This is the Time of Our Lives

Previously published: http://www.scarymommy.com/family-life-time-of-our-lives/

My baseline default mode for the last five years has been “frantic.” I gave birth to my amazing twins, and if I thought I was “busy” before, I was sorely mistaken. The kind of acrobatics I came to accept as normal with juggling life and these “darling” newborns of mine was nothing short of chain-my-right-arm-to-a-40-pound-weight-and-ask-me-to-balance-a-stack-of-fine-china-on-my-forehead kind of acrobatics.

I remember a conversation I had with a colleague who confessed that he was not yet ready to have kids. “I’m not ready to give up my freedom,” he said. I didn’t think twice about what he said, really. Not ready? My ovaries have been rioting with their readiness for years! This conversation faded over my pre-baby months, and resurfaced with a vengeful vigor post-babies as I began to understand exactly what “give up my freedom” truly meant.

Giving up my freedom meant holding onto my full-three-hours-ago bladder just 10 more minutes (or 15 or 60 more minutes) while I finished changing my daughter’s dirty diaper, got their snack ready, and wiped up that weird stain on the carpet, and—is that another dirty diaper I smell? Dear lord, children! This is not a race to fill up the diaper pail!

Giving up my freedom meant forgoing brushing my teeth today because I had just finished breastfeeding the twins, and my daughter was already asleep, but my son was bright-eyed and ready to goo-goo and da-da-da, until of course, my daughter started to stir and wake up again.

Giving up my freedom meant staving off the surfacing panic as I came to the realization we were out of diapers in 3, 2, 1…and I needed to go to the store with both my infant babies.

Giving up my freedom meant date nights with my husband—wait, I can’t stop rolling with laughter. What are date nights with my husband?

I never knew what “I’m not ready to give up my freedom” meant. I could have smacked my colleague. Why hadn’t he shaken me ferociously and waved his hands frantically in my face while shouting and knocking some insight into my head so I truly knew what he meant? And by the way, was he some kind of secret sensei for figuring this out without ever having experienced it himself? Or was I just blinded by my ovaries?

“I’m not ready to give up my freedom” is an ever-changing phrase these days. As my infants grew into little toddling an-injury-is-a-step-away cuties, it was a game of chase and keep track and forgo finishing that sandwich you have been craving for the last six hours. As they became so smart and so verbal, it was a game of respond to their every demand for blueberries, milk, their favorite stuffed dinosaur and clap vigorously at their potty-training-in-training achievements. Today, it is a game of “why?” and congratulatory compliments over their new family portrait with house and tree and sun.

I think back to before I had kids and how much that is all I longed for—to have a family. These idealistic daydreams I had of family life, of Janie and Jack-clad children playing sweetly with their not chipped or half missing set of wooden Pottery Barn Kids blocks. I think about the things that kept me busy before kids, that I still try to accomplish with a fraction of the attention and energy I paid it in the past. I think about my constant struggle between enjoying my kids and maintaining this person in this life I lead before them. And then, it all came together. I came to realize that maintaining this pre-children life was no life to be maintaining, because it wasn’t my life.

This is my life. This is our life.

This is the time of our lives—this life that my husband and I have nourished and that is the center of our world. These three kids of ours, that are constantly in tow, like our very own pack of three little ducks clipping at our feet. And it is a full life and an amazing life. And this is what I yearned for and am so, so lucky to have in all its imperfections and all its fullness.

When life changes, let your expectations change. This is the time of our lives. This is the time of our lives when the dishes can wait in the sink after dinner, because it is the holidays and Rudolph the Red-Nosed Reindeer is on TV, and you are so excited to share this part of your childhood with your children.

This is the time of our lives, when my hair might (will) still be wet when I pull it back, because there are kids filled with joy who want to be a part of my day right now. There is my daughter who wants to show me her latest dance-twirl-robot move in her pink tutu with stars and flower-print leggings and princess slippers. There is my son who has 20—make that 40—questions during a football game as he discovers his love of the sport, and I discover the unexpected love I have for witnessing his flourishing passion for something.

There are their questions and commentary and the way they process and regurgitate information and memories when we engage in undistracted conversations that make me marvel at how their brilliant minds are growing.

