The Wounds of Parenting

Z, my two year old has been attending gymnastics class for the last two months.  I say attending because it is largely her running around randomly or crying.    Generally she will do a few tricks with the promise of a lollipop at the end of class.  When she received her first lollipop it was with some consternation that she declared, “lollipop…. it’s like a sucker!”   (Did I mention this kid is a genius).

At first, she adorably referred to it as “flip class”, but now if I ask if she wants to go to “flip class” she haughtily corrects me and says, “It’s Gymnastics” as if she’s Dominique Dawes.

At last flip class Z managed to perform a contortion in such a way that it nearly resulted in a concussion for Mommy.   She didn’t seem to notice the blinding pain that she had caused me and kept happily doing log rolls.

When we arrived home, I decided to rest from my closed head trauma by relaxing on the floor and allowing Baby Bird to crawl all over me as is her new favorite nine-month old pastime.  She promptly crawled onto my chest and shoved her first finger on her right hand so far into my nose that her jagged, impossibly sharp baby fingernail ruptured something and I immediately started bleeding.

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I am thinking about what could have possibly given Baby Bird this idea.  I flash back through the lancinating pain to a moment in flip class where Z and her new friend were discussing their “stuffy noses”.   I was thinking to myself how great it was that she was socializing appropriately when I noticed that the other little girl had started picking Z’s nose prompting her mom to recite the well known saying, “You can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose.”  I had largely viewed this as anecdotal and not instructional until this point.

As I was trying to staunch the bleeding, Z leaps from the couch in what can only be described as a Bruce Lee impersonation and lands a windmill kick squarely to my left ear, rupturing my eardrum.  My world goes dark with pain.   I am bleeding and about to vomit from the instant vertigo that this perfectly landed blow has caused.

In fairness, as I was writhing on the floor, crying, Z did give me “double hugs” and got her Doc McStuffins doctor bag to give me a “check up”.

While I was still bleeding and deaf in one ear, she put a bandage on my thumb (which ironically was not injured), kissed me, and declared me to be “all better”

 

Let’s Make A Deal

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Getting Z to eat is ALWAYS a challenge.   Lately she is pretty fixated on marshmallows.  She keeps talking about hot chocolate and how she is going to have marshmallows on it (incidentally she has never had hot chocolate and I am not really sure how she knows it exists).

When I noticed that she was just transferring her grilled cheese from hand to hand to give the illusion of eating, I decided to bribe her,  “Z sweetie, if you will eat the rest of your Cheesy, I will give you FIVE marshmallows.”

Z shrewdly looked at her cheesy and responded with enthusiasm, “I want TWO.”

All my dreams of Ivy League just went out the window.  Hubby observing the whole process says, “Kiddo, are you sure about that?  Mommy offered you FIVE.   Are you sure you want TWO?”

I am glad he is trying to give her a mulligan on this marshmallow mathematics issue.   Clearly she misunderstood the proposition.

She nodded with enthusiasm, “I want TWO.”

Hubby: I don’t think you understand how negotiations work. (this is a direct quote from my favorite blogger, “thebloggess”)

Z:  Yeah (giggles)

Hubby:   So to be clear here, you want TWO marshmallows not FIVE?

Z: Yes, TWO

Hubby:   TWO not FIVE?  Are you SURE?

Z:  Yes, TWO (at this point she gets a confused look on her face), NO SIX.

Hubby:  SIX was not on the table.

Z:  I want SIX

I don’t know y’all.  Maybe she is a better negotiator than we realized.

 

 

 

 

A Joyful Moment

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There are wonderful, priceless times in our lives. These are times that we are carefree and joyous; times were the bad things in life don’t seem so large. When I was young, it was easy to overlook these times and not recognize what a blessing they were.   As I get older, when I have one of these transient life-moments of delight interspersed between the moments of pain, it is easier to distinguish it as the glimpse into heaven that it is meant to be.

When I was in medical school, we lived in the University Cabana Apartments, affectionately known as Cabanaland.   This was not some pre-professional school luxury condo.   This was a section eight apartment complex in Memphis.   Let me say that again so it can sink in. It was a section eight apartment in Memphis.   Also, this complex had eight foot fences with razor wire around the top, and an ACTUAL moat around it.   Okay, so maybe it wasn’t an actual moat as much as it was a giant culvert going around the whole property to drain overflow sewage from the city, but it did make me feel marginally safer from outside marauders. There was also a twenty-four hour armed security guard at the gate.

One sunny afternoon, Hipster Doctor found a bag of crack and money on our adjacent front porch.   She, being the good Samaritan that she is, turned this over to the security guard (who incidentally was later fired for being found high in one of the public bathrooms on the property. I think there is a possible connection here, but I cannot be sure.)   I think I would have flushed the crack and kept the money (considering my husband and I were living on about $9500 annually).   One of the neighbors (a self-professed cocaine aficionado) came by all the time to borrow our phone (this was the day of land lines).

