I am still in shock... pumping horror story:

So, today was psych didactics. I was warned that the psych director in charge was super wierd, eccentric, awkward, you know the type. I was excited to meet her. She was as expected- crazy dress with tags sticking out, tennis shoes, no make up - a mad professor type. Anyway, I had to pump. So, I let her know that I probably wouldn't be back from the 5 minute break on time and why. She offered her office which was great.

So, I went in and got settled. It was disgusting and dirty but better than a bathroom. Then, bra off and pumping away, I hear a knock. "I'm using this room" I say. I hear an "OK" and then relax. Next thing I know, someone is unlocking the door! I ask them to wait out side and give me a moment, but they keep coming. It was the psych doctor! I told her to give me a moment and she said, "that's ok, keep going." No, I informed her that it was not OK (as I was detaching boobs with milk dripping everywhere) and she STAYED in the room and started making a phone call! She told me to stay, she would just be a moment, but I told her I was uncomfortable. I finally got bra and shirt on and packed the stuff up and she tried to convince me that I could still use it, she wouldn't be back in. No, thanks.

I walked out with my mouth wide open and found a different place. WHAT?? How is she a psychiatrist? She has no judgment! I would say that her judgment was impaired if I were writing a note on her. The worst part is, I felt so interested and engaged before that happened and now I feel turned off to the whole field of psych. I was planning on going to all the didactics, even if they were not required, but I want to see her as little as possible. I left early and might get in trouble.

Was that sexual harassment or just disrespect? She is married with a kid... but it made me feel so embarrassed. I don't know. That was weird.

Anyway,

I know DS would act out in some way when I began leaving. Turns out, it is suddenly wanting to hurt the baby. Great. MIL told me the second day I was gone that she stopped him as he was about to hit baby in the head with a heavy book. He hit the baby in the head twice two different days when I had just come home and was holding him and then today tried to twist his arm hard and hurt it.

It makes me so sad. What I do, is get angry (can't help that) and give a loud, stern "no" then he gets a time out and has to say sorry. Am I reinforcing the behavior by giving attention? I ignore him while he is in time out though, and he has to have a consequence. I try talking with him about what he might be feeling as much as you can with a 2 year old. I ask if he feels angry when mommy holds the baby or if he feels sad that mommy has to go to school. He says yes. I always go to him first before even looking at the baby and spend a few minutes with him.

I want my life back. I want my ridiculous mother in law to leave. I couldn't do this without her though, that's for sure. She is making dinner every night and cleaning it up. She is doing our laundry and dishes. She is really being so helpful. I just resent that they are with her instead of me.

Can you tell I am a little bit busy? Haven't written in almost 4 months!
I have been sort of avoiding it because so much has happened emotionally and otherwise, how could I write anything that makes sense without staying up all night and writing a book? So, I will just start from where I am at this moment.

All those old feelings are still there, but they are no longer paralyzing. I miss my boys while I am gone, but I don't feel like I can't breath not knowing what they are doing anymore. I don't feel crushed with guilt. I worry about them a lot, but I am able to focus on what I am doing on the wards. I am beginning to trust her with them. She still drives me crazy when I get home. I still wish she would retreat and give me time by myself with them when I have free time, but I am beginning to see her as a part of the family. This would NOT be working without her.

That said, this is exhausting, but exhausting in a good way like after a full day of swimming and sun as a kid. I am on medicine right now with call Q4. I am only awake because I have apparently lost my circadian rhythm entirely. I slept 3 hours last night on call then came home and napped during baby nap time, now I am all strung out! I am doing ok, but just barely. I don't cry at work anymore. I would even go so far as to say I am enjoying myself most of the time! I was pretty starved for adult interaction and academic thought last year so I am kind of eating it up. I am not as behind as a thought I would be. I actually feel pretty good about how it has been going on the wards. Being intuitive and able to read people seems to be the most important thing you need this year!

I think everything got easier when I stopped breastfeeding a month ago. I got mastitis pretty bad and that was the last straw. My energy went back up, I wasn't constantly worried about finding the time and the place to pump.... I can just be there while I am there. I miss it a little but mainly in the early morning. I miss those cuddles. I still take him into bed with me though. He is so much more satisfied with a bottle too. I made it to 6 months and I am ok with that.

ps- last call all 3 of my new patients were penile issues. It cracked me up! What are the chances? The first one, I was totally awkward, but by 4 am I was examining balls like they were ear lobes. Good times.

Impossible to attempt to sum up what has happened since I last posted.

