Gendler's blog

Baking bread seems so daunting and time consuming at times (which explains why it's been over a year since I've done it), but when I made this recipe the other day it was such a fond memory to enjoy the way it feels to go through the steps of the mixing and rising and smell that wonderful baking bread smell in the kitchen.  This recipe is particularly aromatic because of the rosemary (which is very mild tasting in the end) and really easy (as far as making bread from scratch goes anyway).  I did use my kitchen aid to knead it which takes out some of the labor and if I hadn't had the kids at home from school I probably would have done it by hand just for the physicality of kneading dough (stress relieving).  It required more flour than they stated (and I didn't know if that was because of the mixmaster or not).  Yes, I know I could probably waltz into a bakery and buy something just as good but in the end it is a very gratifying feeling to produce a delicious loaf of bread made from scratch, if you've never tried it before you should try this recipe!

Thank you Dr. Harris for putting into words (click here to see his commentary) just one piece of the struggle that I have with continuing to be a doctor.

I just finished this book (on CD) and wanted to share a little review of it.  I don’t typically like books that fall into the “self help” category.  Not that they are bad, but I feel like it is sort of a messy area because people are often spouting their own theory about whatever topic or field where they are an “expert”  without a lot of evidence. And usually they present one sort of “key” that only they possess that will fix everything in an overly simplistic approach.  But I was at the bookstore looking for a book on CD (because I get tired of listening to music sometimes on my commute to work).  This caught my eye because one of my friends had taken a sort of “happiness” class and I thought maybe this was the same guy.  It is a topic I’m interested in exploring because it seems so elusive (happiness that is).  

Listening to this book was a very positive experience.  In fact, I’m pretty sure I’m going to have to listen to it all over again because I didn’t catch everything the first time through.  There is a lot of repetition of the same concepts but they are fairly heavy ideas and so I think you almost have to hear them over and over to begin to change the way you conceptualize happiness.  He suggests that his book is more of a “meditation” on the topic of happiness and I think that is accurate, there are no real “steps” that you have to take but he does offer some exercises and some ways to change the way we think that might let us see the happiness we already have in our lives and in ourselves.  Nothing he said was earth shattering, but I found each chapter pushing me toward a much needed paradigm shift.  I guess I’ve always known this about myself but he helped me see that I have two large stumbling blocks in the way of my own happiness:  futuristic thinking and dysfunctional independence.  I’m the person that enjoys planning the vacation so much that by the time I get to the vacation I’m already planning the next thing and I don’t enjoy what I’m doing at the moment.  The dysfunctional independence has been obvious to me for a long time but I’ve just never really tried to change, partly because it has a positive feedback loop.  But I see now that I should work on that, that I should let go of some of that control and by doing that I will probably let go of some of my stress.  I’ve always felt like my “to do” list was way too long and that I can’t be happy until I get through the list.  I’m realizing that when everything is finally done I will probably be dead and then it will be too late to be happy and so I’m going to try to turn that around.  

I’ve tried two of the exercises he recommends (there are probably around 10-15 in the book) and found them very valuable.  One is to sit down and imagine where you are at on a happiness scale (0-100%) and then write down what would need to happen for you to be 10% happier RIGHT NOW.  Not after you get a raise, not after the kids are grown up, but right this moment what would make you 10% happier.  I thought this was good, because I actually can’t conceptualize what 100% happiness would be and so a 10% increase is something I can imagine and something that I can change.  I’ll share with you what mine was: “to have one meaningful moment with my kids every day.”  You might be thinking that it is sad that I don’t already have that, but it’s not that those moments don’t exist, they do, I’m just not recognizing them and appreciating them, so I’m going to work on that.  Then you do a 20% increase, etc until you get to 100%. The other exercise I liked was the “no complaints” exercise where you monitor your own thinking process to see how much you complain (to yourself) or out loud.  It’s amazing what a whiner I am to myself!  I made a conscious effort to recognize the complaint and then let it go or do something about it if it was valid and I thought it was positive, I felt better afterward.  I’m looking forward to doing some more of the exercises when I go back through the CD’s a second time.  In the end, I think just the reminder that he gave me to sit and think about happiness and to think about being present in my own life and enjoy the abundance that is right in front of me is an invaluable lesson that I hope I don’t forget anytime soon.

