Archive for the 'Fatherhood' category

Summer is magic

Jul 28 2011 Published by under Fatherhood, Narcissistic self-involvement

Last night it rained.  A lot.  Six inches in some areas, and enough to supply a steady rumble of rain on the roof.  But it wasn't the rain that woke me up: it was an insistent tapping on my arm.

"Daddy.  Daddy. DAADDDDY! I'm scared Daddy."

The rain came with thunder, and the thunder was loud enough to wake my little kiddo.  She does not like thunder.  At all.

"Grumph hrmph," I said, gesturing her into the bed.

When my wife was in the hospital, PalKid slept in my bed as often as not (OK, every night), but to have all three of us in one bed, comfortable and without IV lines was worth the lost sleep.  We lost a lot of family time time this spring.

But August is our month for family.  I don't generally take much time off, and having recently joined a new practice I'm ambivalent about leaving town.  But August is mine.  I spend two weeks away, each in one of my favorite places.

The first is here:

A misty morning

Me, PalKid, and EldestSis will get in the car before sunrise and drive until the road ends.  Once there, I can take out splinters, hug homesick kids, swim in deep, cool waters, and turn off my pager.  And of course, paddle.

That's my paddle and I made it.

A month is what I want; a week is what I'll get, and I'll be thankful for it.  It's a working vacation, but one with a nice cabin, good food, friends...but I'm bringing my own coffee.  I'll drink any coffee, but if I can avoid camp's pishechtz, I'll be much happier (and so will the nurses I'll share it with).

(For those ignorati who think my canoe is tipping over, go study your Omer Stringer and Bill Mason, then get back to me.)

Anyway, despite the pile of work that will await my return, it'll be well worth it.  There is nothing like reaching for your belt and realizing that your pager isn't there and you don't need it.  After a presumably joy-filled reunion of Pal, PalKid, and MrsPal, and a few late nights at the office, we'll head up to Favorite Place #2, my family's summer retreat for many, many decades (I'm fairly certain my dad first went up there sometime in the 1930's and we've rarely missed a summer).

This is the real-deal Up North summer vacation, with bikes, beaches, fudge, and family. The cast changes from year to year, but the setting does not (although, like every other idyllic place, people always complain that "it's not the same anymore").  Maybe we'll drive down to Sleeping Bear Dunes.  Maybe we'll take a ferry to Mackinac Island.  Maybe we'll just sit on the porch reading and watching the sun cross the sky.

For me, summer ends when I cross the 45th parallel heading south.  The trees are still green, the heat is still there, but the air feels heavy and the fun has gone out of it.

10 responses so far

Fathers' Day

Jun 19 2011 Published by under Fatherhood

If you look closely, you can see MrsPal's well-manicured hands

Becoming a father isn't some sort of careful metamorphosis: one moment you aren't, the next you are.  It's insane.  Within a day you can go from overwhelmed former non-parent to head-over-heels in love parent.  When PalKid was born, I couldn't keep my eyes off of her.  I still can't.

These little creatures change daily, and you have to change with them.  And there's no one way to raise a kid.  I hope MrsPal will forgive me this liberty, but at a gathering for a first birthday a group of parents were talking about all the books they were reading to teach them how to raise a child.  We had already been through the "What to Expect" series, meaning they were tossed in anger out into the snow.  When one parent looked at my wife and asked, "So what are you reading?" my exhausted wife answered, "I read the book that says don't read so many fucking books."  I love that woman.

And as all parents know, it's not all hugs and kisses.  It's not just the exhaustion during infancy, or the terror after first blood is drawn (PalKid learned to cruise, pulled off the padding on the coffee table, and immediately slammed her face into it, getting her first stitches remarkably early). For Fathers' Day today, I just wanted a bit of time to myself which most parents know is damned unlikely.  It's doubly unlikely given my wife's illness, but things have a funny way of working out, especially when you have a spouse who loves you.  My niece slept over but had to get up early to go out with her dad, so no sleeping in.  My my folks called and I managed to convince PalKid to come out to breakfast, no her favorite thing to do (but one of mine...MMMM...bacon...).
And I finally picked up my new bike.  I've always loved to ride; not like those serious teams of Spandex-clad road bikers---I just love to get on my bike and ride.  It feels like freedom.  Today I rode with the kiddo very slowly, then took my own Fathers' Day ride to the cafe for espresso and reading.  I came home, hung a bag if IV fluids for the Mrs, and ordered pizza for me and PalKid (a bit cruel given MrsPal's inability to share, but...).

