Friday, May 17, 2013

Being the Biggest Person

It probably would surprise most people to know that there are very few actual rules in medicine.  Being a doctor is a whole lot more art than science.  But still, there are a few rules, which often seem quite arbitrary but are actually based on science.

Today I was trying to decide on when to induce one of my patients, and I was struck by a dilemma resulting from one of those rules.  We followed some rules and settled months ago on May 30 for this patient's due date (OK, so maybe this story is about two rules).  She and I both want to induce her labor because she lives quite far from the hospital and is worried about delivering on the side of the road, but this kind of induction is essentially elective, which means that we can only do it a week before her due date.  This rule is one of the biggies.  Choose to deliver a baby too early, and you risk delivering one who isn't ready to breathe on its own, among other things.  Frustratingly, I am on call the day before we are clear to induce her and then have a  lot going on the rest of the week, so for convenience reasons, I would really like to fudge things a bit.  In fact, the patient and her husband both thought her due date was the 29th.  Oh, how I wish that were written in her chart!

Here's where it gets even stickier: I am the sole OB/GYN on a committee that reviews cases at our hospital.  Recently several cases came up for review for patients who were electively delivered a day or two before the 39-week mark.  All of my colleagues on the committee were irritated: how much difference could one or two days make?  I found myself defending my department and my specialty.  Yes, a day or two probably doesn't make a difference most of the time, but we've got to draw the line somewhere; it's a slippery slope between one or two days and four or five days or more, and there are few errors worse than delivering a baby who isn't ready for life on the outside without a really good reason.

As thoughts about fudging things entered my mind, I thought back to my role on the committee and my whole-hearted belief that people need to stick to the rules.  Most rules are there for a reason.  And so, with a somewhat heavy heart, I stuck with the patient's established due date and scheduled her induction for a day that is super inconvenient for me.

As a mother of an almost-two-year-old, I find myself internally debating this same issue all the time.  We set rules for our kids for one reason or another--I generally try to limit myself to those with a real purpose--but often enforcing them becomes a burden.  Just this evening, I was trying to get Asher to help me feed the dog, which is one of his "chores," and he was totally unreceptive.  I was too tired to fight that battle any longer and decided to do it alone.  His father was annoyed that I had caved like that, and I knew he was right.  Kids need us to be consistent with our rules.

Now that I have some time to contemplate my day, I have a couple of thoughts.

The first is that as parents we need to be the biggest person by setting a good example for our children.  This includes sticking to our own rules.  At work, that means not breaking a rule just because we know it doesn't really make a difference.  At home that means being consistent with our rules for our children and the consequences of breaking them.  It also means living by certain principles ourselves.  If you don't want your kid eating junk food, you need to stop eating all those cookies and chips and learn to love your veggies.

The second thought is that none of us is perfect.  I feel somewhat guilty for even having thoughts about breaking the rules at work, and I feel even worse that I let Asher slack off on his chores tonight.  In both cases, the offense is miniscule, but the slippery slope lies ahead.   Consistency with rules, which sometimes means being the bad guy, is my weakest point as a parent.  I always feel the pull to be lenient "just this once," but how many "just this once" incidents are too many?  I will always have days when I just can't summon the energy to fight the battle, but hopefully by reminding myself of the importance of consistency, I will be more mindful, and the battle won't seem quite so challenging.

Doing the right thing can be a challenge, but as parents, it is our duty.  The great thing about parenthood is the opportunity to grow along with our children.

Wednesday, May 15, 2013

MY Mornings

It all started in college.  My freshman roommate didn't have much of a social life, so pretty much the only time she wasn't in our tiny room was when she had a class.  Fortunately, her classes were always earlier than mine, so after she rushed off to her 8:00 lab, I had the room to myself for a few precious moments before my 10:30 lecture across campus.  Every morning, my CD player would wake me up to the same song--"The Kiss" by The Cure--around 9, and then I would get up, make coffee (the good stuff--I was probably the only kid in the dorm with a coffee grinder, and my mom would ship me my favorite roast from a shop in my hometown), nibble on a bagel or some sourdough (also shipped by Mom), and waste time on the internet, which was just starting to be a big thing.  It was the time I was most comfortable and the most myself.  There are a lot of things I don't remember about my years in school (SO many years!) because the moments got bulldozed by the knowledge I was acquiring, but those mornings when I was eighteen are still vivid.  The first measure of  Kiss Me, Kiss Me, Kiss Me takes me right back there.