I haven’t been writing much lately and it’s because all of this damn running is tiring me out!  I ran 27 miles this week and my body is plain exhausted.  I am sleeping a lot more than usual which is good in terms of keeping up energy, except it keeps me from all of the things I used to do after the kids go to bed (work, read, knit, blog, etc.).  The training is still going well and I’m actually enjoying it more and more each week.  In a way it’s the only “me” time that I get during my week and so I revel in that and allow myself to ruminate and contemplate and ponder my way through the mileage.  So far  this month I’m injury free, I’m having some knee pain here and there but it seems manageable and directly related to running hills.  I haven’t missed a workout yet, which is shocking considering the chaos our lives have been with work and deliveries and nanny problems I’ve had over the past couple of months.  

On a very practical level I am learning to use all the various sugar products during a run.  I like the Luna little jelly things ok, and I’m going to start using the jelly bean type products, more because they don’t stick to your teeth as much and they don’t have the same gross consistency of “gu” (it sort of makes me gag to think about it).  I continue to use the “throw sugar at the problem” rule.  Today I started getting horrible stomach cramps halfway through my run, and I was super hot and felt nauseous.  100 calories of straight sugar and a cup of water later and I was fine for the next 4 miles.  It works so I’ll stick with it for now.

And just so I can bitch a little, wouldn’t you expect someone who has been running more than 23 miles a week for over a month to lose weight?  I’ve actually gained 4 pounds, WHAT THE HELL!?  I should have never weighed myself, because weight loss is not my goal, finishing the race at less than 12 minute miles is my goal.  I just sort of thought weight loss would be a pleasant side effect.  But I guess it’s not.  And don’t even tell me that it’s muscle, because I don’t believe that for one second.  It’s my ravenous hunger is what it is.  I go out and burn 800 calories and how much does my body want to consume? 1600, at least.  Someone said the other day, “but isn’t running supposed to suppress your appetite?”  Maybe, but not for me I guess, I’ve sort of always been that way, I once ate fried chicken before racing a mile (swimming) and swam one of my best times ever so I don’t really have that problem.  Andy told me he has heard of an ultra-marathon runner who will order a pizza to go, pick it up, and eat the entire thing, all while running.  So I guess I’m not alone.   I am hoping that at some point my body will adjust a little bit and won’t want to sleep and eat all of the time!

This training schedule is keeping me busier than usual and so unfortunately I haven’t been blogging like I planned.  But, it’s going well so far.  I’ve actually surprised myself because I’m truly enjoying my runs.  I have never been very good and so I didn’t think I would like it, but it’s not unlike swimming in the sense that it’s very rhythmic and feels sort of “zen” when you get a few miles in.  Plus endorphins are great, they ease my anxiety and keep me from sweating the small stuff.  

Week #3 was challenging only in that we were traveling and so I ended up running in 3 different states that week.  I had a pretty good outdoor run Phoenix along the canals and then my Dad did my long run with me in Spokane and we ran 9 miles along the Centennial Trail which was nice, it sort of made me want to run the Centennial Trail marathon that starts at the Idaho border and goes into downtown Spokane, I guess there’s always next year =).  I'm still trying to talk my Dad into running this half marathon with me.  I mean, if you can run 9 miles you can run 13 right?  I'm really impressed with my Dad because he didn't start running until he was in his mid 50's and now he is in his 60's and I bet he never thought he would be able to run 9 miles without stopping, but he does it on a weekly basis now!  I had “gu” for the first time because I’ve been informed by Andy that I must have “something” during my long runs now that they’re over 8 miles.  They are kind of gross if you ask me (a waste of 100 calories) but I guess when you’re burning 800 calories it’s ok to waste a few.  They are easy to carry at least.   I’ve also started carrying water bottles and continue to debate with myself whether I like the handheld kind or the waistpack kind.  

