I had decided not to start a blog here, since Drey's got an excellent one, and we're at the same school. Then I realized that we have several differences:

1) I had my kids before I started med school.
2) I'm significantly older than Drey (I turned 30 in October) even though I look pretty young, so people think I had my boys when I was in college.
3) I'm a bit of a peds clinical research nerd. (Oh, who am I kidding, I've already got my research set up for this summer, pending funding. More on that in another post.)
4) I'm definitely in the middle of the pack academically. On a good day. (But hey, I have 3 year old kids and a grad student husband who works part time in addition to his graduate funding. I'm feeling not-so-bad about being in the middle-ish.)

and 5) I started doing our school's independent study program yesterday.

This ISP thing is pretty crazy, since it's not a great idea if all you want to do is skip lecture. (We have podcasts for that, so anyone who just didn't like getting out of bed at 8:30 does that. We even have a guy who speeds up our podcasts.)

But 38 of us have decided (well, the MD-PhD people didn't have a choice) to:
1) Learn a different curriculum
2) Forgo lectures
3) Learn from course packets and books, going to module leaders with questions
4) Schedule our own exams, given only guidelines and max dates (after a max date, apparently you get a zero)
5) Pass some NBME shelf exams at the end of the year
6) Get a pretty nice set-up in the ISP lounge/library.

We still do our physician development and patient centered medicine components with the rest of the class, but otherwise, we're on our own.

But why on earth would I do this if I don't even really have to show up to lecture anyway? Simply put, I haven't been able to get much from lectures, so for me, lectures are benign at best, counterproductive at worst. After that, I looked at how the curricula were structured, and realized I like the organization of ISP better. And the days that I haven't had to do anything but study have been the most productive and fastest-moving for me.

So, here I am. Two days in, and I'm ahead of the schedule I set for myself, which gets me finished in 80% of the recommended time. (I want breathing room for things like getting sick, kids getting sick, insanity, etc.)

I'm learning biochemistry now, and it's amazing A) how much I forgot from my undergrad biochem course, and B) how quickly it comes back. I will put in a plug right now for Lippincott's Illustrated Review. It's pretty much the perfect tool for me. I read it after my course packet and everything that was fuzzy becomes clear.

My kids are also doing really well right now. We had parent-teacher conferences last night. I was really dreading it, since at their old childcare centers they turned into "how much I hate your kid" sessions. (Okay, I'm projecting, but they did like to nitpick and bring up negative things.) But last night was wonderful. I knew that my kids had really pretty great literacy skills (they learned to read a year ago and now can read pretty much anything they have the attention span for), but I didn't know that they could count to 100. I also (and call me a bad mommy, but he never colors at home!) learned that one son is left-handed! The teachers talked about what fun my children are and what a pleasure they are to have in the class. I guess they have been adapting quite well for new 3 year olds. (Obligatory plug for Montessori schools. At least this one is perfect for busy families who need some help bringing sanity to the life of a preschooler.)

Anyway, we're home together for the next 5 days. We're going nowhere for Thanksgiving. We've been so busy with life that we just want to relax (and get my kids over their coughs). We'll cook a Thanksgiving meal together, kids involved in every step. Tomorrow we shop, Thursday we cook, Friday we get the Christmas tree. And I hold my breath and hope the kids don't beg to go to the zoo again, because we've been twice in the past week.

My Sons' Interpretation of How Santa Works (at age 3 3/4)

(I got part of the story, so I had to get to the beginning and ask "what comes next" about 30 times.)

Santa uses his sleigh to get down the chimney.
He then comes out of the chimney.
Then he is in our house.
Then he gets some cookies.
He eats the cookies.
He goes back up the chimney.
He moves on to the next house.

I love it - Santa's just in it for the cookies!

Today was probably my most "MomMD" yet.

We've just finished a unit on human development in our Patient Centered Medicine class, and it was "bring the kids in" day. There was also a "human development jeopardy" thing, too. So I brought my boys in.

They were very, very busy, very friendly, and had a great time. I brought books, paper, crayons, scissors and glue for them to keep them entertained. So, next thing you know, one son is handing out papers to most of the small group (18 people, counting me) and getting them to do various things (color, cut, glue) and asking them what they're doing.

