I'm sitting here agonizing over whether or not to start a diary. Isn't that silly? It's just that I'd like to, but every time I've ever attempted to keep a diary or journal I've failed. Make a few entries, and then totally forget about it. But hey, what's the worst that could happen? Might as well stop agonizing and just do it

I think I'll start small so I don't overwhelm myself. What usually happens with journal-keeping, I think, is that I start to feel obligated, and then I don't have time, and it's just one more thing I have to do. So here's my promise to myself: I will not let this become one more thing I have to do.

There. So. I'm the proudest momma in the world (I know, I know, bold claim to make on this site ;)). Baby girl R was born on July 14, 2009 and I can't believe she's already approaching 6 months! How the time flies. She is so big and beautiful and I am completely head over heels in love with her. I've always wanted to have kids and I knew it would be special, but nothing can ever prepare you for the experience. It is so wonderful and amazing and yet incredibly difficult. And I knew intellectually that my life would change forever, but that's 100% different from having it actually happen.

The very basics, just to get this started off: I'm 26, been married since 2005 (but with DH since 2000). I finished second year of med school and am now on a LOA doing a research year at a different institution (much closer to family, thankfully). I head back to med school this summer, with much trepidation. More on that later.

DH is a bit older (33), just finished undergrad after a long arduous process. This year he is being a SAHD on some days and substitute teaching on others. He is planning on doing a 1-year program during my third year to get a Master of Arts in Teaching, with the goal of being a high school science teacher.

I'm going to ignore my temptation to keep going now, because this could easily turn into a novel and then I'd be in trouble More to come, hopefully! Happy New Year everyone!

I'm concerned about my husband. These are worries that have been ongoing to some degree or another for the duration of our relationship (almost 10 years!), so I guess some background is warranted.

When DH and I met, we were both very irresponsible party animals. We had a lot of fun and didn't give much thought to safety or responsibility. While I won't claim to regret those years, I am past them, and have embraced my "adult" life. DH, on the other hand, has resisted "growing up" from the start. The notion of losing his youth and freedom is a very depressing one for him. I might add that we both have a history of depression, and are both medicated for it. My depression is very well controlled and I am generally a happy person who enjoys life. Depression is a little more central to hubby's personality, however. As a teenager he was the kind of kid who enjoyed wallowing in his own misery, if that's possible. It's probably relevant that he didn't really have positive role models. His father committed suicide when DH was 12, and his mother remarried and started a new family, and left DH behind when he was 18.

DH dropped out of high school and got his GED at some point. He's a brilliant guy, just not disciplined and hates school. When I met him, he was a well-paid software guy, but as I said, he has problems with self-discipline (he often slept late and didn't show up at work until mid-day), so when the dot com bubble burst and his company started laying people off, he was among the first to go. He mostly hasn't been able to keep a job since. He worked briefly at a bank and at a cafe, but was fired from both and has otherwise been mostly unemployed. I finally convinced him he needed to go to college. College was a real struggle for him - he withdrew from several classes and failed one, and so it took him quite a few years to finish. He finally did this past spring. He majored in chemistry and decided he wants to be a high school chemistry teacher. (The one job he did manage to keep, until we moved for my med school, was as a lab tech at his uncle's chemistry business).

So now we're in a new city while I'm doing my year-long research rotation. DH tried to find a job as a lab tech but didn't succeed (I think this has more to do with his motivation than with the current economy, but I'm not really sure). For a while DH stayed home with the baby, which was awesome for me, though he wasn't always thrilled with it (but he did enjoy his quality time with R), and now he is working occasionally as a substitute teacher. As I mentioned in my previous post, he wants to get an MAT next year, which means he needs to finish his applications by Jan. 15, and he's barely started.

This is one of my frustrations with him - to get him to do things, I have to put a lot of time into nagging him to make it happen. This drives both of us nuts, but if I don't do it, things don't get done, and then we're both unhappy. I mean, if he doesn't get into this program next year, he'll be miserable. I have tried varying degrees of backing off over the years, and I think I've found a place where the nagging isn't too bad but things actually happen. But it's aggravating that it has to be that way. And after 10 years, I've realized that it probably always will be, no matter how much I'd like it to change.

In addition to a general difficulty taking responsibility for himself, DH has also had a very hard time leaving the partying lifestyle behind. For many years he was a serious pothead. This may sound pretty tame, but he was seriously addicted. I don't think it's possible to be physiologically addicted to marijuana, but he was definitely psychologically addicted. I worked really hard at getting him to quit, and he finally did when we moved for med school. We had been living in the same apartment for 8 years and I think the change of environment helped. He has gotten better about getting his stuff done since then (i.e. he made it through the last two years of college with much less difficulty), but he still misses pot. He also did hard drugs when he partied, and he misses that too. It's all intertwined with social life, too. Before we moved for med school, we had a group of mutual friends that DH had known before he met me. I don't know exactly how those friendships formed, but I think they were mostly through work. But since moving, he really hasn't made any new friends. He's an introverted guy and really picky about his companions, but I think he'd be happier if he had other adults to interact with. And then there's Burning Man. For those who don't know, Burning Man is an annual weeklong event in the Nevada desert. It's the coming together of ~50,000 for a celebration of community and radical self-expression. It would take a novel to really explain it, but if you're interested, check out www.burningman.com. Anyway, DH and I went together three times, with the aforementioned group of mutual friends. It was somewhat of a religious experience. Then DH went in 2008 without me, because I was taking cardiology and couldn't afford to miss a week of class. The problem is that that year was one of the best he ever had there, and he really longs to go back. He couldn't go in 2009 because of the birth of our daughter, and during the entire week of the event (and a few weeks before and after), he was in a total funk. He seems to have it in his head that he might go this year, but there's just no way: he'll be a student, and I'll be on third-year rotations, and we'll have a one-year-old. Not to mention that it's very expensive, and we'll already be traveling next summer for my brother's wedding.

So anyway, DH has recently expressed to me that he's feeling trapped by life. When pressed to say what it is his life is missing, he said it was a sense of adventure. He defined adventure in the "classical" sense, as something "exciting, dangerous, and maybe even a little bit stupid". Beyond that, he's not really sure exactly what he wants. I think he's really struggling with this whole grown-up thing. He loves me and our daughter very very much, but as he said, something's missing from his life. I wish I knew what I could do for him. I want him to be happy, but even if he could identify what that would mean, there are things I would not be okay (such as starting heavy drug use again).