Week #4 was a nice recovery time from our trips and so I took most of my runs pretty easy, long and slow.  Our long run was a “date” run where we got a babysitter for the evening and Andy and I went for an 8.3 mile run.  We probably chatted more during our run than we do when we go out to dinner so it was nice.  The only problem was that our route got a little bit screwed up because we had mapped it out on Mapmyrun.com and on the maps what look like railroad tracks are usually bike trails (they’ve been paved over) so when we got to where we were supposed to turn we found an actual railroad track and not a bike path.  So we had to try to get back in a sort of roundabout way that involved some running near the freeway (which I hate doing), but was relieved that Andy was there with me.  Lesson learned to check out our routes IN PERSON ahead of time.

Week #5 involved another injury. I got a version of “runner’s toe” except instead of blood there was just a blister under my toenail.  It hurt so bad I had to drain it and so I did and was able to keep running, but it just kept draining and draining for 2 days and then the drainage turned to pus and I thought, “uh oh, this is NOT good.”  Our podiatrist was kind enough to see me at lunchtime because we were both worried about infection and he cut back to the nail until there was just about 1 mm of nail left so that the bed is all open.  He described the contents under the nail as fungal-bacterial soup, yum.  It’s sort of funny though because in Phoenix Andy’s sister and I went to get a pedicure one afternoon and we got all fancy and got little rhinestones and artwork on our big toes (I’ve never had “bling” on my toes before).  So when you look at my feet it’s sad because you see this fancy nail and then next to it this open draining sore of a toe with almost no nail at all.  Quite the contrast.  The podiatrist told me that I should expect more, that runner’s toenails are black, deformed ugly things, but that it’s not really harmful, just not cosmetically appealing.  Great.  Ugly toes, yay.  My long run this week felt tough, I think because it was a 4 mile out and 4 mile back route.  I do better with loops I think.  I don’t know why, I just don’t like turning around and retracing my steps I guess.  Plus it was hot, really hot.  I need to figure out how to acclimate better because the weather always throws me for a loop unless it’s perfect.  In July all my weeks are over 20 miles and I’m both excited and nervous about the next month of training!

Ouch.

This week hurt.  And it's my own fault.  I broke one of the rules of training and tried to do too much distance and too much speed training in the same week.  (here are The Golden Rules from Runner's World).  I ran my long run yesterday too fast and now I'm paying for it.  The first part of the week was good (the 4, 4 and 3 mile runs during the week, I did them all with speed training too).  Then yesterday when I woke up it was raining really hard, and I looked at the forecast and it said thunder and lightening and while I would be ok getting a little wet while running I didn't want to be 4 miles away from my house with lightening all around me.  I am slightly a wimp when it comes to the weather and I knew that would be a challenge for me during this training (I'm prone to "it's too hot" "it's too cold"  "it's too sunny" "it's too windy" and then not doing the workout).  So I decided to run on the treadmill.  That was the first mistake.  A long easy run is much easier to do on real ground, with scenery and things to look at and a distance that HAS to be traversed in order to get back home (you can turn off a treadmill but you are obligated to come back once you get a certain distance away).  So I got on the treadmill.  Andy and I had discussed how fast to run and we thought 2 min slower than my normal 3-mile run pace would be good (I run about 10 min miles for a 3 mile pace, I told you I was slow =)).  So I put 5 mph into the treadmill and started running, it seemed SO slow and after the first mile I increased the pace, then the next mile I upped it some more.  With those numbers in front of me I felt like I really needed to go faster, so I kept increasing the speed until the 5th mile I was running about 10:30 min/mile.  And then my left hip started hurting, my right knee started hurting and the bottom of my right foot started hurting.  So I slowed it back down to 12 min/mile but the damage was already done and my hip really hurt by the time I was done.  I'm sure it's some sort of bursitis.    Hopefully some ibuprofen and easy runs this week will fix it and hopefully I learned my lesson.