There is the time when I step on another Cheerio and resist the urge to run for the vacuum and Swiffer WetJet, because my 18-month-old squeals in delight when she sees me break for the vacuum, thinking instead that I am coming to chase her, and she takes off in the cutest diaper-butt shaking baby sprint, clapping her sticky hands with pure glee. Why would I want to do anything but chase her? There are still the occasional 3 a.m. wake-ups when I pick up this sweet, sweet baby of mine and indulge in her warm tired body, snuggling on my chest as she falls back to sleep, burying her head deeper into my shoulder.

“I’m not ready to give up my freedom” these days means that I will never go back to those pre-kid days and I wouldn’t want it any other way. This is the time of our lives. The time I always daydreamed about, and now it is life and it is reality. This life is bursting at the seams. It is love. It is full. It is joy. It is tiring, exhausting, unrelenting. But it has never been better.

The Anticipation is Killing Me

My twins are 6 months old. They are the quintessential marshmallow babies with rolls upon rolls in their healthy little legs. They are eating an array of mashed up steamed veggies that include spinach, green beans, carrots, and squash. They are ravenous eaters, and I am a proud mommy. I am proud of the choices I have made for my kids and I am proud that they are gobbling up all this healthy goodness. A sweet mom of two kids, 2 and 4, passes me in the restaurant. “Oh, your kids are adorable!” She exclaims. “And what good eaters! Oh, my kids use to eat everything too. But wait until they hit toddlerhood! They’ll be fighting you over every last pea you put on their plate, and then all they’ll eat is mac n’ cheese!” she chuckles and passes on by.

My twins are 12 months old. We are out shopping for the holidays. They sit in their stroller and stare at the crowds of people while munching on raisins. “Your kids are so well-behaved! Just wait until they hit their terrible two’s! Oh, what a nightmare!”

My twins are 2 years old. We are at the grocery, and they happily hold boxes of crackers I hand to them or bottles of condiments. We are at the cash register. “How old are your kids? Two? Oh my, twins! Just wait until they are three, they won’t be good listeners anymore!”

My twins are 4 years old and my baby girl is 13 months old. We venture out as a family on a Friday night to the local pizzeria. My twins giggle and pass toys back and forth across the table, and my little girl stares at the people at other tables, then stares and babbles at her siblings. “Your kids are so sweet! Get in all the family time you can now, because when they’re older, they won’t want to have pizza with you on a Friday night anymore!”

My 4-year-old girl and I go out for a mommy-daughter date. I introduce her to shopping for her own things for the first time. She is in awe of all the little girl jewelry at the jewelry store. “Your daughter is so sweet! Wait until she’s a teenager! You’ll be singing a different tune then!”

Here is the thing. I know you have good intentions, but your anticipation of what horrible things I am to expect is killing me. Maybe in the years to come my kids will not want to spend a Friday night with me. Maybe my daughters will be a handful as teenagers. (I can hear it now, “you have TWO daughters! Oh boy! Just you wait! They are awful!) But right now, I am a mom of three young kids, proud of how I am raising them and proud of the kids they are. I am enjoying them when they are good eaters, I am sappily admiring them when they are adorable and well behaved. I am not preparing yet for puberty. I am not preparing yet for Friday nights when all the kids are out with friends and I am hopeful they will be home by curfew. I am sure that time will come, but the last thing I am thinking about when my kids are giggling over my silly only-funny-to-four-year-olds joke is how this won’t be funny anymore when they are 10 or 15 or 23.

I understand that I am beyond lucky having three healthy kids. Don’t get me wrong, we have our moments, but for the most part, we are enjoying every milestone as it comes.  I know that every child and every mother’s experience is different and unique. I appreciate you reaching out to me, trying to connect with me, reminiscing of a “simpler time” with your own kids. But please allow me to enjoy my kids for who they are right this minute and maybe at another time, you can share your own experiences of what came after this stage for you and your kids. But not right now.

Let Grief Be

A 23 year old girl is roomed with abdominal pain. It is a busy Friday evening in the emergency department and on my mind is my patient that I just told is having a heart attack and am having sent to the cardiac procedure center where they can determine where the blockage is and hopefully open up the blockage before any more of his heart tissue is damaged.

