Lunch love

Upon receipt of my first paycheck, I was finally able to justify the purchase of an awesome lunch sack. After much online research, I found this gorgeous neoprene bag by BUILT. It arrived yesterday, and it has already exceeded my expectations. The size is just right, and the colorful dots make me happy. It's also machine washable. I think I'm in love.

If you can't live without one, they are sold at Whole Foods, The Container Store and Amazon.com.

ED

It's 2:28 am and the ED is quiet. In 92 minutes, I will flag down a security guard and request a walk to my car. This is my fourth shift; and my feelings of utter uselessness and anxiety are steadily dissipating. The days immediately prior to a new rotation are inevitably unpleasant. As my worries mount, my brain starts to malfunction. Just last weekend, I went to the ATM and was unable to recall my PIN. After several incorrect tries, an error message informed me that I had exceeded my alotted attempts. My first shift was also a bit unnerving. I had the ill fortune of starting on a Thursday morning, the one time that ER residents are all at an educational conference. I was thus alone with the attending who pushed me to see as many patients as I could as fast as I could; he suggested that my threshold for not taking another patient would be the onset of gastritis. In other words, I could stop taking new patients if the stress of my circumstance started to make me ill.
Thankfully, I am much more settled in now. I've always been a night owl and the night shift suits me. I especially like the drive home at 4:00am. The streets are empty and still, the store fronts are dark, and the quiet soothes my ears.

Lovely lady

On Tuesday, we celebrated Gilia's Birthday with a picnic and concert at the Botanic Gardens. I won't divulge the birthday girl's age, but I will say that she looked absolutely fabulous (as usual)!! Happy Birthday, Gilia! I love you.

a

Tonight

Tonight was fun. I put our little picnic table in the salon (livingroom), and Elijah arranged the placemats, plates and silverware. When Amiel arrived, we announced that it was family picnic night. The menu? Frozen pizza; sauteed zucchini with dill; and lots of green olives. Not your typical picnic faire but no one seemed to mind.  For dessert, we had melon and raspberries. We then had a special treat, chocolate pudding!! My mom used to make JELLO chocolate pudding with sprinkles in a little picardie glass and that's exactly how we had it tonight.  Watching Elijah savor the pudding was quite entertaining.  After licking every last bit, he poured water into the pudding glass and slurped the resulting 'chocolate water.' He did this several times, repeatedly adding water to the glass and eventually dumping in some raspberries (which he drank up too).

One down

Yesterday was my last day on the stroke service. As is often the case, the end of this rotation was bittersweet. It was a huge relief to have completed my first month of residency. That said, I was just starting to develop a sense of how to manage stroke patients, and it's a little unnerving to start general neurology. Thankfully, someone is always willing to answer my questions, even those that are embarassingly elementary. Taking care of patients is not unlike raising a child. The learning curve is unavoidably steep. I'm sure I'll get up to speed... just in time to move on to my next rotation.

As for the rest of our little family, Elijah is thriving at preschool. He seems to have a crush on Claire, the woman who takes care of him after nap time. When I went to pick him up the other day, he was making green playdough pancakes with her. As it came time to say goodbye, he told me that he "likes her and loves her." When he's at home, Elijah is mostly interested in being read to, playing his keyboard and making 'pillow houses' in the couch. He arranges the pillows at one end of the couch and then hides stuffed animals beneath them. He will spend long stretches of time talking with his animals and rearranging the cushions. As for reading, Elijah loves to hear the same books over and again. His current favorites include "Make the Team, Baby Duck," by Amy Hest and "Lost" by David McPhail. He also enjoys books about using the potty, but this has yet to translate into an interest in potty training.

Amiel is also doing well. Now that I am working, he is responsible for getting Elijah fed, dressed and off to school. They have clearly bonded over the past weeks. When I pick up Elijah from school, he typically asks, "Where's Daddy!?"

Still kicking

I am very tired. The one day weekends are painfully short, and the early mornings are barely tolerable. In my view, feeding a baby and catching a plane are pretty much the only justifications for leaving bed before 7:00 am. I snack and drink cold water to stay awake. When I'm really exhausted, I have a tendency to misplace my water bottle. I recently lost my beloved SIGG. It was red and had a cool samurai motiff. One of my med students has started to keep tabs on its mauve replacement.

Despite my exhaustion, things are going well. I'm learning quite a bit, and it feels good to make some small contribution to my team. It's still strange to be addressed as a doctor, but I'm sure I'll get used to it.

The hospital

After yesterday's illustrious day off, I was hesitant about returning to the hospital today. "I've given it four days, time to stay home again." Needless to say, Amiel was had other ideas, and I was back to work this morning. The hospital is like a casino. The lack of windows and miserable artificial lights make it impossible to appreciate the true time of day. There is always someone on the go. The building services guy is pushing a dumpster of soiled linens, the stroke patient's husband is looking for his wife's room, and a gaggle of white-coats is making its way down the hall. The nurses are wearing muted pastels and speaking Tagalog. One of them has a bandaid beneath her left eye; another has a long hair sticking out from the side of his face. Silence is elusive. Monitors are beeping, phones are ringing, and pagers are buzzing. I see someone swipe a jello from a patient's tray.

After rounds, I head outside with my resident and med student. The sun blinds us and the swooshing wind soothes our ears. My resident smokes a cigarette and pulls out a bag of barbeque potato chips. I'm thankful that he's a smoker because it gives me an excuse to slip outside the hospital.

