Surprise, surprise

Despite the fact that its advent couldn't have been less of a surprise -- that's what happens, I suppose, when you're infertile and conceive only on monster doses of recombinant gonadotropins followed by in vitro fertilization, then go on to have what I can only describe as an intensely monitored pregnancy -- motherhood itself has consisted of one revelation after another for me. Ever since Sam was born, I feel continually surprised. Something new and unexpected, just about every day. Almost all of the surprises are wonderful. I never would have guessed how fun it is to take a baby for a walk or to the park. I didn't expect my infant son to be such terrific company. I didn't know how immediately and thoroughly my friends and parish family would embrace my baby, how sincerely they would delight in him. And my husband has bowled me over with his skill, patience, instinct and love -- he is an even more wonderful father than I dreamed he would be.

But the biggest surprise for me has been my own response to motherhood. Specifically, I expected to be torn apart by guilt when I returned to work. I expected to agonize. I anticipated crying jags, threats to quit, despair.

Didn't happen. At all.

Instead -- shockingly -- I don't have any guilt about working whatsoever. It's so clear to me: my working is what's best for my family. And -- more shocking -- my passion for the practice of medicine and my pride and optimism about becoming a doctor has only expanded and deepened. Not a small part of me is actually looking forward to residency. I can't wait to introduce myself to my future patients as a physician rather than as a medical student.

However.

Another thing I didn't fully anticipate: being a working mother ain't easy.

Sam is sick today; I think he probably has an ear infection given his spiking fevers in the absence of an obvious source, although since I cheaped out a couple of years ago and declined to purchase the otoscope my medical school recommended, I can't actually confirm this diagnosis. Both Brian and I had important and full days planned for today, so a sick kid presented a real challenge. There was very, very little sleep in our house last night and today was a logistical maze that resulted in me sprinting through the halls of our university hospital twice, once with a sick baby strapped to my person. I'm sure I looked like a lunatic, shuffling frantically along, carrying two large bags (diapers, a half curdled bottle of breastmilk, the results of my logistic regression all stirred together) and singing to my son to keep him (and me) from crying. No doubt: working motherhood at its worst.

On the other hand, somewhere between the two sprints, I sat between two senior and accomplised researchers, calmly and competently leading them through my recent analyses. Quiet murmurs of agreement, surprise, interest. Smart questions. Plenty to think about as I begin to draft our manuscript this week. More important, these men support me as a colleague. We plan to undertake a small interventional study on the basis of my new results, the kind of study that might provide pilot data for a larger grant. Needless to say, I am ridiculously excited about this possibility. Walking out of our meeting, my boss grinned at me. "You won!" he said. "Now go home and take care of that sick baby."

Working motherhood at its best.

Catch up

Sam and I are home from our whirlwind trip to Boston. We had a wonderful time! We stayed with my college roommate, Rachel, and her husband, Eric. We were joined by my other college roommate, Teena, and her finance, Matt. In the space of two days, we celebrated Rachel's pregnancy and Teena and Matt's engagement. We shopped, cooked, took walks, hosted parties, and caught up on the happenings, big and small, in each other's lives. Weddings and babies are blessings under just about any circumstances, but this wedding and this baby could not be happening to lovlier people. I'm so happy for them!

In other news, yesterday was my first residency interview. I interviewed for a categorical spot in the internal medicine program at our county hospital. Definitely my lowest pressure interview ... the only non-academic program I have on my list. Despite that, the program impressed me. The people are smart and kind, the call schedule is sane and -- I hadn't considered this until yesterday -- the patient population is almost ideal for residency training. At a tertiary referral center like Stanford, most patients arrive at the hospital with a diagnosis. There's plenty of learning in caring for these patients, to be sure, but there often isn't much diagnostic mystery. At the county hospital, on the other hand, patients mostly come from vulnerable, underserved groups: immigrants, refugees, homeless, the poor. These folks have limited interaction with the health care system before getting sick and as a resident, I'd be the one puzzling out the diagnosis. And, on a personal level, I think I'd really enjoy caring for them. I wasn't strongly considering this program before yesterday, but my interview may have changed my mind. I could remain involved in the research I'm currently doing while receiving excellent clinical training AND sleep in my own bed seven out of eight nights during internship. Not bad at all.

I'll post pictures from my trip to Boston when I have a chance.

PS. Just for my own accountability: mama-mojo makeover is in progress and going very well:

1. Haircut
2. Brow wax and pedicure
3. Better skin care
4. New glasses
5. New make-up
6. A pretty new dress

In which my life is awesome

I learned yesterday that UCSF offers part-time residencies for parents. I am so excited about this, I feel a little giddy.

Defining success as a mother

Lately I've been thinking about how I'll know, someday when my son is grown and gone, if I was a good mother to him.

I spend my mornings these days doing epidemiological research in geriatric nephrology, which is a fancy way to say that I mess around with huge data sets, trying to coax out new stories about the way kidney disease plays out in the lives of elder Americans. So I do medical research, basically. One of the first things you learn as a medical researcher is that you must be very explicit about outcomes and endpoints. You must be clear, from the begining, about how you're going to measure whatever it is you're going to measure.

So I'm trying, as a thought experiment, to apply the same concept to my mothering.

As a matter of belief -- because I don't have any proof; the idea is controversial on both sides -- I happen to think that parenting has a negligible effect on intellectual development. I don't think there's much parents can do to make kids smarter. I think, chances are, my kid is probably pretty smart. Chances are, he's about as smart as Brian and I are: smart enough to have plenty of choices and opportunities in this life, but likely not a rare genius. And short of locking Sam in a closet for the next 18 years, he's going to be about the same smart. No amount of Baby Einstein, Kumon, oboe practice, flashcards, or whatever other enrichment nonsense is going to transform him into a genius. (I do think parenting affects fund of knowledge, of course. My choices will help my kid learn more stuff. So we're planning to send him to private school and we'll probably do some part-time homeschooling. Because, hey, knowing more stuff is useful. But knowing stuff and being smart aren't the same thing at all.)

But I do think that parenting can affect character development. So that's where I'm going to focus my attention as a mother, on forming my kid's character. I'm making a list of the ways I hope to shape his character. It's a work in progress.

1. Kind. I can't stand mean. If Sam isn't kind, I failed. It's that simple.
2. Disciplined. It's critical that my kid can do stuff he hates, delay gratification, work hard, save money, etc.
3. Humble.
4. Generous. My husband has a tendency to be stingy and I don't like it.
5. Manly. This one is tricky for me, because as a woman, I have only an indirect appreciation of manly virtue. But I know it when I see it, and when I see it, I like it. The heart of masculine virtue, in my opinion, is strength and courage coupled with a sense of duty to protect the weak. There is also an "uncomplainingness" about men that I so admire, a willingness to do the hard job and take the hit and get up tomorrow and do the whole thing over again in service of those they l0ve.

So that's my list. Harvard, Schmarvard. If adult-Sam is kind, disciplined, humble, generous and manly, I've succeeded. I'd love to hear how other mothers are thinking about this issue. What do you hope to teach your kids? How will you know that you've been a good mother?

First Halloween

Earlier this week, Sam helped Brian carve our pumpkins.



Despite this seeming endorsement of all things Halloween, he was decidedly unenthusiastic when we put his costume on last night.



Eventually, he perked up.





We spent Halloween with some friends after all. (I really hope they don't catch Sam's cold.) They made the most amazing lamb for dinner. Definitely going to add this to my recipe box.