The daycare thing is even better than I thought, in terms of ratio. So the infant rooms are 3:8, right? Except for one, which is the room R will be in, which has 3 teachers and SIX babies! Holy cow, that is so awesome!

R has been having a developmental explosion. She is now using consonants (endlessly): her favorite word seems to be bababadabadadaba. Or something like that She has also figured out how to walk while holding onto our fingers, and she LOVES it. She has also stood unassisted a few times and looks close to almost cruising all the way OFF the furniture.

The downside is that her morning naps have been really problematic the last two days. Lots of crying and little to no sleeping, leading to a grumpy baby until the afternoon nap. We started packing today too so the chaos is abounding - I hope she's able to get back into her groove for the next week, until we go to Barcelona next week and then move right away - ugh. It's going to be a crazy couple of weeks - keep your fingers crossed for us!

Well, here we are. DH and I spent the last 6 days furiously packing and we're basically ready to move, just a few last minute things to take care of. Meanwhile, we leave in an hour by taxi to get the shuttle that will take us to the airport, where we'll board a plane to Barcelona! We checked last night and saw that the flight is FULL, except for some seats in business class. Ugh, we were really hoping for a spare seat so R could go in her car seat. Now we're going to see if we can upgrade one of us to business class and hopefully the resulting empty coach seat can go to her (hopefully they don't have people on standby). We'll just have to talk to them as soon as we get to the gate. I'm not optimistic though - we might have to keep her in the baby bjorn the whole time, and I'm not confident of her ability to get a good (short) night's sleep that way. Not to mention that WE won't sleep. Right now R is in her crib, NOT napping. Great. Then she gets lunch in the shuttle, which takes 2-3 hours to get to the airport. Then she gets to hang out in a stroller at the airport where she'll probably skip her afternoon nap. Great again. Then the flight. We are SO doomed. I just hope that DH and I can make it through without fighting - I don't think we've ever managed an international flight without a big blowout. Please, please, please let this trip be fun and not just a complete nightmare. PLEASE.

Sooo much has happened since my last post. Let's see... Spain was great. Somehow I managed to snag us three seats together on the plain, in the bulkhead (!), despite the fact that we only paid for two and that the flight was full with 25 people on standby! Not sure how I pulled that off, but R slept most of the flight in her carseat as a result. I'm not going to get into all the details of Spain itself - suffice it to say that, despite spending most of her days in her stroller and being deprived of her usual naps, R was very tolerant and even seemed to enjoy herself. The hotel room was much bigger than we expected, and we were able to hang a sheet to section off the pack'n'play. DH and I took turns going out with friends at night, so we both got to experience yummy Catalan cuisine, though unfortunately not together. The flight back was not quite as nice, since we didn't have an extra seat, but somehow me managed, and we even managed to move back to med school town just a few days later as well.

R learned how to say "ma" and "na" while we were in Barcelona. She now loves to walk around holding onto one finger, often holding a toy or something else (my phone or sunglasses!) in her other hand. She even took her first step, though my husband, who didn't see it, doesn't quite believe me.

R started daycare this week. On Tuesday I spent the morning there with her. We are trying the one nap a day thing to see how it goes. It would have been fine but the cable guy came while she was napping that day and it woke her up. Wednesday she spent the morning there alone, and napped for 3.5 hours at home after! Yesterday she stayed through her nap, though I went in and nursed her first. I forgot to remind them before I left that she sleeps on her belly and not to rock her to sleep, so they rocked her and put her down on her back. She slept 40 minutes. Today she was there all day and I didn't go in to nurse. She fell asleep on the cot while someone patted her back, but she only slept for 20 minutes or so (plus 20 minutes in the stroller during the morning walk). Then on top of it all, the poor thing had a fever tonight. Nothing major, just 100.7, but it's her first fever!

While I'm not feeling great about the nap situation, everything else is fantastic. R seems to love it there. Yesterday they had water play outside, and did finger painting, and I love that her teachers take lots of pictures so we get to see them being so cute and having such a great time. The biggest development is R's eating - the center provides all the food. While R had had a little bit of finger food before, she still ate pretty much entirely from a spoon. Well, not anymore! This little girl feeds herself now, thank you very much, and no thanks spoon! She shovels all sorts of food in by the handfuls and it looks like she's always been eating that way. She's apparently a very big eater.