Back in the workroom, I vie for a free computer and start writing my notes. The computer table is cement grey and littered with piles of paper. When no one is looking, I covertly wipe down my mouse and keyboard with an alcohol pad. A few hours later, I'm preparing to leave when our team receives a new consult. More on her to come.

Doctor

Quick update on my first four days of residency. I am lucky. My first month is much less intimidating than I had feared. I am on the neurology team right now and since I am a psychiatry resident they don't trust me to do much. Specifically, I don't take call (sleep over night at the hospital). This is a wonderful thing for someone who is unaccustomed to spending long stretches away from home. I've been leaving the house around 6:45 every morning and this has been quite an adjustment. That said, I've yet to be late and that alone feels nearly miraculous. As for the work itself, I definitely have alot to brush up on, but I am cautiously optimistic that this might actually be manageable.

I've enjoyed seeing patients again. I was called to the Emergency Department to assess a woman who was having stroke symptoms. Sweet lady. She said that she was having troublesome symptoms for a few days and things got worse when she heard about Michael Jackson. People are so fascinating.

First day of school

Yesterday was Elijah's first day of preschool. Here is a guest post from Amiel.... Sarah took the lead in doing a very nice job preparing Liji for his first day of school. We both took him to a couple visits to the school and Sarah talked about it a lot in the last couple weeks so he would be familiar with the concept. She even got him a couple very cute books about “first day at school” and a brand new “Blue Doggie” to take with him. I think he was as well prepared as possible.
One of the last steps yesterday was laminating some family photos so he could take them with him and be reminded throughout the day of his cast of fans supporting him. Sarah expertly punched holes in the laminated photos and tied them together with a pretty piece of yarn.

Today we had his clothes all picked out from the night before, bag packed, and off to school we went. He was calm but with a VERY serious face when I took a couple photos. After we entered the school – a little tentative and not ready for smiles yet. We met one of his very nice teachers, Dee, who already had one little girl in her arms, just getting over her own “first day trauma”, eyes still wet with tears.

We said hello, handed off our bag and some frozen veggie food, and as is the procedure at his school, were shown where Elijah can wash his hands first thing every morning when he arrives. (They are very conscientious about preventing spread of any germs!) Elijah liked having a little sink at his height with a grownup soap dispenser and paper towels. Then it was time for Daddy to say good bye, love you, see ya later, and leave quickly. You can imagine how much he liked that… Not so much. Immediate crying. But I had to run to the car to get out a box of diapers and when I returned two minutes later, Elijah was in Dee’s arms, already calmed down. (You could tell right away she has a great touch with small children.) I didn’t let him see me, so as not to get upset again, and quickly slipped out.

Amiel picked up Elijah and it sounds like the day went quite well. His only difficulty was falling asleep at nap time. By the time he fell asleep, it was almost time to get up. Apparently he was unhappy to be awakened... he must have been really exhausted because he dozed back off. Amiel reported that Elijah was fast asleep on a little couch at pick up time. Tomorrow is Elijah's second day and I am hoping to pick him up myself. Tomorrow is also my first day working in the hospital!! A big day for our little family.

One last day

Yesterday, Elijah and I visited his new preschool. He was a rockstar. I lifted him up to ring the door bell, and he held my hand as we were lead to his classroom. The children were finishing their music class and there was alot of commotion. Elijah warily surveyed the scene and opted to keep his distance. Snack time was next on the agenda, and we really lucked out in that department. It was little Rachel's birthday and her Mom had brought cupcakes for the class. The kids eagerly washed their hands and raced to their little blue seats. After washing his hands at the pint-sized sink, Elijah made his way to the tables. A cheerful girl with curly red hair asked if Elijah would sit next to her. He thought about it for a moment, but I think the girl's exuberance was a little much for him. He eventually found a spot next to a quiet boy, and stood beside the chair for some time. I fought the urge to slip my hands beneath his arms and slide him onto the seat. I tried to be patient. When he finally climbed into the seat, I smiled from the inside out. The promise of gooey frosting had prevailed, and my little boy had willingly sat at a table of strangers. Amazing.

After cupcakes, the class headed out to the school's cool playground. By now, Elijah was all smiles. Climbing the equipment, letting a girl give him a hug and blowing kisses to his teachers when it was time to say goodbye.

Today was another special day. I start work tomorrow, and today was my last day home with Elijah. I usually hate to wake up early, but today was different. In an effort to make the day last as long as possible, I actually set my alarm clock to ensure an early start. For breakfast, Elijah and I made a puffy oven pancake. He helped dump the ingredients into the mixing bowl and cracked an egg for the first time. When the pancakes were ready, I let him cover his plate in a flurry of powdered sugar.
It was a rainy day, so we decided to visit the nearby Nature Museum. The museum is famous for its butterfly haven, but Elijah's favorite part has always been playing in the (over-priced) photobooth. This time, we actually had our picture taken and Elijah couldn't wait to see the strip of grainy images. On the way home, Elijah used his new umbrella as a walking stick/pointing device. "What's that!?" he'd inquire. The answer was usually "goose poop!" and Elijah found this hysterical. "Smushy-gushy-stinky goose poop!" I said. Squeals of delight. By the time we reached our street, we were damp and cold nosed. We grabbed a slice of pizza and headed home for nap time.
Before nap, we read "The Kissing Hand," by Audrey Penn. The story is simple. Chester raccoon is hesistant about starting school, and his Mommy teaches him the secret to keeping the warmth of home with him all the time. Elijah loved it, and it nearly brought me to tears. I purchased the book to help with Elijah's transition to preschool, but sometimes I think that I am the one who needs reassurance.