Frustrations and concerns like this have been ongoing for years, as I mentioned. They don't always take the same form, but I think the underlying phenomenon is the same. I'm trying to be at peace with the fact that some things will never change, but then I have this vision of the future, where I'm trying to hold down a tough career, the kids are in school, and I'm having to parent him as well as the kids. I mean, unless it's a morning when he has to teach, I have to wake him up or it doesn't happen. I hate that. I really wish he could be a self-sufficient adult so that I could feel like we are running our lives TOGETHER.

For all my complaining, I really don't want people forming negative judgments about my husband. He is a wonderful man and I love him very much, and I'm thrilled to have had a beautiful, precious baby with him. He is amazingly smart (definitely smarter than I am), a wonderful chef who cooks dinner every night (I'm a mess in the kitchen - talk about not being self-sufficient: if he didn't cook for me, dinner would always be out of a box. ALWAYS). He is totally devoted to me and is 100% behind me in the pursuit of my career. He has followed me across the country for that very reason, without any complaint, and he plans to keep doing that. He is wonderful with R, even if he has no experience with kids and was never as gung-ho about the whole thing as I was. And the crux of our relationship, the thing that has always kept us afloat even in the worst of times, is our open, honest communication. We have always maintained that love is necessary but not sufficient for a successful relationship; communication is essential as well.

My hope is that the frustrations won't build up so much over the years as to create unresolvable conflict in the future. I hope that together we are able to be positive role models for our baby. And I want us all to be happy. Sometimes I think I'm asking to much.

Update: DH and I had a great talk last night after R went to bed, so we're both feeling a lot better about things.

So, being only 6 months away from when I gave birth, and being on a site with lots of other mommies, I can't help but want to share my labor story. It may be more info than anyone really wants, but for some reason I like to tell the story, so here goes:

I woke up at 1:06 am on July 14 (exactly 36 weeks pregnant, to the day) to go to the bathroom and when I stood up my water broke. I called my midwives and they said to try to get some sleep and come into the office at 9 am. They said I MIGHT start having contractions by then. Of course, I couldn't fall back asleep, and my contractions started within about half an hour. DH hadn't come to bed yet, but went to sleep at around 3, when my contractions were regular but spaced and tolerable. I labored on my own until about 5:30 or so (I even managed to take a shower and wash my hair!), at which point I couldn't tolerate the pain alone anymore (I had really wanted DH to get as much sleep as possible, figuring it was going to be many more hours before she was born, so I held off on waking him up for as long as possible). At this point there were no breaks between contractions, but I was being silly and measuring from peak to peak and the peaks weren't two minutes apart yet, so I figured I should wait before calling the midwives. Sometime after 6 I started feeling the need to push and couldn't keep myself from doing it, at which point we finally called again and they told us to head straight to the hospital. I had spent much of the last hour on my hands and knees on the bathroom floor telling DH "I can't do it". He got a bag packed (pretty incredible, since he hasn't packed a bag in years), got a nightie on me and got me in the car. I couldn't sit so I rode on my hands and knees in the back seat. The midwife called while we were in transit and helped DH navigate to the main entrance (we were going to make a dry run before the baby was born, but since she arrived early...). The whole time the midwife was telling DH to tell me not to push, which he was telling me, and I was trying not to but I really couldn't help it. We got to the hospital around 6:50 or a little after. The midwife met us in the lobby, wheeled me straight past triage and into the delivery unit in a wheelchair (she kicked everyone off the elevator), got me on the bed, and three contractions later, R was born at 7:06. 6 hours of labor, exactly. I'm relieved it was so fast but it was truly the most intense, terrifying experience I have ever had, and I can't help but think that maybe if it had gone more slowly and gradually it would have been a little less frightening. I have a friend who tells me that since it was so fast, I don't get to complain, since most women have to suffer for far longer, but if you think about it, I still had to go from 0-10 cm. I just did it way faster, so I imagine it may have been more intense than some longer labors. Not that it really matters - it isn't a competition, now, is it? Regardless, we all got through it just fine, and here we are!

Thanks for letting me share

I'm trying really hard not to be a worrisome or competitive parent. Unfortunately, it's in my nature to be competitive, but I really don't want that to spill over into my parenting. I realized this might be an issue a while back, when I found myself comparing R's development to that of my colleague's son, who is the same age. As soon as I realized I was feeling competitive about it, I took a step back, saw how silly it was, and afterwards was much more comfortable. However, while I'm no longer feeling competitive, I realize I still have some concerns that are probably not justified.

R is a wonderful little girl who is quite healthy and growing and developing just fine. She'll be six months old on the 14th though, and I don't know why but I've started to feel concerned about motor development. I lay in bed last night thinking "what if she never learns to sit or crawl?" I guess the problem is that I have a rough idea in my head of when these things happen on average, but not of the acceptable range. My memory from when R was younger and I was in a baby yoga class with some older babies was that 6 month olds were able to sit supporting themselves. Sure, they would topple over frequently, but they could sit. R can't really do that. Then I start to worry that I'm doing something wrong. She loves to stand, so when I hold her or play with her on the floor, I'm often holding her in a standing position. So maybe she's not sitting yet because I haven't given her the opportunity.

I'll get a chance to air these concerns at our 6 month check up next week. I'm sure I'll get reassurance, and I'm sure R is doing just fine and will do just fine. I feel like I should clarify that I don't worry about this stuff a lot - mostly I just sit back and enjoy how amazing R is (it is so fun to watch her explore her environment!). But every once in a while, something like this nags at me. Another example is that I read in one of those parenting books that stacking toys are good for 6 month olds. We don't have any stacking toys, but I don't think R would be able to manipulate them, nor would she think to purposefully stack them. I know, I know, all of this stuff develops gradually over time. She'd probably get a kick out of watching me or her daddy stack the blocks and knock them over. I guess the issue is just that I'm a first-time parent, I want R to be healthy and to do the right things as a parent to encourage her development, and it's hard to be sure that what's happening now indicates a future of normal progression.

I guess the fact that I do autism research doesn't help. But it's not abnormal for me to have these concerns, right?