All in all, I'm happy with how things are going, I'm just worried about the naps. She used to take two one to two hour naps a day and is now down to one under an hour! Hopefully she'll learn to nap there on the cot soon and will be a better rested, happier baby for it.

In other news, DH is driving me absolutely insane. He misplaced our one fully operational car key (it has the remote lock/unlock feature) and is totally perseverating over it, looking in the same places over and over again, bitching about how much it will cost to replace ($250), and being a total grump. I realize $250 is a pain, but I don't see why he's become so consumed by this. We have a spare that works, it's just broken so it's hard to keep the two pieces together. Yes, we need a new key, but our apartment is still in total chaos, and I'm convinced it might still turn up. Even if not, we'll survive a $250 blow. What's further bothering me about this is that, while I'm trying to be supportive (though am getting seriously frustrated), if I had been the one to lose the key he would be FURIOUS with me.

He's just in a mood. Today as we were leaving IKEA I went back in to grab a frozen yogurt, and he asked me to grab him a drink - this yummy carbonated pear stuff in a can. After we left he opened it, took a sip, said it was flat and that the can felt mushy even before he opened it, and how come I hadn't noticed? I apologized but he sat there fuming and then several minutes later asked how much it cost. I don't know about you but when I'm buying a couple cheap items, I don't usually pay that much attention to the total, other than the general ballpark, so I told him I wasn't sure. That made him mad - how come I don't pay attention to stuff like that? I just freaking bought it... Ugh. I hope he snaps out of it, he's ruining my fun!

Anyway, that's all for now. One more week off before rotations start... something to gripe about later, I guess!

Short update:

1) I found the key in the bottom of the diaper bag.
2) R has Hand foot and mouth disease
3) I thought I broke my toe walking into the legs to the dining room table, which are in a pile on the floor. Seems it's not actually broken but is black and blue and hurts like a b*tch.
4) R took three steps today, sick and all!

I think this may be the longest I've gone without writing. That pattern will probably continue as third year kicks into full swing. The disadvantage is that I will summarize things briefly that ordinarily I would have written in depth on. I suppose that might be an advantage to you

So let's see, Family Medicine. It went fine, definitely not what I want to do with my life but I had a reasonably good time. Hours were 8:30 or 9 to 4 or 4:30 most days. I had didactics Tue 2-4 and Wed 12-5, which wasn't the greatest, but it was tolerable. I worked mostly with residents, and got to spend the majority of my time with one R2 in particular. Usually I saw patients before the resident and then filled them in on the history and physical, though often I ended up doing the physical with the resident. My preceptor recommended me for honors, which is nice, but of course to get honors you have to get above a certain score on the exam, which is a ridiculous in-house exam. Ridiculous b/c it's based off this evidence-based textbook, and the questions are drawn randomly from the professor's question bank by the course administrator, so there's no way to know what to study - it's random, not high-yield. Still, I don't think I did too too badly. And I think I did really well on the OSCE and on my Family and Community Assessment (an essay based off a home visit). So I'm hoping for a High Pass at least.

Meanwhile DH was taking one class for his Masters program, which he didn't like very much but did extremely well in. Then the first week of this month, we went to Alaska for my brother's wedding (his wife is from Alaska). It was a great trip overall, not always well-organized and there was quite a bit of time when I was saying to myself "gee, this is ALMOST fun". Traveling with a 1yo is stressful, especially when you're in a big group and yours is the only child there. It was hard to keep up with everyone. But, Alaska is beautiful, the ceremony and reception were great, and I'm really happy for my brother and sister-in-law.

Now we're back, I'm on research and DH is on... nothing! I haven't gotten much research done yet but we're getting other important administrative stuff done (like wills - we went a whole year after DD was born without them!). I made some changes to my schedule, so next month I have neonatology, then OB/Gyn, then Medicine up until Christmas break. Those will be a rough three months after neonatology, but I figured it was better than putting all the heavy stuff at the end. Now I have Peds in January, when I figure I'll be more ready for it than if I had it in October as originally planned.

In baby news... R is now a toddler! She started really walking a week or two after her first birthday, and she hasn't stopped since! She still doesn't have any words, though I think she's starting to say "buh" consistently for book. Maybe she's got "words" and I just don't know it yet I'm starting to figure out what I'm going to do about weaning when heavy rotations start, but I wrote about that on the Family and Parenting forum so I'll skip the details here for now.