   I didn’t really want to discuss this publicly at first because it makes me feel more committed to actually following through and doing it, but I’ve technically already committed (sent in my registration) so I might as well share.  Last week I decided I would train for a half marathon.  I’m not exactly sure why I want to do this. I think I realized that I don’t have a lot of short term goals at the moment (other than continued survival of my hectic schedule) and so maybe I should have something to push me a little bit.  Initially I thought my goal would be to run a marathon, but then thought that since I’ve only ever run a little more than a 10K before (Bloomsday is what, 12 K or something like that?) that I should aim for a half marathon first.  Just to clarify,I am not a strong runner. Even though I’ve been running off and on for the last several years I’m not very good; I’m very slow.  But I know from swimming that I have endurance so I hope I can pull this off.
    Today was our long run of 7 miles.  There haven’t been very many times in my life I’ve run for 7 miles without stopping to walk, but today I did it.  Unfortunately I also experienced “hitting the wall.”  I have read about this phenomenon before but not really truly experienced it (I guess I was pretty well conditioned for swimming back in the day because I didn't have issues with this).  I was doing really good until I got to about 6.25 miles, in fact, I started to pick up the pace because I felt so great.  Then, suddenly, just half a mile away from home, it was like someone had dropped a large bag of bricks onto me and that I couldn’t run anymore, every movement required great effort, it was as if I was running through waist deep mud instead of air.  I had to slow down to an almost walk but I kept jogging until I got home.  What a relief to finish!  I guess it is important to work up some endurance, I can’t imagine that happening during a race, I would probably have to walk.
    The other really funny thing that happened today occurred while we were running through a large park.  There is a lake on one side of the road with some marshy area and trees and we always see a lot of wildlife (it is one of Avery’s jobs while in the Chariot to point out the birds and bunnies and it is Asher’s job to point out any heavy machinery).  Even though Andy was pushing the Chariot with it’s 70 pound cargo he still would get ahead of me (since he’s a much better runner) but then every 10 minutes one of the kids would start crying for some reason or the other (they are starting to fight a little bit, provoke each other and such) and Andy would have to stop and get them whatever they needed (snack, drink, sweatshirt, book, etc.) and I would run ahead a couple hundred yards and then he would catch up and pass me again.  So it took us all by surprise while I was running in front of them that a BIRD LANDED ON MY HEAD.  While I was running I felt sharp claws on my head and could hear the flapping and instantly knew what was happening.  I screamed (I’m a screamer) and Andy and the kids saw the whole thing and were laughing hysterically.   It was a male red-winged black bird.  But why?  Did it think I was attacking it’s nest?  Did it think I was a nest? (I did  have a little bedhead but it wasn’t that bad...).  I have never had anything like that happen to me before, it was bizarre.
So that was it for the day, I can’t wait to see what animals will attack me next week!  And we will have to figure out something to do with the kids, an hour and a half in the chariot is more than they can tolerate being in such close quarters with one another.  I’ll give updates when I can!

Those of you that know me know about my love of cookbooks.  At this point I have more cookbooks in my library than I do medical books (cookbooks never get outdated which is part of that).  So I'm always thrilled to find a great cookbook and I read it over and over and I'm twice as thrilled if the food tastes great and is easy to cook.  I also have really started to come into my own in terms of grilling.  I used to be afraid of the grill and felt like I had very little control over the heat and ended up overcooking everything which was so frustrating, but when we moved to Wisconsin we bought a slightly better grill (that has a temperature gauge) which has helped my comfort level immensely.  Also the first summer we had the grill I mistook the "low" on the dial for the "high" (it doesn't say hi or lo, it just has things that look like a full moon, half moon and no moon) and I couldn't figure out why with just one burner on I couldn't get the temp to be less than 450, I mean it was on "low" right?  But really it was on "high" (silly me), so then I read the instruction book and realized I had it all backwards.  Now that I have it right and have the ability to use some indirect cooking I haven't fricasseed anything lately and I feel like I can finally get things cooked just the way I want them to be cooked.  I still get frustrated with keeping the grill grates clean, I've found it to be a critical element but it's time consuming clean up (the only down side to grilling that I've found so far).  Anyway, I've been looking for awhile for a good grilling cookbook.  I have Weber's Art of the Grill which is decent in terms of methods but somewhat blah recipes.  Then last week I bought Bobby Flay's Grill It! on a whim and it is so good.  If you love grilling or you know someone that does you should buy this cookbook.  I knew I was buying the book the moment I flipped through the first chapter (7 different grilled asparagus recipes), I LOVE grilled asparagus. Then last night I made the Molasses-Mustard Glazed Pork Chops with Apple Butter and they were the best pork chops I have ever cooked, it immediately ascended into the "top ten best meals I've cooked".  Even the kids liked it (very rare for them to like what we like), although they did think it was chicken.  And it was EASY (and relatively healthy, the apple butter had more apples than butter =)).  I like Bobby Flay's style too, it's not too fussy, he lets the strong elements of the dish show through (the good cut of meat isn't drowned out by overwhelming flavors) and he pays attention to mixing textures and flavors. I can't wait to try more recipes from the book and am looking forward to a summer of tasty grilling! 

