Friday, August 31, 2018

Each one, multitudes

Things you may not know about surgery/medicine/humans: 1. Blood congeals really quickly. This knowledge has started to inhibit my ability to enjoy a good police procedural. 2. It is pretty much universal for people’s guts to stop working when they have abdominal surgery. And there’s not much that we can do to get them going again. Patients think it is really weird for their doctors to ask them about farting every day. 3. Different tissues have different smells when treated by electrocautery. Blood & fat together is my least favorite. Muscle is the most confusing, it smells like you are grilling.
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The way we can take care of all our patients, but especially patients who are really sick, who need real doctors, while we are learning: layers. There is a team taking care of every patient “I” see. There’s a chief resident above me, there’s an attending above her. I talk to my chief and my attending about my patients. Sometimes I ask if I should do what I think I should do, sometimes I tell them what I’m doing. Often I am confirming what I know and they are refining my understanding.

This is all information the front of my brain knows.

The inside of my brain, however, is pretty heartbroken today. It thinks that learning medicine is pretty shitty when you have to almost kill someone to learn things. My basic instinct brain thinks I’m essentially an attempted murderer. Today has been a hard day.

The truth is, I didn’t miss something. I really don’t think so at least. I think one of my patients had early symptoms that resolved while I was caring for her and then acutely had some really bad shit go down. Women really do die after having babies. It’s a thing.

She didn’t die but she was and is very unwell. There are implications for the rest of her life. I didn’t miss it when I saw her yesterday afternoon, because it wasn’t there yet. But this morning she was whisked away from our care and sent to the intensivists, to the ICU, where they will hopefully stabilize her.

I will never ever forget this constellation of symptoms and circumstances and I will work hard to catch it sooner next time. If it could even be caught any sooner. It is quite possible that the complications were caught as soon as there was something to catch, that her body was hiding the problem even from trained eyes, that there was no telling that she was going to go into that level of distress based on any information we had at our disposal before she actually crashed.

I can’t save everyone. Today I am confronted with that reality and it hurts. 
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Today I delivered a baby that weighed a pound and a half.
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After work today I was too keyed up to go straight to the Mom Duties that await me. It was also warm enough to consider a swim so I invited the kids to join me and my daughter and I went for a quick dip. When you have a pool at your immediate disposal, you use it differently than how I used to think about going to the pool. It can be a quick 15 minute dip, floating in the water, staring at the sky, or maybe swimming a few laps to get some pent up energy out or practicing cannonballs and somersaults. Then you just head home, take a shower and make breakfast burritos for dinner. Onward and upward!
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Today I delivered a baby that was alive yesterday.
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My son made dinner tonight. Wouldn’t let me into the house when I got home (our main door is through the kitchen) so I sat outside on the porch with my feet up and listened to music. And had a delicious dinner delivered to me! Don’t let anyone tell you that raising boys is easy or that young men have simple emotional lives. This kid contains multitudes and he’s amazing.
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One of my children or the other has lost their temper three times now and and damaged a piece of my home. All the pieces are repairable, but it is still a huge pain in the ass. They need to reign in their tempers a little bit. At least the latest one is an easy replacement part (door shelf on the fridge) and I can charge Little Hothead for it. Good thing they made all that money this summer!

Saturday, August 25, 2018

Personal life? What personal life?!?

