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.

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.

I Love Being a Working Mom...I Think

Recently I happened upon this article http://www.huffingtonpost.com/wendy-sue-swanson-md-mbe-faap/i-love-being-a-working-mom_b_3156152.html?ncid=edlinkusaolp00000003, and it got me thinking.  I admire the author's dedication to her profession and her desire to make a change AND to instill that desire in her child.  Yet, it really didn't hit home with me, and not just because I will never be flown to the Netherlands to do a TED talk or any other sort of public speaking.  I feel like she missed the real-life, day-to-day reality of being a working mother and how awesome that can be. In fact, I think she missed the boat entirely.  I think her viewpoint is definitely doctor-centric, and I don't think it speaks to women in other lines of work.  Being a working mother, for me, has little to do with charging my child with social responsibility and is in no way connected to what I actually do for a living; it has everything to do with providing me with the balance that I need.  I suppose my outlook could be considered selfish, but I believe raising a healthy child starts with being a healthy parent.

As working parents, we miss out on some things.  Asher is one of two kids in his mommy-and-me class who attend with a nanny.  Lately, he has been singing a color song to the tune of "Twinkle, Twinkle Little Star", unbeknownst to me.  For days I thought he was just singing gibberish until Becca joined in the other afternoon.  Mostly I feel gut-wrenchingly awful about this.  It's hard enough knowing that your child spends most of his day with another person, but it's even worse when you have clear evidence that someone else understands your kid better than you do.  On top of that, I worry about judgment from the stay-at-home parents in Asher's classes.  I would love to meet his friends' moms, but I honestly worry about what they'll think of me, the absentee mother who lets a nanny do all the dirty work.  The secret of working moms that a lot of stay-at-home moms don't know is that we see them as a higher order of mother in some ways--part of us wishes that we could do that ourselves, but the reality is that we know that we couldn't be kid-focused all day long--and we're pretty sure they look down on us.

On the other hand, I know that I am a better parent because I'm not parenting every minute of every day.  At work, at least to a certain extent, the part of my brain that is fixated on scheduling and enforcing rules and, essentially, trying to create order out of chaos turns off.  I can focus.  I can think.  I can have adult conversations.  I get to learn about what's going on in the world around me.  These are things that only happen at naptime when I'm home, and I notice that when I go too long without turning off the parenting part of my brain, the caring, loving, fun mommy part of my brain starts checking out.  In order to be the emotionally connected parent I want to be, I need to not be a parent for a good part of the day.  I need to have the freedom to connect to other parts of myself.

That said, there is a fine line between working enough to stay in touch with those parts of my brain and working too much.  Earlier this year, my work schedule had changed so that I was working fewer days but those days were each unbearably busy.  I came home exhausted and checked-out.  It's a matter of finding a way to giving enough time to each part of me without any part taking over.  When I notice one part dominating at the expense of the others, I know it's time to change things.

 Being working parents certainly teaches our children a lot about the world and their role in it.  I like to think that, by seeing his mommy work as a physician and his daddy run a web development company, Asher will learn the value of hard work and not take what we have for granted, that he will learn how to work ethically and treat people (clients, patients, colleagues) with respect, and that by seeing what we do professionally and how it evolves with time, his mind will be opened opportunities that aren't necessarily the 9-to-5 cubicle grind.  More importantly, though, I expect that he will learn to take care of himself in a more holistic way.  He will see the struggles we have to keep a balance between work and family and the mindfulness it takes to realize when balance is lost.  He will also learn the importance of understanding and respecting his own needs.  He will understand that in order to care for others, he first must care for himself.

These are all lessons it has taken me years to learn, and I constantly have re-examine myself and adjust things accordingly.  The hardest and most important lesson is that no one can really "have it all" in the more traditional sense, and trying to do so just brings pain.  You must identify what's important to you and what you need to be happy, and then you must work to make those things a reality.  Then you will have it all, and so will your kids.  It really doesn't matter one bit what your employment status is.

24+ Hours of Mommy Fails

The last 24 hours have been tough around our house.  I am exhausted after two nearly-sleepless nights in a week.  Asher has been discombobulated by my absence and more baby-sitter time than usual, and he has been busy all week with activities.  Crockett is stressed about a lot of exciting but work-intensive projects.  It should come as no surprise that this all takes a toll at some point.