I know, it's early for Mother's Day.  But I had a little bit of time today that I won't have for another week or so and had to plan ahead =).  You'll still get a card, Mom, but I hope you like this.

   When I dredge into the faintest and earliest memories that I can pull up out of the nebulous cloud of my first few years of life I remember mostly my mother.  I struggle to give words to the experience of that memory: like being held tight and the smell of closeness and a light tender touch all at once.  I can’t pinpoint the age that comes from, maybe 1? maybe 2?  That memory feels almost like a constant rhythm humming in the background of my mind; maybe all of the routine of caring for me as an infant and child somehow left that steady beat imprinted on me.  The more distinct early memories also involve my mother.  One very clear early memory is the image of an empty room and my eyes shut tight but wet with tears and the smell of carpet in my face, feeling completely forlorn and confused and lost and then being picked up in mother’s arms and having that feeling that she would protect me and make everything right.  I’m told that is from when I was 3 and we moved to a new house, they had kept me out while they moved everything out of the old house and when I saw that everything was gone from my room I laid in the middle of the floor and wailed until my parents reassured me we would all be going to the new house together and all of our things would be there.  Today, as an adult, I still want that from time to time, to crawl up into my mother’s lap and have her hold me and protect me and make everything right.  The image is a lot funnier now because in real life I would crush her since she is much more petite than I am.  But in my mind, in that image, I’m a child again.  And I bet in her mind I’m still a child too because when I look at Avery I don’t see how I will ever be able to see her as an adult, even when she becomes one, I think I will always see her little girl face.
    The constant presence of my mother in my life was something that I did, and still do, take for granted.  Of course she was there when I came home from school, of course she was there to take me wherever I needed to go, of course she cooked all my meals and made my favorite lunches, of course she would wake me up before dawn every morning to drive me to swim practice for years and years and years.  None of that was ever even a question for me and while I knew other people lived different lives from mine I was so busy with all of my things that I didn’t contemplate the difference.  I never conceptualized that maybe other mothers were torn about working and being with their kids and about how to simply make it through the day juggling their responsibilities.  And of course I would grow up and try to do everything and be everything I could be, because I was born in 1976, and while my mother wasn’t an active feminist she was there at my ear telling me I could be anything I wanted to be, that I could be an astronaut or the president or a famous scientist just like Madame Curie (one of my idols at the time).  She didn’t have to push me because I pushed myself, I wanted to make a difference in the world and I wasn’t afraid to work.  And she was still there for all of it, at every crossroads and every setback and at every accomplishment.  I think I’ve talked to my mom almost everyday for my entire life, there aren’t many days that go by that we don’t communicate in some way.  I like it that way and I don’t plan to change (although we have changed many phone plans in the past to try to keep the phone bills reasonable!).
