Thursday, September 21, 2017

Creating lists so you remember what you've accomplished and don't give up

A little over a year ago after a two year hiatus (secondary to the first two years of residency) I started exercising again.  It wasn't pretty.  I couldn't even run a mile anymore.  Add to this, the only activity that I actually had time for was running, which.... ok it's not my least favorite kind of exercise, but it's certainly not my favorite.  Only problem was I didn't have time to do my favorites.  I still don't.

But the truth was, even though I am meh on running, I felt better when I did it.  After I did it moreso than during, but still better.  It was at that time that a friend at work suggested logging my runs so that I could see my improvement.  He's in the military, and that's part of what he did to hold himself accountable.

I thought it was a good idea.  I did it for like... a month, and then I stopped.  I don't really remember why I stopped.  I think it was because I found myself on a more difficult rotation and then was too exhausted to exercise at all anymore, and it started to depress me.  And then I fell off the wagon again.

So, among other things like, um, research, this research month I decided to get myself back on the wagon and start exercising again.  I promised myself that I would try to run everyday, even if it was only for 10 minutes, or even 5 minutes. Even though I knew I wouldn't actually go every day, I knew that the extra guilt would keep me from skipping running too many days in a row.

When I started up again it turned out that I still could run about a mile before getting tired, which... hey, when I'd started up again last year I couldn't even do that.  And I went pretty much every day this past month.  I skipped... maybe two days a week on average, which I think is pretty good.  Most of the time I run for at least 12 - 15 minutes.  Today I did 20 and then walked another mile home.  On one hand I feel lame because I can really only run for 25 minutes before needing to stop and rest.  On the other, I definitely couldn't do that at the beginning of the month, so even that lame amount proves that I have made progress.

My only concern now is how am I going to keep this up when I return to the OR next week?  Naturally I will be on call my very first day.  It is possible that I will get assigned a day of lates on Monday meaning that I go in at 11 and not at 6 (OMG it makes such a huge difference when they let us do this), but it is also possible that they won't.  I most likely will be up all night, which... is wretched.  And it makes for the shittiest feeling runs on my post call day -- EVER.

So, I think what I should do is log my runs so that I can have at least some level of accountability.  It's only one more month until I do research again, after all.  Maybe that will help.


In a similar vein, I have so much to do, yet I am now running low on time to get things done.  I thought I would make a list of my various projects with their next steps so that when I do have time to work on them, deciding what to work on will be easier.  So here goes:

DNR Project
- work with data person to compile data (I usually do this myself, but I am learning to delegate, and I have been given money by one of my mentors to have someone do this for me, which is AWESOME)
- analyze data
- write manuscript (this can be divided up into various stages as well, but it's a goal for my next research month so I will leave that as a big block now)

Readmission Project
- finish chart review (it's about 1/2 done at this point)
- compare my data to reaudit data to my data and compute kappa scores if applicable (delegating the independent re-audit to my co-resident in exchange for authorship worked really well, and I definitely consider doing it again)
- figure out how I'm actually going to analyze the data
- figure out what data to present in the results section
- write the results section of the manuscript
- write the rest of the manuscript (I usually start with results, then do methods, discussion, introduction in that order)
- polish the two abstracts I'm submitting to SPA on this project
- prepare the poster for one of the abstracts (I already did the other one)

Grant Writing
- Continue working on specific Aims pages for a FAER and a K grant (separately -- I plan to apply for both -- this is for my research, my ideas, for early career funding)
- Start writing up section of grant for how I plan to do the research parts specifically.  I think this is good next step because it will help me figure out whether my aims are doable, and then I can go back and polish the aims some more
- Start thinking about the other sections of the grants that I will have to write, such as my biosketch, the biosketches of my various mentors, timeline, etc.

Future Projects
- after I do DNR project, pursue collaboration with colleague who is now an attending to do a similar project in adults
- think about survivorship project/grant
- potential ethics project
- mixed methods palliative care project

Maybe putting this down on paper will help me when I have a few hours to work on these over the weekends, but I can't remember where I was.

Wednesday, September 20, 2017

Mom happenings

Last night my husband and I attended "Curriculum Night," which my daughter's school hosts every year so that the parents can meet the teachers and hear about what the kids are going to be doing this year in school.  I wasn't able to go this year, and similarly wouldn't have been able to go this year had I been in the OR and not on research because whoa I heard last night was a doozy at the hospital.

It was fun!  In fact, this whole week has been fun from a mom standpoint.

