On being a mom...

I spent my first Mother’s Day at the hospital taking care of other people’s babies, but spent some time today reflecting on being a mother and what it feels like navigating this new world of motherhood...

It’s been less than a year but I can hardly remember what he looked like when we brought him home from the hospital, what it felt like to hold him when he was only a little over 6 pounds.

The first days/weeks/months of motherhood were a blur. Part of it was the stress of moving two weeks after he was born, starting orientation when he was three weeks old, spending a few weeks home with him and then starting intern year….but part of me knows that no matter what the circumstances, the first moments of motherhood are a blur.

It’s different than I expected. There is guilt like I knew there’d be, but I thought that it would be about leaving him, about being at work while he was at home. It’s actually more about the feeling that I can’t give him 100% when I’m at home because of the inevitable physical and mental exhaustion that residency brings. And then there was the almost tangible pain that I felt for the first time when Stephen texted me to tell me that he was sick while I was working, and the tug that I felt when he cried for the first time when I was leaving for a shift.

But it’s really less about all those moments and more about the deep joy that I didn’t know existed before he was born. His little hands wrapped around my neck……the excitement of each milestone that he reaches…the newness of each stage…his deep giggle at the smallest things...the joy of watching him discover the world…the sweetness of the little curls around his ears…the heavenly baby smell…the comfort of holding and nursing him…the peacefulness of cuddling him while he sleeps…the new and different love that I have for his dad when I watch them together.

Motherhood is a beautiful, incredible gift...I'm grateful and humbled to be his mom.

Resurrecting the blog....

I can't believe that it's been months since my last post! There are multiple reasons why I haven't written...intern year has a way of making you feel like you're drowning at times, and I'd say that's the number one reason. I've also felt a little afraid of putting my life out there...sometimes it's easier to just be anonymous and as tiny as my blog is in the wide open expanse of the blogging world, the world of resident physician bloggers is relatively small. Lastly, I don't have much time to read blogs anymore, but when I do it's easy to feel inept when looking at the professional photography and graphic design of other bigger and better blogs out there.

But I've really missed blogging! I love to write and I'm so grateful for the connections I've made in the blogging world. So here I am again, although there's no telling if my next post will be next week or next year. Residency has a way of wrapping you up so tightly in each day that the length and intensity of every shift feels like running a marathon while at the same time making the days fly past so quickly that I sometimes don't even know what season it is...

Case in point, this picture. It feels like yesterday but in actuality was taken in early December, back when Stephen Gabriel was a mere 6 months old and pre-crawling/waving/curly hair/belly-laughing at things to the point where his little eyes well up with tears. Such a difference a few months makes...

Photo by A-B Photography

The blog is not dead...

 ...it's just called intern year. It's hard to explain the implications of those two words to those not in the medical profession. Intern year a.k.a. the first year of residency is at times draining, exhausting, defeating...one of the hardest things I've ever done (I won't say the hardest since that's reserved for childbirth and the time I spent working in Haiti after the earthquake).  Other times, it's glorious and affirming... like last week when my patient's wife hugged me with tears in her eyes and told me how grateful she was, or today when I got all 6 of my intubations. More often though, it's the former. There are days that I come home and feel like I have nothing left, I'm drained to the last ounce.

Part of the reason why intern year is so tough is because you work incredibly hard to get into medical school...and then even harder to make it through medical school...and then when it seems like there should be some sort of reward, you're an intern. A lowly first year resident...feeling like you know nothing most of the time...  at the bottom of the totem pole among all of the residents and physicians. You have the worst schedule, and the most to learn. You still don't feel deserving when people call you "doctor."

The toughest days for me are when I'm away all day or all night and come home on one of the 'drained-to-the-last-ounce' days. I spend so many hours feeling like I'm missing a piece of myself at home..and then when I get home, I feel like I have so little left to give him. But I'm trying, and I know that his daddy is giving him what I can't (although it's hard to accept this sometimes). I also know that he loves me unconditionally...that he'll smile and giggle when I come home and wrap his little arms around my neck no matter how tired I am or how long I've been gone. And I take comfort in that.

Changes...