I walk in to see my 23 year old patient, and see her near hysterics, writhing in pain on the hospital bed. She grabs the railings and thrashes back and forth yelling out in pain. I ask her quickly where her pain is, and she yells, “My stomach! My stomach! Please! Help! My stomach!” I try to get more of a story, but she is in so much pain. I find out that she thinks she may be pregnant but she doesn’t know how far along she is. She appears to be having contractions, lower back pain, maybe she is in labor, but she seems early along in her possible pregnancy. I tell her I am going to find her nurse so we can start an IV and get her some pain medication while I try to figure out what else is going on . So, I step into the hallway and look up and down, and see no one in sight. I step out further and see that all my nurses are in patients’ rooms taking care of other people.   I step back into the room, and see my patient sitting slightly up against the incline of the bed with her legs bent at the knees. She is calm. I also see under the edge of her hospital gown, an image I will never forget.  She has miscarried her baby.

I look up again at my patient. I’m not sure if she knows what has happened. I sit down next to her and rest my hand on her arm. “I am so sorry, but you have miscarried your baby.” I stare intently at her face, trying to read her expression. She stares at the warm glow of her smart phone. I want to throw my arms around her, comfort her, talk to her. She says, “Ok.” I tell her I am going to have to deliver the rest of her pregnancy, that I’ll need to deliver the placenta. She responds monotonously, “Ok. But please. I don’t want to see. Please don’t tell me how far along I was.” She never looks up from her phone. I finish taking care of her and sit back down next to her. I explain what I have done, but am sure to honor her wishes. I explain the next steps and what to expect. She nods, she is void of any expression. I ask her what questions she has, what concerns she has, how I can help, what resources she needs. She needs nothing. She has no questions. No concerns. How long until she can leave. Please don’t tell her boyfriend who is waiting in the lobby. I say again, “I am so sorry.” I linger. She nods again. I have so much empathy and support to give. She would rather not have any.

I think about her often. I wonder what I could have done differently. I wonder if she had questions or concerns. I wonder what thoughts were spinning through her head.

What I have learned over the years, is that everyone grieves differently. Some cry. Some panic. Some act brave. Some become frustrated and angry. Some are in denial. Some use humor to get them through. Some ask questions repetitively and talk in circles, as they are slowly processing this big moment in their lives. And some are like her. Expressionless. Detached. Dealing with whatever it may be in their own ways. And that’s the exact thing about grief. It presents in different ways. No two people grieve the exact same way. I may have wanted to throw my arms around her and I may have expected tears, but that is not what she needed. She needed space. She needed me to stop talking. And that is okay. Her grief and my grief and your grief are not the same. We need to respect that of one another and let each person take the lead on how they need to react and how they need to heal. No quick judgments that because there were no tears or outbursts, that she is not in pain. There is no need for her to explain her reaction.

I still wonder what more I could have done. But I was there. And I will be there again and again for my patients. And that is the best I can do and what I will promise to continue to do. I will wonder and ask what more I can do and be there however they need me to be there.

Letters to my Four-Year-Olds, Part II

Today is the last day my twins are four. I wrote them each a letter on this last day of being four. Here is my letter to my son.

Dear Max,

Today is the last day you are four years old. The thought of you turning five fills me with pride, fills me with excitement, and anticipation. There is a small part of me that feels bitter sweet, realizing that you have left everything baby and toddler behind you, but mostly, I can’t wait for what is to come. I say this not for generic reasons, but I say this because of who you are becoming.

You, my four-year-old boy, are one of a kind. Yes, I say that because I am your mother and all mothers think their boys are one of a kind, but I say that because I know, like the back of my hand, who you are. You are sensitive, you have a kind heart, you have a moral conscience, you want to be good, you wholeheartedly love and care about your sisters, your grandparents, your friends, your mom and dad. You are aware and considerate of the company you are in, and you are observant and have a ridiculous memory for last summer’s vacation, last week’s Vikings game, and that time we went out for pizza and your baby sister didn’t want to eat her peas.

