Remembering E’s Birthday

IMG_6961This week my not-so-little E celebrated his 4th birthday.  This little boy is now a bundle of rambunctious, over-the-top, hard to control, 100% boy.  Most times I feel like I was never quite equipped to be this little man’s mommy.  To celebrate his birthday, he requested a Paw Patrol party, complete with a Paw Patrol cake.  Mommy did her best to deliver.

From the very beginning, little E has kept me challenged – including his entrance into the world.  I love this boy dearly and with all my heart (remind me of this when I want to smack him across the head for never listening), yet sometimes I forget how much he has effected change in my life.  When little E came into this world, he was whisked away after about 12 hours to be taken to the NICU.  After he was there for 4 days, I wrote him a letter.  I thought, in “honour” of E’s birthday this week, I would share that letter with all of you here.

Dear E,
Today you are 4 days old.  When I think about how your life should be when you are 4 days old, it is very different from what you are living.  You should be at home, warm and safe with the people who love you.  You should be in my arms and sleeping next to me; be nourished by me and comforted by me.  Instead you tied up in tubes and wires and you spend all day in the bright lights and noisy sounds of the NICU.  I know this is what you need right now but it makes me cry every time I think about how unnatural it is for you to be there.  I hope you know how many hours I spend sitting with you and holding your hand, caressing your beautiful, tiny face.  I only wish I could be with you all the time, to hold you and comfort you when you are in pain.  I try to hard to cherish the one night that I got to hold you and feel your skin next to mine, but it already feels like a distant memory that is slipping away from me – further with every second that passes.  My body misses feeling you inside of me and when I look at my shrinking belly, I see the place you used to live and I wish you could still be there – because it’s better than where you are.
I know there is nothing I could have done to keep you from the pain you are feeling, but I find a way to blame myself for not making someone really listen to my concern for you in the hours after you were born – maybe you would be home right now if I was more persistent, if I didn’t let other people try to convince me that what you were going through was a normal part of a newborn’s adjustment period.  I thought they were wrong, and I was right.  For all of that, I am very sorry.
Before you were born I worried that I would not have enough lough to share with a second child.  I was nervous about bringing you into this world with the thought that I wouldn’t be able to love you and cherish you in the same way I do your brother.  I have learned, however, that it is impossible for me to not love you.  In 4 days I have spent more time longing for you to be in my arms, crying for your pain, and wondering how my life was ever complete without you.  I know it was only 4 days ago that you were not here, but that is already another lifetime ago.  When I look at you, I recognize your face – as if I have known you forever.  When I touch you, I know you were always meant to be my child.   Until I can hold you and care for you like I mother should, I will do my best to be strong for you and I will be by your side, loving you from a short distance, and counting down the minutes until you are healthy and ready to come home and finally join our family.

With lots of love and tears,
Mommy

(March 25, 2012)

15 Best Parts of 2015

This past year has been a tough one. Instead of focusing on the worst parts of my year, let me highlight the best parts!  If only I didn’t vow to not post pictures of my kids and I on the blog… This post would be slightly more exciting for you all!

In order from the beginning of the year:

1. Watching my two little monkeys grow into crazy little boys!

2. Registering A. For kindergarten. 

3.  Mountain retreat with my resident buddies. 

4.  E’s third birthday party. 

5. A Mother’s Day surprise after spending the morning sick in the emergency room. 

6.  Running my first half marathon. 

7. A’s fifth birthday party. 

8. Time with my family at my sister’s wedding. 

9. Disneyland and Florida with the kids!

10. Rappelling down a building for charity. 

11. A summer of gardening with the kids. 

12. Excelling at taekwondo. (I actually got my blue-stripe while I was pregnant). 

13. Reaching my goal of reading 12 (non-education  related) books this year. 

14. Finding out I was pregnant. 

15. Finding out I am having a girl. 

My Backstory

“We are all special cases.”
~Albert Camus

From The Old Blog, November 21, 2014

We all have a story that makes us who we are.  I would argue that these stories are not always fun to tell or easy to accept.  It is these stories, however, that make us “special.”  My story is far from great, but I know it could have been worse.  I am the grown up child of a messy divorce, and this simple fact has made the “special case” that I am today:

