Tuesdays with Mommy

Back Camera

I had a very special brunch date today with my son.  He’s been staying home with me on Tuesdays, my work-from-home day that allows me the privilege of extra time with my son and my work is luckily flexible enough to be shifted to nap time, evenings, and weekends.  As he became increasingly comfortable at nursery school I began to wonder if keeping him home with me was selfish—he loves school, has many friends, and learns a ton from his teachers.  I didn’t know if Tuesdays with Mommy could compare, but as a working mom the bonding time is important and special to me, so they continued.

Today we accomplished something for which I have been waiting a long time.  B and I have taken N out to eat MANY times, sometimes successfully, sometimes leaving restaurants in shame or with very generous tips, but I had not yet done this on my own.  I’ll admit that mostly this is because I was overwhelmed at the idea of taking him to an actual restaurant without an extra set of hands.  Usually one of us preoccupies him while the other childproofs the table and digs through the diaper bag for toys, snacks, and other tricks of the trade.   I worried that this would be too much for me to do alone.

With a recent burst in language and declining number of tantrums, I decided to brave it as part of our Tuesday adventures.  I asked N if he wanted grilled cheese and with the ensuing repetition of “cheese, cheese, cheese” I agreed that we should head out to a local café.  We were lucky that our waitress seemed to understand the urgency to ordering and bringing our food promptly.  I ordered French toast and N ordered grilled cheese.   He of course ate my French toast and ignored the grilled cheese.

A major difference about today’s brunch though, besides being the solo parent, was there was no diaper bag full of distractors, there was no pacing around the restaurant, and there was no screaming.  We sat and had a civilized, almost adult meal.  We discussed the “straw straws” (strawberries) that came with the French toast, we said “buh-bye” to the ladies at the table next to us, and we politely asked for water when thirsty.   We ate off plates.  No food touched the ground.

In the haze that is sometimes working full time and parenting, I sat at the café table today and saw my little baby as the little boy he is becoming.  I glimpsed a future of brunches together where we share stories and meals like friends.  If I didn’t already treasure these Tuesdays together, I certainly did today.  I’m looking forward to next week already.

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Filed under Childcare, City Life, Parenting, Work-Life Balance

The Elmo Around Us

Everyone likes Sesame Street and even critics of television give Sesame Street support.   Like many of you, I grew up watching Sesame Street, however, I remember the traditional characters of Oscar the Grouch, Big Bird, and Snuffleupagus, making a bigger impression on me than Elmo.  My first real Elmo memory is from college, when I got the Special Edition Tickle Me Elmo as an audience gift on the Rosie O’Donnell Show.  At that time though, Elmo symbolized the chance of winning $200,000, rather than educational children’s television.

I have allowed N to watch Sesame Street multiple times, but it has yet to capture his interest.  Whenever on TV, he points at Big Bird and shouts “banana,” obviously leading me to believe he wasn’t really following this show.  With minimal exposure to Elmo, you can imagine my surprise when at Barnes and Noble he pointed to a stuffed version and shouted, “Elmooooo,” in that classic falsetto preschooler tone.  How did he already have character recognition for something to which he had less than 20 minutes of cumulative television exposure?

Elmo is everywhere, that’s how.  Exhibit A: Elmo is on the fruit pouches he eats on a daily basis.

Earth’s Best

Exhibit B: Elmo appears on so many articles of clothing that in any given week at least one classmate is wearing Elmo paraphernalia.

Elmo t-shirt at Target

Stride Rite Elmo shoes

Exhibit C:  Elmo loves to party.  He shows up in the party décor and cupcakes at 75%* of birthday parties for kids under the age of 3 (*this is a fabricated statistic, but I’ve been to enough baby parties to make a pretty good guess).

Courtesy of The Cupcake Blog

Exhibit D:  Elmo is a party pooper.  As I was working on writing this piece, I was doing a diaper change and N pointed to his Pamper shouting “Elmo” and lo and behold that little red rascal is on our diapers too.  I hadn’t previously realized that I wrapped my toddler in Elmo every day.

Pampers

And yes, sometimes my support of Elmo is more volitional.  When an Elmo character arrived at a party, I rushed to hand over my baby to this costumed stranger for the sake of a good photograph.

Elmo

There are worse characters on television for N to recognize and enjoy, so I’m not discouraging his interest in Elmo.  It makes me more aware though of the influence of television characters on children and their presence in children’s lives beyond television.

