Bearfins in Rhode Island

Therapy

Too much grist, not enough mill.

our son is suddenly a teenager

um, what's going on?  it's like he's 13, coming down the stairs to borrow money for a movie. 

 

and then going to adjust the cogs in the garage

 

right, so we have 3 wks left in ny.  it's crazy.  had a residency going away party this weekend with hill country bbq, bocce ball games, board games and lots of alcohol.  my co-residents gave me the most amazing going away 'bellevue survival kit' complete with bed bug spray, psych restraints, an ID badge detailing all the jobs we do and syringes with fake sedation.  it was hilarious. 
 

brief update

have fallen off the blog wagon again.  a victim of the new overscheduling consult service brings.  i'm back in a white coat in the mornings, buzzing between floors, evaluating capacities to refuse treatment and alcohol withdrawal.  afternoons are packed with patients.  i'm trying to balance re-learning medicine and terminating with my patients.  it's odd. i didn't expect it to be so hard.  the terminating.  it's like i didn't know these people would affect me so much.  i thought i would just be their doctor...that i wouldn't have this kind of loss in not seeing them week after week and knowing what is going on in their lives.  freud said, and i'm paraphrasing, that it's most difficult to let go of the ambivalently held object.  i'm not sure if i agree but i am finding that this prolonged exit from new york, the program, our friends and my patients has taken more of a toll than others. 

we went to my co-resident, rachel's wedding several weeks ago at the essex house off central park.  it was black tie and i got to see john in a tux for the first time.  this wedding was way out of bearfin league.  chelsea clinton was there.  i ate two steaks...john's and mine...and then rolled home before midnight. 

despite the busy last 2 months, the sadness of leaving friends and the arduous task of moving, we are looking forward to new england and becoming Brown Bears.  stay tuned for the boy in a collegiate ivy league onesie.

sigh, massive anxiety. this weekend was my last 24 hour call and for some reason, I haven't slept since friday night. not sure if it just upset my whole sleep/wake cycle or if the impending logistics involving moving to yet another state are looming. the bearfins are tired of moving and would really like remain in one state for more than 4 years. or two... as the upcoming case might be.

here is a photo of the boy:

thrown together

napa cabbage asian salad with mint, cilantro, soy sauce, orange and lemon juice, cayenne and a touch of agave nectar. again, from millenium.

this would be after my on-the-couch therapy session #2 of the week. we are "in the shit" now as my good friend likes to call it.  which means it's not all funny patient anecdotes and ironic commentary about my odd ball habits.  it's transference and countertransference and me not trying to over-intellectualize the whole thing...a defense i'm trying to monitor. 

instead, i defend with cabbage salad.

panic on the streets of birmingham

balls.  outpatient is hard. the further along in your training, the more you realize you don't know.  3rd year is like being a real shrink with patients saying they held a bottle of pills in their hand this weekend and contemplated taking them.  to kill themselves.  which in the bellevue ER is fine with me because i have the experience to know when to admit them and when to do something else. in the office, it's less clear.  every week i spend 2 hours of my own time in my own therapy processing my feelings of inadequacy as a therapist.  bless my shrink who tells me to take it easier on myself.  it's just hard. you're invested in these people. they are your patients. they say things like, "what ever you think is best, doctor" and what feels like ridiculous shit like that.  and it becomes very hard to remind myself that these people have survived 29 or 49 or 69 years without me. and that they will do whatever they are going to do.  they will show up... or not. they will take the medications i prescribe... or not.  they will attempt suicide... or not.  and it may not depend on if i said the right thing on august 22nd at 4:15 pm. in fact, it probably doesn't matter.  it just feels like it matters. 

so now i'm home drinking chardonnay and eating cheese for dinner.  when i should be running or meditating or doing something i advise all my patients to do.  i had a moment this weekend where i was tired of being in residency.  i was tired of having trained in medicine for now 7 years, looking down the barrel of 2+ more.  and at the same time feeling like i need 14 years more training/supervision/practice before being released to be an attending on my own.  i may also just be tired because rhys is waking up at 4.  that's possible too. 

anyway, in good news...brown and columbia offered me interviews.  without receiving my formal application. they had apparently received my board scores and transcripts and decided to call.  it's weird and i need to remember that my own distorted expectations are perhaps not congruent with my level of training and my general performance.  yarg. 

pictures of the new place to come...when we locate the camera and its accessories. and of course, many photos that need no explanation of the most adorable boy in the world.  who is now saying mama, dada, duck, dog and book.  his favorite word though, is duck.  everything is a duck.  so cute.

nyt + pdx

The New York Times once again attempts to cuddle up to Portland, making the number one most emailed story today.  This article is all about the "frugal city" (though most cities are frugal when you compare them to NY), and spawns in me the bi-monthly ache to return to pdx.  I know only one of the places mentioned in the article...the Laurelthirst (oh and stumptown but i think i'd only been there once), making me believe that if we returned that we'd be exploring a whole new city. 