I'm lucky enough to have two living parents.  My dad was born in 1926, one of the few first generation Americans left in my family.  When we had a dog, one that managed to live over twenty years, he would kvetch about the old thing, but he would also sit on the floor hand feeding her until she finally had to be put down.  He's very loving, but I like to think that I had a hand in teaching him how to hug his adult kids.  But when it came to my daughter, he was immediately smitten.

Better than a pet, and talks a lot more

And she is a charmer.  A charmer who hates to go to sleep because it means she would have to stop talking.  When my wife was in the hospital, I had an opportunity to spend more time with her, to both appreciate how much my wife really does raising a child, and how much more time I wish I had with them both.
My father is a physician, one who trained in the 1940's, went off to the Korean War to try to patch up broken minds, and spent decades doing similar but less horrid work in the US.   He is a man who went to college during WW II, and given the absence of young athletes, worked out with the University of Michigan football team---until it interfered too much with practicing the violin.  He rode a train through Nazi Germany as a passenger, riding with his parents to convince our family to leave Europe.  At least, this is how I remember these stories.

As a physician, he has high expectations of himself and of his colleagues.  He taught me very early---before I even considered medicine---the importance of confidentiality, of watching a patient, looking for details, even those that might supposedly be outside your own specialty.  I still call him from time to time to run questions by him, both psychiatric and medical.  My sister, also a violinist, plays the piano, and when I hear her play, I can't believe it's her second instrument. It's the same with my father and internal medicine: it may not be his first instrument, but he sure can play.

The first rule of fatherhood is "there are no rules".  Every child is different, every father is different, and every father-child relationship is different.  I'm still new to this, and I have no advice to offer, but dad's, please adore your children, as much as my dad adores his, as much as I adore mine.  The rest is commentary. Go and learn it.

3 responses so far

Old time rock and roll

Jun 08 2011 Published by under Fatherhood, Medicine

"Daddy, is that an electric guitar?"

"Yes dear, it is."

"It's cool! Is it rock and roll?"


"Daddy," she said quietly, almost conspiratorially, "don't tell anyone but I like Bob Seger more than Taylor Swift."

We drove toward her swim class, and Radio Disney was thankfully unavailable.  I put my MP3 player on shuffle, and for once, PalKid didn't freak out.  Van Morrison, The Beatles, Carole King, Elvis Costello, Daniel Lanois, Los Lobos, Miles Davis---all sorts of music poured into the car.  She didn't like it all, but she asked all the right questions.

"Is this jazz?  It sounds like jazz."

"Well, jazz and rock and roll, they're sort of cousins."

"I like the girl singers. Who's this one?"

"Her name is Norah Jones."

"She sings so pretty, Daddy."


We finally made it to the pool.  She was, as has been her habit lately, very clingy. A broad-shouldered swim instructor with a whistle hanging from her lips like a cigarette peeled her off of me and tossed her to the young men in the water.  As I walked away, she began to swim a damned good front crawl, breathing and all.  I haven't taken her to swimming in a long time.  The crowd of mostly young parents was dressed in everything from t-shirts to shalwar kameez and all the kids were cute, but not as cute as my kiddo.  I promised her if she comported herself well (no whining!) we would go to our favorite frozen custard place.

Thank god she did.  There's nothing like real frozen custard on a 95 degree evening, letting my daughter sit in the front seat (in park) and spin the tunes.

At home, it was time to make the beds, set up the IV, tuck in the kiddo, and that's really about all I remember until MrsPal woke me from PalKid's bed to flush the IV.


And medicine keeps happening.  I'm finding that in general, my patients tend to listen to me more than to quacks.  Daily, they offer me clippings or printouts of the latest miracle cures, asking if it's too good to be true.  Thanks to the research I do for my writing, and to the writing of others such as the crew at Science-Based Medicine (from which I've been sadly absent of late), I can tell them not only that it's bunk, but exactly what kind of bunk and why.  The preliminaries dealt with, we can move on to the real business of preventing and treating disease, a job that gets more fun by the day.


5 responses so far

It's Quiet

May 22 2011 Published by under Fatherhood

I'm sitting on a chair in my family room listening to Blood on the Tracks and it's peaceful.  Six hours ago, my wife was sitting in this same chair while a brave nurse tried to find one more vein to get an IV in.  In the last six weeks, all of our routines, every simple act we count on have been upended.