In fact, I had decided that it was a waste of time. Then, I began to crave an anonymous place where I could vent my frustrations and organize my thoughts without judgement or repercussions on my relationships.

I have given up the idea of talking *anything* through with my husband. Unless it is something positive. He simply cannot respond to negativity or confusion in any other way than to feel threatened. I have given up on creating a sane, amicable relationship with my mother in law. She is. She is a necessity in my life because I can't afford a nanny. She will never like me. She will always wish I was out of the picture and it was just her, my husband, and our boys. Her IQ hovers around the low 70's.

(This girl is mean, you are thinking) But I need a place to be mean!! I have a plate of pressure served to me most days with no sides of Grace or Fun. God, I could use some fun.

Anyway, maybe this will help.

Third year is over!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

yay. Fourth year has begun, and I am at the end of a self-imposed 2 month fallow period. I used all my vacation time and foux-electives right at the beginning because I had to. We just moved out of that little tiny box of an apartment into an amazing, beautiful, feels-so-huge house!!! It has lifted my mood more than any pill could have. Before we moved, our 18 month old was still in our bedroom (His bedroom). MIL was always in the living/dining room so we literally were never alone to talk (or whatever). Now, everyone has their own room, and we have a yard! And neighbors that brought brownies! Seriously?

Guilt update: It has subsided considerably. I am 88% sure that I am making a good decision. That am doing this for all of us. That they don't need ME to be the one to serve them ravioli and press play on the Cars movie. Also, I can't handle being with my wild men all day and night. I still wish there was some middle road to meet on, but oh well.

MIL update: She is the single most difficult part of my life. Some highlights from this year. "Medical school is no excuse for falling behind on laundry if you are a mother." "You should take care of your husband when he gets home from a hard day of work, I feel so bad for him." (Wait, didn't I get home from doing the same thing??) "I guess everyone has different values, but I never liked to raise my children in a pig-stye." (I have a housekeeper come every two weeks, how bad can it be??) Literally EVERYTHING I do for the boys/home is wrong, from haircuts to couches. It is exhausting. My husband who prides himself on never arguing will never intervene.

(What a whiner this girl is, get over it!)

School update: I am doing peds!!!!!!!!!!!!!!!!!!!!!!!!!!!! Hooray, it is the only thing I liked last year. I should say LOVED last year. The hours flew by while I was away for the first time ever. The work just felt so IMPORTANT. I mean, these are babies for crying out loud. I love the well babies and the hospital cases, I love the variety. I love working with neurotic mommas (aka people like me!) I can't wait to start my AI in 3 weeks. The only problem is that I remember nothing from last november. And I just can't bring myself to read during my staycation.

I think what I should ponder with this time off is my relationship with my man. Why am I so resentful of him? I can pinpoint when it started: the birth of our first child. He went from this perfect Grecian God that I revered to a stonlike man selfish and cold. What happened? It floors me that when I cry out for support if I am sad or hurt, he shuts himself off and leaves. I can't get over it. Things I would never tell a soul: He sexually needy, but needy in NO other way. He is simple minded. He has NO empathy. He has no backbone.
This is how I feel today. Please, let that change. I want to love him again. I want to respect him and feel connected. But I don't know how.

My boys: they are perfect, hilarious, wild, and free as weeds!

So here I am today. Excited about Pediatrics, loving how my boys are growing up, hating every encounter with my mil, and sick about my feelings toward DH.

I am not a negative person in real life. I feel rather guilty about it here. The reader won't like me! But oh well. I need express things even if they aren't perfect. so there you have it.

I keep thinking that at some point, life will sloooow down. As soon as I will my way through one struggle, a new one comes. One heavy decision made is answered with a new question. I think this is just life so I need to slow myself down if I am to experience it at all.

Anyway.

Turns out that I am pregnant again! I just found out last night that it is a girl. A girl! Ballet slippers! Pink! No more Thomas the Train! She will be the fluffiest little puff until she can start to voice her own opinions-age 18 months if she is going to be like her brothers

My emotions have evolved from ecstatic->horror/dread->depression
->acceptance->excitement->planning. I must say that I am the most fertile woman on earth. I got pregnant on day 28. Day 28! I thought I knew how the cycle works... guess not. So, I will be due literally the day intern orientation starts. Taking time off is NOT an option financially so here we go!

In other news, my husband and I started going to counseling which is a good thing. I feel like it has helped a lot. There is still a lot of work that needs to be done there though. But, I know that what these babies (and myself!) need most is for the two of us to be stable and happy. I can't put it on hold.