You are my sensitive boy that wants to hug me just a minute longer before you go to bed. You startle me in the still, dark hallway at 6 in the morning before I leave for work, “You are my favorite mommy in the whole world.” Your face falls with devastation when you get in trouble for something you know you shouldn’t have been doing. You fight back tears welling in your eyes when you are disappointed and your expectations have not been met. You can’t help but let out that pure joyous giggle when you learn about a surprise that is to come your way.

You are dedicated and responsible, which are things I am not so sure can be taught entirely. This past Friday, you had your holiday program, and you were sick and vomited on stage, then proceeded to sing and dance for an hour-long program, including starring as Mr. Turkey in Hello Mr. Turkey. And you did so, unfazed, singing and dancing in a pile of your own vomit. Unbelievable. Your perseverance is unparalleled.

You are so smart. You remember scores to football games from three weeks ago. You memorize the most obscure dinosaur species from your big book of dinosaurs. You can add. You can read. You are inquisitive and asked your dad the other night, “what was the first thing that lived on earth?” You use logic and reasoning in ways I had no idea a four year old could do.

You are gentle. You adore your baby sister and want her hugs and kisses. You watch out for your twin sister and protectively put your arm around her when you are both timid in a new situation. You tell her how she hurts your feelings when she is sad.

You love football, making crafts, playing board and card games—your new favorite is checkers. You love being outdoors, you love adventure, you love books. You love dinosaurs, superheroes, and robots.  You love to eat.

You are confident. You are sensitive. You are kind. You are smart. Your smile is infectious. Your dimples are to die for. You have the sweetest words, and I couldn’t ask for a better son.

To you, my four year-old son, on the day before your turn five. Thank you for giving us these five wonderful years with you and for giving us so much to look forward to as we watch you grow. You are my favorite little boy and I am so lucky and thankful to have you as my son.

All the love in the world for you, my baby Max.

Your mom and biggest fan forever and always.

Letters to My Four-Year-Olds, Part I

Today is the last day my twins are four.  I wrote them each a letter on this last day of being four.  Here is my letter to my daughter.

Dear Sofia,

Before I had you, I always daydreamed about having a little girl.  A girl to adore, a girl I would love, and a girl who would become my best friend. When you came into the world, oh, you did not disappoint. You were exactly everything I ever wanted in every one of my daydreams and everything I wanted that I didn’t even know I wanted. You had pink, flushed cheeks, and a smile to melt away every worry in the world. You have come into your own; you are the girl of my dreams.

You are everything I ever imagined and so much more than that. Since the moment you were born, you have always been laid back and happy. Your giggles fill the room and infect every person around you. You smile as if happiness is at the core of everything that you are; I could just stay in your glow of giddiness and effortless laughter forever.

I love to watch you when you don’t know I am watching. Your imagination runs wild, and your dolls and princesses come to life in your hands. You act out their magical lives and I listen to your animated voice narrate the stories that emerge at your fingertips. Your creativity unleashes, and I am amazed by you. I watch you as you emphatically direct your own play of characters, as the plot thickens. I love that you can create a world in your mind and nourish it with your almost five years of experience.

You love to color. Your most asked questions is, “Can I color?”  I don’t know any other four year old that can sit there for hours, surrounded by crayons, markers, and colored pencils and color picture after picture with such meticulous attention. You’ve started drawing this last year, and your dad and I are seriously in awe of the things you can draw.

Last week was your holiday program. You sang a duet about Hanukah, and your dad and I just couldn’t be prouder. You have a way about you, that smile, that awareness of being a performer, it is a talent that cannot be taught.

In a million ways, you remind me of me. I’m pretty sure you are just a mini mold of me. I hope, when you are older, this is not insulting. I just see so much of me in you. I remember the day you were born, your dad holding you, and having it feel so surreal because I felt like he was holding a mini baby version of me.

I have so much hope and anticipation for you and what lies ahead. I know that you will be loved by everyone that meets you. You are easy going, kind, so lovable, sweet, positive, and your love of laughter is too infectious not to want to be around. You love your family and have a selflessness about you that makes you unique from other four year olds.

You love “everything pretty” as you put it, which includes tutus, skirts, dresses, flowers, pink, glitter, sparkles, tiaras, heels, princesses, ballerinas, fairy wings, jewelry. You squeal with delight when your baby sister has on something adorable, and say, “you are soooo cute!!!!” You do a super, super adorable shy tilt of the head and smile when someone tells you you look beautiful. You love to sing and dance.  You usually can’t be bothered to wear anything that isn’t super girly. You are appalled at the thought of having a pajama day, even when you are sick.