On a more positive note, my coworker/friend is coming over to babysit tonight so that DH and I can go out for dinner - it's been soooo long since we had any time alone! I'm a little worried because it will be the first time anyone other than me does bedtime with R, but I'm going to try really hard not to worry and just have fun. I can reassure myself that the worst that could happen is that she'll have a rough night. I'll be home for the 10:30 dream feeding and everything should be fine after that

Well, after all that worrying, yesterday when I got home I sat R down in her boppy pillow and gave her some toys, and she did just fine. She may not be able to sit fully unsupported yet, but I feel much less concerned about her getting there one of these days

Dinner out was wonderful. We really needed that time together, and we continued our constructive discussion of life (where we are in it, what's missing, etc.). It was so good to reconnect. The downside is that the evening ended on a kind of sad note, with us acknowledging that we've really grown apart. We just aren't as close as we once were, and we don't connect as often or as easily. It made me really sad, and of course caused me to also reflect on the loss of my mother (she died in October 2008 - we were extremely close) and how alone I feel.

But with the growing apart thing - we've been together about 10 years now. Never having had experience with a relationship this long, I don't know if growing apart is a natural development that happens in lots of relationships, or something to worry about. I mean, have we grown apart some and are now settled in a place where we will stay? Are we going to grow together again, or perhaps grow apart and together in waves over the years? Or are we going to continue to grow apart, until we eventually aren't meant to be together anymore?

I love my husband so much and I want our relationship to thrive. I guess I could be okay with us not getting closer again, as long as we don't get more distant. I would prefer, though, that we find some way to reconnect. I don't know if it's something we can control, or if it's really out of our hands. And if we can control it, how?

I'm sure having recently gone from 2 to 3 with the birth of our daughter plays a role, and my guess is that many relationships have a transition period when this happens. I'm sure for many it's a bumpy road. I just want the best possible outcome, and I'm not really sure what I should be doing to ensure that.

Today was R's 6 month check up! I always love bringing her to the pediatrician - I feel so proud when the doctor gets to see how amazing she's doing! R was trucking along at the 25% for weight and length since the beginning, and as of today she's still at the 25% for weight (14.5 lbs). However, she's now at the 50% for length (26 in)! Someone's getting tall!

It has been so rewarding to watch R grow over these past 6 months. She is such a content, inquisitive little girl. She loves to watch her father or me do things like eat, drink, talk on the phone, talk to each other... she's so cute when she reaches out for my iPhone and tries to put it in her mouth She's recently discovered her feet, though I don't think she quite realizes that they are attached to her and under her control yet. She LOVES to stand, and likes to make big shrieking and grunting noises when she's doing it (I like to imagine that she's feeling proud of herself). She's got these big, beautiful blue eyes (I'm pretty sure they'll end up brown or hazel, though) and a huge contagious smile. Lately she's been blowing lots of big, bubbly raspberries. The best thing in the entire world is when she laughs a nice deep belly laugh.

I know I'm being a big cheese-ball (my new favorite word for it is cheese-tastic), but I just love her sooooo much and I can't get over it!

On a side note, I hopped on the scale today at the pediatrician's office. I'm 10 pounds over pre-pregnancy weight (with all my clothes and shoes, mind you), and I basically haven't exercised since giving birth (I gained almost 50 pounds during pregnancy, too!). Not too shabby, I think. I started doing power yoga once a week two weeks ago, and I'm loving it. I'm still not right where I want to be, but I'm getting there, and I feel pretty good about it!

A question that many of us on this site spend, or have spent, a considerable amount of time on is "When should I have kids?". It's a tough call and depends on many circumstances, and is clearly a very personal and individual decision. Thinking back on my own decision-making process, I wonder how I'll feel about it all 5 or 10 years from now. Obviously, I decided to have a baby during medical school. Having a baby has really made me question what I am doing, because I worry so much about having enough time with my daughter as she grows up. Since I have gotten this far, however, I am going to forge ahead. There are two possible outcomes, as far as I can tell. 1) I could end up loving medicine and being really glad I did this. 2) I could end up miserable and really wish I had chosen something else. The reason I bring this up is that I realized that, had I had a baby before med school, I would have been very likely to bail on that goal and set my sights elsewhere (PhD-land, most likely). So waiting until partway through med school was either a great idea, because it protected my career goals, or a horrible idea, because it trapped me. Only time will tell, but I think it's a really interesting question.

Thursday was R's 6 month birthday! I just can't believe it's been 6 months since she was born. Where does the time go? I'm so worried that each 6 month period from here on out will seem just as short. I want to get as much of these moments as I can. And I'm not ready to go back to school!!!

So that competitive mommy thing is still a bit of an issue for me, apparently. I think I mentioned before that my colleague B has a son, N, who is three weeks younger than R. He was born full-term though, so I guess their ages just about even out? Anyway, B's wife J stopped by the office with N on Friday and we were chatting, and she mentioned at some point that if she puts N on his hands and knees, he rocks. And what was the first thought I had? "But R can't do that!" Why did that have to be my first thought? Sure enough, when I got home I tried putting R on her hands and knees. She doesn't really get the concept of keeping her knees under her - she just wants to be flat on her belly. Which is fine. I'm not going to push it. I just wish I hadn't cared! SIGH.

On another note, R discovered her feet today! When I was changing her diaper this morning, she kicked them up and grabbed them and tried to put them in her mouth. It was soooo cute She hasn't figured out that she needs to bend her knees in order to get them to her mouth, so she just keeps opening her mouth and yanking on her feet, but never actually getting them there. She's so adorable

DH and I bought rice cereal today. Next weekend my dad will be visiting, and probably my brother and his fiancee as well, so we're going to wait until then to try it out. We figure it will be fun for them to watch her try food for the first time. I'm really looking forward to seeing her reaction the first time she gets it in her mouth. We will definitely have the video camera out for this one!

Boy do I need to vent. Here's the background: at work I share a common office space with many of the other people in my lab. We have a communal mini-fridge in the room, and I store my breast milk in there after pumping. There's a research assistant in the lab, M, who is not well liked for very good reasons. She's rude and disrespectful, she comes in late and leaves early and spends much of her day on facebook, she managed to talk herself into a higher salary than the other RAs and then told them about it, etc. People have tried being nice to her but she always ends up pissing them off by being insulting. She's always smiling while she does it too, so I can't tell if she even realizes she's doing it. Either she has no social skills or self-awareness, or she just doesn't care.