In other baby news, we had a bit of a scare after R's 1-year check up. She had blood drawn for lead levels and they did a CBC, and her neutrophils came back under 350! Her pediatrician had us recheck two weeks later, and they were up over 650, so still low but better. She decided she had probably rechecked too soon, and now wants us to go back 6 weeks from the last time (4 weeks from now). I'm not too worried anymore b/c R seems well and the numbers are climbing, but it was definitely scary, and I feel so bad making her get her blood drawn that many times. It's so sad to sit there and hold her down in my lab while they poke the needle into her and she screams Hopefully next time will be the last for a long while, but if it's still low they'll probably send us to hematology, which will probably mean more pokes. Fingers crossed...

Can't remember if I confirmed this before, but DH is definitely going to Burning Man, which means R and I will be alone from 8/26-9/7, and most of that time DH will be unavailable by any means of communication. He's gone without me before and I was EXTREMELY lonely. I know now I have R to keep me company, but I'm a little scared about being a single parent for so long (I know, that sounds pitiful if you are a single parent, and btw if you are I have SO MUCH respect for you!). I also hate the notion of DH being impossible to get a hold of. Fortunately my dad is going to visit for the second weekend of that time, which will provide some relief, but that first weekend will be tough! I'll have to make plans with other moms and their kids, if I can. Hopefully I'll be able to hold it together - I'll be incredibly sad, I know.

Ok, well, I think those are the important points. I wish I had found time and energy to write more because I feel like I had a lot more to say about each of those things, but I'm not much of a writer so getting it all down now would be a challenge. Such is life - hopefully I'll be able to maintain this diary when the really tough rotations start, even if it's just a note every couple months or so. Thank you all for your support!

Ugh, I have to gripe about my morning. So my health insurance is covered by my tuition scholarship. My husband and daughter, however, aren't, so to cover them we'd have to fork over a whole lot more money than we can afford. So I applied for medical assistance from the state. That was quite a while ago. I never received any mail or anything, I just happened to think to log on one day and check my application and saw that it was denied. No reason listed. They listed a phone number to call for questions, which I tried on and off for a couple weeks. It always rang off the hook or was busy. So I found some 1-800 number helpline and was told the reason the application was denied was that we didn't provide proof of income. Strange, since neither one of us is employed, and when DH originally dropped off the paperwork he mentioned that and said there were no paystubs, and asked if that would be a problem. Nope, they said, that's fine. Guess not. Anyway, the hotline gave me my case worker's name and number and her supervisor's name and number. I called the case worker numerous times - always went to voicemail and she never called back. The supervisor's number also always went to voicemail, only his voicemail box was always full, so I couldn't leave a message. I finally got someone on the 1-800 helpline again and they told me to bring the last of my paystubs from my "job" last year (I put "job" in quotes because it was my research fellowship) along with a note explaining the situation. They said as long as I got it in by the end of this week, they'd reprocess the application without me having to submit a new one.

So fastforward to today. I type up the letter of explanation and get the paystub and drive to the office where DH dropped off the original paperwork. It's in the city's State Building. I find decent meter parking, put in the only 4 quarters I have which gets me a whopping 30 minutes (yeah right, visit to the welfare office in 30 minutes?). Then I walk up to the building only to discover that it's...closed. Like, big construction paper with hand-written "CLOSED" on it. I walked all the way around the building, but each entrance was the same. No explanation or anything. So I walk a few blocks and find some police officers at a construction site and ask them for help. They direct me to a different building several blocks away. Luckily I was walking with another woman who needed the same building and she knew how to get there. She reassured me that I'd have time to go and didn't need to move my car, and for some silly reason I believed her. Well, we finally got to that building only... nope, the welfare office was in a different building. It's actually a good thing in some ways because if it was there, I never would have made it to my car in time. As it was, I ran back to my car with zero minutes left on the meter but avoided a ticket. Then I drove to my next location. I couldn't find parking anywhere (not that I could have paid for a meter anyway since I used all my quarters), and finally pulled into a garage, but the rate was outrageous so I bailed and kept looking. I finally managed to get DH on the phone, and he looked up a cheaper parking garage and directed me to it. Once I parked I walked to the address I had been given, only I couldn't find a building at that address. Some kind pedestrian directed me to the family court building, where I spoke to a security guard who sent me several blocks up the street. FINALLY, I made it to the welfare office. Only... it was the district headquarters, and despite the fact that the original paperwork was dropped off at HQ, I was supposed to have gone to my local office. ARGH! The local office was also downtown so rather than move my car I just walked. I waited about an hour in their waiting room and finally was able to drop off the paperwork to a very nice gentleman caseworker. He even gave me his name and phone number, though I'm skeptical as to whether he will actually pick up or return messages, given my prior experience. So this whole fiasco took over three hours and shaved a couple years off my life, or so it seemed. All I want is healthcare coverage for my little girl! It is so upsetting to have to go through this. I can only imagine what it might be like for people with fewer resources. I guess the upside is that I get an inside look into the process that many of my future patients will endure. But man, was it ever frustrating. Fingers crossed that the application gets reprocessed and approved!