It all became apparent last night.  Asher and I took a shower, and while I was straightening up afterward, I let him run around naked for a while.  As I came out of my room, I saw him proudly peeing on the hall carpet saying, "Clean up!  Spray soap!"  Ugh--the downside of having a kid who loves to clean and is obsessed with spray bottles.  Needless to say, he did not fish his wish.  Instead, we soaked up what we could with a towel, and then I declared an early bed time.  I stuck to my guns with the usual three stories in the chair, one story on the potty, and then to bed.  I thought I was so smart.  On the webcam, I could watch him rolling around, sipping on his water bottle and getting settled in bed.  I was sure he'd be asleep any minute.  Then 20 minutes later, shrieking.  Eventually, I went in, rubbed his back and reminded him that it was time to sleep, and when he seemed nice and calm, I left.  Another few minutes of silence, and then more shrieking.  Finally, about an hour after we had first said goodnight, I caved.  I got him out of the crib, sat back down in the chair, and held him until he fell asleep, something I hadn't done in ages.

This morning he woke up about 20 minutes earlier than usual, and he was cranky.  We made it through the first part of the morning without too much trouble, and at 8:00, I handed a seemingly happy kid off to the nanny before I headed off to an appointment.  A couple of hours later, I had planned to meet them at the children's museum, where they had a playdate scheduled with one of Asher's friends and her nanny.  There was a large school group on a fieldtrip there, so the nannies decided they would rather go elsewhere.  I wanted to squeeze a workout in before heading to the office for an afternoon full of appointments, so I took Asher back to the car and said goodbye.  Apparently, I underestimated the effect my brief appearance would have.  By the time he got home, he was tired and frustrated and upset that I hadn't been there.  Oops.

I eventually had to head to work, again leaving behind a seemingly contented kid.  Little did I know that a volcano was about to erupt.  Nanny leaves around 4:00.  At 4:20, I got several calls to my cell phone, which I could hear from the exam room where I was talking with a patient.  Finally I decided something must be wrong, so I went out an answered.  Crockett wanted to know where I was, forgetting that I had to work that afternoon even though Thursday is usually my day off.  Asher was a mess, crying and fussy and inconsolable.  Apparently he had been like that for a while.

When I finally got home, Daddy and Asher were both exhausted and vegging out in front of some A-B-C youtube videos.  We had dinner and planned an early bedtime for the little guy.  Normal bedtime routine, and again, the shrieking.  Again, Mommy held Ashie until he fell asleep.  Goodbye, sleep training.

Weeks like this, lots of thoughts, mostly self-critical ones, enter my mind, ranging from doubt about my understanding of my own child and wondering if stay-at-home moms have a better sense of what to do to frustration with myself for not sticking to the cry-it-out method of sleep training that we've used for months and concern that I've ruined his ability to self-soothe permanently with the last two nights.  This time, I even wondered if my assumption that we have successfully potty-trained him--something I have been so sure and proud of--was premature.  I wish I could see the glass as half full: my child loves me; he misses me when I'm gone; despite having a working mother, he has secure attachment.  While it's normal for a mother to worry about her child, and I suppose it's healthy to examine your parenting behaviors, I think it's sad that we hold ourselves to an imaginary standard of perfection.  We all struggle.  We all have bad days.  We all have moments when we misinterpret our children's needs.  We all cave from time to time.  But few of us are willing to admit it.  The good news is that our kids are resilient, and so are we. 

Besides, it feels damn good to snuggle up together in that big chair. 

Travelin' (Wo)Man

This evening I am leaving for my first business trip in over two years. In fact, it's my first solo trip of any kind in the last couple of years.  It's a quick flight to Denver to observe surgery tomorrow, and I'll be home tomorrow night, but I am dreading it.  It's not my first night away from home since Asher was born--as you might imagine, there are some nights that I just don't make it home because L&D is busy--and there are even more nights that I'm home to sleep but miss Asher's bedtime and wake-up, but somehow having to go on a plane and planning to sleep in another bed makes feel more "away."  Mommy is not handling things well. 

Being a physician in private practice generally means staying close to home.  Whereas some docs travel a lot to conferences and training gigs, those of us in private practice don't get out much.  It's one thing when your employer pays for these kinds of trips and doesn't dock your salary.  Unfortunately, I don't pay myself for time out of the office, so most of my continuing education comes from reading and local meetings.  Honestly, it's what I prefer.  I am definitely a homebody.  I've never wanted a job that would acquaint me with airports all over the world.  My fear of flying might have something to do with that.  I am happiest in my own space, with my own stuff, and surrounded by my own people, even moreso now that "my people" means my little family.