You are brave, and even when things are scary, you can handle them. You try to put on a brave face, even when I can see the emotion in your eyes. You know when your brother is upset and needs to have his way, and you let him have his way and are nurturing and compromising in that way. Yet, you are decisive and unfaltering in your choices. I love this about you.

You love your “pretty things” but are not consumed by materialism; last Christmas, when we asked you over and over what you wanted, unlike the usual laundry list of things other kids may ask for, your list consisted of one thing, “Jasmine.”  You have self-control.  If you eat cake, you will stop when you are done, even if that means leaving on your plate a mound of frosting.

Sofia. You are beautiful beyond words. Under the glitter, tutus, pink, and heels, what I see is a beautiful soul filled with laughter, freeness, creativity, imagination, talent, strength, and a wonderful energy. I can’t wait to see what you become and how you flourish in your element.

You are my every daydream come true. Thank you for letting me watch the wonder that is the Sofia Show unfold. I love you more than anything and will always be here to cheer you on as you go down this journey. You tell me you want to be a chef and a doctor like mommy, but whatever you decide, I’ll be here to support .

Every night, I tell you I love you to the moon and back, and you tell me, “I love you more than that.” Then I tell you I love you more than that, then you tell me you love me more than that, and on and on we fight.

So let me just tell you, I love you more than any “more than that” times infinity and beyond. No matter what, no matter where, no matter when. I love you more than that.

Your best friend, biggest fan, and mom always and forever and more than that.

Adapt to the Unexpected

With four year-old twins, I have embraced the saying “expect the unexpected” and taken the challenge one step farther and come to live by the motto, “adapt to the unexpected.”

The unexpected uncovers, bit-by-bit, who my children are becoming.  The unexpected teaches me to grow and adapt just as my kids do.  The unexpected is an opportunity for me to teach my kids by example, and last night, I learned, for them to teach me by example.

Last night, I sat in the audience with fellow parents, grandparents, and other superfans of our pre-schoolers as they entertained us with an hour long holiday program complete with song, choreographed dance, and utter, unparalleled adorableness.

We oohed and aaahed and laughed heartily in delight, smartphones in hand, snapping away, waving emphatically at our hearts standing bravely on that bright stage, staring right back at us.

They sang and swayed to songs about Kwanzaa, Hanukkah, the first Indian tribes, and Christmas.  They sang in French, in Spanish, with sign language.

I beamed as my four year-old daughter courageously stood in front of the microphone, stage center, held the menorah, and belted out her duet about the eight days of Hanukkah and the star of David.

I giggled and smiled from ear-to-ear as my four year-old son starred as Mr. Turkey in the hit song, “Hello Mr. Turkey.”

These preschoolers.  They nailed it.  We were a room of overjoyed, over emphatic, over proud parents to say the least.

After the performance, complete with standing ovation, I hurried up the stage to hug my amazing four year-olds.  My daughter glowed and smiled that win-you-over-a-million-times smile she has trademarked.  She swayed from side to side, the sequins on her dress shimmering under the lights.

My son broke into a huge grin when he saw me, but he appeared slightly pale, slightly run down.  I went to embrace my sweet, tired Mr. Turkey and shower him with my mom pride.  He stuck out his right sleeve.  It was covered in vomit.  He pointed down at the ground where he had been standing for the duration of the performance, and there it was.  A big pile of (I won’t use any descriptors) vomit.

I came to learn that thirty seconds before the curtains opened on this adorable class of preschoolers, my sweet boy had released the substantial contents of his stomach (he’s not a light eater, let’s put it that way) onto the top bleachers, right where he was standing.  He then wiped his mouth with his crisp white button down shirt sleeve, and proceeded through his well-rehearsed one hour performance about the seven days of Kwanzaa, lighting the menorah, jingle bell rock, signing “rainbow” and “friends”, and fearlessly leading the other preschoolers while holding a full tail of turkey feathers in his feature debut in “Hello Mr. Turkey.”