They enjoyed playing with our facilitator's 18 month daughter, and our facilitator was bringing up significant developmental issues in all 3 kids as they came up, and how it would play out in a clinical setting. Good stuff.

I think it was also nice for my small group (that we have a lot of stuff with, so we know each other pretty well) to see me as a mom, and not just someone who talks about her kids.

One of the funniest things was that one of the "answers" was "Children have generally learned to stand on one foot and ride a tricycle by this age" and at that very moment both boys stood on one foot and one said "I like my tricycle." Everyone knew instantly that the answer was 3 years.

Of course we got back home too late to return them to school or take a nap, but that's okay. They'll go to bed early today, since they're totally worn out.

First block of tests done!

I love ISP. Having, in general, a day with at most one interruption for an hour or two, with the rest devoted to study, is my idea of academic perfection.

First, performance-wise: my biochemistry grade was my best yet in medical school, including "easy" things like biostats and epidemiology. My genetics, not so much so, but then, yeah, whatever, no one did well.

That and I hung out playing ultrasound for a while the night before the exam. So, we have an elective ultrasound class taught by fourth years, modeled by second years, that had its first "real" meeting this week on Wednesday night. It was a lot of fun, and ironically, this is better for me understanding locations of structures than all of gross anatomy was. Anyway, I found a liver, kidneys, heart, spleen, and bladder. The best part, however, was hanging out with the fourth years and getting their perspectives on life and med school.

Anyway, I'm "done" till January 3, but I'm getting a start on my neuroanatomy and writing my proposal for this summer's research funding. Without going into too many details it's a cool project in neonatal clinical research. I'm really excited about doing this. But I'm such a geek that way. The more I read, the more I think I want to do this thing. (The big test, of course, will come when I return to the NICU as the clinician, rather than as an observer or as a parent.)

So I'm in a good place.

Our class was having a canned food drive competition with the second years, and I wanted to have my kids get involved. So we got a list for a "kid pack" and got everything on the list. After school today, we let my kids pick out each item (Thomas toothpaste, Sesame Street toothbrush, a huge tub of reduced fat Jif, and so on). Then we drove over to school (husband was in tow, thank goodness) and dropped it off in the med student lounge. We, of course, had to take a tour of the entire school, it seems. Lots of running up and down the aisles of the lecture hall. (It was very hard to explain that this was the room for listening quietly and learning, while my classroom that they'd been to before was the room for working together.) Then I took them upstairs to the ISP lounge and library ("the quiet rooms") and they just loved every minute.

Good day, in all. I can't believe Christmas is in a week and a half. Presents ordered online are coming in and promptly being hidden, but I really do need to wrap them. We never got the house lights up, and I feel astoundingly terrible for this, since I have this "thing" about Christmas - my parents never did much and I hated it. So maybe the lights will go up this weekend. But the tree's been up since the day after Thanksgiving, as well as our mantle decorations, so I'm not too broken up.

I am really realizing that, while it's difficult to have kids and be a medical student, and while life would've been easier if I'd gone when I was 21 (late birthday), I really wouldn't trade my current life for anything. I have beautiful children and an amazing husband who's way smarter than me and who has great dreams of his own. I go to a school that genuinely cares about the practice of medicine. I'm in a program in my school that I love. And I'm learning medicine. Not really the most clinically relevant stuff yet, but still. It's really clear why I'm learning what I'm learning and the answer is not "to pass Step 1."

Pollyanna signing off.

Put this one in the "surreal bedtime conversations" category.

Last night my husband and I are putting the kids to bed. I'm by one son, he's by the other. Here is the conversation:

Him: There is something sticky behind my ear.
Me: It's probably ear wax. Don't worry about it. [My kids have lots of ear wax. This is a regular thing at our house.]
Him: It's not ear wax. It's sweet.
Me: It's probably just candy cane or something. [They'd been eating candy canes.]
Him: Nope - it's peanut butter!
Me: Well, I don't think your ear is a good place to keep your peanut butter; I certainly wouldn't try that.
Him: Why not? It's a great place for peanut butter. Then I can eat it later. It is very good.
(By this point, my husband and I were stifling laughs, and my son keeps trying to convince me that his ear is a great place for peanut butter if he wants to have some later.)

This was, of course, the highlight of my week so far.