I’m having something of a parenting challenge right now. Teenager’s brains are difficult to live in and difficult to live with. My son is man-sized. I have to regularly remind myself that he is NOT a man. And I have to check my own issues with male anger and avoid getting worked up when he’s worked up. He’s working through some very appropriate and very complicated emotions but, like most men-type people, he’s lacking some of the emotional intelligence and self-regulation to really experience and process his emotions. Walking him through this process is sticky. It’s really REALLY hard to see the 10,000 foot view.
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I’m coming out of a place in my life where I performed hypervigilance in response to someone else’s emotional state and needs. As such, I’m having something of a backlash against expectations that I read people’s minds. I don’t mind hard work, I don’t mind staying late or staying up late to help you with your problem. But don’t expect me to intuit your problem. I’m more than a little bit psychic but I’m still a terrible mind reader. 
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Back on the dating horse - we’ll see how it goes this time around! 
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Had a good conversation with my son to work toward helping him with some of the things that are holding him down right now. It was a successful conversation and forward steps have been made in the process. It is hard to blog about these huge aspects of my life because I want to respect my kids' privacy and right to own their own digital identity. I want him to get help. He’s got a lot of emotions tucked inside but anger seems to be the door we need to go through to get to them. I think we've found  the start of a solution.  I love it when I’m able to navigate the psyche of a teenager and it goes well. 
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I absolutely cannot stand gossip. It is right up there with mind reading. Once my ex remarked to someone that something he liked about me was that I wasn’t catty or gossipy. I was surprised, I guess it was a little like someone complimenting me for not being an aggressive picker of lint off of the clothes of strangers on the bus. Of course I don’t do that! Why the fuck would I want to do that? I don’t get any joy from talking about people behind their backs. It is malicious and poisonous.
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I have shrines that want constructing and it is making me sad that I can’t get that done. I need a few little bits for one of them - some nice paper & an hour of internet research and printing of things, plus someplace to put the things I print (I’m thinking tiny picture frames). The other I think is just a matter of cleaning off a shelf and rearranging things that are in other places in my room. I also want a full moon calendar. At this point, I should probably just wait and get a 2019 one, but dammit money is always tight around the holidays and I forget to get it in the new year. These are things that will make me feel more centered and authentic in my home. Lots of little shrines and a full/new moon calendar as art. Life goals.
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There are many areas of my life where I am full of curiosity. Curiosity helps me understand people who are different from me. It helps me parent. It helps me do my job and it helps me learn and grow as a human.

I get texts from people I’m dating, asking about my day or sharing some tidbit and it occurs to me, I may be crucially lacking the curiosity about that person’s life for casual dating to evolve into actual relationships. I’m not sure I have space in my life right now to care about another person. I care about so many already!

Monday, August 13, 2018

Summertime, and the livin is easy

I just had the best vacation! It involved a lot of driving that mercifully went very smoothly. Every single day I was gone I was able to visit with wonderful friends. Some friendships were formed in the crucible of parenthood. Somehow it is more incredible to me that these children are young men and women than the fact that my own children are. My friends are doing our part to bury the Mommy Wars - we have all made different decisions about how to raise our kids and we respect each other’s paths as right and good. And we can be honest about our doubts about raising teens and the troubles that entails as we were when we were uncertain about toddler temper tantrums and daycare and nap time. It is important to have friends you can be honest with. I did some very Maryland/DC activities while I was there - a visit to Great Falls (wow the Potomac was raging!) and played tourist at the Supreme Court and the LIbrary of Congress. I know that you can’t go back to places and times you’ve lived but I think I might find myself moving forward to a new life in Maryland. It has ocean, mountains, cities. Ample communities in the shadow of our capitol that need doctors. I’m familiar with the politics, the terrain, the culture. There is a good bit of time between now and when I need to make my What’s Next plans, but Maryland is definitely an option.
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Three years ago today I was making a mad dash across the country in what turned out to be a futile effort to be at a dear friend’s deathbed. He sickened and died very quickly but was held close and sung home by the very same people I would have at my side when my time comes. Wicca is a relatively new religion and we are learning and creating rituals for ourselves. With Keith’s passing, we hit on something old and familiar. Many have taken up the commitment to build our end of life traditions and customs as a result. Though I missed the end of his life, I was able to be part of the next steps of preparation of his remains. Death is a Mystery but dying is a human act that should be discussed, anticipated and witnessed. Know what you want at the end of your life. Talk to your loved ones about it. Don’t leave them with the burden of uncertainty during that painful time. I still feel waves of grief from the loss of Keith. But I don’t ever wonder if we did the right thing, in the decisions of his last days, in how we sang him Away or in how we dealt with his possessions afterward.
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Sometimes the surreality of my life hits me at the must mundane moments. Today it was while I was gloving up for surgery. I’m almost 45, I have teens about to turn 15 and 17. I’m a 2nd year resident. I do surgery. I’m an effing doctor.