I had watched him, at times with a slight tilt of the head, wondering why he looked slightly tired and slightly pale.

My four year-old, feeling miserable, literally standing in a pile of his own vomit, had kept on keeping on.  Unfazed.  Unmoved by his own stomach contents.  He had adapted to the unexpected and literally sang and danced around it, over it, and on top of it.

My Mr. Turkey, at four years old, had shown me perseverance and the ultimate adapting to the unexpected by example.  Keep on keeping on.  And you can nail it too–feathers in hand, waddle to your walk, vomit on your sleeve and under your boots.  Truly, whatever it may be.

My Childhood for Their Childhoods

Republished at http://www.scarymommy.com/club-mid/happy-childhood-peer-acceptance/

I was an awkward kid to say the least. I wasn’t good at sports. I wasn’t good at being social. I wasn’t good at knowing what was the hip thing to wear. I had red glasses. I had a perm.

I was no novice to rejection. I once mustered up the courage to ask the boy that I liked in seventh grade if he would go out with me. Or, let’s be honest, I mustered up the courage to ask my friend to ask the boy I liked if he would go out with me. The answer was no, and so I pushed my glasses back up the bridge of my nose and continued to admire him from afar, counting small victories like the time he walked by my table at lunch and glanced at what I was eating.

I can hear your “awwww’s” and your “poor awkard kid!” remarks now. But, this is no pity party. I am comfortable with my childhood. I own it. It is part of why I am who I am today. But now with kids of my own, childhood takes on a whole new meaning. My heart is full of anxiety for what my children’s childhood will be like. Will they be accepted? Will they be good at sports? Will they be picked last at gym to be on the dodgeball team? Will they have an easy time making friends? Will my daughter’s “Justin Kinley” say yes in the seventh grade when her best friend asks him if he will ‘go out with’ her?  (I imagine by that time, I will get an eye-roll–“Mom!  Who says ‘go out with’?  What does that even mean??”)  Oh, I am riddled with trepidation of how this childhood journey of my three children I love so deeply will affect them.

My daughter was telling me about which friend she picked to do work with at school the other day. My ears perked up. Friends? She has friends? She has friends!!!!! I went to pick my son up from pre-school and one of his friends asked me if my son could sleep over. I had to control myself from breaking into somersaults right there, right then, in front of 20 preschoolers. Another mom was telling me how her daughter is obsessed with my son and how she won’t stop talking about him at home. Does someone like my sweet, sensitive son???? Oh, stop my bursting heart!!!!

Here is the thing. I accept my childhood and acknowledge how it has helped me become me. But I won’t lie. It wasn’t easy. There may even have been tears. Maybe even lots of tears at lots of times. But as my children enter into this new phase of starting school and being around their peers, I have new found respect for the experience of childhood. I lurk in the sidelines and wring my fingers together hoping and silently rooting for them to be accepted and not teased. I vigorously hope this will be a joyful time that will help build their growing confidence.

I know there is still a lot to experience and I am definitely getting ahead of myself; my three kids are all four and under for crying out loud. But I would relive my childhood, the tears, the awkwardness, even the teasing on the bus, if I could trade it for acceptance for my children among their peers and a childhood filled with positive experiences. Oh, I would just give anything for that. So, if you see me perched in the bushes at my children’s preschool, please don’t judge me, I am just rooting for their success from the sidelines, or, I mean, from the bushes.

My Parade and Me

Republished at http://www.kevinmd.com/blog/2015/12/physicians-jaded-keeps-medicine.html

Republished at http://www.scarymommy.com/life-as-a-doctor-and-mother/

I am constantly coming across articles written by physicians with strong voices.  Physicians that are jaded. Physicians that didn’t go into medicine to be dictated by patient satisfaction surveys. Physicians that didn’t go into medicine expecting that people wouldn’t trust in their training because “WebMD” begs to differ. Physicians that cringe at the drive-through mentality that patients can present with diagnoses in hand and demands for tests to be done. Physicians that want out.

As I read these articles, their sentiments resonate with my own experiences. But what we don’t talk about is what pulls us back in.

