This week. This everlovin' week

[redacted]

Sipur Yisraeli

[redacted]

Setbacks, nursing, Zika, failure

[redacted]

Write a book

Would it be ok if it was just stories? Not stories linked together with trenchant analysis of what this means for Our Times, but just: this sad thing happened, or this happy thing happened, or lots of things occur and I have no other point than to show you that lives are hard but punctuated by great joy and great sorrow and here are some of those times that otherwise would be obscured from your view.

Is that a reasonable kind of book? Or does it need to be somehow More? (I have always thought it would need to be More. More makes me tired, so I just never get very far).

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Here's a possible title: "Every Little Thing Gonna Happen".

Because once I took care of a pregnant patient who had cardiac issues and renal failure and was in general very sick. Every time I took care of her in the office, I would talk about all the things we worried about, and she would say, very gently: "Hey, Dr. C. Hey. Ain't nothing gonna happen." When she got admitted to the hospital, I would tell her what we could, and couldn't do for her and her baby if things go worse, and she would say, very gently: "Hey, Dr. C. Ain't nothing gonna happen.".


And I would go tromping over to the nursing station to sit and write my note, and I would grumble: "That's her motto. We should make a t-shirt with that on it for our whole team. We could have hats, and wristbands: 'Ain't Nothing Gonna Happen'. "
"And I wish she was right, but I think I've been doing this for a while now, and you know what? Every little thing gonna happen. It just does, and it will. Every little thing."

That, to me is pregnancy, and L&D, and high risk and women's health and parentood. Eventually, around here, every little thing is going to happen: bad, good, in between. It's a whole world, over here.

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Anyway, is that a book? I thought so last night. Now I can't tell.
It's probably not, right? Probably not.

Cruel to be kind

[redacted]

Delivering babies

I'm not gonna lie, delivering babies is a pretty awesome job.

It's only part of what I do, but when it is good, it is so very good.

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I talked to a friend who is moving to a consultative kind of job. It's her dream job in many ways, but it is the kind of job that usually doesn't involve any more delivering of babies. She said to me, when we were talking about it: "I bargained my way into some clinical time on L&D", she said. "They couldn't believe I wanted to be on Labor and Delivery"

"I get it," I said. "Of course. How can you not be on L&D? How can you be a credible consultant and tell people what to do when you're not in the trenches with them? And L&D is where everything good and everything bad happens."

"You got it. Everything good and everything bad." she said. "Next time I'm bringing you to the contract negotiation."

Twins

[redacted]

Exactly how many Google calendars?

All this time I was jealous of people who had that expensive call-schedule-management software. Every time I was the subject of or dealt with a schedule snafu, the Bearded Economist would say: "You know, this is the kind of thing that computers are really good at."

And so I envied that expensive schedule management software. I thought you could plug in a bunch of rules (like, say, that doctors can't be in two places at once;  or that doctors can't work if they just worked a 24 hour overnight shift). Then you could copy in your holiday arrangements and let the magic happen. In a most beautiful world, it might notice if you signed in a for a shift that you weren't signed up for, and ask you what was going on. I bemoaned my 19 Google calendars* and the constant view and review required to assess for mistakes, and then stomach-curdling feeling when often, an entirely different mistake had occurred anyway.

Anyway, I was talking to a friend with that fancy software, and you know what? It's not actually that amazing. It's not programmable. It doesn't think. It's mostly just a shared place to keep the calendar, the calendar that a fallible human still has to make. It has some great associated features, like the ability to text or call someone directly from the schedule or other such thing.

Anyway, it's not actually that much better than my 21 Google calendars**, is what I'm saying. And the mistakes I try so hard to avoid, as a human, are not yet avoidable by obtaining a robot overlord. So I feel a bit better now.



* And counting; I'm spending a ridiculous amount of time considering whether to split one of these calendars into 3. On a weekend. No, everything's going just fine, why do you ask?

**I went for it.

Post-call bits and pieces

[redacted]

20 minutes

[redacted]

Anatomy of a piece that wasn't

[redacted]

Language Control

[redacted]

I got nothin'

[redacted]

Consult note #3

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Where'd you go, Bernadette?

by Maria Semple. 

Recommended to me by the wise Loupbleu. Greatly enjoyed. I highly recommend. 

Here is my favorite quote: 

"Are you quite done? People like you must create. If you don’t create, Bernadette, you will become a menace to society."

On a related note, I'm experimenting in thinking of myself as a creative person. So I'm  trying to put together a book proposal, similar to the stuff I put up here (and to many of the posts I took down, partially to see if I could use them in a book). 

Any title suggestions out there? 

Trying something new

[redacted]

Telegraph Avenue

Only for you would I have read "Telegraph Avenue", because I generally avoid anything having to do with birth or trauma on my time off. And, per expectations, I kind of hated it the first time through, because birth! trauma! midwifery politics! evil obstetricians! (Honestly, not one female OB, even though that's, like, statistically improbable these days.). But then I loved it, because Michael Chabon's language is just...fun. It's hard to read, for me, the first time through, because it's so very loaded. But then you puzzle it out and you laugh. I think this is how some people feel about poetry, right? And once you get past the birth trauma and his language play, his characters are great, too, so there's a lot reward there.

Anyway, I never would have read it either the first or subsequent times if not for your recommendation (was it Loupbleu?) and for The Bearded Economist, who read the recommendation and brough it home from the library. But it's really really good - so thank you.

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Speaking of comments: thanks for the rec, but I don't think the Skeptical OB is the right place for me. The best way I can think to describe it is that she is sort of the Bill O'Reilly of women's health discussion (lots of vitriol and dismissive statements, from what I can see). And I would like to be the Rachel Maddow? Or perhaps this metaphor breaks down. Regardless, the tone is all wrong for me.  Thanks for the suggestions, though.


I just finished the c-section piece (note: I was gently corrected that cesarean birth is the preferred, and overall nicer terminology; did you know that?), and we'll see if the editor takes it.

Passing

[redacted]

Bruised

[redacted]

Fluishly Yours

Dear ABOG;

Although I specifically set aside time this week to study for the upcoming MFM Oral boards, I hope you will accept, in lieu of passing that exam, this monograph entitled: "Care of the Sick Toddler(s) and Kindergartener: A Case of Cognitive Decline". Although not randomized, and an unethical experiment performed without IRB approval, I believe this study represents an important public health finding this winter, relevant to many parents of child-bearing age. It may even represent a delayed (2-5 years) form of postpartum depression. Of course, more research is needed; sadly, I seem to be deeply involved in advancing the field. 

Feverishly yours, 

Me