When I see a patient, I barely get the Cliff Notes; behind every worried look is a drama, one affecting many more people than the one sitting in the room with me.  My usual task is to understand it, not to live it.

Our little drama has had some repercussions of its own.  I normally work three nights a week and every weekend, and with MrsPal at home ill, this hasn't always been possible.  I miss my residents.  I miss the work.  But suddenly I'm spending far more time with my kid and my wife than I'd ever expected.  Much of that time is basic care-taking:  showering, changing dressings, hanging IVs.  But when routines are thrown off so quickly, all sorts of strange things happen.

This morning I woke up at seven.  I cursed, rolled out of bed and got into the shower.  In the shower I realized two things: first, it was Saturday, and I could turn off the shower and go back to bed.  Second, my bed (not my marital bed---that's a bit full of spouse and supporting equipment at the moment) was empty.  Since this journey began, my daughter hasn't been able to sleep alone.  Every night she climbs into bed with me, follows me around in fact until I'm ready to go to sleep.  Once MrsPal got back from the hospital the pattern continued.  She could not, would not go to bed alone, would not be alone at all in fact during the evening.

Last night, after a long evening at a school event, she folded over and snored her way home, and fell asleep in her own bed.  Tonight, she asked for a sleepover at a friend's house.  I was so worried about my kiddo, so concerned that the fear about her mom would overwhelm her, but she's a lot more smart and resilient than I'd realized.  It probably helps that mom looks a lot more like mom and is back to bugging her about her homework.

She's even resilient enough to turn on some more complex scams.  Yes, she's gotten pretty much everything she's wanted the last month or two, but we've been starting to reel her back in.  Tonight she batted her big brown eyes at her friend's mom and asked if she would go with her to get her ears pierced, an activity that we have not endorsed.   The layers of her aborted scam weren't quite The Usual Suspects, but not bad for a six year old.

So it's quiet around here tonight.  MrsPal is comfortable enough to have fallen asleep (and her IV is done for the night), and PalKid isn't here at all.  I'm grateful for the solitude.

But it's really, really quiet.

One response so far

Brief update

Apr 28 2011 Published by under Fatherhood, Medicine, Narcissistic self-involvement

When MrsPal was young she babysat for a local doctor's family. One of her charges is now a resident at my hospital, another a successful business woman, another a teacher if I recall correctly. The father is the head of my state medical specialty society and is one of the finest doctors I know. His wife, with whom my wife shares a unique closeness, has been at the bedside nearly as much as my mother-in-law, helping with everything from showering to answering emails to keeping the flowers fresh. And my mom-in-law has spent hours every day at the bedside, keeping her daughter company, watching over her recovery.

MrsPal is still hanging out in the hospital, and I'm still learning how much work she puts into getting PalKid where she needs to be from moment to moment. If it weren't for the help of friends and family---and a very loving and loyal babysitter---I have no idea how we'd do this. My wife seems to inspire a closeness in her friends, who are in and out of her room visiting, and are constantly calling, texting, emailing, and calling me with offers of babysitting.

I had a close call today: on my way from office to hospital, PalKid's teacher called---Daisy Scouts was cancelled, and she and PalKid were hanging out doing homework. I turned the car around, grabbed the kiddo, and went to my folk's place, where we were fed and watered and generally spoiled for a while. This required missing yet another hospital shift, but my little pal is requiring a lot of love and attention at the moment.

After a good shower, I removed her nail polish (yeah, yeah...) and I'm letting her try to trim her nails for the first time. She's actually not bad at it, and doesn't need reading glasses. If I can get her to fall asleep by eleven, I'll count myself lucky. If we don't get any more thunder tonight, I'll count myself luckier.

7 responses so far

Thunder and lightning

I'd be asleep right now if a loud clap of thunder hadn't sent me bolt upright.  Fortunately, my daughter's only reaction was to mutter senselessly, turn over, and snore peacefully. She's slept with me nearly every night since her mother has been in the hospital.   She's done remarkably well with unexpected changes, even sleeping at a friend's house.  At night she mentions missing mommy, but generally she's her usual charming self.  Last night she realized she'd left her favorite pillow at her friend's house, and that broke her.  She sobbed uncontrollably for her pillow until finally, at nearly midnight, my friend came by in her PJs and dropped it off.