I realize now that that year was the start of a lifetime of being a morning person.  I love having some quiet time after I get up.  It's the one time I can always think clearly.  Now Asher has joined me in a new early morning ritual.  He rises earlier than I would like, but fortunately he also likes to luxuriate in the quiet and slow pace of the morning.   Now we get up together, lounging on the couch while he has his morning milk.  We talk about the dog and cat, who have also just gotten up and had breakfast, and we chat about the plans for the day.  Sometimes, especially on Saturdays when we have extra time to be lazy, we watch a little Thomas or Zoboomafoo on PBS.  Most days, we move slowly for the first couple of hours.  I suck down a couple of cups of good coffee and check my email here and there.  Breakfast happens eventually, as does toothbushing and, sometimes, getting dressed (the beauty of having a nanny is not having to gear up for daycare every morning), but mostly we just chill out until the nanny arrives.  After that, it's a mad dash for me to get showered and ready and out the door.

I can't remember the last time I slept past 6:30, let alone 9, and the soundtrack is different, but my morning ritual continues, and I love it.  I don't truly appreciate how much I need that morning time until something interrupts it, like a surgery scheduled at 7:30.  Or a helpful husband getting up with the child so that I can sleep.  He wonders why a lot of mornings I get up and let him sleep even though it is "his" day.  The reality is that as tired as I might be, my Asher time is my new morning ritual, and without it, my day just isn't right.

One of the wonders of motherhood is how we change to accommodate the new little person in our lives.  The essence of who we are isn't gone, but it manifests in new ways.  In my case, those early hours are when I am most myself and most connected, and I can't think of another person I would rather share my mornings with.

Monday, May 13, 2013

Strut Your Stuff, Hot Mama!

Yesterday was Mothers' Day (I like to put the apostrophe there because it's not about just one mother--not sure what the official punctuation is), the one day a year when some women actually get to think about themselves.  A crazy concept, I know.  I've seen a lot of ads advertising "Mother's Day specials" on esthetic services like facials and manicures, and I venture to guess that those services are the focus of a lot of Mothers' Day gifts.  Though well-intentioned, I'm not sure I like the message that this one time out of the year, Mom should be allowed to primp and preen.  And, as is my opinion about most motherhood "problems," a lot of the attitude starts with us.

This is one of the two cards my husband got me for Mothers' Day this year.  I don't see myself this way at all.  It is a clear reminder of how we can view ourselves so differently from how others view us.  As thankful as I am to
have such a supportive husband, it doesn't remedy the problem.

After we have children, our focus changes.  It doesn't matter what we're wearing as long as our kids look cute (after all, we are always BEHIND the camera).  Our bodies might have changed after pregnancy.  A patient whose daughter is three told me last week that she wears pretty much the same thing every day because nothing fits.  One of my close friends held out hope and put off buying new shoes for six months after her feet grew during pregnancy.  We're always hoping to go back to the person we were before baby, even though that's rarely a possibility.  Even if we are the same weight, we are inevitably changed by the experience.  Then there's the lack of time: I have yet to see the toddler who is patient enough to let his mother try anything on at the store.  I know that many of us resort to throwing things in the cart at Target while we're doing the rest of the shopping, hoping that something will actually fit.  Besides, it's hard to find fashionable clothes that are affordable AND easy-care (heaven knows how much schmutz is going to end up on them).  Not to mention that at some point you realize that no matter how much makeup you pile on, you still look tired.  And those ponytails are so convenient, which means more time to play with the kid before work....The list of reasons not to get put-together every day goes on and on. 

My job has made me especially lazy because I can get away with wearing scrubs every day.  I noticed recently that over the last six months, scrubs have become my regular uniform.  It's not that scrubs actually save me much time--I still shower, put on makeup, and dry my hair (a short hairstyle that became a necessity after Asher was born because I didn't have 45 minutes to do my hair every morning)--but somehow I justified that my mornings were busy and scrubs were simply easier.  And cheaper.  And never went out of style.  And hid a multitude of figure flaws.  And, hey, I was still taking the time to do my hair and makeup, so that's taking care of business, right?

The reality is that wearing scrubs every day was reflecting an inner frumpiness.  I had gone from being a professional, confident woman to being a working mother, and I wasn't completely confident in either the "working" or the "mother" part of that equation.  My identity was drowning in a sea of "blues," smudged by snot and spilled milk, among other things.