My patient in room 7 is 10 weeks pregnant, terrified she might be miscarrying. She hides her thoughts by pre-occupying herself with her blonde, curly-haired 2-year-old daughter. Ultrasound and blood tests confirm that she is in fact miscarrying. She busies herself with readjusting her daughter’s perfectly buttoned shirt while I confirm her worst fears are true. Willing away eyes welled with tears, she nods and smiles, keeping a brave face for her daughter. I sit by her side and hold her hand. I try to give her hope. Before I leave, she squeezes my hand.

My patient in room 1 is dying. She is 92 years old and her daughter is at her bedside. She celebrated Thanksgiving with her family, including her 17 great grandchildren. But her disease is progressing, and she has declined further intervention, because if this is her time, she wants to enjoy her remaining days at home with her family. And today, during my shift, is her time. Her son comes later, and asks me to please let his mom die with dignity. So we turn off all the monitors, dim the fluorescent lights, and remove her from all the wires, and let her be a mother, grandmother, great grandmother enjoying her last breaths flooded by memories of all the love of her family. Her daughter holds onto the necklace we had removed from her neck in our initial attempts. She sits at her mom’s side, this 57-year-old daughter and mother of four. She cries with her eyes clamped shut, and she rocks back and forth and murmurs repeatedly between sucked in breaths of air, “Mommy, Mommy, Mommy. Oh, Mommy, Mommy, Mommy.” I rub her back. I am sure she has forgotten I am there until she turns to me and asks me to put her mother’s necklace with a small angel charm around her neck. I take the necklace and drop it through my fumbling fingers. I pick it up and drop it again. She just has one simple request. Can’t I just do this one thing for her?  The fast pace of the emergency department slows, every beep of a monitor, every hurried set of footsteps, every ring of the ambulance phone seems to muffle and all I want is to put this necklace around a grieving daughter’s neck. One month later, I receive a holiday card from the patient’s son. It has evergreens with snow and glitter and a cardinal on the front. It reminds me the holidays for this family are forever changed. “Thank you for allowing my mother to die with dignity.”   Three years later, this card lies in my box of cherished cards and pictures from close friends, my husband, and my kids.

In room 11, first-time parents bring in their son. He is 3 months old and he won’t stop crying. He cries during the day, he cries through the night, he won’t stop crying. Why won’t he stop crying? They have been to their pediatrician innumerable times. But right now, it is 2 in the morning, and there is nowhere to bring him but to the emergency department, and we have found nothing wrong. How could there be nothing wrong? The three of us hold a quiet conference as to not wake the semi-sleeping baby. We talk, not about medicine, but about my own experience with my son who was 3-years-old at the time. We talk about how he cried too, and he wouldn’t stop unless we held him all the time. And we were so exhausted. My husband was so sleep deprived he was having visual hallucinations. We took turns on which day we would brush our teeth and shower. The three of us laugh (cackle quietly) at what absurd things sleep deprivation can do to a person. We talk about how I never thought it would end. But it did end. One day, he just started sleeping. We were so exhausted that we didn’t even notice until we had slept for four consecutive hours and woke up in a frantic panic. They listen intently. They sigh a tired kind of relief. There is someone that knows what they are going through. They are not alone. They leave with the same son they love deeply that still won’t stop crying, but feeling some sense of peace–or maybe even hope–they hadn’t had before. I didn’t figure anything out for them, but it was worth the visit.

Here is the truth. I went into medicine because I believed that if I put hard work into learning about illness and treatments, I could help people at their greatest times of need. What I know now is that medicine is about caring for people. But it is also about confrontation and conflict. It is about taking things in stride. It is about leaving your work at work so you can come home and be a mother or daughter or wife so you can preserve balance and your sanity.

Except for those moments that hit me in the gut, the heart, the soul. I hold onto those moments. Correction: they hold onto me. They roll over and over in my mind. They replay in my mind when there are quiet gaps in time. They are the parade growing and marching behind me five months later, 3 years later, 8 years later. They keep me going.

I acknowledge that those creeping feelings of wanting out are there. I sometimes hold my breath anticipating my cracking point. But then something happens. I get a squeeze of the hand. A card with evergreens and glitter snow. A couple that just needs to know they are not alone. And it is a big red reset button. And it is worth it. And I keep going, parade and all.