     My heart continues to ache for my nephews and for my deceased sister-in-law (she died in January of this year from a sudden hemorrhagic stroke for those that don’t know).  Her day to day presence in their life is gone and they will never see her again.  I know how much she loved them, how she wanted to see them grow up and become individuals.  She loved being part of the details of their lives and already in the past few months she wasn’t there to watch them play high school soccer together, to watch her son go to the Prom, to see him open his acceptance letter from college.  If her spirit is out there somewhere she is stomping her foot right now in indignation because she was supposed to be there for these things.  I don’t know if the boys recognize the loss in this way,from her perspective.  They are trudging through their day to day lives but I can only imagine that there is a giant void.  I worry about them a lot, I can imagine that underneath their teenage ambivalence a simmering anger is building.  How could it not?  How can they even think about anyone as a mother and not crumble under the painful searing knowledge that they no longer have a mother.  When they were little boys, before I had children of my own, I would occasionally see a look she would share with them, I think we’ve all seen that connecting look between mother and child before that says, “I belong to you.”  And I wanted that for myself someday with my children.  I hope my nephews don’t forget that; the feeling, the rhythm, the connection.
    Now I’m nervous, for Avery and Asher, that maybe that rhythm won’t be there, maybe they won’t have that very primal knowledge and memory of me because I have not been a constant presence in their life.  I went back to work when Asher was just two weeks old (what WAS I thinking?).  And even though I got to spend the first 4 months of Avery’s life with her when I did start working it was at a 120 hours per week pace.  The first three years of a child’s life are very formative, that’s not conjecture, there’s scientific evidence that that is true.  So what was I thinking?  That I could work and do it all and they would be fine?  My own mother tries to make me feel better about this on a regular basis, “they’re thriving and happy” “they won’t have a lot of memories of this time and they are being cared for and loved”  “they know that you are their mother and they love you.” All of that is true, but I still feel like maybe I am conducting some sort of experiment with their lives.  Will they be ok?  Will they hate me later on?  Will they question why I wasn’t there?  I desperately want them to know that I’m here for them, that they are the most important thing, that they are connected to me, but maybe saying it isn’t enough, maybe it takes a constant presence.
    I also wonder what I will tell Avery someday, about becoming a mother.  She already has a lot of questions about when she can have babies of her own someday (she is well versed in the details of the process as she frequently pretends to deliver babies at home and even tells me when her water broke and how strong her contractions are).  Of course I’m already there at her ear, telling her she can be whoever she wants; that she can be an actress or a farmer or a world leader or a musician, and yes, when she is done conquering the world she can be a mother, too.  I’m in new territory though, because I’ve tried doing everything at once myself and I don’t want this struggle for her, I want her life to be simpler, to be easier.  I don’t have an answer for how to do that and so I am at a loss for advice to give her, except that life is short, as evidenced by the loss my family is still feeling so acutely, and so you have to make the most of it and do the best you can.  And that is where I am left, and where a lot of other mothers are left, in the land of “trying to do the best I can”: trying to make it through the day and get everyone to where they are supposed to be, trying to do a good job at work, trying to carve out more time for the kids, trying to show them how much they are loved.  I think I will always want to be more like the mother that my mother was to me and I’m glad I have her example to draw from and cherish. I sometimes think that the rhythm, the one that feels like it is part of my early childhood memory, is the sound of my mother’s heartbeat.  Maybe I heard that comforting rhythm of life in the womb and again when I laid my infant head against her chest and again when I crawled into her lap as a child.  The connection I have with my mother has been with me my whole life and I am so thankful.