When my son (the almost 15yo) was in 2nd grade we decided that what he needed was to be in 3rd grade. It took some doing but it worked and he went from being old for his grade to being young for his grade and has been just fine with that ever since. But one of the things I remember thinking, calculating, considering, when he was in SECOND GRADE (he was 8) was that if everything went my way, he’d graduate from high school the same year I finished my residency if he moved up a grade. I have been doing this for a long long time.
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Did you ever listen to the NPR show Car Talk? Two of the funniest, smartest guys on a radio show. They used to have all sorts of people call with problems with their cars they KNEW were caused by a certain event that correlated with the onset of the problems. They were pretty unabashed about telling people when they thought, in their expert opinion, the 2 events were actually not related at all. They could be pretty funny about it.

Humans are trend makers. We look for patterns, in the stars, in chicken entrails, in our lives. People in medicine are no exception. There are all sorts of superstitions about saying that things have been “quiet” on the floor and people often label each other as Black or White clouds, leading to doom or peace. Our patients do the same thing. Very often someone will associate getting their tubes tied or some other event with other problems in their lives. And no one else knows your body like YOU know your body. But as someone who knows BODIES in general better than the average person, I often don’t agree with their assessments of cause and effect. I have learned not wish co-workers a “quiet shift”, instead I say “smooth” and mean quiet in my head. And if you insist that while we are taking out your uterus, we need to get your tubes too because of an association between your tubal and your skin rash, I’m not going to try to dissuade you of that notion. Respect the patterns, people. Otherwise it’s all just chaos.
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My kids are home! They are jet lagged and a bit feral but they are coming back into house manners quite well. I hope they will re-learn the skill of putting themselves to bed. They are loving the dog, fixing meals and today they helped me assemble a futon frame. Actually, I would say that I helped them. I read the instructions and they did the work. The worked well together after their summer of construction/handyman work with their dad. I wish I had an ongoing need for home improvement tasks so they could continue to work together. And tonight they are celebrating their accomplishment by playing GTA, sitting on the futon together.
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I was going to comment on a friend's FaceBook post but didn't want to get off topic of her own adventures with a ketogenic diet. Ketogenic diets sound frighteningly complicated. Likely complicated enough to trigger my eating disorder but *maybe* going gangbusters on it would just re-direct all that dysfunctional eating into something that was less unhealthy (and a good bit more creative) than just eating fewer and fewer calories each day.

I spent 4 months not eating sugar (well no desserts or sweets, but not monitoring hidden sugars in foods, which are myriad). I think that most of that time I struggled against the urges of my eating disorder. I had this overpowering drive to add more rules, change my exercise habits, set goals and critique my body in such self-hateful ways. I fell off the wagon for a vacation, and I don’t regret it. And though I am making some subtle efforts to reduce my bad food choices again, I am wary of making declarative statements about my eating. I’m pretty annoyed with the weight I’ve gained in the last 18-24 months, but I am leaning more toward buying clothes that fit instead of trying to lose the weight.

I hate that I’m so limited in my food management options. I really walk a narrow, potentially dangerous space between disregarding all limits (and therefore gaining even more weight, which would put me closer to a health-debilitating BMI) and imposing disordered eating upon myself. I wish I didn’t have this particular mental hiccup. And I want a pony.
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Yesterday I worked 11 hours then came home and made dinner - pork chops, couscous & peas. I cook, you clean up - house rules. I don’t care if it gets done right after dinner but it has to get done. This morning when I walked into the kitchen at 0530 to go to work the dinner pans & dishes were still there. I woke up both kids and put them to work. To their credit, they got right up and did it. To my credit, I did not harp on them or lecture about it. I have a penchant for lecturing.

I also put tracking and blocking apps on my kids' phones this week. They are pretty pissed but I don't really care. I know that their shiny new iphone 8+s are going to be a major distraction when school starts and I'm not going to be around to tell them to get off the games and videos. They are going to have to learn to manage their tech, yes, but expecting 2 teens with ADHD and very little parental oversight/micromanaging to just figure it out is not reasonable. I hope that these tools will ultimately be useful. Their dad has concerns about taking the learning away from them and I appreciate and respect that opinion. I may be hindering them. But I also don't want them to have to learn from mistakes that involve failing classes and harming the trajectory of the next 5-10 years of their life because they have the whole of the internet at their fingertips without limits.  My goal is to make it a conversation and learning experience. 