Rents are falling fast here, tempting us to move but putting us in that lousy position of not knowing whether or not we'll remain in the city for fellowship, and therefore whether or not we'd be faced with subletting a place for the last 3 months on our lease if we left next June.  I would give a limb at this point for an elevator and wood floors that didn't have sealant peeling from them, ready for baby ingestion... for less than we're paying for this cute but miniscule place.  Perhaps we just have to think positively...that it can be done (the subletting if need be) and that the space gained by moving would be worth the stress at the end. 

I started the child unit at Bellevue this week.  It both reaffirmed my desire to do a pediatric fellowship and emotionally drained me from watching these neglected, abused, mentally-ill children.  One funny thing to share: every week they have a course called "Fine Dining" where every child (ages 4-12) dons suits, ties and dresses, learn to set a formal place setting and exhibit proper manners.  They all love this dinner and it is the cutest thing I've seen.  Also hilarious is watching a 5 year old in a bowtie stomp down the hall in response to limit-setting, mumbling "fuckfuckfuckfuck".  Okay, maybe not funny ha ha, but funny none the less.

avril

john threw out his back this week.  he did  it getting up from a chair. we are old.  i had to come home early as he had the baby boy down on this new tumbling mat we bought and couldn't pick him up.  on arrival, i found them both splayed out on the mat unable to get up for reasons congruent with their respective ages.  since then, he's been eating advil like candy and icing down the lumbar region with packages of frozen peas.  rhys has been quite patient.

we started sleep training sunday night.  the first night was horrific with him screaming for 3 hours until we finally gave in and fed him.  since then, he's started to be able to put himself back to sleep only waking up 5 times last night.  5 times you say? yep, a major improvement. i don't even want to tell you how little sleep we've had in the past 6 months. the baby is currently learning to soothe himself to sleep in our bed. we are in the living room.  eventually, we'll work our way back to the bed without hopefully disrupting things too much.  we're not in a place to get a crib, in terms of space, money and our emotional attachment to cuddling with the boy at night.  that may change if we can't start to share the bed again without regressing into former sleep patterns.

i finally navigated the mess of bureaucratic bs that is the ny state medical board and became a licensed physician this week.  which means i can practice on my own, moonlight (basically work in other hospitals for additional pay) and prescribe narcotics to the people of ny without supervision.  mua ha ha ha.

what else...the cub and the bear went to the zoo yesterday which was thoroughly enjoyed by all. john is in a nyc stay at home dad's group, led by an incredibly ambitious friend who sets up weekly meetings for all the dad/baby duos.  they get quite a bit of attention while out in public and lately, have been interviewed by a ton of news programs including the today show and fox news. for those of you who know the bear, you know he's such a sucker for the limelight and is front and center in all these clips.  okay, he's avoided all of them but has been featured in several still photos.  more to come, i'm sure.

central park picnic season, declared open

though it looks like we're picnicking in january, it was actually close to 70 degrees this weekend and the bearfins gathered with friends in central park...

yes, we did park ourselves in wood chips but only because the lawns are closed for growing.

cuddles from mommy:

this week i had meetings with the department regarding the possibility of my 'fast tracking' into the child/adolescent fellowship.  because of the shortage of child psychiatrists in the country, residencies now allow you to skip your fourth year of training and go directly into the two year fellowship.  i plan to do this for reasons that are basically outlined in the above photos...  baby, family, baby.  suddenly, the decision as to where to apply is upon me.  the nyu child study center is incredible...arguably the best in the country.  they are, however, acutely aware of this and being an adult nyu resident in no way guarantees your way into this program.  the columbia and cornell programs are the others that i'd consider in the city but they are combined, making for limited spots.  yale's program is also a strong possibility as is brown's.  oregon...of course, has a mere 3 spots and washington takes (i'm told) only their own residents, so returning to the PNW may be out.  applications start to go in early this summer and the match is in january.  kind of can't believe this whole process is starting again.  feels like i was just interviewing for residency.  exciting though...we'll know our destination in less than a year!