Top: Loft // Skirt: Loft // Boots: Steve Madden (via Amazon warehouse last year) // 

Necklace: Lisa Leonard (Stephen asked why I was wearing a tree branch around my neck)

There have been so many changes lately; Stephen Gabriel seems like a new baby every day with how much he's learning and growing...fall is just beginning...Stephen is adjusting to being a stay-at-home dad...I'm coming to the end of my ultrasound/EMS rotation and about to start a new one in anesthesia/psych. Sometimes I feel like I'm grasping onto the very few threads of normalcy in our lives right now...but it's exciting. Learning how to be a doctor, learning how to be a mother, learning how to be a family...we're blessed.

Linking up with the Pleated Poppy.

It's fall again...

 Top: Corinna heathered dolman top from Stitch Fix

Jeans: J. Crew Factory

Boots: Steve Madden via Amazon Warehouse

1. I recently saw this quote on Pinterest:

It made me think about how much I love fall, but it also made me reflect on the excitement and anticipation that I felt at this time last year in early pregnancy. Life has changed very much for the better since then (harder, but better!), and I'm so grateful for all of it.

2. It's been hard lately to find time to keep this little space on the internet going. I have several half-written posts in my drafts about intern year, motherhood, medicine that I can't seem to finish. I'm having a hard time expressing my thoughts completely on it (and maybe even grasping how I really feel about it) so I guess I'll finish them in due time...or maybe not, and that's ok.

3. In the meantime here's a shot of what I've been doing at work lately on my EMS month:

Emergency medicine has it's perks.

4. I totally missed out on the opportunity to do a sappy, sweet anniversary post when we celebrated two years on August 31. My mom gave us the best gift ever and flew in for the weekend so she could help us around the house and watch the little man for some dates. We went out to dinner twice (!) and also went for a hike, which was totally therapeutic and some time that we really needed together.

 

5. Continuing on the fall note, it's my favorite time of year for outfits. I recently picked up a few things using a credit that I had from my Loft (everything is currently 40% off with the code fallstyle!) I definitely did not need another pencil skirt, but the mustard pattern was too good to pass up. The blouse is breastfeeding-friendly and both the skirt and the blouse will be great pieces for an emergency medicine conference that I have in Chicago next month. The cardi and top are great basics.

Links: Skirt // Cardi // Long-sleeve top // Printed blouse

 6. And another outfit that I planned to share last Sunday but didn't have time to post:

Skirt: J. Crew

Vest: J. Crew Factory, super similar here or here

The last time that I wore that utility vest was actually when I was very pregnant so it was nice to be able to zip it this time ha. I'm not sure that I love it how I wore it with the maxi skirt/tee but I think it'll look great over a striped top and skinny jeans/boots for fall.

7. You probably noticed from the pictures how big our little guy is getting...I feel like I can barely remember bringing him home as a teeny newborn on the cusp of being small for gestational age...now I'm guessing he's 60th percentile? We shall see at his 4 month (!) check up in a little over a week. We love him so very much and he is worth the sleepless nights a thousand times over (I can't imagine what it's like to have a baby that sleeps through the night but someday it'll come). He is getting to be more and more interactive and it's such a joy...

Linking up with Jen // The Pleated Poppy

Sunday musings...

Top: Piperlime clearance, dress version here//3/4 sleeve version here

Skirt: J. Crew (old), current version here//similar here

Shoes: Sam Edelman

Lips: Nars

I spent the whole summer looking for a white peasant top with blue embroidery and finally find one just as the summer is lagging to a halt. I originally loved this one but it was too pricey and waaay too short when I tried it on...so I was pretty excited when I found this one on popback at Piperlime (I used a 40% off coupon). The length is perfect and it's nice and light for summertime.

If I look tired in this picture, it's because I worked until 4:30 a.m. The pediatric ER was crawling this weekend which didn't lend itself to getting home on time  (side note that I had some really interesting cases...including my first case of Kawasaki). And on the plus side, having a baby is probably the best way to train yourself to function on very little sleep.

We walked to mass this morning and when the priest saw Stephen Gabriel, he said "That's a new one!", which is funny because he seems so big to us now. I'll be spending the day with my little guy before I go back to work tomorrow. Have a lovely Sunday (linking up with FL&P).