 I am amazed that despite the recent negative Kevin Clash publicity, Elmo’s image is going strong in the kiddie product market.  I imagine I’ll continue to run into him at school, the grocery store, and parties for years to come.  Maybe the next time I see him, I’ll ask who does his marketing, because that’s someone who deserves some recognition!

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Playground Potential

There’s a new playground in town, except it’s an old playground with a new facelift.  Of course, the reopening quickly attracted every parent looking for weekend entertainment, including us, and after a short walk we were back at Seger Playground, exploring the new slides, swings, and twirling things.  Any parent who walks past Seger regularly knows how highly anticipated this opening was for the preschool scene.  Once interested in gallery openings, where we discussed the art, fashion, and wine, we now find ourselves on playgrounds analyzing the climbing equipment with the same scrutiny.

playground

A red rope course linking pieces of playground equipment enticed kids big and small, but once on it the little ones were overwhelmed by how challenging it actually is.  A rescue by dad and we were back on track.  There were plenty of options for climbing though besides the ropes and I think we tackled all of them.  For sensory-seekers like N, there were not only swings, but see-saws and spinning pyramids.

Playground 2

As parents we enjoyed the cushioned terrain for the inevitable toddler stumbles and the well-gated and separated toddler area.  It took a whole 15 minutes before N realized there was another area for the “big kids.”  The only complaint was there were not enough garbage cans around for disposal of the tissues that I always end up stuffing in my pockets.  As I’ve mentioned here before, we have a garbage obsession in our household, so in some ways the lack of garbage cans in the play area limited that distraction.

Playground 3

It’s amazing how quickly I remember the excitement of a new playground: exploring new places, playing new games, and meeting new people.   My husband has a story he tells about “painting” a wooden playground boat with water with a preschool friend and they reminisce about this childhood innocence as adults.  I met a friend when she broke her clavicle falling from the McDonald’s playspace slide and we ended up roommates nearly twenty years later.  It is this sort of impact that childhood play has on us that I am excited to watch unfold as we venture to the various Philadelphia playgrounds each weekend.  I love watching N’s imagination develop and in entering his pretend world, I get to relive my own.

Here are some of my other favorite Philly playgrounds/parks:

Palumbo Playground

Sister Cities

Smith Playhouse

Nest

For more information about playgrounds and things to do with kids in Philadelphia (I have no affiliation with these blogs/websites):

http://phillyplaygrounds.blogspot.com/

http://www.phillyfun4kids.com/

http://kidsincentercity.com/

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Trashed

I knew that in parenting a son I would be out of my comfort zone on more than a few occasions, however, I had no idea how often we would be discussing garbage.  “Gar-gar,” as N affectionately calls it, is the topic of almost all conversations.  Sometimes when he wakes, yet to be rescued from his crib, I hear him babbling about gar-gar and it makes me laugh.

He brings garbage that he finds to the nearest garbage can, points to any garbage cans or trucks he sees on the street, and drives his toy garbage trucks around our house– it’s all about garbage.  At first, having him pick up pieces of garbage and run them to the trash can was helpful: “here, put this in the garbage for mommy.”  Then, when he started collecting garbage on the playground it became less cute and I became more germaphobic.

Back Camera

I’ve learned that many little boys are obsessed with garbage trucks at this age (and I’ve been reassured that they usually outgrow it).  If your son is as well, I recommend the Green Toys Recycling Truck as it has provided many hours of durable play at our house.  I like to think of N’s garbage obsession as a sign of a budding environmentalist and so his toys reflect that.

One of the most peculiar garbage experiences yet though occurred as we watched our garbage being collected one Saturday morning.  N yelled “hi” from our doorway as he watched the men fling bottles and cardboard into the monstrous metal machine.  He squealed with excitement as the driver honked and waved.  Then, the driver came running up to our door and handed me $3.  Baffled by this generous gesture, I immediately refused it.  However, he waved the dollars at me with pleading eyes and said, “come on, it’s for the baby.  Trash men have a heart too.”

Garbage truck

Three dollars richer, I thought about what to do with the money.  N already has a savings account, so I thought about doing something more frivolous with the money.  I could buy him a new gar-gar truck, but our playroom already has at least 4 and I’m thinking that’s over-quota.  So, I decided to use the money as an inspiration to invest in some stocks and created an Education Savings Account.  I bought some child inspired stock to get it started and hope that as it grows along with N we can learn together about saving, investing, and taking risks.  While my hope for his savings accounts are that they help pay for his education someday, I hope he also learns from the man who helped contribute to it and shows kindness to strangers.  I know he will pay it forward.  After all, gar-gar men have a heart.