Then, about a month ago, I decided to use some store credit to order a new dress, shades of pink in a geometric print, bright and perfect for spring.  When it arrived, I let it sit in the box for a couple of days.  Hubby couldn't understand why I didn't want to try it on, but I was scared--if it didn't fit or simply looked awful, it would just confirm the insecurity that I was already feeling.  Finally, on a weekend when no one else was around, I tried it on...and it fit...and looked damn good.  And I couldn't wait to wear it to work.

Since then, I've bought a few more dresses: comfy but bright and colorful and feminine, and all purchased online at a deep discount price from one of the same outlet sites I usually look at for toddler clothes and paraphernalia.  I have only worn scrubs on the days that really require them.  As a result, I find myself standing a bit taller and feeling more confident.  I admit that part of me wants to run and hide whenever anyone comments on what I'm wearing--I have spent so long hiding behind those scrubs--but I'm sure that if the trend continues, it won't seem like such an anomaly, and eventually, the attention won't feel so foreign and uncomfortable.

More importantly, I have reminded myself that I'm still a woman who deserves to feel good about herself all the time, not just on special occasions.  It doesn't matter how impatient the toddler, or how much your shape has changed, or how tight your family's budget might be, you deserve to look at least as good as your kid, and there are ways to make it work.  It's time to start showing who you really are.

Thursday, May 9, 2013

A Friend in Need...

Most mothers are challenged by healthy children who are ready to take on the world.  We worry more about unplanned pregnancies than the possibility that pregnancy might not be in our future.  The day-to-day stresses of mothering and trying to have a life wear on us.  And then things are put into perspective by a friend who is not so blessed.

Unfortunately, I have several such friends.  Friends who have struggled with infertility and abnormal pregnancies.  Friends who have successfully made it through pregnancy but find themselves months later with a child whose development just doesn't seem normal.  Friends who fill out hundreds of pages of forms to get their children the special education they need.  Friends who put their careers on hold to take their children to hours of various forms of therapy every week.  Friends who love their children dearly but cry every night about the hand they were dealt.  I know I'm not alone.  We all have these friends.

With Mothers' Day approaching, I am especially mindful of the great luck I have had in having a child who is brilliant and healthy and thriving with minimal work on anyone's part.  Despite coming up on two, we are having an amazing, wonderful time.  But I also realize the tinge of guilt I feel about this when I think about my friends who are not so fortunate. I am embarrassed to gripe about the normal everyday toddler stuff (number one on my list: the incessant babble) when I think about what my friends are facing every day. Working in a small community, I see this happen to my patients too; the scenario where one patient miscarries and her best friend, also a patient, has a completely uneventful pregnancy happens all he time.  The new mother feels awkward about the miscarriage and doesn't know what to say to her best friend.  It puts a wedge between them.

I know that in my own case, I am not the friend I wish I were.  I feel awkward, not sure what to say or what to do.  I know I can't fix the problem, and that makes me feel powerless.  I am afraid to share anything that is going on in my own life because I don't want my friend to compare.  I simply don't know what to do, so sometimes that means I just avoid contact.

What I do know is that real friends share in each other's joy and pain.  We are thrilled when a friend's child succeeds; we feel sorrow when a friend's child struggles.  And while we might feel a twinge of jealousy over one another's good luck, we never feel that the other's success is at our expense.  The reality is that as parents, we are all working and struggling to keep up, and every child has his talents and limitations, and every woman needs her friends to keep her afloat.

My pledge this Mothers' Day is to be a better friend.  I intend to stay mindful of the feelings of guilt that have kept me from providing the support my friends need.  And when my need to gripe about my own life creeps in, I WILL gripe...because I am a friend in need as well, and we're all in it together.

Monday, May 6, 2013

Bullies on the Playground

I am very confident about some aspects of parenthood: providing a healthy lifestyle, choosing a good education, teaching love for all living things, fostering a loving home environment.  There is one big aspect that leaves me quivering in my pumps (or clogs if I'm on call): discipline.  I would do almost anything to avoid confrontation, and even with my child, I am insecure at times.  Add another parent and her child to the mix, and I am totally hopeless.  Put me on a playground with a bunch of these people, and I want to cry.