I am ripping my brain into shreds trying to decide how to rank programs next year! I just posted hoping for some advice. I could use any I can get. I absolutely do not know what to do. My husband (and just about everyone I talk with) thinks I am crazy to consider ranking a community program when I know well the fabulous, huge, academic program affiliated with my school. But other things matter besides didactics! The smaller program has a fabulous 9am-4pm preschool nearby. I could stop losing sleep over the hours of time my boys spend watching the wiggles. It has slightly better hours and slightly less intense rotations. Housing and commute would be better. But, would I come out less well trained? Would I endanger a future patient? Miss something rare and hurt a baby? Obviously, that would not be worth it.

Also, I am on peds neuro ICU rotation right now. I have never been so depressed by what I have seen in the hospital. I wish I could describe the cases as an outlet but that would probably be unethical. Suffice it to say that all of my patients were previously prefect, healthy kids who are now basically vegetables because of freak accidents/missed diagnoses. It is horrible. The first day I just came home and cried and cried. Once sweet baby looks so much like mine. Their families are so dedicated, so groundlessly hopeful. Wish I could describe it more. How do people handle doing neuro? No one gets better. Consulting neuro is like consulting the grim reaper. This will be a long month. I am, more than ever, quietly, cautiously, thankful for my healthy boys and my new little 16 week girl that I can't even feel yet. Life is desperately unfair. I think I will go and eat more ice cream now.

Feeling like a crummy momma.

This week was my boys' 2nd and 4th birthdays. I arranged to have it off so that I could celebrate and not miss a thing. Well.

I knew we could bring in cupcakes to preschool to celebrate my son's 4th. So, I'm feeling good- I have the day off! I actually get to go and have a special day and feel like a mom. I brought in a dozen funfetti cupcakes. To my horror, when I walked in I realized there were 15 kids! So, the teachers graciously cut them in half saying "oh, these are so big, we need to split them!" The kids weren't buying it. I want more! Where is the rest?! I'm hungry! My mommy brought 4 different kinds on my birthday! Then started in, Where are the goody bags? Where are the hats? Where are the horns? Seriously???? Could someone throw me a flippin bone or at least an email to let me know what all the other kids' moms have done all year?? I had no idea I was supposed to provide a full blown party for 15 preschoolers. I asked another mom later how she knew to bring so many things, and she said "well, I always pick her up, of course, and I see what everyone else has been doing." Absent mom here didn't know. It was a painful 10 minutes- felt like I was getting pimped, and missing all the questions on rounds only worse. More personal.

Luckily, my fabulously oblivious son didn't care AT ALL. He was just ticked off that we kept saying happy birthday a day early. It is NOT my birthday! Why does everyone keep forgetting that it is not until tomorrow?? Ha. He wouldn't even wear his special hat (which the teachers had to make since I didn't bring one from home!) I love him.

I think I had always imagined that I would the fun mom with the perfect cupcakes, the MOST SPECIAL birthdays every time, my kids would stand out! Hahahaha- every day I see more clearly how far from that perfect mom I am. And you know what? That's ok.

There will always be someone richer, prettier, skinnier, and making homemade bread! But, hey, my kids are growing up fine and we love each other. It is not about the best cupcakes, but the fact you tried with sincerity.Early on, in my attempt to be super mom, I spent $70 worth of felt and over 2 months, while in residency, to sew a Mutant Ninga Turtle costume. Yeah, it was used and they liked it. Next year I was at a conference and my husband took them to some store and they picked out costumes that doubled as pajamas. My son wore that Batman pajamas/Halloween outfit till it wore out.....

They are happy when you are happy. It can be a book at bed time cuddled up next to them, or read over the phone from the call room. You love them and they know it.....

Where (if?) I will be has already been decided, but I won't know for another week. Oh, boy. I surprised myself by choosing to rank the busy, stressful, academic program first. I didn't think I would do that. I think it was for two reasons. First, if I chose a different program, we would have to move. Normally, no big deal. But, I would be moving with a 3 week old. Am I totally insane? It just seemed impossible. I can hardly string together sentences at 3 weeks post partum much less organize a move with a 4yo, 2 yo and newborn to care for! Also, we have a good preschool here, live in a good neighborhood, have some nice friends. Why rock the boat even more than it will be when mommy disappears for 3 years? The other reason is that I don't want to close any doors. I am 99.9% sure that I want to stick with primary care, but I do also like peds rheumatology... you don't get a lot of exposure to that in a community hospital. Oh, but now if I don't get it I will be so disappointed! I paid for next years preschool deposit (and now have no savings), finally finished unpacking here, even planted some flowers. Come on March 17th....!