Friday, July 27, 2018

Around we go


The Wiccan calender is all about new beginnings. Yeah, Samhain is the "new year" for most of us, but really the whole frickin' thing is about renewal and fresh starts. Now I have another New Year celebration - July 1st. Thus begins my second year of residency. Happy New Year. 

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I’m now 3 weeks into second year and I can report a couple of things: I like not being new at my job, surgery is fun, complicated pregnancies are complicated.

I’m on the benign gyn rotation during the week but second year involves lots of weekend call so I’m also spending time on L&D. I had an absolutely insane shift the first time I worked a solid 24 hours (we don’t do 24 hour shifts as interns, a hold over from some old duty hour restrictions that got lifted but our program kept them. I’m eternally grateful). The second 24 I worked was THIS weekend and it was a bit different, I worked my regular day shift job and then showed up on L&D to take report from the day team and work a second shift on L&D until morning. I managed to sneak in about a 40 minute power nap prior to my shift and the night was a steady stream of busy but not the insanity of over a dozen deliveries, half done by me, that last weekend brought us.

I have admitted a couple of people with some interesting problems to our Maternal Fetal Medicine unit on my weekends on L&D. It is interesting how much of a Black Box Warning pregnancy is for every other kind of medicine. If someone happens to have something else going on - Lung infection? Cellulitis? Broken bone? Odds are good that we will either be called to consult or be asked to admit a person to our service even though we have no idea how to manage the medical issue that brings her in! We had someone who was miscarrying recently and still the medicine docs would not recommend surgery for an unrelated and REALLY IMPORTANT problem she was having. Instead they opted for “conservative management” which involved NOT fixing the problem that they wanted to fix surgically before they realized she was pregnant. The consult note from my gyn-team colleague had very explicit ALL CAPS instructions about recommending “DO WHATEVER THE HELL YOU WOULD DO IF YOU DIDN’T KNOW SHE WAS PREGNANT!!)”
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Two small raccoons, one lying, still, on the side of the road. The other approaching carefully, tentatively forward from the tall grass. Nose to nose. Heartbreak in a flash of my headlights at 5am
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Laparoscopic surgery is a different kind of frustration. There are issues of dexterity and muscle memory with all surgery but this year I’m getting more exposure to laparoscopic surgery. It’s making me wish I’d played a LOT more video games in my youth! It is so frustrating to be looking at my tools on a screen, trying to grasp and maneuver, find the right angle.Trying to make the tools do what I need them to do, while remembering they are on a fulcrum, that levers move backwards (If I want the grasper to go up, I move my hand down). And on a 2 dimensional screen. And that is real tissue you are grasping, so don’t pull too hard, watch where the instruments are going, and please for the love of everything holy, do not require us to open because you perforated the bowel or tore open a blood vessel. Also, I’m trying to remember crucial details like the names of the different types of graspers and when you use them, a Maryland is different from a Prestige which is different from a Hunter Bowel (really, you have to know what to ask for. Often the scrub knows what I need before I ask for it, but sometimes s/he is wrong and I need to adjust my field of view. AND I need to remember the steps of the surgery - DON’T FORGET TO INJECT THE DILUTE VASOPRESSIN!!!!! WHY DO I ALWAYS FORGET THAT STEP?!?!?! Sigh, anyway, it’s July again and I love my job but I am going to be a LOT better at it in six months!
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I just had an amazing half day in clinic. As I think I mentioned, as a 2nd year a lot of your responsibilities increase. We have a lot more people on our clinic schedule and they can be more complex than return OB prenatal visits. This time, I had 8 patients on my schedule - and they all came!! That in and of itself is a little unusual for me. I usually have at least 1 no show to give me a little breathing room. Today I had 3 Spanish speaking patients, 3 return patients, a consult for PCOS, a woman needing a new contraception plan (one of the Spanish speakers), a woman with gestational diabetes who wanted a trial of labor after cesarean and didn’t have her sugars with her and didn’t know how she was supposed to be testing her sugars (also a Spanish speaker) and what turned out to be a VERY complicated IUD removal. I didn’t get a single note done before the end of seeing patients, but I got all the prescriptions done as I went, I had all the salient details either in the notes or in my head or written down someplace so I could write my notes afterward. My last patient had a 4pm appointment and I walked into her room at 4:22. That is running spectacularly on time in a resident clinic! Then I stayed after work and finished my charts before heading home. I’m getting good at this!
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I’m on vacation as of this afternoon.. I haven’t started packing yet. I need to be at work in 40 minutes and I’m still in bed. I will be driving to DC at some point today. I should probably get up!