Well, today was the 4th full day without DH, and also the first day of neonatology. My friend L came over this morning to take R to daycare with me, so she can do it for the rest of the week since I have to be at the hospital before daycare opens. I totally owe her!

So, neonatology. This is my first inpatient rotation, so I wasn't entirely prepared for FOUR AND A HALF HOURS of rounds today! I've heard of walk rounds and sit rounds, but never 'stand rounds'. 8-8:30 was radiology rounds, where admittedly we were sitting, but the next four hours were spent standing at the nurses station. It was pretty agonizing. I've got good shoes (Danskos) but my back is killing me now! And since rounds went late, we had to go straight to resident lecture without lunch, so I didn't get lunch until 1:30 or so, after having breakfast at 6 am. I know, I know, I'm pathetic for complaining about this, this is nothing and many of you deal with far worse on a daily basis. But I'm still entitled to a little whining, right?

After lunch not much happened. My intern showed me how to remove an umbilical vein line. I listened to a PDA murmur. I observed a suprapubic tap. That's about it - I was out by 4:15. A little less exciting than I was hoping for, but I guess it was just day 1. I'd like to attend some deliveries but I think I might have to do evenings for that... not sure yet. My intern gave me one of his patients, a fairly straightword Downs premie who's in the transition pod, to cover for rounds tomorrow. Then they plan on giving me a couple more as they come in, so I can have them from the start.

I had to wake DD up at 6:30 this morning and she was not thrilled. They said that she was pretty tired at daycare, but still happy. She only took an hour nap, though - I was hoping she'd start taking better naps there with an earlier wake-up time. When we got home tonight she had a little fit - was clearly exhausted. Got her into bed at a nice early 5:45! I have to wake her up a bit earlier tomorrow - hopefully she'll manage a better nap tomorrow. I worry about her becoming permanently exhausted. I guess I should just face the fact that we're going to be an exhausted family this year

Oh, P.S. DD and DH got approved for medical assistance .

First of all, let me say that I am LOVING neonatology! I have always had some interest in the field and it is really being renewed right now. I realize this is only my first inpatient rotation so I'll have to see how I feel about other things, but... I'm really starting to think that I can see myself as an intensivist. Eek! I tried to explain this to my husband, which included a discussion of personality. I described myself as somewhat Type A and he didn't agree, but I'm not sure we were using the same definition of Type A. I think I am intrinsically Type A but have worked hard over the years to become more laid back and less competitive - having a baby has helped with that to some degree - but I still seem to thrive on stress, feel a sense of urgency about things, am a control freak, am detail oriented, etc. DH also disagrees with the thrives on stress part, but his point is that I don't do well with stress, but what he sees is my reaction at the end of the day, not how I respond in the midst of crisis. I guess it depends how you look at it. I always find myself steering towards stressful things, and I feel a great sense of accomplishment when I achieve such things. But no, I don't ENJOY being stressed out, per se. So what does it say about you when you and your husband describe your personality in different ways? Which one of us is more likely to have it right? One thing I pointed out to him is that he only sees me at home; he's never seen my professional side, really. Anyway, with all of this discussion, he asked me "given what you've just described to me about your personality and why this describes an intensivist, how does child psych fit in?". Umm... hmm, I guess I hadn't thought of it that way before. Honestly, I think the greatest appeal in child psych has been one of lifestyle.