Anyway, today she was at the fridge getting her lunch. My boss and four other colleagues were all in the room, and she calls out to me across the room "hey, your breast milk is leaking everywhere!". I got up to check it out and she commented that this wasn't the first time it had happened. When I asked why she hadn't mentioned it before, she said something like "well I never really noticed before." Huh? Then how did you know that this wasn't the first time? I looked in the fridge and there was literally one drop. I said as much as I wiped it up, and she said "can't you put it in a paper bag or something?". A PAPER bag, so she can't see it, I imagine. I said it was just milk and wasn't going to hurt anything and moved my bottles to the bottom shelf, which is where I usually put them (I hadn't today because the shelf was full). Of course when I did that she immediately moved her stuff from the bottom shelf to a higher shelf. I was so pissed, I yelled at her "It's just milk!" I couldn't believe how disrespectful she was being, especially in front of the whole office. I found out later that she has complained about me keeping my breast milk in the fridge before, behind my back. If you have a problem with it, come to me personally, don't blab about it behind my back and then confront me in front of the entire office!

The good news is that everyone noticed and no one was happy with her. Two of my colleagues said as much to me later, and one said that my boss had literally turned scarlet during this (out of anger, not embarrassment). He sent me an email saying he was horrified and apologizing for not dealing with her behavior sooner, and said he would take care of it. I'm lucky to have so much support.

I decided that I should get a paper bag for the bottles, but write "nbp's breast milk, pumped fresh daily" in big letters on it. Part of me hopes that one day when this girl grows up and has kids, and is struggling with being apart from them at work and the hassles of pumping in order to provide her baby with breast milk, some little twit gives her sass about it too. Seriously, if she brings it up again, I'm going to tell her to find a different fridge if she has a problem with it. I shouldn't have to put up with this crap...

Yesterday's incident got me way more down in the dumps than I initially realized, and it upset me even more because this person is so inconsequential that I couldn't understand why I was so affected by her behavior. I guess it hadn't really hit me how hard it is to leave R every day to go to work, and the fact that I've had nothing but support from my colleagues up until now. Yesterday was the first day that I ever felt my efforts were being undermined.

So today I had a brief private chat with my boss about it, and I'm so glad I did! First of all, he gave me reassurance that steps are being taken to deal with her behavior. But he also said that you'd have to be stupid not to realize that the best way to get him mad is to come after me or anything having to do with R! I am soooo lucky to have this guy as my research mentor! He has been so supportive the whole way. I used to bring R to work with me (his idea!), and one day the business manager noticed the bassinet and said that there was a policy against "kids and pets" at work (yes, she lumped kids with pets). He told me that R couldn't come to work "over his dead body", and went to the center director to get things straightened out. I really need to remember how unusual this is, especially from a male boss, and not take it for granted.

As for other things to complain about... unsolicited advice. A fellow student asked me about R the other day, and then asked what my husband is up to. When I told her that he stays home with R and how great it is, she told me she was going to give some unsolicited advice (at least she warned me!) and went on to tell me about her friend whose husband stayed home with their baby. I guess he got to be very resentful about it and they're now getting divorced. What was the point of that story? Be careful, or you'll ruin your marriage? Thanks for the advice, but no thanks. I think we've got it under control. Sheesh.

I feel like all I ever do in this diary is complain. I guess it's because I have ample opportunity in my daily life to share the positive things with people, but less to vent about the negative, so I come here for it. Thanks for putting up with it

In GOOD news, the online scheduling system for third-year clerkships opens tomorrow - eek! I'm dreading going back but at the same time I'm kind of excited to put my preferences in. We don't get our schedules until March, but still... hopefully each step will get me more excited, rather than more anxious!

More good news - I had an abstract due this Friday and I was super-stressed about it, but I just found out that the deadline has been extended for one week! Now I'll have time to actually put together a decent abstract. The conference is in Barcelona in June, so I hope I get accepted!!!

And the best news of all - my dad, brother, and soon-to-be sister-in-law are coming to visit this weekend. I love living as close to family as I do (2 hours away, as opposed to 9 or 10 where I go to school). I can't wait for everyone to see how big R has gotten since Christmas! We're also going to set up her high chair and give her her first taste of rice cereal. Should be fun

Okay, so maybe I don't ALWAYS complain...

Sorry to keep posting about this, but I finally realized what upset me so much about the incident around my breast milk at work. M's behavior and words implied that my breast milk is disgusting, and that's what really got to me. I was insulted, but it went beyond that. I take the time every day to go and pump that milk. It's what nourishes R, and it's a very important thing that she and I share together, and the fact that M found this gross made me feel defensive, protective of R, and as I said, insulted. I feel a lot better now that I've made this connection.

Oh my goodness, so much development in such a short time! R is now sitting unsupported for several minutes at a time. She hasn't figured out how to get her knees under her when she's on her belly, but she pushes all the way up on her arms and lifts her hips off the ground. She is clearly and purposefully looking at her toys and trying to get to them. We started her on rice cereal this weekend - it went well. She obviously spit a lot out, but she swallowed some too and while she didn't seem incredibly enthusiastic, she didn't complain one bit. AND, I see the beginnings of a tooth popping through!

She is such a delightful little girl. She's got such a winning personality. She's cheerful and friendly and pretty laid back and just so much fun to be around! We had a lot of fun Saturday with my dad, my brother, and his fiancee. DH was sick on Sunday, which is too bad, but R and I spent the whole day alone together while he was in bed, and we had such a great time together! I just can't get over her

One thing that's sort of nagging at me - when my dad arrived Friday night, R was pretty tired. She exhibited a little stranger anxiety, which my dad handled just fine. He didn't take it personally, and the next day she was totally fine with him, and with my brother and his fiancee. But my dad kept telling me I should try to find some activity group for her to make sure she's getting exposure to other people, since she stays home with DH during the day. I used to take her to a baby yoga class and a breast-feeding support group, but they were in the middle of my work day as well as her morning nap. I think it's more important for her to get her sleep than to go to some group activity. When I mentioned that to my dad, he seemed to think naps could be adjusted, but she's at an age right now where she's really fighting her naps, and I just don't agree with him. Even if I can find a group on the weekend not during her nap time, I'm not sure I want to fork out the cash and the time. There's enough to do on weekends as it is, and I'm not sure how important it is for her to get lots of exposure to other people right now. It's not like she lives in a bubble, and stranger anxiety is a normal part of growing up. She'll be starting daycare when she's 12 months. Surely not going to an activity group now is not going to make it impossible for her to adapt to daycare, right? Of course I want to do what's best for her, but I'm just not sure how much this particular point matters. It did make me a little annoyed at my dad, just because I felt like he was giving me parenting advice I didn't necessarily agree with, which made me feel like I am doing something wrong. If any moms feels like they have any input on this, please feel free to PM me!