Wednesday, July 18, 2018

Highs and lows, but mostly highs


I just had the best day ever!!!

It started with an interesting surgery, that I did not actually do but rather watched 2 community docs work together to do. It was interesting because of the problems of approach and there were some techniques that were used to accomplish the surgery that were the very definition of mastery. The problem was not one either had exactly seen before, the situation required flexible problem-solving, innovative application of familiar surgical techniques and a good bit of communication and collaboration. It was an interesting bit of medicine. And an interesting bit of people watching, to see a relatively recently graduated physician (it was his patient) work with one of his more experienced partners.

After the surgery, I found out that I PASSED my Step 3 exam! Last hurdle before I abandon general medicine and start focusing on Ob/Gyn stuff exclusively!! The stupid exam administrators send you an email, make you log into a rarely used account, download a score report and THEN open the report to find out whether or not you passed. Believe me, doing all that shit then seeing the word FAIL on your score report is heartbreaking. But no more!!!
Then I did a cool ED consultation for a patient who needed to be admitted. I got a lot of the workup right and learned a lot about managing this diagnosis. She’ll be my patient for the next few days.

In the afternoon, I got to do a cool in office procedure that we have done exclusively in the OR until very recently. It was a boatload of fun. Then I put in an IUD, and THEN I put in a Nexplanon. Birth control!!!!

Then I met the boy who is dog sitting for me and found out that he and his mother are lovely and are going to watch Bear for me while I’m on a 24 this weekend. I had dinner with my dear friend Christy from Portland who is here with her extended family on a vacation. She dragged them from Nashville for the week so that we could hang too! Efficiency!

Finally, my swipey app has born some interesting fruit and I’m enjoying some texts and planning some dates. This has been an all around amazing and fun day. Yay!!!!
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I think it is safe to say that I’m having a good week. I’m so fucking relieved not to be an intern anymore I can’t even tell you. I underestimated what a difference it would make to my coping, my mood and my performance. Being just a resident (well and a dog mom) is so much easier than being a singlemotherresident. I had aspirations of getting some home updates done but I find I’m not focusing on that as much after all. The time I’m not parenting, I’ve filled with other things. I’ve done some administrative and educational tasks, I’ve done a few things around the house, I’ve spent some time with friends & on dates. But honestly, I had a lot bigger to do list than what I’m accomplishing. Part of the issue is that I’m saving money for my vacation, part of it is that if I have time, I’m choosing to use it to relax or have fun. Errands and buying house fixer upper things is not as entertaining.
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I worked a 24 hour shift this weekend, something doesn’t happen in intern year in our program, but will happen a LOT this year, and continue but to a lesser extent for 3rd and 4the year. It is actually more than 24, I started at 6am on Saturday and left around 8:15am on Sunday. It was an absolutely insane night after a series of what were apparently record breaking days on L&D. I personally attended 6 deliveries, was primary surgeon on 2 cesareans, assisted another, and did 3 vaginal deliveries. I could have done a cesarean delivery of twins too if I hadn’t felt like I was losing my mind by that point. Plus the 2nd year answers the answering service pages and there was a fair amount of helping the intern figure out how to do her job. July is a nutty time. I am a bit intimidated by the 24 hour shift. I am worried it is going to kill me. That is only a little bit of hyperbole.
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Power napping seems to be a crucial element to managing my new weekend work schedule. I took a 20-30 minute nap the 2 days following my weekend and I was able to go to ballet class and take the dog to the vet and make dinner (well dinner happened on the not-ballet class night at least). I set my timer for 30 minutes and just let myself drift off. I don’t think I slept hard but it was very restorative!
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I’m only going to parent full time living with me children for another 3 years. One of my kids only has 2 years left on her lease. I can’t believe it is almost over! Thank goodness for the dog.
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Until recently I was struggling with temptation to suggest reconciliation to my ex-husband. To be clear, the idea is a product of a tiny minority portion of my mind. The rest of my mind is working on bringing her around, but she’s pretty stubborn in the notion that the only happiness in my future lies in the past. and is gone now. When I realized how such an action would be repeating self-defeating behaviors of the past, a lot of the wind was taken out of her sails and she’s been pretty quiet since for a few weeks.