It is so hard to know how to figure lifestyle in to the equation. I need to enjoy what I do for it to be worthwhile, but isn't missing your family one barrier to enjoying your job? But I don't know, now that I am having an inpatient experience and loving it so much, I am becoming less and less sure of what I want to do. Luckily I have more time to figure it out, only neuro and psych are going to be at the very end of 3rd year for me! Ugh.

Two things I'm frustrated about. I haven't been able to do as many procedures so far as I'd like to. The trick seems to be a combination of assertiveness and being in the right place at the right time. I'm improving on the assertiveness factor, but there's only so much one can do about the other. I came down with a baby from the OR today and was hoping to hang around and do an art stick, but I made the mistake of running to the workroom to get something, and I got trapped by the attending from the other team, who was explaining ventilators to the new interns and invited me to stay. My senior resident told me later I should I have just told her I was in the middle of something, but I sort of thought I was obligated to stay. So I sat there listening to information I've already heard, and missed the art stick! Argh! And then they were getting ready to do a UV line on the baby but by that time I had to go get DD from daycare. So frustrating... I'm also worried that finding the opportunity to do procedures will get even harder now since the new interns started today, and there are three of them and they are VERY green around the ears.

The other thing that frustrates me... I got my Family Med grade. The evaluation was positively glowing, expect for the last line, which said I would have received a better grade had I done better on the written exam. The evaluation described me as being better than the students to whom I was being compared, as well as saying all sorts of other nice things about me. And the written exam was a set of randomly drawn questions from a Family Med textbook - it was next to impossible to prepare because you couldn't just focus on high yield things, since the questions were completely random. So I only passed, even though I was recommended for honors and thought for sure I'd get a high pass. Bummer :((

Off to read up on infantile hemangioendothelioma

We found a babysitter! I am soooo relieved. We took the suggestion given by some on this site to post on care.com and sittercity.com. Both require you to pay, but sittercity had a 7-day free trial and care.com allows you to post a job without paying (you have to pay to reply). It just so happened that the reply that interested me the most was from a student at the university my husband and I are affiliated, and she provided her full name in her response, so we were able to look up her contact info in the student directory and never had to pay anything! Mwahahaha! But anyway... she's a speech and language pathology student, has been babysitting since she was 14, had multiple great references, brought her clearances with her, and best of all, DD seems to love her. We met her on Saturday and R was rather shy, but tonight M (the sitter) did pick-up at daycare with me and stuck around for dinner, bath, and an explanation of the bedtime routine, and R clearly adored her. Within minutes of us getting home R was sitting in M's lap reading a story. When R was in her jammies and M was getting ready to leave, R reached out to M (from my arms) and when I passed her over, nestled up in M's neck! Yay! She has also agreed to a very good rate, which is fantastic because we don't exactly have much to spare. She starts doing pick-ups on Mondays and Thursdays next week. It's such a relief to have found someone I feel confident in.

Over the last few days I've cut out DD's before-dinner nursing, which means we're now down to just the AM one. I've never had supply issues, and in the past when I'd cut out a feeding I'd get pretty engorged for a few days and then adjust, but this time that didn't happen, and I actually feel like my morning supply has dropped some. A sign that we're ready to stop? Once I have to get to the hospital at 5:30, I really don't think it will be worth it to R to be deprived of sleep just so she can nurse, so I guess that's when we'll stop. It does make me sad. I'm working with an intern right now who is still nursing her 20-month-old, and it makes me feel bad to be cutting R off now. But I know that nursing to 14 months is great, and R will be just fine without it. Still, I love that nice snuggly time in the morning together.

As for when I will be getting to the hospital at 5:30... who knows? We don't get our schedule for OB/Gyn until a day or two before the rotation starts. Maybe this is normal in med school, but I think it's completely unreasonable. Haven't we moved away from the "med students are dirt and aren't worthy of any extra effort on our part" attitude? We're people too, and not knowing even the rough outline of our schedule at least a little bit ahead of time doesn't seem right to me. How am I supposed to schedule that dentist appointment? I don't see why we couldn't get our schedules at least a week in advance (and really, I think we should have two. Even with two weeks, plane tickets would be sooo expensive - how are we supposed to plan our lives with so little notice?). Am I overreacting? Should I just suck it up? I have half a mind to speak to the Dean of Students after this rotation. Not a complaint per se, more of a suggestion.