We're doing fine...

1. In case anyone has been wondering, we're doing just fine. I survived my first week as a real (resident) doctor, so did the boys, and so did my patients. The Stephens have had some serious bonding time in my absence:

And Stephen Jr. has apparently learned to watch baseball with his dad, ha.

2. In all seriousness though, it's been hard. There have been tears on more occasion than one, and I miss him desperately. Fortunately ER shifts are so incredibly busy and it's so powerfully overwhelming to all of the sudden carry the responsibility of a physician (even a baby one) that I haven't had much time to think about it. But when I leave to go pump breastmilk for him or I'm nearing the end of my shift and faced with staying late or I see a baby on my pediatric shifts, I miss him...really miss him.

3. But then I get to come home to this, and lots of baby snuggles, and the world is ok again.

4. I'm finally finished with his birth story (I think? No matter how much I tweak it, it doesn't feel like I'm doing justice to the momentous story of a new human coming into the world) and I'll hopefully be (over) sharing it on the blog...so if you're a fan of birth stories in all their glory (not ashamed to share the details) check back in the next week or so.

5. My brother got married two weeks ago and I fully intended to recap it on the blog...but one half-written draft post later, it's prob not gonna happen. I did share some pics over on the 'gram, and I can't help but share what Stephen Gabriel wore (full disclosure that this outfit that I was ridiculously excited about lasted all of 15 minutes and the rest of the night he was in the backup sleeper I packed). Anyways, at least we got some good pictures.

What Stephen and I wore (and what Stephen Gabriel really wore):

6. On another note, I tried Stitch Fix (that's my referral link...if you sign up, I get a small credit toward my next Stitch Fix if I decide to do it again, and you get your own referral link that you can pass on) for the first time.  If you've never heard of it, it basically involves filling out a style profile after you sign up and then paying a $20 styling fee to have 5 items shipped to you. I wasn't crazy about the fee, but it goes toward anything you end up keeping. I bit the bullet and signed up after talking to my cousin, who had a baby two months before me and said that it really helped her to find a few things that work for her during this crazy postpartum/breastfeeding time. Here's a sneak peak of the loveliness that was in my 'fix' and I'll share some reviews soon...

7. Last but not least, Freshly Picked so graciously sent the sweetest pair of baby moccasins for Stephen Gabriel aaaand they're giving away a pair of your choice to one lucky reader. You can find the review/givaway here. 

My shift tonight will round out close to 80 hrs in the emergency department this week, but this is my weekend off (we get one off per month) and I can't.wait. to spend it with my boys. Linking up with Jen.

I knew this day would come...

Photo by Vafa-Koffman - they took some amazing newborn photos for us that I'll share later

Last Monday was my first official day of residency, Stephen Gabriel's 3.7 week birthday, and my first full day leaving him. Before I started residency, I had a lot of comments from friends, family, acquaintances, etc. to the effect of "I can't believe you're moving with a two week old" and "I can't believe you're starting residency with a newborn" usually followed by "I could never do it"...but here's the thing, when you have to do something, you just do it.

I didn't get off to the best start for the day; my institution requires a full suit for orientation, meetings, etc. so I had my suit all ready (which thankfully fit, albeit just barely). I laid out several shirts the night before that were looser on me pre-baby, but I guess I had underestimated the effect of breastfeeding because after trying on 5+ shirts that morning that were either too short or too tight in the chest area, I resorted to a plain black t shirt that I never would have worn with a suit pre-baby: normally this would have been a small crisis for me but having a baby sure puts life into perspective ha.

I didn't cry when I left. I had been preparing myself for this day for months...10 months really, since I knew from the moment that I saw that plus sign that I would need to start residency with a newborn. It helped also that I knew I'd be spending a month on maternity leave after orientation. It felt weird though without Stephen Gabriel...walking downtown among the huge clinic and hospital buildings empty-handed.

The hardest part was when Stephen brought the baby to me during my first break so that I could nurse him. The boys had a hard time finding my building and the lecture went a little later than planned, and by the time I got to the car to pick up baby Stephen he was crying his little eyes out, that unnerving newborn hungry cry that is completely heart-breaking. That's when I felt myself retreat into a sea of guilt, and the tears that I had held back that morning started to silently flow.