So I'm testing out this piece on my friends and family on vox, my friend from college asked me to write something for her blog (www.ivymama.com) about what it's like to deliver babies and be a mother.  Feedback is welcome (if it comes in a constructive format).

    A few weeks ago my husband came into the bathroom in the morning, yawning and bleary eyed, and found me sitting on the floor in my towel with my head in my hands.  He looked alarmed but I waved him off, I didn’t know what to do, I was feeling really stuck, I needed advice.  I had started an induction (of labor) the day before on one of my patients because she was postdates (greater than a week past her due date) and it was taking much longer than I had expected. I had stayed all night at the hospital because I kept thinking things would pick up speed, but I had come home in the morning to shower and get a fresh set of clothes since she wasn’t close to delivering.  It happened to be my day off of clinic (but usually involves work) and typically we have someone to cover us for childcare.  This day we had our nanny for the morning but through several twists of fate we had no baby sitter for the afternoon and it was looking like that would be when my patient would most likely deliver.  I told my husband about my predicament. I couldn’t be everywhere at once; I couldn’t take care of the kids and deliver the baby (although for a moment I thought about taking the kids with me to the hospital and letting them watch TV in the physician call room, which is about the size of a closet, but that thought ended with a variety of imagined disasters that would likely occur within 2 minutes of them being alone in that room together).  My husband told me that I should just “sign out” (transfer the patient’s care to my partner who was on call) that that is why someone is “on call” so that you can do that.  I told him that it’s not that easy, and that’s when the tears came.  I feel VERY responsible for my patients, I see them at least 10 times during their pregnancy over a period of months and I really get to know them and I want to be part of their delivery.  I feel enmeshed in the process and extracting myself is more than just physically removing myself at that point. 
“Are you crying?” he asked. 
“Yes, I’m crying, I don’t want to miss this delivery,” I said while covering my eyes, “but I don’t have anyone I can call today to take the kids.” I had already mentally run through a list of possible options of who could baby sit, but I was totally out of choices.
“If they only knew,” he scoffed.
“Knew what?” I asked.
“That you care this much,” he murmured.
    I get the impression from  my husband from time to time that he thinks I care too much, that maybe I get too attached to my patients and maybe it’s not good for my own emotional well-being.  But I think that pregnancy and childbirth is such an emotional process anyway that it’s hard not to become a part of that.  Plus I like to be a part of their journey to motherhood.  I don’t know if that is because I am a mother myself or if it is the caring part of my doctor-self, it’s too hard for me to separate, but I know that for whatever reason I do care and I want to be there for them.  Don’t get me wrong, I have a level of objectivity when it comes to their medical care, it’s not all emotional.  I have a touch of control-freak in me and I also have a combination of knowledge and experience that makes me respect the process of giving birth and I am wary of the pitfalls.  Taking care of a patient in labor is a little bit like chess in some ways, you don’t know exactly what moves the opposing player is going to make at the start of the game (in this analogy the baby is the opposing player) and so your mind is trying to keep 3 moves ahead so that you can expect what will happen and have a plan in place before it even happens.  My patients don’t see those things going through my head, and that’s good, because I think it would make them nervous.  And as anyone who has been through or watched labor knows, there is a lot more going on in the room than the medical part, there are emotions and relationship dynamics and nursing interactions and resident physicians and all sorts of other things.  So it’s a fun job, delivering babies, it’s all the wonderful things about medicine wrapped into one.  Except for the sacrifice on the other end; my family.
    That day I took my husbands advice, I signed out my patient.  I had been by her side for more than 24 hours but I recognized that I needed to do it.  And she cried.  And I felt terrible, like I was abandoning her.  But an hour later it was sort of refreshing.  I took my daughter to her gymnastics class and as I watched her out there bouncing and jumping I felt so free.  For 4 hours I had lifted that worry off of my shoulders and handed it to someone else.  And during that four hours she did deliver, and I missed it.  I felt bad, but the bad feeling slowly faded because I knew she was getting really good care, that someone else was doing just as good as I would have done (because I trust my partners completely) and that I was with my kids, which felt right.
    And then tonight the whole situation reversed.  Tomorrow is my son’s 2nd birthday.  We knew it was going to be somewhat tricky to have a mini-party for him (just the 4 of us and some candles and cake) because our weekend was chock full of activities for everyone (presentations, being on call, friends’ birthday parties, art class, work, preparing for meetings, ice skating lessons, show tickets, etc.) and so when I had a patient go into labor this afternoon our well laid plans fell apart.  My patient was progressing rapidly and I texted my husband as I was about to go into the delivery room and said “let’s have his birthday tomorrow instead.”  But he didn’t get my text, and he didn’t want to upset the delicate balance of a 2 year old and a 5 year olds expectations and so he went ahead with the cake and candles on his own.  When he told me how excited our son was to see his cake and how he loved blowing out the candles and how he scarfed down his slice it was like someone had kicked me in the chest and taken my breath away.  And then the tears came. (And again my poor husband was saying, “are you crying?”).  I had missed his BIRTHDAY.  The celebration of his life so far, of the day 2 years ago that I was the one in labor and gave birth.  The day that I went through that surreal and overwhelming experience of watching the moment that his little body came from my own and he took his first breath.  I gave him life, but I’ve been missing it by not being there, regularly.  And tonight, I missed it.
    I’ve wondered how long I can go on delivering babies, and now I know there will probably come a day when I have to stop because I don’t like feeling ripped in two.  I’m going to keep working on it, trying to find some sort of balance, because I love doing it.  But tonight was a taste of what might happen 20 years from now.  I imagine I will always have fond memories of delivering babies, of being in the shadow of that miraculous moment a new life begins and of making that journey with my patient.  But I also imagine that I might lift my head up and see my two grown children and realize that I missed it.