But right now my co-parent is with the kids, staying with my parents at a property that we have in Northern California. A place my children will someday own. He’s helping clean up from a tragedy there and doing traditional fun things - swimming hole & soft serve - with the kids. So last night that tiny short sighted part of my brain did something only your brain can do. It delivered unto me a dream, full of visceral, physical sensations. Reminding me what good parts of a long marriage include. It wasn’t a sex dream. That I could handle. It was a dream of walking next to someone, hands gently intertwined, feeling their breath on your neck. The comfort, familiarity, intimacy were overwhelming. But it was a dream, the reality was starker. My body aches for something it hasn’t had from my ex in years. My stupid brain doesn’t care how long it’s been, it’s so sure we could have it again if only I would…

Even in the dream I managed to stop myself. I left the room, I tried to walk up stairs but they were covered with obstacles (tiny stupid part didn’t want me to leave I guess). I’m left this morning with the aching feeling of a missing touch. Grief is a circle.

(Has anyone noticed I have 2 terms for the same person? He is my ex-husband when we are talking about the relationship between us that is gone. He is my co-parent when we are talking about the relationship I still have with him. That’s deliberate)

Tuesday, July 10, 2018

Summer snippets

I wondered how I was going to manage with meals while the kids were away, cooking for one and for my own tastes & preferences is very different from cooking for myself & 2 teens. It’s been going pretty well. I think I may have mastered the pork chop! I made 2 the other night and it gave me 2 meals worth of main protein source. I’ve been eating a LOT of broccoli & cauliflower. I’m struggling with reducing my portion sizes (to reasonable sizes, not diminutive ones, fear not) so I’m trying to fill up on veggies and water if I find myself wanting bigger portions, carbs, seconds or dessert. I bought a Brita water pitcher, I think I have FINALLY tired of drinking only seltzer water. I need to get a new water bottle too, the handle of my current fave is broken. Also the charger for my computer finally kicked the bucket (it’s been frayed and precarious looking for a while) so I’ll need to get one of those soon. And I need a shop broom so I can sweep water out from under my carport where my fancy new outdoor seats are. It’s been rainy in the afternoons the last few days and it is pooling and cramping my style. This evening Bear and I sat outside together for a bit next to the big puddle, I didn’t make him go out in the rain again!
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I wrote about my chronic occasional health thing recently. I just realized that the likely source of my recent remission was my abstention from alcohol. I didn’t drink from January through April. In the last 2 months I have had more symptoms despite being okay during spring allergy season and while sleep deprived. I am going to start a new experiment. It’s not super complicated: I’m going to stop drinking again and see how I do. I’m pretty irritated but on balance I would much rather not drink than have the annoying and often debilitating symptoms I have to deal with. I’d be curious if the aforementioned provoking factors would still provoke symptoms if I’m not drinking at all. I look forward to this new era of discovery. 
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Today I started my second year of residency. It was mostly a fun day. Figuring out how much time I had to teach and how much time I had to do my own work was something of a task. And watching the new interns work gave me a little PTSD flashback and I had to remind myself that I never had to be at the bottom of that learning curve again. It was a little like the feeling I had during my second pregnancy when I viscerally remembered the experience of labor and was like “Oh SHIT” about having to do it again. Except this time it came with the happy reality that I DON’T have to do it again. Second year will be hard in a different way but it won’t be hard in the myriad of ways first year was hard. Learning to be a doctor, manage orders, notes, pages, locating places in the hospital, meeting my superiors (literally everyone on the care team) and managing expectations...breathe, breathe, breathe. Anyway, suffice it to say that it’s a new year and I’m pretty happy about that! 
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Today I went for a swim after work. It was perfection, floating on the cool water during a hot evening, staring up at the puffy clouds in the sky. I almost went to ballet but I decided against it. The class tonight is a 90 minute class. Not sure I’m up for 90 minutes of ballet just yet. Maybe next week! 
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I have gone to 3 ballet classes during my “summer vacation”. Last night I inspired 3 of my co-workers to go with me to that 90 minute beginner ballet class. It was a good class! Not too many jumps (which I have to sit out due to old injuries I’m not quite ready to poke) It is also closer to my house. I liked it a lot! And it was fun to go with friends. Ballet is hard but also something I feel competent at. It challenges me but is also meditative. 
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That person I was falling out of interest with ran out of patience for my schedule so they have been “archived” per their request. But now I’m back on one of those swipey dating apps and I’m surprised by how much choice I have in dating options. I’m quite limited by my own availability but otherwise I feel really good about my options. And I continue to be completely unapologetic about my availability or lack thereof.
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Until recently I have been overwhelmed by an urge to act in a way that is contrary to my best interests regarding my ex-husband. I know that these urges are part of the grief process and that I shouldn’t act on them. Last time I was bowled over by these desires, I also realized that if I were to cave into them, I’d be investing emotional labor into a relationship that already showed me that my emotional labor did not bear fruit. Something about that realization has helped free me from the fantasy of reconciliation. Also I’ve had a few opportunities to cry about the whole thing that have been very cathartic.