I left the house much earlier than necessary.  I could have carpooled with someone, but that would mean leaving the house right at dinnertime.  Certainly not an ideal time for me to say goodbye.  But I think I realized that the longer the day wore on, the harder it would be for me to leave.  We tried to explain to Asher about my trip and how I would be home to see him in a couple of mornings.  The fantastic thing about two-year-olds is that he really didn't need an explanation.  Tomorrow he will be surrounded by people who love him--Daddy and Nanny Becca--and though he might think about me a lot, it won't really occur to him too much that I'm gone.   Most of me was hoping for a panicked, tearful goodbye from him.  Only a small part of me can acknowledge that this kind of goodbye was better for all involved.

So here I sit in the San Jose airport, about 3 hours before my flight is actually going to leave (an hour delay...so far).  The few belongings I need for this whirlwind trip are packed into the diaper bag I no longer need since it's the only bag I have that is remotely the correct size.  I realize now that it's been ages since I've traveled so light, and the bag is a not-so-subtle reminder of the 25-pound cargo I left back home.  I feel self-conscious about it all, feeling like I don't fit in with the rest of the Silicon Valley business travelers for whom today is just like any other Sunday.  Unlike the other travelers, I've got a super cute cuddle bug to spy on via webcam while he sleeps tonight.  Can't wait for bedtime!

Moving Day Madness

Yesterday was a big day in my office: we grew!  More precisely, "we" had grown over the course of a couple of years from five docs to seven, without adding any office space.  Quarters were tight, and everyone's office hours were cut back so that we could share the exam rooms.  Yesterday our physical space grew.  And I was the lucky girl who got to work in that space.

You realize at times like this that you take for granted the systems you have in place.  Where does the medical assistant put charts to indicate that a patient is roomed and ready?  Which computer do I use?  How do I call my assistant in to help with an exam (for now, it's just a shout out the door, so I'm a bit hoarse from screaming, "ANGELA!!!" all day long--it turns out the new office space is quite large)?  And I got quite a workout running back to the main office to gather all the little things that I use throughout the day.  Then there was the grumpy guy putting in the phone lines who was yelling at his assistants too.

All of this led to some serious mental chaos.  This was my "desk" AFTER cleaning up.  Note the open purse spilling all over the place, charts strewn about, the stool that is way too low for the counter height.

Good thing it was a slowish day for me because not much work got done.  Not a single afternoon chart note got written.  Between the mess and the grumpy phone guy yelling in the background, I simply could not concentrate.

I couldn't wait for the day to end, but if you look, you can almost always find something positive amid the madness.  I see at least four lessons in all of this that definitely apply to real life.

1. Messes slow mental function and disrupt concentration.  Have you ever seen your kid over-stimulated?  If not, you haven't been paying attention!  We try to stick to one big rule in our house: before you get out a new toy, you put the last one away.   We don't always stick to it, but I've noticed the less mess on the floor, the less frantic the boy's behavior.  This rule applies other places as well.  For example, the fewer morsels of food we put on his plate at a time, the more he eats in the long run.  Simple, calm, and tidy always gets us better results.

2. We all thrive on routine.  I definitely felt out-of-whack yesterday.  Today back in my normal environment (the docs in the office rotate between different work areas), I'm back on track.  Yesterday one of my patients commented that she has been stressed out because her grandsons, ages six and seven, have recently moved in with her and they are "bad kids."  They've never had a stable home and haven't been taught basic manners and rules.  Children need consistency to learn and grow.  My least favorite part of parenthood is having to enforce the rules I've made, but it is vitally important.  Rules and expectations make kids feel respected and loved.  Likewise, never underestimate the value of a bedtime routine, meal schedule, or reading and re-reading a favorite book.  Having a rules and a system for things is comforting.

3. Change is hard, even when it's a change for the better.  For me, more office space means more time available to see patients, which in turn means that I can schedule more down-time into my day.  This is all good.  But living through the change is difficult.  You might even mourn the loss of the old way a little--I definitely felt that way yesterday.  This is true whether the change is a new exercise program or a new bedtime routine.  It's important to acknowledge the difficulty but also remember why you made the change in the first place.  Sometimes you have to work to get the life you want.

4. Change is exciting.  Despite all of the stress and frustration, part of me can't wait to work in that part of the office again.  It's new and different and interesting.  It reminds me of the excitement we had as kids eating breakfast for dinner or spending the night in our sleeping bags on the family room floor rather than in bed.  You've got to balance the routine with the thrill of the unexpected!