My parents were newly divorced and were too busy hating each other and making each other miserable to really realize what they were doing to their children.  They provided the necessities and we never wanted for anything physical – we were clothed and fed, we went to school and we did well.  Emotionally, they gave us nothing.  I never felt special or like I mattered to my parents.  My accomplishments always seemed to fall on deaf ears and land in front of blind eyes.  I was a 12 year old girl with nothing to motivate me and no one to encourage me.
~From The Old Blog

Some days I go back to being that 12 year old girl, and I get angry at myself every time I do it.  I am embarrassed that this so heavily defines who I am and how I interact with people.  I fear that I will never be able to escape from that 12 year old me.  And, that right there is the problem: I should not want to escape from her.  Rather, I should want to open up my arms to her and give her that which she never had.  I should be the one to support her, motivate her, cheer her along, giver her advice, and be her best friend.  That is exactly what she has spent the last 20 years trying to find.  Now I can be that for her, I just need to believe it.

We all have stories that make us special cases but many of us are too afraid to go back and read those stories.  Those stories are what make up who we are and we need to understand them to really understand ourselves.  Going back to the beginning can also tell us how far we’ve come and, hopefully, allow us to realize how much we can help ourselves.

I an not a special case because I am the grown up child of divorced parents.  I am a special case because of what I have become as a result:
I am sensitive, kind, and loving.
I work hard, seek perfection, and achieve my goals.
I put others before myself and passionately give everything I can.
I am a loving mom, a sincere wife, and a good friend.

I am all of those things, even if I don’t always believe it… even if other people don’t always believe it.

Sense Out of Sense

“Hope is definitely not the same thing as optimism.  It’s not the conviction that something will turn out well, but the certainty that something makes sense, regardless of how it turns out.”
~Václav Havel

 

It seems as though this quotation didn’t fit with my mindset last year, and it certainly doesn’t fit with how I am feeling now, either.  Or maybe, if I look at it from a different angle, it does make sense.

A few days ago I wrote a post about hope being a song that we sing in the depth of our being – something that never stops no matter what.  Right now I am tired and overworked and I feel like hope is the only thing I have – I hope that I get through all of this and that it will be worth it in the end.

Does that make sense?  I don’t know.  Maybe according to this quotation, it is supposed to makes sense.  Whether or not all of this hard work pays of in the end… hmm… I’m not sure if it makes sense for it to not turn out.  That would be a whole lot of “nonsense.”

The other day I met with one of the staff to go over my evaluations from a few months ago: For July and August.  Apparently everyone only had good things to say about me: I am hard working, I have good surgical skills, I work well under pressure, I don’t get stressed out, I make good assessments and plans, I know my limits, I don’t get bogged down in the minute details… but there was one thing that seemed to concern people – they were worried that I seemed unhappy.  I didn’t know what to make of that comment, or what to do with it.

I’m happy, but I’m not happy.  It’s hard to always be smiling and cheerful when you are tired and wondering if you’ve made all the right decisions in life.  Or more vaguely stated, when you’re not sure if everything in your life makes sense.  So what do I take away from that feedback session?  I should be happier when I’m at work, maybe?  Obviously I know that these last few months haven’t been easy for me, and there is a reason I see a psychologist on a regular basis.  Overall, I didn’t know what to say.  I enlightened her on the whole “people at work found my blog and I was criticized and harassed online because of it and everyone at work was talking about it behind my back” situation that happened in the middle of July.  I told her how I completely shut down at that point because I didn’t know who I could trust to talk to about anything, even something as simple as a night with my kids.  Maybe that contributed to it… I don’t know.  Or maybe it’s just my personality… maybe that’s it!

Regardless, nothing ever makes sense.  I feel like I am blindly floating around with the hope that in the end everything will fall into place… some kind of place.