Tuesday, June 26, 2018

Fewer children, more blog posts

This evening I had a massive craving for chocolate. But I don’t have any in the house. The craving was strong enough that I drove to the grocery store with my mind’s eye specifically on a raspberry dark chocolate I am a fan of. I walked through the bakery, considered some dangerous things, turned the corner to the cookies & candy aisle (conveniently located together, right next door). I walked between the mint oreos and the chocolate bars (alas, no raspberry dark chocolate bars). I felt like I was playing with the tip of a knife on my skin. I walked out without buying anything. 
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Maybe it is a product of the individual, maybe it is a result of where I am in my relationship arc, but right now, I’m falling out of interest in someone I’ve been seeing. This is a perfectly nice person, and someone who is doing interesting things with their life. But if they were to spontaneously not exist on this Earth, the greatest loss for me would be the occasional opportunities to scratch an itch. While I have enjoyed time we’ve spent together, in no way do I crave their attention, time, conversation, company. I have no idea if I will at some point develop those feelings toward another person. I’m sitting with this emotional place and letting it be. I will date when it is fun, stop when it isn’t, and not make myself go out to dinner with someone when all I want is to make a pork chop and hang out with my dog. I have a huge hole in my heart & soul. This is not a hole that can be filled by pouring someone else into it. It has to heal by secondary intention. This is a slower path, it requires me to create MORE of myself to fill the hole. Why isn’t there a Spiritual WoundVac?!? I wonder what my emotional & relationship landscape will look like when I am healed. From where I stand right now, I can’t imagine loving someone else again. I can’t imagine craving someone’s presence in my life. I’m have faith that it may happen, because I have enough trust in the infinite capacity for healing for the human spirit. But I’m not there yet. 
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My dog has gone completely soft. It was lightly raining this evening and I took him out and he was like, NO I WILL NOT. Refused to walk, tried to go back under the carport. When I managed to get him around the side of the house, he went behind some bushes to a space under the neighbor’s walkway and sniffed around and peed UNDER COVER. He’s completely abandoned his PacNW roots. 
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A few times a year it becomes necessary to take a chunk of our residency team out of commission. We run skeleton crews and mostly throw the rotation schedule out the window. We call these weeks Freak Week. Some people find their existence stressful. Probably because they have more responsibility than I do. This week, our 4th years are graduated and getting ready for written boards which are the last week of June for all Ob/Gyn program grads. Our new interns are still in orientation. Yep, it’s Freak Week. I’m in clinic 2 days and on L&D for 4 (I’m working Sat but not Sun). Then next week starts our first rotation of the new year. I’ll be a second year on the benign GYN rotation. This week I’m an intern plus. Or a second year light. Everyone is anticipating the move up to the next rung in the ladder.