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Adopting Hope for Orphans Everywhere– the Russian Chapter

I just put my son down for a nap and have a million household chores to complete during his slumber, but my heart is heavy with the thoughts of the 650,000 Russian orphans (120,000 of them available for adoption) who will fall asleep today without being rocked, read to, and kissed as sweetly as my son was before his nap.  Yesterday, Vladimir  Putin signed the Yakovlev Act, which bans intercountry adoption between Russia and the US, limiting the possibility of those orphans, many with complex medical conditions, finding a loving forever family and 1,500 of them who have already had the promise of a family given to them now with an uncertain future. Image

Thirteen years ago, my parents traveled to China to bring home my sister.  Despite that she was born in a region of the world that I have never seen and a family I can only imagine, she has always been my sister.  She was young enough at the time that she doesn’t remember the loss of her birth family, but I assure you that as she enters her adolescence that loss is palpable.  A recent documentary film, Somewhere Between, does an amazing job of exploring the coming-of-age of adoptees from China, so I won’t attempt to duplicate it here but rather refer you to this beautiful film.  While the loss of her birth family and culture is something that my sister will have to grapple with in finding her own identity, she now has a family who will always be there to help and support her along her journey.   I can’t help but think of the Russian orphans who will someday be facing these issues alone, without the unconditional and profuse love of parents or siblings to provide a secure base from which to explore the splendor and sadness of the world.

I am also reminded of the orphans in our own country.  Fifty-three years ago, my father was one of them until adopted into a family of his maternal aunt and six cousins.  His aunt, my Nana, did not see him as a commodity or political statement, but as an innocent child looking for the love of a family, which she could provide.  Without this adoption, he may have ended up in the US foster care system, where 423,000 other orphans experience the transient affection of semi-permanent families, with repeated loss and disruption, and 30,000 of them come-of-age without a forever family.

In my work as an adoption medicine specialist, I am often counseling families about the risk of adopting a particular child, based on their medical, developmental, and emotional needs.  We have never discussed the risk though that the child whom they fall in love with and becomes their own will be prohibited from joining their family due to retaliatory political laws.  We do not discuss that they may have to parent their children across an ocean, for years, or a lifetime.   We do not discuss that while they have a warm bed, plush toys, and endless affection waiting for their child that a crowded, cold, silent room will be their home indefinitely.   My heart breaks for these broken families and the children, who already orphaned by a family are now orphaned by a country.

For more information about the above topics, check out:

http://www.nytimes.com/2012/12/28/world/europe/putin-to-sign-ban-on-us-adoptions-of-russian-children.html?pagewanted=all

http://www.state.gov/r/pa/prs/ps/2012/12/202401.htm

http://www.davethomasfoundation.org/

If you are already in the process of adopting from Russia, the U.S. Department of State requests that you email the Department of State at AskCI@state.gov and state the stage and status of your adoption.  Use “Intercountry Adoption in Russia – Family Update” in the subject line of the email.

To subscribe to email alerts regarding Russian adoption, click here:

http://adoption.state.gov/country_information/country_specific_alerts_notices.php?alert_notice_type=alerts&alert_notice_file=russia_5

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New Year, New Mom

Back Camera

A year ago was my second ever blog post: Resolutions.  At that time, I was still writing for myself and had not yet shared publicly my 2012 resolution to use my experiences doctoring to be a better mom.  A year later I can say that I have honored that resolution and use my daily experiences in the office to inspire and guide my parenting decisions and reactions.  I am definitely a better mom as a result.

This year I have been thinking a lot about what my resolution should be, and now I have a much broader audience to hold me to it.

Parenting a toddler makes you feel powerless.  It’s hard to predict when the next tantrum will strike, what food will end up in his mouth or on the floor, and how quickly he will learn new skills (like jumping off the stairs).  Our parenting approach is often a tag-team effort, meant to give one of us a break while the other keeps our toddler alive.  While we each get quality time with our son, we end up seeing less of each other.