Now, don't get me wrong.  We are actually really laid-back parents as far as the discipline goes.  We believe that children learn best when they experience the natural consequence of their actions.  We only intervene when there is actual danger.  We let Asher do all sorts of daring things that a lot of parents think are too risky.  We figure that if he gets a little bump on the head or is frustrated when he can't solve a problem, it  helps him learn about the world.  But we're also sticklers for manners and rules ("please" and "thank you," cleaning up after yourself, etc.) and are trying to teach Asher to use verbal communication to express his needs.  Too bad he's learning this from the queen of non-confrontation.

This problem became apparent about a year ago when I took Asher, who was just barely walking, to a playground in our neighborhood, where we met a little boy who was just a couple of months older.  They were interested in each other.  The little boy had a couple of big brothers running around, and Asher was fascinated by the three of them.  Until the little boy hit Asher.  And not by accident.  I had no idea what to do.  I quietly told the other boy that he wasn't being nice and then told Asher, half-heartedly, that it wasn't a big deal, hoping that he wouldn't freak out.  The other mother laughed it off, saying that he had learned that behavior from his older siblings.  Flustered and frustrated, I kept my mouth shut and, shortly thereafter, declared that my pallid child had been in the sun too long and that we needed to go home, and so we made a cowardly exit.  I realized that I had chickened out.

What I've learned in the last year is that I have a child who is by nature non-confrontational, just like his mother.  When other kids want his toy, he lets them take it.  If a kid pushes him down, he doesn't cry.  He might look bewildered for a second, but then he finds something new to do.  Similarly, if he's interested in someone else's toy and that kid won't give it up easily, he moves on.  He's one of those smiley kids that everyone wants to be friends with.  He's incredibly charming and incredibly versatile, and I never worry about how he's going to mix with other children. 

I know a lot of you are wondering right now how this could possibly be a problem.  Yes, having a child who is contented and easy-going and polite in his interactions with others does spare me a lot of the usual kinds of toddler discipline.  But it leaves me with a whole different set of problems: how do I teach my kid to stand up for himself without spoiling his happy-go-lucky attitude, and how do I keep the bullies from running all over him?  Today was a prime example.

I had the afternoon off after being on-call this weekend, so Nanny Becca and I decided to use a Groupon that I had bought a couple of weeks ago to take Asher to one of those bounce-house facilities where they have a bunch of inflatable slides and things to play on.  I was encouraged when we arrived that there was one other child there, a boy about a year or two older, and he seemed pretty energetic.  I thought he might be able to show Asher the ropes.  Unfortunately, I was wrong.  While his mother spent the whole outing on her phone, presumably checking email or playing a game or something, this kid set out to own the "playground."  Anything that Asher touched, he wanted.  And if Asher showed any interest in what the other boy was touching, the boy got physical.  I had no idea what to do, and this kids' mom was not doing a damn thing to teach her child how to play well with others.

At one point, I realized that Asher needed to learn to ask directly for what he wants, so we started learning a new phrase, "May I please...."  Amazingly, this bratty kid heard him and then responded by telling him what Asher could and could not touch.  I realized this was the key to teaching my less dominant child how to assert himself.  They were actually getting along.

Then Mom saw what was going on and, assuming that he was being his usual domineering self, yelled at the little boy and gave him a time-out.  And then she went right back to her phone.  And then he got up and again started taking things away from Asher and trying to push him off the equipment he was playing on.  And then, when Asher was happily running across the floor, he checked him (in the hockey sense).  I have no idea where the kid learned this move, but he was clearly an expert.  Again I was stuck in the same playground situation: what to do when another kid is nasty to Asher?  How do I make it not too big a deal for Asher while at the same time teaching the other child that the behavior is wrong? 

I am without an answer.  Again, I told Asher that the other boy's behavior wasn't nice but that he wasn't hurt.  Asher, who didn't cry or show anything besides shock at what had happened, started saying, "Sorry.  Sorry," because he knows that is what you say when you've done something hurtful to another person (or animal, as is most often the case in our house).  It broke my heart.  The little boy eventually was instructed by his mother to look at Asher and apologize "like he meant it," but I'm quite certain he doesn't really get it.

I don't want my child to learn to be a bully, but yet, I want him to learn to stand up for himself.  It's not my job to fight his battles, but I am responsible for giving him the tools to function in the world.  And here I am battling the enemy--the parent who doesn't provide these tools for her own child--myself.  What do I say to her?  How do I balance teaching my child how to get along in the real world without letting hers get away with nasty behavior?  How do I encourage mine to communicate his needs directly when all she does is punish hers for expressing himself physically?  How do I keep my kid "nice" without making him a target for the bullies?