Amazingly enough I don't really have anything to complain about today R is doing great - she now gets on her hands and knees and rocks (see, I knew it would happen!), but she still seems to prefer picking her hips and belly up and being in the plank position. So cute! And while she's not crawling yet, she moves fast! She's got two itsy-bitsy teeth, not all the way in yet, but man are those puppies sharp! I've got to stop letting her chomp on my hand! She's a champion eater of rice cereal now, and has also started peas (boy did that lead to a hilarious photo-op). She's such a perfect little pumpkin. I'm sorry I gush about her so much if it drives any of you nuts, but I can't help it. I'm sure I've said it before, but I just can't get enough of her!

We spent a wonderful weekend at my dad's for his 65th birthday. My brother and his fiancee were there as well, and we all had such a nice time together. R did really well but was overwhelmed with all the people at one point when some of my dad's friends joined us. She seemed really exhausted after the weekend, but then we all were, so I guess it's just the effect of traveling and being away from home.

We just cut out the late night nursing three nights ago. Everything is going well so far, though R did wake up a few times last night. She eventually got herself back to sleep, but I was tired today from having my sleep disrupted. Small price, I know - I am grateful that she generally sleeps 12 hours at night! I haven't taken up pumping at night, because I haven't had supply issues so far and I hate pumping so much. Things have been fine supply-wise, but R didn't seem terribly interested in nursing at dinner tonight. I worry that maybe she's getting so into solid food she's not as keen on the milk? Though DH didn't notice any preference this afternoon when he gave her a bottle for lunch. Maybe it was just a fluke, but I'll definitely have to keep an eye on that. I am so not ready to stop nursing altogether! Plus R still needs her milk!

Had a little bit of a rough day. I've been feeling like I'm not as smart as I've always convinced myself I am - that I got this far by working really hard and fooling everyone into thinking I was that smart. I guess the problem is that I'm constantly surrounded by brilliant people who have a lot of content knowledge in areas I know very little about. For example, I'm trying to learn some new concepts related to processing functional imaging data, and the people explaining them to me are incredibly smart math/computer gurus, and the fact that I struggle to understand what they're saying makes me feel dumb. Then it's worse because I don't ask enough questions because I don't want to seem dumb... this reminds me of before I went to college. My husband is 7 years older than I am and we hung out with a group of ridiculously smart ivy-league educated people, and I always felt so out of my depths. It's amazing how much going to college helped with that (I'm sure there are other things, more related to personal growth, that helped as well). Med school was interesting in that I certainly wasn't the only smart person, but I didn't feel like my intelligence was threatened, because it mostly had to do with how well you memorize things. I'm not the greatest memorizer, but then I don't value that skill as highly as I value raw intelligence. So that didn't pose too much of an issue. But now, here I am amongst people smarter and more educated than I am (in a certain area, anyway), and I just feel... dumb.

I also feel a certain degree of brain fog that has diminished since the early months after giving birth, but is still present nonetheless. Will that ever go away? Am I doomed to feel cotton-brained for the rest of my life? Ugh.

I got my third-year schedule last week. I was really hoping getting it would get me excited about next year, but it did the exact opposite, at least at first. Part of the problem was trying to figure out what to schedule when my husband is away in September. There's a whole thread about this in the General Discussion (Third year scheduling help), so I won't rehash all of it here, but basically I was trying to decide whether to get Surgery out of the way early, but be a single mom for the first week and a half of it, or do it back to back with Medicine at the very end of the year. Neither appealed at all and I got very stressed out about it. I think I've found a reasonable solution. I managed to rework my schedule so that I'll have either Family Med or an easy elective during September. Surgery is still scheduled back to back with Medicine at the end of the year, but I'm going to try to swap it with Ambulatory Care a block earlier to make things a little easier. Anyway, I'm not certain I made the right decision so I don't feel completely at ease, but I'm definitely a lot less stressed than I was before, and I'm actually pretty excited about the elective I have planned in Neonatology. I no longer consider neonatology a career goal (who knows, maybe that will change), but I've been interested in it since I first started thinking about med school. My big brother was born at 28 weeks and I remember always being fascinated with the stories. That's what sparked the interest anyway. At our school Neonatology has no prereqs and is supposed to be an amazing rotation. Plus the hours are about 7-4, which really doesn't sound bad. So that's at least one thing to look forward to!

R is doing so great. I brought her to a bridal shower on Saturday. We drove down after lunch, when she's usually awake. I was hoping she'd sleep so that she'd be able to handle the shower, during her normal nap time. She slept some but not the whole 2 hour ride, so I was convinced she'd be a total grump. Nope! She was a doll the entire time - we were there from 3:30 to 8! She was very tired by the end but never once broke down, and was happy to socialize with everyone. I was so impressed! She still hasn't figured out crawling, but sure is working hard on it. She did manage to take a few backwards crawl steps yesterday. The weather has been really nice so I took her out to the back yard yesterday with a blanket and we hung out for 20 minutes or so (it was a little chilly with the wind). She kept wanting to creep off the quilt onto the grass so she could try to eat it, which I didn't let her do, but it was very cute. Speaking of which, she can creep so fast now - from one room to the next in a matter of seconds! Tonight I enjoyed watching her try really hard to figure out how I got in the little toy mirror she has. She kept craning her neck to look sideways into it until she could see my reflection, and would get really excited, and try to get to me with her mouth, but would get confused when her mouth just hit the mirror. Soooo adorable! I just love my little peach <3

Hubby's birthday is tomorrow. The neighbors are going to take the monitor after R goes to sleep so we can go out for a yummy dinner. Looking forward to it!

Ugh, I hate my med school sometimes. After all the schedule changes we were alerted that there had been a problem with the add/drop system, so all schedules were reset. From then on we had to email our schedule change requests to the registrar, rather than doing them ourselves online. I managed to get things back the way I had them, except that Neonatology isn't available when I wanted it so I'm signed up for Disabilities Medicine. I'm interested in Disabilities Med, but I was really hoping to get a hospital-based rotation in before Peds, so now I'm trying to switch OB/Gyn or Specialty care (EM + ophtho + ENT) to my first rotation. It will be less of a smooth entry back into clinical life, but at least would help me get my feet wet before I hit the wards for Peds in October. Of course I had to email the registrar so now I'm on waiting lists for those clerkships... so in effect, I have no idea what I'll be doing in July. Part of me hopes I won't get one of the cores so that it will be a nice easy month with Disabilities Med, and the rest of me really wants to get into OB/Gyn or Specialty Care. We shall see...