- On Monday the bus driver had some issues getting to work, and she texted us as a group to let us know the bus would be late.  We ended up all texting one another updates on where the bus was, and eventually I managed to figure out what number belonged to each parent on my daughter's route.  When I ran into them last night at school we all discussed how great it was that we now had this contact information, and that we should keep in touch.

- Dylan has tomorrow off for Rosh Hashanah, and since we're not Jewish, Dylan will have a random day off with our au pair.  To spice things up a bit, we asked a friend of her's (whose parents we've met once) over for a playdate and they said yes!  Apparently the threshold for playdates is lower when you're offering a free ride on your paid childcare.  Haha.  So we will be hosting a drop off playdate starting at 11 tomorrow.  And when we were at school last night, another mom asked if we'd be interested too, so apparently this is a thing.  Yes!

- As the teachers were talking about literacy, and encouraging us to read to our children at least 20 minutes per day, one of the moms raised her hand and asked if she had any advice about what to do when the child resists being "taught" by the parent.  For instance, she'd say, "X, can you find a word on this page that you recognize," which is something that they had suggested we could try, but her child would refuse to cooperate with this.  The teacher didn't really have a lot of helpful suggestions about it aside from saying that's what school is for, but I seriously wanted to stand up and say, "Oh My Gosh thank you so much for saying this.  My daughter does the same thing."  I didn't, but I really wanted to.  Oh, and btw all of you who homeschool?  I don't know how the heck you do it.

- We saw some of Dylan's art, and were pretty impressed with her drawing of a hand.  Quite frankly, it was better than I could do (which is not saying much, but still).  It kind of reminded me of the hand of god depicted in the mosaics in San Vitale in Ravenna, though I'm sure that wasn't her intent.  Rock on Dilly Pickle.

- We really like her teachers.  One of them is new to the school this year and lives in West Philly five blocks away from us.  We talked a bunch about the neighborhood and how great it was, and how much things have improved over the past few years.  A brief conversation about public urination may have occurred.  See, there is an abandoned parking lot on my street with an empty shipping container in it.  If you sit outside to do work, you will notice that every 15 minutes or so, a car or a cab will pull up, park, and a dude will get out and go to pee in the parking lot.  They are totally brazen about it!  I wondered whether there must be an app of spots where you could go pee around the city, and it turns out -- THERE IS.  Now, I didn't look long enough to try to find my particular street, but OMG that totally explains it.  It was suggested that I put up a really bright light over there (though, that wouldn't help for the daytime urination).  I told everyone I'd taken to yelling across the street, "HEY, YOU KNOW THERE ARE CAMERAS OVER THERE," but unfortunately so far nobody had been deterred.  Sigh.

Anyway, all of this is to say that I'm really enjoying being a mom to a five year old, she's fun, she talks, she has opinions and can do things, and takes pride in doing a good job.  To all of you who are not baby people who are struggling to get through the days of baby and toddlerhood, just know that fun times lie ahead and you will get there too.

Tuesday, September 19, 2017

My daughter has her 5 yo well visit today, and my husband had planned to take half a day off to take her.  But... I'm on research, and I've literally never met her current PCP, so I offered to do it.  

But no, he insisted he didn't mind.  He wanted to make sure I had plenty of time to do work.

I told him it was fine.  That I could spare the time today.  I wanted to go, even.  That he could stay at work and come home at his regular time and have a normal, uninterrupted day.

He continued to insist that it was no problem for him whatsoever.  Work was driving him bananas today anyway.

Finally I said, "Look, what I'm gathering is that you want to take Dylan to the doctor as an excuse to get out of work for a day, right?  That's fine, but please just own it.  That's probably the real reason I want to go as well."

At least he finally admitted it.  

Ah the motivations behind martyrdom.

Monday, September 18, 2017

Weekend Rundown

Last weekend worked pretty well.  I think the bottom line is that if I want it to not be horrible, I absolutely have to go into it with a plan.  Behold, what a schedule that left me rested and happy looked like:

7AM wake up
730 walk dog
8AM ate breakfast with fam
talked to husband, had pleasant conversation
845AM went for run
930 arrived home (I ran for about 25 minutes, which is good for me these days), showered
10AM left for Dylan's swimming (it started 30 minutes later than I thought)
1030-1115 swimming and changing, also did anesthesia questions
1130 lunch at Whole Foods with Dyl
1250 arrived home
130 commenced work
430 finished work (took 30 min break in the middle)
430-630 Dyl played outside with neighbor's kid, Luca got carry out which we ate at the park
645-9 family movie (I only had to ask my husband to put away his phone twice)
930 bed

I did learn that in order to both walk the dog AND go for a run before swimming, I needed about 30 more minutes than I thought I did, if I wanted that time to be relaxing.  Which means I do need to get up at 7.  I guess compared to my usual 5AM that's not so terrible?