I know that there will be a lot of moments like this, and I'm not going to try to analyze it or downplay it or justify it. I'm excited to be a doctor and I feel incredibly privileged to have the opportunity to train at one of the top hospitals in the country, but at the same time I know that my baby will always come first. I'm not sure how I'll do it, but for now I'll just trust that I'm going to figure things out along the way. In my favor are that my residency program has been incredibly understanding and kind (in a way that I'm certain other residencies wouldn't be with a new resident coming in with a fresh newborn), one of my fellow first year residents has a two year old and has been a huge support for me, and most of all, Stephen Sr. has been a rock star in all sorts of ways. We can do this...I know it won't be easy, but few things in life that are worthwhile are easy...we can do this.

Match Day!!

It's crazy how four years of hard work and craziness all culminates into one moment: Match Day. My heart was pounding when I received the envelope that contained the place where I would be molded into a real doctor, and where Stephen and I will raise our little family for the next few years. Some med schools have a ceremony where students are called one-by-one to a podium to receive their fate, but since I am in a rural medicine program with only a small number of students we got to do our own thing. Most of my classmates wanted to open their envelopes one-by-one with each other, but I chose to just open mine with Stephen and then join the group afterward. I knew that one little envelope contained so many emotions for me (regardless of what program I would get), and I wanted to process it with Stephen first. My top two programs were two of the most family-friendly institutions that we had encountered on the interview trail, and my number three was Hopkins (my dream hospital when I started med school, but very far from my family and a longer/more intense program than my top two). I ended up ranking a world-renowned institution as my number one and then a Michigan hospital close to Stephen's family as my number two. I wanted my number one so badly, but at the same time I knew that getting it would be bittersweet since neither family would be closer than a 7 hour car trip away.

After I got my envelope, I rushed to the car where Stephen was waiting and couldn't wait any longer to rip open the envelope. And then I saw it, my number one program...I felt a flood of excitement and then relief at knowing where we are going. Stephen kissed me and told me how proud he was of me...and the rest is kind of a blur :)

When I look back at the journey that has brought me to this point, I really see God's hand in it all. After sharing our news with family and then on Facebook, I started realizing that I know several nurses and doctors from my Haiti volunteer work that live around the area where I'm going (some even offered to help us with moving!) Over the weekend, I found a rental house on Craig's List across the street from the hospital where I'll be spending all my time except for a few off-service rotations. A close family friend who lives in the area was able to go look at the house and see that it is beautiful (much nicer than we require!) and only a 5 minute walk from the emergency department where I'll be working (such a relief that I'll be so close to Stephen and the baby). And when I talked to my residency program about our baby due just a few weeks before orientation starts, they were incredibly supportive (I have multiple options including taking maternity leave or some vacation time in July). 

We are thankful for so many reasons right now, and excited for the journey to come!

I finally know what I want to do with my life...

via

And it was the hardest decision that I've ever made.

I started medical school with the clear idea that I wanted to be an ER doctor. Having worked almost two years as an ER nurse and spent extensive time volunteering in Haiti with ER docs, I felt confident in my decision. But the farther along that I got in medical school, the less certain I was...I liked continuity with my patients, with is not really present in emergency medicine, and I found myself with a different personality than many of my classmates planning to pursue emergency medicine. Then enter OB/GYN...

Delivering a baby is unlike anything else in medicine or life. There's something about the raw joy of that moment and the privilege of being a part of it...nothing really compares. I also liked the prenatal care, the postpartum care, and supporting women with fertility issues. There were a couple of problems though. I knew that I would be a natural family planning OB, which mean that I wouldn't do tubal ligations or prescribe contraceptives, placing me in a very small minority of OBs. This would have implications on where our family would live, based on me finding a hospital and group that would support me practicing this way. I also knew of the implications on family life in traditionally one of the worst residencies in terms of hour requirements, and even after residency as an attending since babies are never born at predictable hours.