So last week of neonatology. I've managed 3 art stick attempts (well, 4 if you count the second attempt on one baby), but no successes, sadly. I got a flash once, but that was all. At least I never blew out the vessel. I also bag-masked a baby while the intern did her first intubation. And I put in a UV line! I was all prepared for it to be difficult but it just went right in. Of course my fellow said "well that was easy" so I had to point out to her that the explanation was actually that I'm just awesome . I really like my fellow, and I wish I'd get to work with her beyond this. She's going to bring in hand-me-downs for R from her 3yo daughter .

I had an interesting/amusing/frustrating experience today. My attending told me to call radiology on one of my patients, so I got the radiologist on the phone, explained the situation to her, and asked her my question. She said she'd need to call me back, and asked if I was the fellow. So after hearing me present my patient, it seemed reasonable to her that I might be a fellow. I should feel proud, right? When I told her I was a medical student, she laughed. WTF? Shouldn't you be impressed, not scoffing? You thought I was a fellow? She then asked me if it was a sub-I (I said yes since I'm treated almost like an intern, even though it's not technically a sub-I), and she said "ok, so you know your patients." Um, yes? I guess she figured calling her was scut work? I guess this is just the beginning of me being belittled for being a med student. I realize I'm the bottom of the totem pole, but sheesh, cut me a break.

Soooo, guess who has started blowing kisses? Soooo cute! She doesn't really blow them or even throw them, she just puts her hand up to her mouth and says "mmm". And sometimes she misses her mouth, so her hand ends up on her cheek or eye while she's saying "mmm". It's so adorable and I can hardly stand it. I love that little girl more than anything, and sometimes I just can't believe how lucky I am to have her I know, it's cheesy, but it's true! She's the best.

Eek, how did that happen! Have I really not written since SEPTEMBER? Wow. I guess that's third year for you

So many experiences, so much to share but there's just no way I'll get it all down. OB/Gyn in November was tolerable, nothing more. DD and I stopped nursing at the beginning (she was 14.5 months) and it went really well - no problems at all, actually. In retrospect it seems silly to have been so worked up about it. During my OB/Gyn rotation I had a pretty disturbing experience. I was doing a shift in the ED and a teenager came in with vaginal bleeding. When we took a look, she had two teeny tiny feet hanging out of her vagina! The poor thing didn't even know she was pregnant. We delivered what was probably a 15 or 16-week fetus. The girl was so distraught, obviously, but I was also pretty overwhelmed with emotion. It was only 15 or 16 weeks, but it was... a baby. A tiny, bloody little baby, but a baby nonetheless. I have always been very pro-choice (still am), though I've never felt like I could ever get an abortion myself. But I found it very difficult to contemplate abortion with the new sense that this was a baby, not a fetus. Does that make sense? I don't think I'm articulating myself well. Anyway, I've never been pro-abortion (who is, after all? Pro-choice is NOT the same as pro-abortion), but this experience made me feel pretty yucky about the whole thing, for lack of a better word. What I've come away with is nothing new: We really need to focus our energies on preventing unwanted pregnancies. That is the only reasonable way to reduce the number of abortions in this country. I'm going to stop myself there because I really meant to reflect more on my own experience than to begin a pro-choice/pro-life debate.

So as I said, OB/Gyn was tolerable but I sure was glad when I finished. I am NOT meant to be in the OR. Delivering a baby was pretty amazing, but now that I've done it a couple times I've had my fill. Also, not that I'm planning on getting pregnant again in med school, but seeing what I've seen there is no way I would ever deliver in that hospital! The nurses want to give pitocin at the drop of a hat, the residents bad-mouth the patients, especially the rare ones who (gasp!) have a birth plan or want to avoid an epidural - puh-leeze! Makes me so happy I delivered at a midwifery-friendly hospital with wonderful midwives. And to all the OB readers out there, I understand this was a small skewed perspective and I don't mean to pass judgment on your entire field based on it. It was just a really negative atmosphere.