I miss lovely summer evenings at the Cabanas when a string of tricked out Caddys, Buicks and Cutlasses would come pick up a parade of scantily-clad, deftly made-up young women for their evening employment.

So you may ask, “What was so great about being poor in a section eight housing unit in Memphis filled with crime, drugs and hookers?”   This is a valid question.   No argument, but let me tell you what else the Cabanas featured.   Hubby’s sister, Aunt Panda, my brother, Dr. Pepper, Wild Pharmacist, Italian Stallion, Tim The Overly Italian Optometrist, The Librarian, Art Student, Hipster Doctor, Insane Newscaster (story to follow at eleven), and Evil Genious all lived at the Cabanas.

Every single one of my friends at the time lived in Cabanaland.   There was always someone to go to dinner, or a movie, or for a walk at any time.   There was constant entertainment at a moment’s notice. Impromptu parties abounded, and someone always had a video game system fired up somewhere.   I was too naïve at the time to realize that this was magical and something that most people don’t experience.   I didn’t know that for the rest of my life I would have to work to socialize and plan for a party.   It was about the last couple months as we were graduating and it was coming to an end that it hit me that this time in life was a gift from God. It was my support during a difficult time, giving me good memories and fun times to sustain me. When it was over, I mourned these times.

As I have grown in age and wisdom, I have come to distinguish these enchanted times in my life. As I was getting ready for church last week, I was standing in front of the mirror brushing my hair.   My daughters were dressed in beautiful matching outfits. Z was dancing around in a sunbeam from the window with motes of dust sparkling in the air singing, “Mommy, look, sparkly!”, while Baby Bird was army crawling after her and shrieking with laughter.   As I watched her exultant expression, sun shining on her hair, so delighted in this discovery that we have all experienced of the beauty of dust dancing in the sun, it hit me with a force that took my breath away that this is one of those joyful moments.   I am drowning in joy.

I wish I could bottle these moments of my daughters laughing and playing as sweet chubby babies to sustain me in sad times to come.   I wish I could freeze them like this. I know there are times to come when I am not their hero.   There are times to come when they won’t greet me at the door with screams of excitement.

Now I know a joyful moment when I see one.   These days are a gift from my Father, and my Father only gives good gifts.   James 1:17 Every good and perfect gift is from above, coming down from the Father of the heavenly lights, who does not change like shifting shadows. All praise to the one who knows my heart and crafts these perfect moments just for me.

Unintended Consequences

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A couple of days ago President Obama revealed a new agenda to push for state and federally funded early childhood education.  I am sure this is with the best of intentions, but much like other social programs their are unintended consequences to every action.

First of all, every social program in existence today started with the best possible intentions of MOST of those involved.   This obviously doesn’t apply to Lyndon B. Johnson who started most of these programs:

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These programs were designed to be a “safety net”.   Some people use these programs as such, but more and more these programs simply trap one generation after the next into the despair of poverty.  An important economic concept in this equation is that whatever we subsidize, we will get more of.   Reflect on that.   Medicaid, Food Stamps and Welfare are set up in such a way that many people who are married are ineligible due to a slightly higher income.  They are set up so that if the individual receiving the aid becomes just slightly more successful then their aid is discontinued.   The result is that many people born into the system are simply trapped there.

If these systems were really about providing a safety net and not an attempt to buy votes, then why are they not designed to help people?    Many of my friends would be eligible for significant quantities of monies from the state if they were unmarried.  If they just got divorced and lived with their spouse and were willing to lie on that little form, they would be a candidate for welfare, food stamps, Medicaid and our already present head start program (which provides free daycare to preschool children).

I will say again, what we subsidize, we will get more of.   We should offer incentives under welfare programs if the partner stays in the home, and if they are able to make just a little extra money.  If we subsidized married partners, and emerging success then we will get more married partners and emerging success.   This is a system I could get behind rather than just expecting people to be grateful enough for the crumbs that slip down to them that they will vote for the right candidate.

The second point behind my tirade is that I really don’t trust the government.  There are ideas popular within society that I don’t want my child to learn.  I would like to teach them in a compassionate, educated way about our beliefs.   I know that this is going to sound really paranoid, and take this for what it is worth, but it is right out of the communist manifesto to indoctrinate children early.  Don’t believe me, actually look up the ten points of the communist manifesto as presented by Karl Marx written in 1848.  This was point ten on his list of how to control society.

This was practiced in Russia.  It was practiced in Nazi Germany.  Ever hear of the Hitler youth?   It was encouraged under Mao in China.   Children were indoctrinated and encouraged to spy on their parents in the home and report them to the government for “wrong thinking”.   I know how this sounds, and for those of you who think I sound crazy.  Yeah, you’re probably right.  Nothing LIKE that could EVER happen here!   I am sure we are all a completely different class of parents than those in Germany, China and Russia who were subjected to this.  No worries!  Whew…. I feel better already.