Uncharacteristically, I am without an answer.

Friday, May 3, 2013

Let It Out

When I first started working in private practice, I was informed by someone that a bunch of websites listed me as a psychiatrist in Los Angeles (my awesome hubby has since fixed that error, thank goodness).  I found that a bit ironic, given that my least favorite rotation in all of med school was psychiatry.  And yet, it turns out that I deal with mental health issues almost every day both at work and (no shock) at home.

Today I jokingly mentioned to a couple of patients, who were both apologizing for breaking down in tears during their appointments, that I don't feel like I'm doing my job right if I don't make at least one person cry every day.  Obviously, crying is not exactly my goal.  But I guess part of me knows that I'm providing a therapeutic environment when patients feel comfortable crying in front of me and telling me how they really feel.  I can honestly say that it is a rare day that I don't see any tears or talk about sensitive, painful issues with someone. When I picked my specialty, I never realized how much of this my job would involve, and yet, unlike my psych rotation, which never really clicked for me, this feels a bit like my niche, and as much as I sort of dread appointments that are likely to involve tears because I know that they will be draining, I always feel a closer connection to those women.

Dealing with depression and anxiety and other big emotions can be intimidating, but I think the biggest hurdle for a lot of people is facing the person crying in front of them.  The tendency is the shove a bunch of Kleenex at her and hope she'll perk up.  The crying is uncomfortable to watch, especially when there is just silence cut by sobs.  All we want is for her to stop crying so that our discomfort will end, but, as you might imagine, just telling her to stop will only alienate her and teach her that her emotions are not OK and that you don't care.  On the other hand, if you can suck it up and sit through the crying and help her express what's wrong, you might be able to start to understand what the problem is, but it is not an easy thing to do.

The big news here is that it's the same with our kids.  We all hate when our children are upset and crying and throwing tantrums.  Most of us try to hush the offending child, telling him that he's fine or ordering him to stop crying or trying to distract him, but even if that diffuses the situation, which it often does not, it doesn't fix anything.  Worse, it just teaches him that his parents don't really care what's going on with him and that his feelings are unimportant.

Being mindful of our discomfort and feelings of insecurity when people are expressing big emotions can help us respond more empathetically.  If we can join in our children's tantrums in a more empathetic way, we teach them to process their feelings rather than just shutting them out.  They learn mindfulness, which is a key to being able to respond in a positive way to stress, rather than a way that emphasizes stuffing the pain away.  Imagine what it would be like if, instead of saying, "Oh, you're OK.  Get over it," you said, "I can see you're upset.  Tell me what's wrong."  Granted, what is wrong might be something that seems trivial to us, but asking your child to put the problem into words will start helping him learn to identify his emotions so that he can have some control over them.  Your toddler's tantrums probably won't stop overnight, but when he starts understanding better where his feelings are coming from and he starts to feel that his parents are really engaged with him, tantrums will become increasingly less frequent and more productive.

But the change has to start with you.  You've gotta let the tears roll down.  When you see tears, hold out the tissue box to offer help, but don't try to stop them.  Then, when the sobbing subsides, offer a caring ear.  It will connect you in ways you never imagined.

Thursday, May 2, 2013

Carpe Diem(s)

OK, so my Latin isn't so hot.  No idea what the plural of "diem" is, but you get the idea.

Anyway, onto the real topic of today's post.  The other day I picked up a preschool application for Asher.  We have sort of planned all along that we would start Asher in preschool in January 2014, when he'll be a little over two-and-a-half.  Because he is an only child, we are always concerned about his exposure to other kids and the lessons they can teach him about getting along with others.  And because he is so energetic and physical, we are also concerned about him learning some self-control and order.  Both of those lessons are hard to teach to a kid who stays at home with a nanny and, therefore, whose world revolves around him.  Preschool is the remedy.

This preschool plan was mostly MY idea, but when I pulled into the parking lot and walked into the door of the school, I felt overwhelmed.  Like most parents, I couldn't believe my little boy was big enough to be taking that step, even though that step wouldn't come for almost nine months.

So, a little vulnerable and sad, we moved into yesterday, when my husband and I started talking a bit about trips for later this year.  I have been thinking for a long time that next winter would be a good time for a trip to Disneyland--Asher will be old enough to enjoy it but young enough to qualify for free admission.  In considering that, I realized that we would have to do it before school starts in January because I wouldn't want to pull him out of the new routine we were trying to establish.