After OB/Gyn, I had Medicine in Nov and Dec. The first month was at a small university hospital (not the main one), the second was at the VA, which I loved. I have to say, I didn't hate Medicine as much as I thought I would. I actually had some fun, and I learned a whole lot. I still want to work with kids, but at least it was a more positive experience than OB/Gyn! Not to fixate on grades, but what was really frustrating was that I got glowing reviews clinically, but the Shelf was so hard! I really haven't been doing the greatest job on focusing on studying outside of the hospital, unfortunately. So I didn't do well enough on the Shelf to get Honors in the course, but I managed a High Pass. Forgot to mention that I did get Honors in OB/Gyn - figures I'd do the best in area I'm least interested in. Oh well.

January was Peds. I've been operating under the assumption that I will either go into Peds or Child Psych, so I really expected to love this rotation. I don't know if it's just the fact that it's January with yucky weather, I'm halfway through third year and a little burnt out, I was sick half the rotation, or that I had to be there at 6 every morning and was exhausted, but the month really wasn't that amazing. Yes, I had fun. Yes, I prefer working with kids to adults. Yes, all the residents and faculty were great. I guess I just expected to feel about it the way I did about neonatology, and I really didn't. I don't know how much weight to put in this impression - it is so hard to make career decisions based off a 4-week experience! Maybe when I do psych in May it will seal the deal for me. Of course, then I won't know if like psych more for real reasons, or because the weather is nicer and fourth year is in sight. Luckily I should have time for both a psych elective and a peds elective before finalizing my residency apps.

Another unpleasant experience I had - on peds I had a patient with a history of non-accidental trauma. He was a premie who had been developing well and then at 5 months was found unresponsive. He had huge sub-dural and sub-arachnoid bleeds, numerous broken ribs, and a broken humerus. He was in the PICU for a month and almost had life support withdrawn, but he made it through. He breathes on his own now, but he is reliant on a g-tube, can't take anything PO, and is developmentally like a 2 month old despite being 9 months old. He also has a seizure disorder. I was reading through all these old notes on him when I was writing my H&P for his current hospitalization, and I can't even describe the mix of emotions I experienced while doing so. I came home that night and cried about it, and what kept going through my head was the fact that I just cannot comprehend how someone could do such a thing to a baby. It is totally and absolutely beyond my ability to understand, and it makes me so so angry.

Next month is a hodgepodge month: one week of peds ED (only 4 6-hour shifts: woot!), one week of adult ED (4 10-hour shifts), one week of ophtho, and one of ENT. It should be a light month compared to everything else. Just what I need, too, since come March I'll be heading into the dreaded surgery!

I realize in looking over what I've written so far that it all sounds pretty negative, to varying degrees. I wish I was one of those students who thoroughly enjoyed everything about third year, but I guess I'm just not. I really see it all as a necessary evil, and at this point I'm just looking forward to figuring out what I want to do with my life and making progress in that direction. I do have to say that I think I'm doing a really good job balancing family life and well-being with medical school. Maybe that's why I'm not getting enough studying done: not because I'm slacking off, but because I have other priorities. Spending time with my beautiful daughter is really important to me. So is my relationship with my husband - we have started having twice monthly date nights so that we can stay connected. I highly value my sleep - I get in bed at 9 every night, even though I know many people would view that as several hours of studying time missed. I've even started walking/jogging to try to figure out an exercise plan that works for me amidst the chaos of life. So I guess while I may sound somewhat negative about med school, I'm feeling pretty positive about life in general. I may look back in the future and wish I did a little better grade-wise, but honestly I think I'm more likely to appreciate the time spent taking care of my family and myself.

A long, jumbled blog entry wouldn't be complete without dedicating some space for my daughter! She is 18 months old now - so hard to believe! I can't get over how amazing she is. She is running, climbing (just figured out how to climb onto the futon by herself today), talking up a storm, feeding her baby doll and walking her in her little baby-doll stroller, giving precious hugs, doing silly dances, and having a blast at school. She really makes everything else in life seem worth it. Having a child in medical school is certainly challenging, but I feel in some ways that it has actually kept me sane at a time when I otherwise would have become all-consumed with school in a not entirely healthy fashion.

Well, I never promised to write eloquently, but I think I've done reasonably well for spilling out four month's worth of thoughts in one abbreviated blog entry. Hope you all are doing swimmingly in your own hectic lives!