We stopped by another friend's house last night.  It turns out that when there's a crisis, friends are a good thing to have.  She played with the other kids and I ate sushi with the adults, two of whom she refused to believe were married because "girls don't marry girls"---except of course when they do.  She'll figure that one out eventually.

Despite her sticking to me like glue, she's getting pretty tired of a boring old adult, so I just dropped her at another friend's house to play and paint Easter eggs, so for a while at least I get a break from single parenthood.  At least it's a temporary single parenthood.  I was chatting with a colleague yesterday who recently lost his wife.  I am also even more amazed that MrsPal gets done everything she needs to in a day.  I've bent my work schedule nearly to the breaking point and it still takes all the help I can get just to get PalKid where she needs to be from moment to moment.

I don't really know yet how PalKid is processing this whole thing, except that I have a little bedfellow every night, one that despite her diminutive stature can turn a king sized bed into a small palate.

Hopefully she'll enjoy the whole Easter egg thing and come home nice and tired.  Daddy needs some sack time.

16 responses so far

Weekend musings

Jan 15 2011 Published by under Fatherhood, Medical Musings, Medicine

It's another cold, windy, winter day here in the Great Lakes state.  From my kitchen table I can see the snow drifts pile up against an old oak tree.  There's a baby swing still hanging from the lowest branch.  PalKid hasn't been able to sit in it for years, but for some reason, I've never bothered to take it down.

Yesterday around five a.m., a small voice woke me up.

"Daddy, I can't sleep."

"Come on in bed next to me and you can stay here, just be quiet, honey."

A few minutes later: "Daddy, I don't feel good.  I have a headache. Can I have a cold cloth?"

Mrs. Pal called me at work later to tell me PalKid had a fever of about 102 and was feeling miserable.  I ran into a colleague today at the hospital and he told me, "You're only as happy as your least happy kid," and that seems about right.  Last night was rough, and that cute little voice got me up at four this morning.  She was feeling miserable, and after getting some tylenol in her, she asked for a cool bath.  A few hours later, I was on my way to the hospital, not for her thankfully, but to see patients.

My new practice uses a hospitalist service, so I'm not the one taking care of my patients in the  hospital anymore, but I still like to check on them once in a while when time permits.  The new practice is very, very busy, which is great, but there really isn't time to round regularly.  I did manage to visit a couple of folks today (and missed a few also...sorry).  I got a big hug from one patient, and nearly cried.  I was happy to see he was recovering nicely after a big scare.

Someone asked me this week how I deal with giving bad news, with maintaining a clinical distance.  I have no idea.  Much has been written about this, but there is no right way to deal with these boundaries.  Being a physician is a privilege, and a strange one.  It's a bit like being a writer, inhabiting lives that aren't yours, being privy to the private dialog of others, to their happiness and tragedy.  Sometimes it hurts.  Sometimes it is ecstasy.  Rarely is it simple.

But for today, at least, I'm mostly a daddy taking care of a sick kid, bringing her ginger ale in bed, enjoying a smile meant just for me.

8 responses so far

My daughter the writer

Nov 04 2010 Published by under Fatherhood

OK, PalKid is only in first grade, but her new school insists that she write regularly, a practice I strongly endorse.  For those of you who don't have little kids, the current practice is to let kids spell however they wish when they are free-writing.  Because I love my readers, I will share with you some of the earliest works of the soon-to-be famous PalKid.


My Weekend

I plad a socr gaem.  it rand. it was fun. I went to pik up my cussin for a move. it was fun.


If i was a fair fitr for a day. I wud put out the fire. i wud be fun and i wud slid down the poll vere sopr dopr fast

If an alien landed in scool. I wuod giv it loss ov fod. and I giv it a bubule bath.

I went to the appal orchrd I had cidr and donas i pikd like 80 appals. i went an a hae rid. i went with my Daddy and Granp and my Grama. it as all fun.

If trick-or-treating was cancelled my Mommy and daddy would put candy in a estr eggs. it wuld be cool.

She also sent me her first text message today: "it is [PalKid's full name]    i love you very much daddy            a lot"

All that's left to do is set her up on WordPress and twitter.

9 responses so far

A monster?