On vacation with family for the holidays, my husband turned to me on day 3 and said, “Oh hey, how are you?  I feel like I haven’t seen you.”  This is representative of our lives currently, where we see each other all the time, but we aren’t actually connecting due to the many interruptions of life.   In the process of becoming better employees, homeowners, and parents, we have become worse spouses.  So it became obvious that my 2013 resolution should be to work as hard at being a wife as I do at being a mom.  These roles should be complimentary and not contradictory.   Reflecting back to the lessons learned in 2012, I’ll listen to the advice I’ve given many parents: a cohesive team of loving parents will lead to a happier toddler and teach him valuable lessons about relationships as he begins to navigate his own.

What’s your 2013 resolution?

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The game of Life

Back CameraI’m a working mom, but being a mom doesn’t define my career goals.  Long before I ever thought about having children, I had decided that I wanted to be a primary care physician.  In fact, I went to medical school to become a primary care pediatrician and felt so strongly that this was my path that I would have switched professions rather than settle for another specialty.  It’s true that primary care affords me many luxuries as a working mom though, including no overnight calls in the hospital, office hours that allow me to do daycare pick-up and drop-off, and flexibility in scheduling.  These are just added benefits to a job that I love.  These lifestyle factors are increasingly becoming more important to women in medicine and are why so many more women end up in general pediatrics and primary care, whereas fields like cardiology and critical care are predominantly men.  It makes me feel bad for the women in these fields who have to make significant family planning decisions based on their career interests.

Recently though, two physicians have asked me if I was only doing this job for a few years or when I was going on for my fellowship.  The assumption here being that a former CHOP chief resident wouldn’t do primary care except for the lifestyle factors and that motherhood must have contributed to this decision.  I doubt that this question is asked to men in primary care.  I resent that there are still pediatricians who look down upon the important work that primary care physicians do and view my career as a loss of potential.  I am also saddened that while being a working mom in primary care is viewed as a “good choice” for raising children that the opposite is then thought of the working moms who follow their passion to the PICU/NICU/Onco [insert your favorite fellowship].  These moms face different work-life balance challenges than I do, but this doesn’t mean they love their children less or are less committed to motherhood.  I don’t think we should judge working moms based on how competitive we think their careers are, or aren’t.  I have many great mommy role models who work 30-hour shifts, weeks of nights, and 9-to-5.  We all do the best we can as mothers and doctors within the construct of what our specialty allows and in the more inspirational cases, we change the definition of what is allowed.

So the answer to your question is, I’m doing this forever.

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All Better

Image“This is the doctor, she’s going to make you feel all better,” countless moms have told their children as I try to examine them.  As a new attending physician, this statement weighs heavily on me.  Will I actually be able to make them feel better?  Our hospital’s latest marketing slogan is “All Better,” which suggests that it is my job to make this come true.  The last mom who promised her child this came in with a viral syndrome.  I was able to make the diagnosis, but unfortunately there was no treatment to be doled out and the only promise I could fulfill was that I expected him to improve in 3-5 days.  While I felt bad for the child, I think I felt worse for the mom because I had failed holding up her promise to her child.  Fortunately, there are many more cases where I am able to provide an answer and remedy, proving a mom right that the doctor really can make you feel well again.

The first time that my son fell and looked to me for comfort, I felt the magical power of being a mom.  Without any special skills or tools, other than hugs and kisses, I am able to soothe bruises, mend abrasions, and rejuvenate the spirit.  When I know his injury is minor, I am overjoyed to scoop him up give him hugs, and let him dry his tears and sniffles on my shoulder.  I am mom.  I am the one person who has the birthright of this role, but I work daily to maintain this privilege. There are few other roles in life other than mother that give you such an entitlement.  I have the fortune though of filling this role at home and at work.  The same way that my son looks to me for comfort, relief, and cure, children coming into my office have the same expectations.  However, when a recent fall landed us in the Emergency Department for stitches, I had to focus on my role as mom and not doctor, and like all the moms who come to see me, I promised my son that the doctor would fix it.  While I knew I could have done the procedure myself, I enjoyed being the one who wasn’t causing him to cry but rather letting him know he was safe and loved.  When the doctor was done and I kissed the salty tears off his face, I found myself saying, “now you are all better.”  And we both were.