730 wake up
8AM walk dog
830-930 lie on couch, hydrate, did anesthesia questions
945-1100 run (1.9 miles, or 20 minutes on the nose), shower, dress
1115 lunch, hung out with fam
1215 left for movie
1-345 mother!
4-5 beer
5-630 sat outside watching Dyl play with neighbor, zoned out, read some of my book
630 dinner
7PM got dyl ready for bed, bath, hair wash, read books
815 lights out, talk to husband
830-930 read
930 sleep

Overall, I think Saturday went better than Sunday.  I felt there were large swaths of underutilized time on Sunday, but yet, I'm not sure I could have done much to prevent this.  I enjoyed the 90 minute zone out time when we got home from the movie.  I am also glad I finished my book (1000 Acres), which I ended up enjoying in the end.  I even actually did get some work done.  I think I need to come to terms with it being ok to take an actual true day off from time to time, and the idea that I don't constantly need to be productive.

The only thing that didn't work great was when Luca was spending time with Dyl, he decided to use that time to do a construction project.  I like that he involves Dyl in that, and she does seem to enjoy herself, and participated in activities like clamping and drilling.  But I don't like that he has a low frustration threshold with any sort of home improvement activities, curses and screams frequently, and occasionally displaces that frustration onto her, which makes her upset.  This seems unfair to her.  He also needs to get better at unplugging, in general.  I can't fix him, unfortunately.  I can only fix myself.



So, let me begin by saying, my husband and I go to movies a) to be entertained, but mostly b) to generate conversation.

Put another way, far and away my LEAST favorite movie from last year was La La Land.  Just wow.  I mean, I don't really like musicals anyway, but I almost could not sit through it, I hated it so.  I must stop now, lest I go on a rant about how vacuous I thought that movie was and how I think Emma Stone has no talent.  I also was meh on Manchester By the Sea which many people also raved about.  If I had to pick my two favorite movies from last year, they would be Elle and Jackie.   Favorite movie from the year before was Whiplash.  I also liked The Martian and Interstellar  which I am prone to confuse in my head.

If these movies do not align with your tastes, please stop reading now.  You should not see mother!.

So.  I liked mother!.  It's the same director as who did Black Swan, which I also enjoyed, but much more effed up.  MUCH more.  It was more effed up than Elle was, but in not nearly as clever or entertaining a way.  It was more gruesome, and often gratuitously so. It was heavy handed.  The literary references were abundant.  It kind of hit you over the head with them, frankly.  Like, The Bible 101 for audience members who have vague memories of being made to read it back in high school, and want to feel smart because they made the connection.  I do not want to see it again. I was originally reluctant to see it because I don't like horror movies and heavy suspense, like where you know something bad is going to happen, and... oh look it just did and you just peed yourself.  There was an element of that to this movie, but by the end I wasn't even scared anymore because that wasn't the point of the movie, even though it was shockingly violent.

 However, it was a GREAT conversation starter.  With my husband only.  It's the kind of movie that I would love to discuss with other people in general, but I'm afraid to even casually mention that I saw it in conversation.  I worry that other people will think I'm a disgusting person for even having seen it, let alone admitting to having liked it.

Here's the NYT review of it which gives a plot synopsis.  I didn't find the movie funny at all, so I don't totally agree with the review.  Here's another review.  I agree that the movie is polarizing!

There's a line in the movie where Bardem's character, a poet who has just published his newest masterpiece, says of his adoring fans, "They love it!  It means something different to every one of them!" which is what makes great art great, or so we learned in high school English class.  I feel the same way about the movie itself.  Most people have talked about the Biblical references and the references to environmentalism.  To me, it was about being in a relationship with a narcissist and whether tragedy and extreme narcissism are needed to produce great art.  Those things AND God.

Oh yeah.  Michelle Pfeiffer was in this, and she was awesome.  Her performance was probably the best part of the movie.

Bottom line: I'm glad I saw it, and enjoyed it because it made me think, but please don't judge me for it!  And yes, I am pretentious movie snob whose tastes aren't nearly as sophisticated as I think they are.

Friday, September 15, 2017

The weekend plan

So, I have trouble with my weekends, and I often finish my weekends feeling neither rested, nor as though I got much of anything accomplished, or had much fun.  Some of this is as a result of lack of planning.  But in my defense, it's really really difficult to come up with fun activities when you're in the OR 12 hours per day and then have to go home and study some more.