Things at work have been getting rather uncomfortable. There are a lot of personality conflicts in the lab and tensions run high. It doesn't help that I sit in a room with several other people who are all major parts of the problem. One of them is even my friend, but she is starting to really get on my nerves - she talks non-stop, making it hard to get work done, spends most of her time complaining, is confrontational with M (the biggest problem in the lab), and is generally very immature. So spending my days here is getting increasing difficult, especially as the weather gets more and more spring-like and I wish I could be at home playing with R. I guess it will be good to leave the lab this summer, though I'm still ambivalent about going back to med school and being so far from family.

Speaking of R, she is just perfect as always. She took her first few crawl steps this weekend (actual crawls - knees and hands together). Only a few steps though, and she's mostly just creeping around, but I think the crawling will be here soon. At over 8 months old, she's still not making consonants, which has me a little worried. However she is very verbal and extremely communicative, which makes me think I should just relax and she'll make consonants in her own time.

This spring/summer is going to be absolutely crazy. I can't remember if I've gone over this before, but I'm going to go ahead and do it again:

May 2-12: back to med school town for preclerkship week and to find an apartment and daycare. We'll be driving (8 hours without a baby), and are trying to decide whether to cram it into one day or stop at a motel for the night so R doesn't have to spend the entire day in the car).

May 20-22: fly to Philly for a conference. This will be our first flying experience with R.

June 1-3: I go to Dallas by myself for a conference. It will be my first time away from R and I am NOT looking forward to it

June 6-10: conference in Barcelona. Flying over the Atlantic with a baby will be an interesting experience.

Mid- to late-June: move back to med-school town. If DH gets into the grad program he applied for, he'll be starting classes, too.

July - first clinical rotation. R starts daycare.

August 1-8: fly to Alaska for my brother's wedding. Another long flight with R.

Rest of August I'm on a research elective (phew).

August 30-Sept 5: DH is out of town, leaving R and me to fend for ourselves while I'm on Family Medicine.

You can see why I'm a little stressed out about the coming months. I just hope we can all survive in tact. People keep reassuring me that it will be much harder on DH and me than on R, but I worry about her anyway. I hope we manage to have some fun while we're at it!

I only have time for a quick post now, but I just had to share: my little girl crawled all the way across the living room yesterday, AND pulled herself to standing! I think she still prefers to creep but at least she seems to be experimenting with crawling. Good job little one! I'm a proud momma!

We're having such a wonderful weekend with all this beautiful weather! I took the day off yesterday but brought R by the office in the afternoon to say hi, and we spent about an hour outside in the grass with some of my coworkers. It was her first exposure to grass (we've been outside plenty but I usually have her playing on a blanket) - she wasn't quite sure what to think but definitely had fun. Today we went for another play date with my coworker's son. It's so cute to see her with another baby!

I was planning on taking Monday off as well and taking R to a play group for babies 0-18 months. It's offered through this mother's group in town. They have membership dues but they let you attend two events before joining. I was all excited to go but I just got an email saying that I actually can't, since it's at a member's home and they can't allow non-members to go to events at people's homes for insurance reasons. Not sure what that's all about, but I'm bummed. Now I have to decide whether or not to go to work on Monday, since I don't have an excuse not to anymore

We found out this week that my husband has been accepted to grad school next year He'll be doing a one-year Master of Arts in Teaching program for Science Education. I'm really excited that he got in, and he's happy too, but he also hates school so he's dreading it a little bit. But one year should be manageable, even though it coincides with the toughest year of med school for me - at least I hope it is!

I also found out recently that we've got a spot at the daycare we were hoping for in med school town. We haven't seen it yet (we'll be visiting several when we go back in May) but my friend has her daughter there and she LOVES it. In her words, it was the only place she visited when looking for daycare that didn't make her (my friend) cry. So we're very relieved we got a spot. It's so hard for me to imagine R being in daycare full time though! At least now I know she's home with Daddy. I think it will be a really tough transition for all of us. At least my first few rotations are pretty light, which might help a bit, and we'll move a couple weeks before they start so I should be able to help transition her in (go in with her, half days, etc.).

Last update for now - I submitted a first-author paper mid-March (we had submitted it during the summer but it was rejected from that journal). I checked the status yesterday, and all required reviews are in and the current status is "decision in progress" - eek! It's so hard to wait! I'm hoping for a revise and resubmit, since I don't think I can expect anything better than that. Keep your fingers crossed for me!

Well, the paper got rejected, but we turned it around and sent it back out within a week. Hopefully three times is a charm!

We just arrived in med school-town today for my orientation to third year, which will go all this week. Meanwhile DH and DD will look for an apartment. I'm excited in some ways - happy to see my friends, even though they're now a year ahead of me, happy to have a break from the crazy lab politics, but not looking forward to a full week of orientation. Last night was R's first night in a hotel. We aren't used to sleeping in the same room, and in fact DH and I just went to bed when she did so we wouldn't have to worry about keeping her awake! But we all woke up a few times during the night, so it wasn't the most restful. We're staying with friends for the next week and a half, and for tonight at least we'll be sleeping in the same room again, but then our friends go out of town and we can put the portable crib in their room. Hopefully R will continue to survive on an off schedule - we really don't have time to restrict apartment viewings to around her naps. Poor thing...

DH got his schedule for next year, and it's almost as bad as mine. He does student teaching 20 hrs/week in the fall, plus classes until 7pm three nights a week. So even though R will be in daycare and they have extended hours (6:15a-6:30p), we'll definitely need a sitter for evenings on rotations where I'm not out in time to pick her up. Maybe someone at her daycare would like to pick up some extra money? I feel so horrible knowing there will be big chunks of time when she's in daycare 12 hours a day Anyone been through this with their kids? Am I being a horrible mother? Will she be okay?

One thing I need to be sure to do this week is get advice on what kinds of books to get for third year. I especially want to know what to start with, since I'm hoping to do some reviewing before I start back. It's amazing how bad I am at remembering what I've learned - I'm pretty sure if I sat for Step 1 right now I'd fail miserably. Not a good way to start third year. Hopefully I'll catch up...