Aug 09 2010 Published by under [Medicine&Pharma], Fatherhood, Medicine, Uncategorized

I'm certain that I've written previously on the perils of being your own physician.  Many of these perils should be obvious to a disinterested observer, and many apply to being a physician to family members.  But in small, close-knit communities, some familiarity with one's patients is often inevitable.  Where does a patient become "too close"? Sibling? Cousin?  Next door neighbor?  Person you grew up with and have dinner with from time to time?

These questions don't have obvious solutions, but to be a doctor, whether to those close to you or to strangers, one must recognize that wishes (in the psychological sense) can kill (in the concrete sense).

One day my daughter was on rounds with me and as usual I bought her a cookie.  A little while later she was complaining of not feeling well, having a sore throat, and a stomach ache.  By the time I got her home, she had hives.  We called the doctor, who didn't seem too concerned, and we gave her benadryl and an albuterol treatment.  She was better within the hour.  My wife pointed out to me that our daughter was having an allergic reaction---a severe one.  I hadn't even considered it, but of course she was right.  An ingredient list of the cookies showed they were made with walnuts, and later testing confirmed a walnut allergy.

As parents, we are like doctors to our own children.  We don't want to believe anything bad can happen to them and we may naturally minimize their complaints.  This is not always a bad thing.  Frequently, physical complaints are what we get from kids when actually they are anxious or tired or cranky.  And for many, it feels saner than its opposite; we may ridicule parents who take the kid to the doctor every time they blink funny.

I recently came upon an interesting blog, whose latest post is called, "I am a monster."  I can understand the author's fears, being a parent myself, but it's interesting how he takes a normal occurrence (trying to judge a  child's level of illness or injury), and conflates it with his own pathology.  Most parents feel guilty when anything happens to their kids, and many parents are burdened with various constitutional biases that determine how they make these judgments.  Barriers to seeking medical care are innumerable.  Aside from the obvious difficulty in determining which boo-boos require a doctor's evaluation, parents may worry about economic barriers.  They may have difficulty getting transportation to an adequate facility.  They may have their own fears of finding something wrong if they do go to the doctor.

But these fears are not the problem.  Introspection---a real examination of motivations in decision making---and collaboration with another adult can help with each individual decision and those that come after.  The blog post was a brave confession of fears all of us parents carry.

2 responses so far

How did we get here?

Jun 15 2010 Published by under Fatherhood, Medicine

My wife is an accomplished professional. She loves her profession, and she's damned good at it. But she is officially "unemployed", and it kills her every time she has to put that down on a form. So how is it that she came to be unemployed?

When we met, MrsPal and I were both working full time---more than full time, actually. I'd have to say she was actually working quite a bit harder than I was. After we were engaged, an opportunity arose for her to cut back on her grueling schedule, but to do it she would have to quit her job entirely. For a variety of reasons, that is what she chose to do.

She became pregnant shortly after we were married, and it was not a pregnancy that would have mixed well with work. Over the years, by default, I have become the primary wage-earner in the family, and she has become the primary at-home parent and manager of the household (i.e. the one who does everything). Various conversations online and off have led me to wonder exactly how we came to this particular pattern.

We met fairly early in my career. I had spent the better part of my life in training, and MrsPal was already a veteran teacher. At that point, we could have made a conscious decision to appoint one of us the primary wage earner. We didn't. We allowed ourselves to carry on working our usual pace, but I know she was wondering how to balance her home life and career. I was not subjected to as much of a conundrum as it was always assumed that as a doctor I would keep doctoring. As a society, we have decided to compensate teachers (about 75% of whom are women) far less than doctors, so there were significant practical concerns. We also don't value pregnancy and early parenting enough to allow people to do it without significant risk to their job.

As my readers know, I love writing about fatherhood, but my ability to be a father depends entirely on my wife's decision to stay at home and work her ass off.  Sure, we could have chosen for her to keep her job, but that would have meant a huge sacrifice in income.  And at the time we established this pattern, it wouldn't have really crossed my mind.  Now, though, I think about it quite often.  Like many couples, we argue about the division of labor in our household.  It's a difficult problem,  trying to make both partners feel their work is equally valued in spite of cultural norms.  I don't have the answer, but it's important to acknowledge that it's a problem; a problem of society, and a problem of individuals such as myself who allow their spouses to feel less than well-compensated for their work.

I'll admit to some discomfort writing about an issue that involves me so personally, and that indicts me as part of the problem.  But someone's got to, right? And thank you, MrsPal, for being a great partner.  I'll keep trying to be one as well.

23 responses so far

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