I worry about starting internship with maternity leave. First, I am worried about missing those critical months of July and August. You learn so much in such a short time, I will be waaay behind and look like an idiot! Also, I worry that it will be hard for me socially. I already have the fact that I have kids making me different, now I will miss all those bonding events and retreats. Feelings of being an outsider, here I come. It has been hard being the transfer but I thought that in residency it would be very different. Hmmm. I've found it hard to know how to be a girlfriend now that I am a mom and a wife. You can't be available all the time. You can't go out whenever it sounds fun. I always want to rush home after classes or shifts which doesn't lend itself to forming deep relationships. I have reconnected with good friends from church. I hope I can keep that up as an intern!

Well, I feel sheepish.

Then relieved, then angry, then embarrassed, then.... a million other things this last month.

So, there I was on match day- so sure of where I would be next year, sure of what that envelope would say. When I opened it, I could not believe it said:
"congrats on match at *your second choice*"
Wah, wah poor me- I know. But this means so many things. My family has to move, we have to move away from our friends, our neighborhood... into a foreign (ok its 20 miles away, but it is another world) place. We have to pay for moving and my loan money is running out. We have to move with a new baby.

So, in that moment, I didn't cry (for once), but I had this bizarre feeling like everyone in the room was watching me. Of course they weren't, but it was an odd moment to be in such a public place receiving such private information tied up so tightly with ego and family and failure. I smiled and said "yay!"

It probably isn't the move. It probably isn't the fact that I put a $1400 non refundable deposit on the preschool here that is now a donation. It probably isn't that I now have to take out a relocation loan on top of my other 400,000 in loans that I am graduating with and freaking out about.

It is my ego that is hurting. Let's just be honest: things have worked out for me. So far, no matter how difficult or far fetched a thing has seemed, I feel like I can get it, can make it happen. I didn't realize that I really felt that way about the world, but I see now that I did. It was like a kick in the stomach to see the other people in my class that did match at the program I ranked first. There was no hiding the fact that I was ranked below them. Yes, they have masters or phds, yes, they did tons of research and extra curriculars... but I birthed two children and still did well academically in med school damn it! Isn't that harder? Guess not. The thing is, I feel like they led me on. All the residents went out of their way to let me know that they liked me, they couldn't wait to work with me, bla bla bla. They incoming chief emailed me saying that she hoped I would rank them first and be her intern. I felt like my AI went great there. Whatever!

This is good for me, I know. It is good for my worldview: Grow Up. You don't always get whatever you want. You are not in control. You are not the best or most qualified.

Now what?

Maybe, this will make me a better learner. I feel like a freer learner already. I am in peds ER this month and I have lost the need to prove my knowledge during a workday. Instead, I feel like a sponge soaking up teaching and experience. I am finally learning to do a decent PE! Talk about doing things backwards.

I know that this program is best for me. I felt more "at home" there, the area truly is better for families, the drive will be much more bearable. The program director is a woman, and a parent, and a nice person (all 3 untrue of other PD!) I like the hospital much better and like the patient population much better. The residents are happy, rather than miserable.... all good things.

Now that a month has passed, I am excited and happy to be at this program, but my sense of self has changed. I feel a little more timid, a little less cowgirl. I thought I was a pretty humble person (what an incredibly non-humble thought!) But maybe this is how it actually comes to be that a person becomes humble- through painful, humbling experiences.

I expect intern year will be another crash course in humility! Here we go.

In other news, I am HUGE. 30 weeks tomorrow, yay! And, I have never felt so old and creaky before. I hurt SO bad everywhere. I tried complaining to my mom bc you get no sympathy from an obgyn husband (are you contracting? bleeding? bad headache? You're fine.) and she tactfully informed me that I am no spring chicken this time around. Really mom? 27 is AMA to you? Ugh. She's kinda right though, I feel about 207 years old today. I'm going to go roll myself onto my left side and snore like a beached manatee and proceed to wake q2 hours with leg cramps.

And to end this long post on a happy note: I get to go to my son't field trip tomorrow! Woo hoo! He is super excited. And, a working momma in the class was freaking out bc something came up and she can't go, so I am swinging by to take her daughter with us. Makes me feel good to be able to help her out. Can't wait for a fun day.