Lastly,  some of the smartest, kindest women I have the privilege of knowing are stay at home moms.  They have made this difficult and valuable choice.   Their personal choice should not be discouraged and derided by the government but recognized as the high calling that it is.  Why are we called upon to celebrate every choice in our society as equally valid and to be lauded except this lifestyle?  I wish with all my heart that it made sense in my family for me to be a stay at home mom.  It makes more sense for my husband to stay with the girls most of the time, and this is a blessing to us and I am jealous every day.   Instilling character, kindness and knowledge into little hearts and minds is the most important job there is.

It is not the place of the government to overreach yet again into the private lives of families.  They should stick to roads, and post offices and providing for the common defense like the constitution delineates.  They should stop trying to socially engineer America.  They are doing a bad job of it.   If they are going to continue to practice socially engineering, perhaps they could do so in a way that would actually lift people out of poverty instead of trapping them there.  This sounds like the truly compassionate thing to do.

 

Patient Advocacy

I had an interesting patient encounter this week.   She is an older woman I have only seen once before. She is new to our clinic because of a change in insurance. She has already developed quite a reputation at our clinic for being a little “difficult”.   She made a complaint against Barbie Nurse.   Barbie Nurse is blonde and cute and sweet as pie.   Patients LOVE her. For this lady to make a complaint against Barbie Nurse, something must really be wrong with her.

So, as I sit down to speak with her, The Complainer says, “Sweetheart, could you speak up a little bit? You speak really softly.”

I almost laughed out loud at this statement. This is something that I have NEVER been accused of.   I am loud to a fault, but to humor her, I start speaking louder.   She asks me several times, “Huh?” and “What?”

I speak louder and louder to the point I am yelling at her. I suddenly recollect that the complaint against Barbie Nurse was that she was “yelling at her”.   A light bulb goes off in my rather dense brain.

“Ma’am, do you think you may need to see an Audiologist?” I inquire in my sweetest, most diplomatic tone.

“Sweetheart, there ain’t nothin’ wrong with my heart.   I don’t need to see no Cardiologist,” she replies.

Houston, we have a problem. I now understand why she complained that I “didn’t tell her anything” at our first patient encounter, and why the last two doctors she had “just couldn’t communicate.”     I wonder how many other interactions she is missing out on because she can’t hear.   I wonder how many other people have dubbed her as a “mean-old-lady” because of this.   I suddenly felt ashamed. Of course, I have scheduled an appointment for her with an Audiologist.

As I was reflecting on this, a student who is doing a research project with patients with lung disease at our clinic comes to speak with me.   She has seen one of my patients.   He is elderly and requires twenty-four hour care.   She informs me that he has no complaints about his lungs currently, but he is not on “the best medications for his condition.” She lets me know that the best choice would be two pricey inhalers

I pretty sarcastically look at her and say, “Oh really?   I had NEVER thought of that.   Why do you suppose I don’t have her on those?

She looks at me skeptically, clearly she doesn’t speak sarcasm, “Well I guess you are worried about his coordination and ability to use these, but I can help with teaching him.”

Great I think, glad she can do that for me since I am incapable of teaching a patient to use an inhaler.   I realize that I may be being a little hard on her.   I try to soften my approach. I patiently explain to her,

“The average retail price of the combined medications you suggested is $350 monthly. That is $4200 yearly. After $2850, Medicare patients are responsible for their own drug costs until they reach $4500.   The medications I have him on, although not the best for his condition are free under Medicare and won’t count toward this.   He is also on medications for his blood pressure, diabetes and blood clots. What do you expect he will do about these medications in August of each year when he runs out of money? And that is only if he only pays for the medications you are suggesting.”

I stop my speech confident that I have conveyed to her a new concept in patient care that was not introduced in her lecture classes. I am self-confident and assured that this will have opened her eyes to a new world of patient care and a different way of thinking.

She looks at me and said, “Well, will you at least put him on the $50 medication?”

Ok, she is a little more concrete-thinking and dense than I thought. Maybe we will take a different approach,

“Ok, I will put him on that medicine if YOU call him and tell him that you would like me to start a $50 medication for a condition he is not complaining about and that it will cost him $600 annually AND that it may very well put him in the Medicare Donut Hole so that he will have much greater out of pocket expenses.”

Oooooppps.   I forgot that she doesn’t speak sarcasm. She looked at me somewhat confused and wondered off.

These two incidents highlight to me what an awesome responsibility being an advocate for my patients first is. I am not to be an advocate for the pharmaceutical companies, or a government agenda or even my place of employment. I am to be an advocate of THE PATIENT.   I am really fortunate to work at a clinic where this is the priority and not the bottom line, but other places this is not the case.   I hope maybe this student will reflect on this conversation with some common sense and change her strategy. Maybe getting a hearing aid for my “difficult” patient will change her life. I hope so.

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