An early Happy New Year's to all.

What am I doing? I'm writing a proposal for my summer research scholarship. When is it due? Not for another month. But considering I didn't get any schoolwork (okay, about an hour and a half) done while my kids were on break, and my goal was to have this thing knocked out before Christmas, I'm feeling a little under the gun. After all, my research advisor has to read (and, presumably, edit) it. The head of ISP and my advisor have to sign the thing. And I have to turn it in, in triplicate, I believe.

This is a really cool project, one that will really stretch me without breaking me. Plus, it's a very fascinating area, one which, if I were actually starting my career (rather than starting my education) I'd want to be studying. However - I will say this: my loves in research seem to be *doing* the stuff and *reading* the journal articles. I'm not so into the whole writing thing. Which is ironic because growing up I loved to write. I think I don't enjoy citations, largely because once I've synthesized the material enough to be able to write about it, I've forgotten where I read each bit of it even if I write down sources as I go along.

Christmas was fine, lots of traveling. I think that we will stay home next year. I'm one for "perfect Christmas morning" and I think my home is much better for that than my parents'. It's nice to visit relatives, but perhaps we can do that for Thanksgiving or something.

On our way home, we stopped in the city where my husband and I did undergrad (the same school where I would've gone to medical school, were it not for the little fact that my husband is not a graduate student there, but rather 2.5 hours away). It was a lovely little trip, reminding us that A) the city is, for us, a better city than where we are, but not enough that we'd give up much to live there, and B) the restaurants there are fabulous. (This was why we made an hour detour: we're always craving food from about 3-5 restaurants, but there's not a whole lot else to do on the tourist front, so we've never gone up for a weekend.)

Oh, yeah, and we got rear-ended. It pushed the exhaust pipe way up into the trunk (cracked the bottom of the trunk) and caused all sorts of other problems. We'll find out on Wednesday if our car's totaled, which all of the "responsible" adults in our life think it might be, since the blue book value is only $5k. Dang it, this car was supposed to last till I graduated. It's a Honda Civic with 180K miles, and we were assuming it would make it to 200K. But there are good people in the world. The other driver admitted fault to us, our insurance company, and her insurance company. She was absolutely horrified that it happened. (The road was wet, she braked too hard and slid into the back of our car at a stoplight.)

On that happy note, good night. Merry Christmas, Happy New Year. 2008 will be great. I'm just sure of it.

I'm having a hard time concentrating on my new module so I thought I'd blog a bit.

First, my car is not totaled. :hyper: However, we haven't found time to take it to the Allstate place to get it fixed. (We've got check in hand for $2K.) Eh. We'll find the time eventually.

Let's see... neuroanatomy. This module wasn't as organized as biochem and genetics were, so it took me quite a bit longer than anticipated to "get it." That being said, after procrastinating my exam for, all told, about a week, I did the best I've ever done. I told myself it'd be better to bail and take the exam later, rather than having a fuzzier understanding of the anatomy, which I'd be using, oh, say, now, in neurophysiology. (Hint to all pre-meds: if you find yourself in a poorly organized class take the time to find the order yourself. You will be rewarded.)

So, I think that the very best thing about my school's independent study is the community of it all. Sure, the lecture folks sit together in that big lecture hall for hours on end every day. Sure, they're all taking the tests on the same day. But with us, we've got 30-40 people per class who do things independently, but are all shooting for the same goal. We've got a lounge area connected to our study library, so there's a natural study break area. The second year people are really friendly and I think we get a better notion of the "big picture" of the first two years because of their presence. It does feel like a big, friendly, nerdy family.

In the "fun" stuff for school: we're learning about taking patient histories now. I'll be practicing for the first "official" time next Tuesday. White coat and everything, recorded encounter with standardized patients. And we're doing our BLS certification course. Pretty fun, pretty basic. All of this to set up for a preceptorship later this spring. That's something I'm really looking forward to.

I've turned in my proposal for summer research funding - 3 weeks early. Woo hoo! Now I just have to get accepted. And sometime soon I'll be working with my last-year's research group to submit an abstract for a poster for the spring medical center research day. There are some interesting, interesting findings.