But it is also because I have a perpetually on-the-verge-of-out-of-control to-do list with respect to:
- studying anesthesia
- my multitude of research projects
- grants to fund more research project
- presentations/lit reviews that I get assigned during my various rotations
- rando administrative BS that comes up for residency freaking ALL THE TIME (I expect this will only worsen when I become an attending)
- preopping my patients for the following Monday and coming up with an anesthetic plan, and completing all necessary paperwork (I do recognize this could be way worse -- I'm looking at you Internal Medicine)
- discussing said plan with my attending
- ordering the necessary supplies for my OR (50% chance that 50% of them will be in my OR in good working order on Monday)
- I also want to spend quality time with my daughter, guys!  And this does not include having her play on the iPAD on my bed while I furiously work on my computer doing one of the above tasks
- Quality time with the husband.
- Walking the dog (I really enjoy this activity).
- Exercise

Part of my unhappiness with my weekends stems from the fact that I will never get as much done as I want/need to do, and I always feel like there is work hanging over my head.  I need to come up with a to do list that is realistic.  Unfortunately, part of the nature of research is that what you need to do has a tendency to mushroom into bigger projects.  It's not unlike remodeling a bathroom in an old house.  That project that started out as a cool 5 grand will quickly blossom into a 20 grand monstrosity because of all the crap you uncover once you dig in.

Unlike most weeks however, I am currently on a research block, and thus have the time to construct a plan for myself this weekend (and blog, but you could probably already tell that).  So, here it is:

7AM get ass out of bed, prepare breakfast for self and the dog
720AM walk dog
745AM feed dog and eat breakfast with Dyl (she'll likely wake up while I'm out walking the dog)
9AM return from run, shower
930AM take Dylan to swimming
10AM observe Dylan as she learns to swim and do questions in my anesthesia question bank
1030AM coerce her into changing clothes in the locker room, drive to Whole Foods
1115AM purchase things at Whole Foods, have mommy Dilly lunch
12PM drive home
12:30PM arrive home, put away groceries, walk dog
1PM do research-type work while Luca entertains the Pickle
3 or 4 PM cease and desist with working and plan dinner with fam
5PM dinner with fam at local establishment where beer can be consumed, maybe take Dyl to park
6:30 return home, watch movie/read book/lie on couch
9PM bed for whole fam

(This is giving me anxiety.)

PS -- This is our au pair's free weekend, so no couple time, unless we can get her to switch.  UPDATE: I got her to switch since the following weekend we have a family picnic at school.
PPS -- I have no chores to do.
PPPS -- Exercise really should happen at some point.
PPPS --Maybe we can see Mother.  I think it's playing at the Rave while AP watches Dyl and then grab a beer after.


Thursday, September 14, 2017

What's the deal with drop off playdates

What's the deal with drop off playdates these days, you guys?

When I was three and four, I remember having drop off playdates with children from my preschool a couple of times per month.  Sometimes I'd go to the other child's house.  Sometimes they'd come to mine.  My babysitter would watch us when we were at my house, and at the houses of my friends sometimes the mom watched us, but sometimes it was a babysitter there too.

In kindergarten, my school was a 1/2 day on Fridays so this continued.  Actually come to think of it, playdates were kind of built in to the schedule.  It seems like I had one most Fridays, but I'm not sure if this is an accurate memory.

We didn't really have weekend playdates when I was little.  Honestly, the only thing I really remember about weekends was watching TV on Saturday mornings and going to church on Sunday mornings.  Sometimes my dad would take me out for an activity in the afternoon like to the park or ice skating at Sky Rink, but mostly I remember being really really bored in our NYC apartment.  When I got older I remember having playdates in CT with friends up there.

These days things are a bit different.  Dylan has one friend that we've had over for a dropoff playdate on the weekend.  We really like the mom, and we've had playdates with her over too.  Dyl also has impromptu playdates with one of the neighbor's kids during the weekday evenings and sometimes on weekends, and they have a really fun time together.

But, arranging playdates with Dylan's new classmates has been.... challenging.

It's not that Dylan has no friends.  She seems to have lots.  We see her playing with other children, and on the rare occasion that Luca or I will pick her up with school, we are often swarmed with children asking us if they can have a playdate with Dylan.  She will come home and tell us she wants a playdate with H or C.  Then we will call the parents and try to arrange it.

Often we run into one of the following problems:
- Family ignores message
- Family responds that they can't this weekend, but can at future date, but when future date arrives they can't anymore
- Family expects this to be a whole family event with me AND my daughter (not Luca)

I find this weird.  Why not arrange for a drop off playdate? We're happy to host!  (Answer: They don't know us, why would they trust us with their kid?)  How do I overcome this?