One last thing... the director of the child psych unit where I've been spending some time invited me to present my research to them. This is really exciting, because I want to impress him - I'd love to do residency there! But, I get back in town a day and a half beforehand, and I am SO not ready. I'm really hoping I can pull something great together, but I'm feeling pretty stressed about it. He did meet my daughter the other day though, and seemed quite taken with her - maybe she'll win me enough brownie points to make up for a less-than-stellar presentation

Well, we found a good apartment, R survived, and now we're in Philly at a conference. My talk went reasonably well - Dr. M said I have a promising career ahead of me. I've started reading the required chapters in the textbook for my Family Medicine rotation, hoping that will at least help me brush up on some really basic knowledge so I'm not totally clueless on day 1. I'm nervous because the other med student I'm rotating with will have just come off peds, so she'll probably be in a better position than me (though infinitely more tired!).

So, daycare: we visited four. One was so-so but didn't have a spot for us, so who cares. One was AWFUL, so it didn't require further thought. Then we saw the university center, and we LOVED it. They keep babies in the infant room until 18 months, have 8 babies in a room to 3 teachers (!!!), are super nice and knowledgable, have really low turnover, and it just seemed perfect. We were pretty high on the wait list - just two ahead of us, but no guarantee for a spot. Then we saw the place we assumed we would be using, since I have a friend who loves it and they already offered us a spot. It was decent, but so chaotic. The baby room had 20 babies (eek!) and 5 teachers, and at 13 months babies go to the young toddler room and start taking one nap a day on a mat. The young toddler room has 15 kids and 3 teachers. The good news is that the people seemed caring and competent - it was controlled chaos. But I just didn't feel great about it. I went home and cried and have just been hoping for a spot at the other place. Well... we got one! Just found out yesterday and I'm sooooo ecstatic! I just know R is going to love it there, and they will take good care of us parents too. Phew!

Unfortunately we were punished for the good news with some bad - DH got his teaching assignment next year and it's an hour commute The daycare we're using opens at 7, which is way too late for me for most of my rotations, so DH will have to do drop-off. Hopefully they won't give him trouble when he tells the school "I do drop-off at 7 so I can be here by 8, no earlier", since school almost certainly starts before then. SIGH.

Oh, about daycare hours. They are open 7-6 but you can only use them for 10 hours max a day, so we will be doing 7-5. DH has class until 7 two nights a week (not three, luckily), so we will have to find someone to pick her up on those nights if I'm not on a light rotation. Here's the issue: even on rotations where I can expect to be out by 4 our 5, there are never guarantees, so it seems like we should have someone lined up from the get-go. But, if I get out early, I'm going to want to pick her up myself and not have the baby-sitter. But I can't very well require someone to be available and then tell them last minute whether they're needed, and not pay them if they're not. Anyone have suggestions on how to deal with this? PM me! I'm nervous about figuring this out!

One week left at the lab (next week), then a week to pack (we decided to save money and NOT get full service packing again - can't remember if I wrote about that before). Then a week in Barcelona, then we move! Phew! We get back from Barcelona on Saturday and move on Tuesday. Luckily my dad will visit Sunday through Tuesday to help out with R while we finish things up, though we're hoping to be fully packed before we go to Barcelona. Also, we have to pay for the whole month of June at our current place, so if we can't leave on the 15th exactly it will be okay, though DH does start classes on the 21st so we'd like to keep on schedule if at all possible.

Things are definitely crazy but have been falling into place relatively nicely and R is taking it all in stride - she's such a wonderful little girl! Here's to all the adventure ahead!

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!

I got honors in peds! So happy. And because I got honors, I have been invited to meet with the chairman of pediatrics to discuss my career options. I'm still very up in the air about whether to do peds or child psych. One of my problems is that I know I need to focus on what my career will look like, not on what my training will look like, but my training is what I am immediately faced with and what I get the most exposure to as a medical student. Child psych will be 5-6 years but (I think) will be relatively relaxed compared to peds training. Plus, I think I am unlikely to be a generalist so I would likely do a fellowship in peds, so the length of training would end up equivalent. But what matters is what I will be doing 10 and 20 years from now, not during residency. I had a peds EM fellow put it to me this way: what kind of phone call do you want to be getting in 15 years? It's an interesting question but I don't know the answer.

It's also tough because I've had a lot of positive responses from people about child psych, particularly from one of the program directors at a program I love (also one of the most competitive in the country), and that motivates me to want to pursue that direction. Conversely, my husband just doesn't hold much respect for the field of psychiatry. Of course, I know that I need to choose for myself and not for anyone else. Still, I find myself running circles in my mind while trying to fall asleep at night. Which is silly, given that I haven't even had my psych rotation yet!

I am doing psych in May/June, and I decided that I will do an adult rotation, since I am doing a child psych AI in July. If I haven't decided by then I will do a peds elective in August, or my Peds AI if I can manage to move it to August (lots of people in my class want to do peds so the AI is really high demand). Hopefully by then I will feel confident in where I want to apply - it's just so nerve wracking now not to know.

As for now... surgery. Yuck x 100. I'm on the trauma service which is actually really not bad at all. It's really easy to get lost so that no one notices your absence, and I've left during the late afternoon on multiple occasions. Never been there past 5:30, and I usually show up at 6:30. Which all makes me very nervous because I end the rotation on hepatobiliary, which I hear will be much worse. Not to mention that I syncopized in the OR on Monday, and whacked my head on the OR floor. It sucked. I have since been very nervous about a repeat incident. Twice the other day I had to sit down in the middle of an operation - I don't know if I really was going to pass out but I am being pretty paranoid about it. I don't know how I'm supposed to manage the rest of this rotation if I'm constantly feeling presyncopal in the OR! It will be especially bad on hepatobiliary when I'm stuck in 12-hour Whipples. If anyone has any words of wisdom on this feel free to PM me or comment on my thread in the Medical Student forum.

In other news, my husband is job hunting and finally got a (phone) interview. He loves the job and is hoping to get called in for an in-person interview. I will be happy for him if he gets the job but I am also really concerned: the job requires a significant amount of travel (at least 50%)! I have no idea how we'll handle that. I know I should just wait before worrying because he might not even get another interview with them, but as you have probably picked up by now, I can't help but worry

Anyway, DH and DD just walked in the door. More later

So about that job possibility... I just don't know how we'd handle it. I wouldn't want to be selfish and ask him not to take the job, but part of the reason I'm handling this year so well is that I don't have to stress out about getting home in time to pick DD up from daycare, etc. If he does get the job (big if at this point, I know), he would have two months of on-site training prior to any travel. IF I manage to get my peds AI in August, I think I might be able to manage him traveling after that, though of course that's way more than two months from now. I can see what our babysitter is up to over the summer - perhaps she could help out more then. But still, this would be a really big deal. I will try not to worry any more until there is something to worry about - a skill I am working hard at

DD is amazing, as always. She is in such a wonderful stage right now. I have really been treasuring every moment I have with her: reading together, coloring together, and my favorite: holding her in my arms and singing to her every night before bed. These are truly some of the most precious moments I could imagine. I am so blessed to have her.