The Story of Ms. Jones

“Life isn’t fair.
It’s just fairer than death,
That’s all.”
~William Goldman

We were about to round on Ms. Jones (not her real name).  I admitted her the other night after she fell and was found in her bathroom by the aides at her assisted living complex.  She was lucky: she didn’t break any bones despite the grapefruit sized hematoma that was forming over her left hip.  I learned from the emergency room chart that she was a relatively healthy 95 year old lady with a history only significant for hypertension and atrial fibrillation.  I tried to go talk to her and do a physical exam, but she was grumpy and drowsy and wouldn’t cooperate (in her defence, it was maybe 3am and the emergency physician had just given her some dilaudid).  I filled out all her admission paperwork and scanned her home medication list.  I opted to continue her medications for hypertension and her aspirin, but since her hemoglobin had dropped during her stay in the emergency room from 108 to 86, I thought it prudent to hold her anticoagulant (blood thinner).

When we walked into the room that morning, I was pleasantly surprised to see a well groomed, alert, and very proper English woman sitting up in bed and eating her breakfast.
“Good Morning Ms. Jones,” my staff said.  “We are your team of doctors and we are here to see how you are doing.”
“Well, if you want to know about my pain, it is okay.  But if you want to know how I’m doing, well I’m rather upset that the nurses won’t give me any hot water for my tea.”

It turns out there was a communication error and the nursing team believed that Ms. Jones was on a thickened fluid diet to minimize the risk of lung aspiration.  As this diet is quite common in our patients, we continued to explain to Ms. Jones the rational behind why she wasn’t allowed to drink her tea.
“Well, that just ridiculous!  I was just drinking tea the other day and I certainly didn’t choke on it.  I don’t see why it is any different today.”
We offered to place Ms. Jones on an “at risk diet” if she insisted on drinking her tea.
“Well doctors, I am 93 years old.  What do I have left in my life if I don’t take risks?”

She had a point, I guess.  We proceeded with our rounds, ordered the necessary tests and continued on with the day.  We thought about re-starting Ms. Jones’ anticoagulation, but her hemoglobin was down to 80, so we held off and sent her for a CT scan instead.  The results came in later that day and there were no identified areas of internal bleeding.  We decided we were going to restart the medication the next day.

When we rounded the next day, we visited Ms. Jones again.  She was happily eating her breakfast and drinking her tea.  She complained that she had been feeling increasingly weak over the past month and attributed her fall to that weakness.  She commented that it was just part of getting old.  Regardless, we asked for a physiotherapist to help Ms. Jones with her mobility and assess if she needed any aids.  As planned, I wrote an order in the chart to re-start the anticoagulation.  It was all ready to go, but we all suddenly felt uncertain: She had only been off of it for 3 days.  Why not wait one more day and make sure her hemoglobin remains stable?  It is a delicate balance trying to decide how to manage these medications for a person with atrial fibrillation who is also at a high risk of bleeding.  Without the medications, there is a chance that the heart can throw off blood clots that can cause a stroke.  With the medications, however, it becomes difficult to control andy sources of bleeding.
Later that afternoon, I passed by Ms. Jones walking with the physiotherapist and a walker down the halls of the unit.  She smiled at me, and I smiled back.

The next day was Friday and we started rounds in the same way we always do.  Our team was a little smaller, so we divided up the work and moved a little faster so that everything would get done.  We got to Ms. Jones’ chart.  The physiotherapist was convinced that she would safely mobilize with a walker.  Her hemoglobin had been stable over the past 36 hours, and from all other aspects, it seemed like she was ready to go home.  We walked into her room to tell her the good news.  However, Ms. Jones was not sitting up in her bed eating her breakfast.  Instead, she was laying with her head cocked to her left side, her right leg flexed and rotated to the left, and her right arm motionless by her side.  We said hi to her but all she did was moan.
“Ms. Jones, are you alright this morning?”
She just moaned again, this time louder and more persistently.  I went to her left side and looked at her.  She wanted to say something, but all she could do was moan.  She reached for the ID badge dangling from my neck and looked at it.  Then she looked at me.  And she moaned again.  My staff had already left the room and was on the phone with a radiologist requesting a STAT CT scan.  But we didn’t really need it to know that Ms. Jones had a stroke, likely sometime overnight.