Now, let's see, in my "real life..." One son is really bummed that he didn't get a real rocket that would take him to space for Christmas. He's also kind of disappointed that I don't come to school with him and study my stuff in his classroom. We're also working through getting them to understand that the last of the sippy cups will be thrown away on their birthday next month. (We only do sippy cups for their twice-a-day soy milk, and we've already introduced the replacements.) And we're tossing all the old, nasty training potties, and just leaving a little snap-on thing for the big toilet. They're much cooler with that, now that I've fixed the toilet seat.

Oh, and speaking of home repairs - my husband and I installed a bathroom sink about a week and a half ago. It was a Lowe's sink-in-a-box (all parts included, easy to install, super cheap) to replace our old, leaky, drippy, un-cleanable original cast iron sink that's as old as the house (1920s). It only took 8 hours.

Okay, I'd really better get back to studying. It's always so hard to begin to dig into things. Especially since our text for this module is Kandel's Principles of Neuroscience (1400 extremely heavy pages), our module packet is 90 pages of questions, and our suggested number of study days is 16. Pretty daunting, but I just keep telling myself that after this is cardiovascular physiology and respiratory physiology (2 modules, 1 exam), which *I* think should be interesting, at least.

So, one reason I blog is to have a written record of the priceless things my kids say. Here is tonight's.

The kids and I are finally, after a long evening, heading up to bed.

Him: I need tape, I need tape. (Grabs his Scotch Tape.)
Me: What on earth do you need tape for? It's bedtime. Are you going to tape your bed or something?
Him: No, I am going to tape myself to my bed.
(And off he continues upstairs to bed.)

A Tribute to my Grandmother

My grandmother died yesterday evening.

It was really the best of all possible scenarios, all things considered. She lived alone, perfectly capable of taking care of herself, in the same town as two of her sons, with a mitral valve that was giving out. She collapsed suddenly at my uncle's house (my dad's older brother, her oldest son), and died instantaneously. Any pain she suffered was short, and she was with those she loved when she died, in a familiar place.

She was hospitalized briefly last fall for her valve. This concerned the family, so all 5 sons, and all of my cousins but two, made it to her house for Christmas. They got a family pictures. My sons, who are pretty dicey about showing affection to most relatives, gave her hugs and kisses when we left. Everyone had a chance to say goodbye in a full-of-life sort of way.

She had a stroke when I was a toddler, and triple bypass surgery in 1981. Her health had been pretty much stable ever since. She ate what she wanted, as long as it didn't cause her indigestion (so foods slowly left her diet over the years). In fact, she really was exactly the same as she was when I was a little girl, just with more wrinkles and gray hair. She shoveled her own snow last winter.

She was not a warm woman; she never liked my mother. She was insistent about doing things the way they'd always been done. It was difficult to understand her, partially because of the damage done by her stroke, partially because her uncle had cut off the tip of her tongue when she was a child because of some lesion on the tongue. But her hospitality exceeded that of anyone else I know, and she was my grandmother. The world is emptier without her.

I'm someone who has lots of heroes. Always have.

The first role model I ever had ran into my life in the Summer Olympics of 1984. For those of you who aren't old as dirt like I am (and even for those who are that don't follow these things) 1984 was the first time women could participate in the marathon. The winner was an American elite runner, Joan Benoit. I was so inspired that I went out and ran a mile, as my dad estimated it, around the cul-de-sac where I lived. (16 laps around) That started a 12 year running career, where I firmly believed that if I just worked harder, that could be me. Mind you, I'm a short girl with stubby legs. But I was captain of my high school track team and ran in college.

I've got a ton of heroes now. Starting medical school just shy of your 30th birthday will do that for a woman.

I don't really have heroes for parenting. I'm pretty confident in my abilities there. My youngest aunt is a hero in terms of household and family management, but I really don't want her life, and I like my style of parenting better than anyone else's I've ever met. That just struck me today, and I realized how unusual that is, given the rest of my track record, and the fact that I will be watching said aunt carefully to see how well she and her husband do with their two littlest ones (2.5 and infant) that they had in their early 40s. (You know, because I may not be done having kids yet.)