Well, the job didn't pan out, so no worries there I guess. DH is being very lazy about his job hunt, and while we could use the extra income, it's hard to complain because it is SO nice to have him at home.

Surgery is OVER, and somehow I survived. I will NEVER set foot in the OR again, unless I am a patient, god forbid. Such a miserable experience. I am finishing up a week of vacation now and then 4th year officially starts Monday! I am starting with my neuro/psych rotation, which will be 3 weeks of inpatient neuro followed by 5 weeks of inpatient psych. I'm a little nervous about the neuro part because I will be missing three days the first week to go to a conference, which is a lot of time given that it only goes for 3 weeks. I hope it doesn't give my residents/attendings a bad impression, and I hope I manage to find time to study for the shelf and do well on it. Psych I am really looking forward to... hopefully I will begin to get a better sense of whether to pursue psych or peds. I am most excited about my child psych acting internship in July. And great news - I just found out I got a peds AI in August! The benefit is that I wanted a peds elective in August in case I hadn't made up my mind yet, and for another letter opportunity. It certainly didn't have to be the AI, but now I will have that requirement out of the way so much earlier (we all have to do one AI in either peds, IM, surg, or family). I originally had it in November - now I've got a light elective then, which means I will have much more flexibility for interviews.

Graduation for c/o 2011 is imminent, which is sad for me as that was my original class and most of my friends will be leaving. Even those that will be sticking around for residency will become part of a different world, it seems. Luckily I do have some other classmates that took a year out for research, so I won't be totally alone.

So much going on with DD - we are in the early stages of potty training, her language has blossomed beyond belief, with three-word combinations on occasion! She is so sweet - she says "thank you Mama" and "thank you Daddy" without being prompted. I'm sure she'll grow out of that eventually but it sure is darling while it lasts. She has been extra whiny this week, which may be because we are at my dad's house on vacation and it's just a change of pace. Maybe it's a phase. We are doing our best not to give in too much but also to choose our battles - it's a fine line for sure! She also has this funny new habit of using hugs as a stalling tactic. She knows we will never refuse a hug, so if we are telling her it's time to do something she doesn't want to do, she'll say "Hug!" and wrap her arms around us and lean her little head on our shoulder. Maybe I shouldn't let it work for her, but I just can't resist those little cuddles

I have to say, I hated surgery so much, my goal all along was to survive (and pass). Needless to say I was SHOCKED when I got my grade, which was an honors. Wha? I seriously considered emailing the course director to tell him there must have been some mistake. The funniest thing is that my first reaction was to be concerned: when I met with the psychiatry PD here I was on surgery, and he asked about my grades and I said "well, I'm not going to honor surgery". He said "Good, it's probably better that you don't." So for a split second I thought "oh no, this is going to count against me!" LOL. In any case, I am far more relieved to have finished surgery than I am happy about my good grade. That really says something.

Neuro and psych are now over. Missing several days on neuro for the conference turned out to be pretty stressful, but it all worked out in the end. I didn't do as well on the Shelf as I would have liked, but I don't think it will be too much of a problem. The grades for neuro and psych get lumped together into one "clinical neurosciences" grade, and for the neuro component there is not cut-off Shelf score required to earn a particular grade.

Psych was fantastic. I was on an inpatient adult mood disorders unit, though in fact we saw few mood disorders and almost entirely psychosis. I learned a lot and realized that I really like adult psychiatry. That was a bit of a surprise - I chose an adult unit specifically so that I could make sure I wouldn't hate it before choosing to pursue child and adolescent psych. I am now about 95% sure I will apply for psych residencies.

Speaking of, ERAS opened on Friday. Eek! I couldn't help myself - it is a three-day weekend in between clerkships and yet I already started filling it out. I want to submit as early as possible in September, and in August I will be way too busy on my peds AI to do much, so I figure I better do my best to complete my application this month. I already have a great start on my personal statement. I am a little concerned about LORs. I have one from pediatrics, one from my research mentor, and plan to get one from my child psych AI next month. I initially planned on having one from the adult psych rotation too, but the primary attending left for paternity leave after the first two weeks so I ended up with three different attendings. The first told me he'd write me a letter, but we didn't work together very long so I'm not sure how amazing it could be. The psych PD had also suggested that getting a medicine letter would be good because programs like to see a good foundation in medicine. While I had good interactions with attendings on medicine, that was all the way back in November and December and I really didn't get to know anyone well at all. The one I knew best was someone who said to me "I really struggled whether to give you high pass or honors." I'm not sure that bodes well for a letter writer! So in any case, the end result is that I will have three strong letters but nothing from medicine or any adult discipline. I'm definitely concerned that this could be a strike against me. I plan on talking to the psych PD about it sometime this month.

As always, a little update on my little princess . Her language is just exploding - she even says full sentences sometimes, like "I have a picnic with Daddy!". She has transitioned to the toddler room which she seems to be loving - I'm sure that is contributing to the language development too. She is getting good at expressing her emotions, too: "R sad, mama work." Heartbreaking, but so sweet. For the last five weeks on psych (and I anticipate continuing next month on child psych) I have been able to participate in drop-offs and pick-ups much more regularly. Getting so much time together as a family - we have started eating dinner all together most nights, which in addition to being pleasurable makes things so much easier, because she sits in her high-chair at the table for that, as opposed to sitting at her own pint-sized table when she eats alone (and then continuously getting up and running around while we try to keep her at the table).

Another benefit of having more time on psych (I didn't have to get in until 9 every day!) is that I transitioned from afternoon/evening jogging to morning jogging, and have now been going every other day for over two weeks! I am very proud of myself. Definitely hope to keep it up.

With the exception of some financial concerns (maybe I'll write about that later), things are going so well these days. I'm enjoying my clinical rotations, feeling good about the upcoming application season, enjoying time with my family, and making personal wellness a priority. Keep your fingers crossed that I can keep this good vibe going!!