By the time Ms. Jones’ sons had arrived at the hospital, the results of her CT scan were back: Large right MCA territory infarct.
We explained to her sons what this meant and that given her age and the size of the stoke, she likely had a poor prognosis.  We explained the options for her further care and it didn’t take long for them to both agree that their mother would not be happy living the way she was now.  The felt that if their mother could talk to them, she would say that it was her time to go.

And just like that, we consulted palliative care for Ms. Jones.  We discontinued all her therapeutic medications, and ordered all our comfort care measures.  She was moved to a private room.  And ever since that day, there has been a constant bedside companion from her family present.  I know this because I visit Ms. Jones multiple times a day.  She knows who I am and she smiles at me when I tell her that I’ve been thinking about her.  Every day she looks more and more like it might be her last day.  But every morning her name is still on my list.  So I go back to visit her again.

It was the day we were going to send her home, and instead it became the day that determined her death.  It isn’t fair.
Ms. Jones was such a fun. happy, feisty little English lady who probably had a few more good years ahed of her.  But our medical care failed her and now she is dying.  Life isn’t fair.
Every day she slips further and further away.  She spends less time awake and I spend more time talking with her family members.  They tell me stories about their mom and it makes them happy.  Then they turn at look at their dying mother asleep in her death bed, and their voices stop.  I let them cry and I place my hand on their shoulder for just the right amount of time.  Death is not fair.

I decided to share last year’s blog post in it’s entirety.  The remains poignant and I still think of Ms. Jones, to this day.

Throwback – Frozen Time

Do you ever wish you could just freeze a moment in time? Maybe not to prevent time from moving, but just to preserve that moment and go back to it as many times as you want. I imagine it would be like having a favorite song and playing it over and over again, whenever you want. It wouldn’t be the same as taking a picture and looking at it whenever you want – it would be more than that. It would involve preservation of the thoughts, the emotions, the feelings… everything that was happening in that moment. It would be like re-living the moment and re-interacting with the people, and re-experiencing those emotions.
I don’t have this desire too often, but occasionally I will be in a moment that I just wish I could re-live an infinite number of times. I try to play it over again in my head and let myself feel the emotions that came along with it. Unfortunately, the feelings fade and the memories become vague. A conversation dwindles into a sentence or two, and even that eventually becomes nothing more than the faint memory of a friendly smile. Finally, there is nothing left to feel and nothing left to remember so I am left waiting for an experience to replace that lost memory. When it finally comes around again, I swear that I will preserve it differently and make it last longer.
Almost always, I want to freeze the feeling of being cherished; the feeling of being cared for and nurtured and being made special. And the more I think about it, the more I realize that it’s not the actual moment that I care most about. Instead, it is the desire to revel in those feelings as much as possible. It’s like I’m trying to make up for lost time, or trying to fill up a vase that as been neglected for too long. I don’t know if I can ever catch up with this emotional short fall – and maybe that is the reason I am always afraid to lose the moments that matter the most to me. 

Originally published on The Old Blog, August 2013

Throwback: The Past is Never Far

…And scars are souvenirs you never lose,
The past is never far.
Did you lose yourself somewhere out there?
Did you get to be a star?
And don’t it make you sad to know that life
Is more than who we are…

She was 13.  She sat in the corner, on the back bench of the city bus.  She held her new Sony Discman in her hand, the headphones circling her head like miniature ear-muffs.  This was supposed to make her cool, make her fit in – but it didn’t.  At least she didn’t think so.  She may have only been 13, but she was older than that, really; she was older than she was supposed to be.  Life was tough and tumultuous for that little girl.  It hurt.

It was a long bus ride to school.  The other kids got on the bus and she looked at them from her seat in the corner.  They were supposed to be cool, too.  She thought they were.  But she just sat there, holding her Discman, watching the white CD spin round and round and round.  She only listened to one song, over and over and over.  Repeated, day after day after day.

“Name” by The Goo Goo Dolls.

It’s been 16 years, but that song still plays.  And, every time it hits the radio, she goes back to that seat on the bus.

Life has changed but the song stays the same.  The hurt feels the same.  A prophesy come true.

…We grew up way too fast
And now there’s nothing to believe,
And reruns all become our history.
A tired song keeps playing on a tired radio,
And I won’t tell no one your name.

**Originally posted Feb 2013 on The Old Blog