In August I spent a month in St. Louis, at an OB/GYN residency that was strong, high-volume, and NFP-friendly (about one-third of the residents are NFP-only). It was one of the best months of my medical school career. I participated in many, many deliveries and did some of my own. I got to know the residents, a smart, kind, and supportive group. I reaffirmed my love for OB and discovered that it was possible and needed to be an NFP-only OB/GYN (possible, but not always easy). I prayed that God would show me what I was supposed to do.

I guess I should add that when I prayed, I told God (always risky in a way) that it would help me make my decision if Stephen and I became pregnant. We had tried for a couple months, knowing that there was only a brief window between residency interviews and the start of intern year, and hadn't been successful yet. I knew that it would impact my decision if I were expecting, because of doing one of the hardest residencies with a newborn. We found out that we were pregnant the month after St. Louis (yes, God listens).

I still interviewed for OB, but I also interviewed in emergency medicine. EM was my 'first love' in a way, and residency and life after were light years different (probably one of the best residencies with a family, and certainly a great lifestyle afterward for having children). However, there was a nagging feeling inside that I didn't want to give up OB. It took me months to make my decision (which I solidified pretty much right before our rank lists were do). I reflected on life, my priorities, why I went into medicine in the first place. As I got closer to decision day, I realized a few things. One was that I didn't like the operating room: as much as I wanted to like surgery and did like the idea of it, it wasn't for me and probably never would be. Surgery is a huge part of OB, and this helped make the decision easier. I also realized that I would miss a lot of the medicine that I'd learned by pursuing OB. It's a very specialized field, and the broad spectrum of knowledge that I'd always hoped to have as an emergency physician wouldn't be a part of it. Knowing both of this things helped me to be at peace in the end, because I didn't want to make the decision based only on family life or the fact that being an NFP-only OB would be difficult.

And so I made my decision of emergency medicine. There's a part of me that still has a hard time letting go of the idea of delivering babies (not that I won't ever in the ER, ha) but I know in my heart that it was the right decision for both our family and for me. It was reaffirmed last month when I was working in the ICU: ER doctors can pursue a fellowship in critical care and become an intensivist, and I realized that the ICU encompasses so many of the reasons that I went into medicine: caring for patients at their most vulnerable, and practicing in a field that requires me to use all of the pathophysiology that I've learned on a daily basis.

That brings me to today, Match Day. If deciding between emergency medicine and OB was the hardest decision that I've ever made, then ranking programs was a close second. I was so torn between the programs closer to family and a few programs at some of the top hospitals in the nation. Ultimately, I ended up ranking the two programs that I felt were the combination of most family friendly with the best education at the top...one is close to family, where we'll have a lot of support, the other is at a world-renowned facility. The Match leaves a certain element to fate (and God) since we rank our top programs and the programs do the same, but then it all goes into one big computer system to give us our assignment. It's 5:30 a.m. now, and in only a few hours we'll know...the countdown continues...

Tough decisions...

 

I've had a lot on my mind lately. I've been lying awake in the middle of the night or early morning feeling the baby move around inside of me and wondering what it will be like when I start residency with a four week old. I had a dream the other night that I missed his first steps because I was at the hospital, and I was devastated.

My attending physician the other day started talking about how she had her first baby during intern year. She said that she couldn't prepare herself for how she felt...it was such a change to go from carrying her baby with her everywhere, inside of her, to leaving him behind. I felt a deep ache when she talked about it, like it was a glimpse of what was to come that I hadn't anticipated and couldn't really fully prepare myself for at all.

I've thought a lot about what to do with my life these past months. I've struggled about what specialty to pursue and where I'm being called. Struggled about the timing of things. Regretted not having more time with our baby as a newborn before it's even happened. Even considered taking a year off to spend more time with him.

Yesterday I awakened again way too early with random thoughts running through my mind, my hand on my belly feeling the reassuring dance he usually does at 5 a.m. (and 3 a.m.). I got up, and finally certified my match list for residency (the list of the programs where we interviewed in the order of where we want to go). Until then, I couldn't bring myself to make it permanent. But I knew what I had to do and I did it, and ultimately I think that what I did was the best decision for our family and our future. And I'm at peace with that.