And then the reality of him starting school set in.

The thing that is great about having a young child is that you aren't hampered by HIS schedule.  Sure, you've got your own stuff going on, so you aren't totally free, but you also don't have soccer games and cub scout meetings to muck up your plans.  I purposely keep Asher free of commitments on my Thursdays off and try to keep him out of weekend activities so that we have the freedom to do whatever we want with my non-work time.

 Then school happens.  And then it's the school schedule plus all the stuff that goes with it--birthday parties, fundraisers.  And then organized sports happen.  And then other extra-curricular activities.  And then you have no time.

Or at least that's how I imagine it.  Having never been a mother of a preschooler before, I wouldn't really know.  But that's my fear.  I see all of our carefree family days slowly vaporizing.  This year, our big family trip will be to a resort in Vermont, where we get a discount because we're traveling before the height of the summer vacation season.  Next year, Asher will be in school, and we'll be taking our summer vacation at the same time as everyone else.  So long, carefree days.

So getting back to the title of this post.  When Asher was a newborn, I got totally fed up with hearing from old women at the grocery store about how I should "cherish every moment" with him.  The reality is that there are a lot of un-cherish-able moments when you have a newborn, and as much as I thought I understood the gist of what they were saying, I was annoyed.  But now I feel like one of those old ladies in the checkout line: carpe diem.

Take advantage of those flexible, pre-preschool days. Take your vacations at odd times.  Don't over-plan your weekends.  Have fun with your freedom.  You might not cherish every moment, but those free days will be gone before you know it.   

Wednesday, May 1, 2013

Comfortable in Your Own Skin

Apparently, when I was a little girl, I decided to run out of the house and down the street naked. The older boy who lived across the street found me and delivered me home.  My husband has similar stories, although in his stories, the police are involved.  It seems that the cops were less busy in his hometown than mine.  At any rate, it turns out that kids like to be naked.  A LOT.

Since Asher has been potty trained, there has been a lot more naked time than before.  Part of this is because we don't worry about accidents all the time, but most of this is because we are a bit lazy--we don't have to help him with his pants every time he gets the urge if the pants are already off.  This leads to a lot of--ahem--self-exploration.  It turns out that toddlers like to touch themselves, and since they don't have the social training we do when we are older, they do it a lot, right out in the open for all to see.  As much as I understand the biologic reasons for all for all of this, it makes me undeniably uncomfortable.

Fast-foward to yesterday when I got home from work and sat down on the stairs to talk to Asher about his day.  Immediately, he flipped up my skirt to look for my (non-existent) penis.  This was a moment only slightly less embarrassing than the time my bikini top flew off on a waterslide when I was in high school (not sure who saw that, and, frankly, don't want to know, so if you were there, please keep the truth to yourself).  What is a mommy to do?

Clearly, I am no expert on child-rearing, but my work has taught me one huge thing: teach your children the names for their parts.  I saw a teenager the other day who had some concerns, and her pediatrician had told her that it was "just her fluff."  I was totally perplexed as to what the issue might be (not to mention somewhat horrified that she couldn't explain it better).  Kids need to know what things are called so they can communicate effectively and they need to know that their parents support this verbiage.  As awful as it sounds, if your child is abused in some way, s/he needs to be able to express what happened and feel comfortable talking to you about those parts.  

It becomes more complicated and uncomfortable when your child wants to talk about YOUR anatomy.  I don't have an educated answer to that.  But I do know that if you take a deep breath and explain things simply and logically, you'll probably get the point across without making it too big a deal.  My explanation: "Asher and Daddy have penises.  Mommy doesn't."  This seemed to do the job.   A friend just asked if Asher also knows about vaginas, and no, he does not, but my guess is that he will soon enough, given the kind of phone conversations I have from home when I'm on-call.  I'm sure we'll take the same no-big-deal approach to that one.

The bottom line is that we all need to be comfortable talking about our bodies.  It is uncomfortable for parents to talk about all of this stuff with their kids, but it is vitally important.  It has nothing to do with sexuality--that comes later--but everything to do with being familiar with your own body and being able to care for it.  Verbal communication is probably the most defining human characteristic, which means that we need to be able to talk about who we are physically.

Tonight Asher looked at me, both of us fully clad, and said, "Mommy, no penis."  Yes, my little buddy, you speak the truth.