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Portrait of a young artist

Moving into a new house makes you imagine the future.  I’ve pictured how my son’s new room will look, where he will ride his first bike, and where he will do his homework.  However, packing to move into this new house forces you to confront the past.  Instead of throwing everything into boxes, I’m trying to pack wisely and eliminate the clutter that accompanies us.  While it may be easy to part with my medical school review books and clothes collecting dust in the back of my closet, any memorabilia relating to my son is much more difficult to spare.  Sorting through each construction paper scribble project makes me nostalgic and since he’s only been scribbling for a few months, they aren’t even very old yet!

Years ago, I went through this with my younger sister.  Since I’ve lived outside my parents’ house for her entire life, my mom has mailed me pieces of her artwork over the years and I saved every one of them.  During this time period, I moved many times and each time packed up her artwork and filed it in another desk/dresser/bookshelf.  Eventually, I came up with the idea to scan each item and make a photo book, which not only organizes the pieces in a tidy format but preserves them through each move and over time.  Now that I am mother to my own little artist, I need to start scanning again so that I can save each project electronically and save the most special pieces for display.

In addition to packing for our move, Hurricane Sandy has made me think about what items in my home I value most.  The mayor and governor talk about taking your “most valuable possessions” with you in the case of an emergency evacuation.  Besides the people and pets in my home, what would I take?  Years ago, I would have said my photo albums, but now most photos are digital.  So many of the things that are precious to me are the little reminders of the good and bad times over the years, because after thirteen years with my husband, six years of marriage, and 19 months of being a parent, I know how quickly it all goes and I want to cherish it all.  As I’ve seen through my sister’s art, children’s drawings are a great way to see their perspective and development over time, which is why these projects are so special to me.  While N’s current art consists of scribbles and glued tissue paper, I am excited to see his progression and add each new masterpiece to his portfolio.

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Raw Image

An intern recently presented to me a premature baby discharged from a two-month NICU stay to her 15-year-old mom.  The intern’s eyes were wide as she read the pages and pages of NICU jargon that she was expected to synthesize into a plan for this baby.  After we discussed the primary care of a premature baby in general terms, I held up the discharge summary and said, “If this overwhelms you, imagine how this mom feels bringing home this baby.”  This pile of papers translates into a very tiny baby, who has already had an eventful life, and his young mother who has to learn how to meet his needs while maintaining her own identity.  “You need to go back in there and give this mom some encouragement and support.  That is the most important thing you can do today.”  This is how I feel about most newborn well visits.  After making sure the baby is healthy and safe, much of what I do is partnering with the mothers (and fathers) about how difficult, and yet amazing, their job is.  There is so much about those first few weeks that makes you barely able to recognize yourself or your former life and while you love your new baby more than anything, you dream about a full night of sleep and the freedom you once knew.  It helps to hear someone who has survived it all tell you that you will too.

I recently read another blog post about moms allowing themselves to be photographed with their children, despite their insecurities and lapses in hygiene.   I wrote earlier about how to dress your post-baby body, but I’ll admit that there aren’t a plethora of photos of me and my son to choose from for exactly the reasons that Allison Tate mentions, including putting my son’s grooming and fashion before my own.   However, I was asked for work to submit a photo of myself and my son for a newsletter and while scrolling through thousands of photos on my iPhone, I scarcely found any featuring myself.  I imagined that someday my presence in my son’s life would be undocumented (besides this blog!) and since then have tried to hand off the camera more often so that we can capture these moments.   I want my son to see the joy on my face when I am holding him, the bags under my eyes because we were up together all night, the pucker of my kisses all over his head, and the body that gave him life.

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Every so often, a family asks if they can take a photograph of me with their baby– usually to document their first exam.  I love these requests because it reminds me how special my work is when it starts to feel routine.  Lately though I have been the one asking families if I can photograph them.  One mother of nine had seven of her children in my office and while we were talking they had all managed to climb onto the exam table, sitting there with legs dangling like the photo of the men atop the skyscraper, so I asked if I could capture this on her camera.  How often could this mom possibly get photographed with her children?

For all the moms I see in my clinic who don’t have the ability to hand off their camera to others, or don’t have the mommy friends that I have to share their feelings, and can’t imagine that one day things will get easier and that the sleep and freedom they once knew will return, albeit in a different way, I try to offer them small pieces of that in 15-minute increments.  As mothers, we need to support each other and create a community that highlights the important work we do every day.  And while sometimes I am not sure what pearls I have to offer the brilliant residents with whom I work, my experiences from the trenches of motherhood are always freely shared because I think these are some of the most important things a young pediatrician can learn.

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