My grandmother, whom I mentioned in my previous post, isn't really a hero to me. But my two aunts, the wives of my dad's next-older and next-younger brothers, are. They had their own lives. But they took care of and visited my grandmother all the time. They got to know her really well, and in doing so, I learned more from them than I ever learned from my mom, about my grandmother. My mother could never rise above my grandmother's dislike of her and harsh manner to do good for her. My aunts did, and it makes me sad how "out of the loop" I was as a consequence. In the coming years, I'll be having the opportunity to make the same choice regarding my mother-in-law, who's in pretty bad health. Do I rise above the insanity that surrounds this woman to make sure that she is taken care of, or do I respond like my mom, and stay far, far away from the toxic behavior? I think I'd better be like my aunts in this respect.

But as far as career goes, well, that's another story.

My two biggest heroes have got to be two neonatology fellows in the lab group where I was last summer. (Their research is in the cardiovascular group, rather than the perinatal group. Go figure. It got me a chance to meet them, and it's a really cool group, so whatever.) Both of these women started medical school at about 29-30-ish, just like me. Both had kids, just like me. The 3rd year fellow had two kids and an active-duty Air Force husband. And one of her kids was a baby. I figure if she could do it with that going, I've got no excuse. The other one, a first year, I met when she was finishing residency. She had "just" one kid when she started school and had her second during residency. These are some pretty great women, and show me that my career aspirations are totally doable "at my age."

Another hero is my former PI. She's mid-50's, and probably one of the most confident people I know. She does amazing, useful research, and isn't afraid to do what's right. She detests bureaucracy and PC-ness in medicine ("it's all about professionalism" she says - treat the patient and family professionally and the rest will fall into place), and will do what it takes to make sure that her patients receive the best care, and her research is good, meaningful work that benefits people. She's been more than happy to offer me advice even once I was no longer her employee. If I can be the sort of person in my career as she can, I'll be a happy individual.

My small group facilitator is a minor hero. She's only about a year older than me; in fact, she went to medical school with some people I knew from undergrad. :yikes: (I hung out with the class ahead of me, but not because my husband was in that class.) She's a family physician, only a few years out of residency. But she not only *knows* so much stuff (someone in our second year class made the comment about her "Most family physicians are jacks-of-all-trades, master of none, she's a jack-of-all-trades, master of all trades), she exemplifies what it means to be a compassionate physician. She's got a similar parenting philosophy to mine, which is really refreshing to hear in medicine.

Another couple of minor heroes are those that I discovered online. (What a dope I am.) I started reading Drey's blog here a little over a year ago, when I started spending way too much time here on MomMD, and discovered she went to the school that was right in town here, where I was interviewing. (My interview was just a touch over a year ago.) Then I got to meet her last spring. Super nice, fun to be around, great perspective. She didn't really turn into a hero, though, till she gave birth to her daughter, and LESS THAN A MONTH LATER was teaching my class ultrasound during anatomy. Hardcore that Drey is. I like to tell myself that if only one child had popped out of me, I could've been that hardcore. We'll see.

My final, super-minor hero is really just likely because I love her blog, and hope that I can be that successful one day. If you don't read The Underwear Drawer - theunderweardrawer.blogspot.com - you really ought to. She's about my age, she's got a little guy about 18 months younger than my kids, and she's in my very favorite city. She also has some really great comics. Perhaps I'm just obsessed with her city. But I'm an urbanite at heart, languishing in the midwest (though I really, truly believe it's great for me to be here right now so that I can concentrate better on studying), doing the best I can. That, and I prefer $6K preschool tuition over $20+K preschool tuition. Otherwise, there's something totally appealing about not needing to use the car to get everywhere. (I hate driving with a passion that rivals little else.) Someday, if everything works out, I hope to move there, and if I don't, I'll have a good reason why not.

I think that's it for now on my heroes. For a while, I wanted to be a knitting superstar like Alice Starmore or Lily Chin (I'm in one of Lily Chin's books), but now I just want to knit pretty things and not think about what I'm knitting. So I knit socks. Just plain ole socks. (Oh, I think as a knitter going into medicine, I have to view Perri Klass as a hero since she's a knitwear designer-physician, but I dunno. She's okay, I guess. I think it would be hard to make a meaningful contribution to both.)

So, to sum up - I have heroes. Heroes help me to be bigger than myself. Heroes push me to my limits and drive me toward excellence. Whatever your time in life, in medicine, may you, too, find heroes that can do the same for you.