss right back at them. I watched parents give up their children to the state and listened to the tears of children whose parents don’t pick up their insulin for their childhood diabetes or take them to doctor’s appointments or leave them on the pysch ward so they can go Disney world or the beach without having to worry about their bipolar kid or their child with Autism complicating their vacation.

But the most important I learned is that play is the thing. No really it is. I’m talking about finger painting, mud pies, water balloons, swimming in a pool, in the ocean, games of tag, checkers,  chutes and ladders, Candy Land, dancing, singing loudly, running through grass barefoot, coloring, drawing, riding your bike,  basketball, baseball, flag football, going fishing with your Grandpapa, making cookies with your Grandmama, running around with your dog in the back yard, wiffle ball, hiking through the woods becomes an adventure, going down the slide, climbing up the slide, swinging so high you are sure your toes touch the sky,  make s’mores  and weenies over a campfire, make believe of pirates and princesses and shipwrecks and hospital (if your parents are in medicine this is inevitable) or army men or playing school, playing with dolls, playing with cars,/trains/trucks, building the tallest tower of blocks, or making a space ship with legos, playing with play dough, dying Easter eggs or sitting down and listening to a story. Sticky hands, muddy feet, paint all down your clean t-shirt,  Easter egg dye from your head to your toe, mud in your hair, clothes soaking wet because you fell in the lake fishing, paw prints on your shorts from playing with the dog, a crown of daises that make you so sure that its made of diamonds and rubies, a sword that to some resembles an dirty stick you found behind a bush, the bad haircut you got after playing beauty shop, the stuff animal whose appendix you tried to take out who needs his stuffing put back in (that is for you Karen)…..

these things are sacred and they are worth fighting for….these are not just obnoxious or silly things…these are the things that teach kids how to laugh, how to talk, how to think and create, how to love and relate to others, to feel confident….these are the things that children who live on the streets (rather they be Bucharest or Winston-Salem) miss out on, these are the things that don’t happen in broken homes or homes where parents are more concerned of their own needs rather than those of their children that become twisted….

Childhood is sacred. Its where we learn everything and can lose more than everything.

so thats what I do in these family meetings and in group thearpy I fight for the right of childhood.

Beauty and Pain

I am in love with the NICU. The tiny, fragile patients with uncertain futures who in their vulernability are beautiful. In their beauty though there is pain, these tiny humans know pain of their larger inpatients but they have few ways to articulate it. There is pain for the ones we can’t save and for the ones we can but whose futures seem less than optimal (rather it be medical, social, etc). But there is such unparaelled joy in the ones we can save, the ones who grow and develop as they should.

This weekend my spinster Aunt got married at 47 to a widower with 4 kids. It was a beauitful ceremony filled with the excitment and joy surrounding any wedding. But there was saddness too, sadness for a mother who died before seeing her children grow up.

I hurt my knee at the wedding. I didn’t do anything but I woke Sunday morning with a hot, swollen knee that felt like I had torn something to bits. Last week I dislocated my elbow… I’m a  bit of a rheumatological mess right now. I’m in love with my work, the babies and peds in general but i am in constant pain. Its been a long winter.  I do believe that the hip’s death spiral is putting undue pressure on everything else.  I have resigned myself to surgery in March of 2010. I am dreading it, the idea of going back to the place I lf behind a decade ago is scary.  but I am grateful for it.  That there is a light at the end of the tunnel! Its a beautiful thing.

and the truth is I want to get on with my life, with doctoring babies and dancing at weddings and loving it.  thats a beautiful reason to be willing to take the risk of surgery.