Getting Stressed, Again...

I realized I never posted pictures of the finished products from the last time I was stressed (last week)... I think the stress was worth it.




As for my new stress...

Our flight to LA is departing in 36 hours, no one is packed, and there is so much to do in between. On my to do list:

1. Hubby needs to get better. Whatever I had got passed onto Hubby... The kids have been having runny noses and I am wondering if they are on their way up or is this still the prodrome.

2. Pack. My mom called me while she was at O'Hare- they needed to get to the wedding earlier to meet my brother's future in-laws. Anyway, she said, "I am bringing lots of goodies for your kids, be sure you have space!" Awesome. I really love lugging stuff around... Ok, seriously, I can't wait to see what my parents are bringing for A&Z, I just could go without the whole packing thing. Not to mention, somehow, I have all these gifts for people that we will see, and it just really adds up. Thankfully, the wedding gift got shipped long, long, time ago.
(BTW, Aidan made his packing list:
1. Star Wars cards {he got really concerned that I kept saying the letters A and R, he thought I was misspelling it all!}
2. Hippo.
3. Wallet.)

3. Work... Tomorrow is another very full day at my private practice. As much as I love the work, it is still work, and it is still a new thing for me, to take on all these new patients, and it can be a little stressful.

On the flip side of the coin, my biggest accomplishment of the day was this:
I told my supervisor at my salaried position that I am cutting down my hours. I think, he knows the inevitable is coming, that I am going to be quitting sometime in 2009. While I didn't explicitly say so, I did tell him that I am just too stressed and I have been sick way too much, and getting to work by 8 and not leaving until 5 really crimps my style- how do full time working moms do this? Therefore, I will only work 8 to 5 on Fridays (for coverage reasons) and then two more days of 9-4, with an hour for lunch. I tried this work through lunch business, and it got old...

Well, I better get crackin' with that packin'.

The Weakest Link

Apparently, I am the weakest link around here. I am not sure what happened, but so far this winter, I have been sick far more than anyone else, and it takes me forever to recover.

Zoe was sent home from school due to a fever about 10 days ago, and I thought everyone else had dodged a bullet. But nope. Yesterday, after my IKEA run, I was achy and exhausted. (I thought I was just getting old...) While I was asleep, I was feverish, sweaty, freezing, all at the same time. When Aidan got up this morning, he complained of "My toes are hurting! Both of them." After some Tylenol for both of us, he was back to his rambunctious self, where as I could barely keep my eyes open when dear R and her family visited us from San Diego. After R left, Hubby kindly took the kids out of the house so I could sleep...

In terms of sickness, Hubby has had very little of it this year. And when he does get sick, he gets over it pretty quick, or at least, he doesn't complain about it.

Aidan gets over his illnesses very, very quickly.

Zoe typically has a runny nose that hangs around for quite a while, but her fevers tend to subside quickly.

Me? I think I am just too tired, not getting enough sleep, exhausted, trying to do too much, and thus, completely compromising my immune system. So, after the New Year's, when I see my boss, we will have a conversation regarding cutting down my hours at the clinic. I just can't keep this pace... Let's not even discuss preparations for my oral boards yet...

Chivalry is Alive, sort of.

Since my posted about looking for a cabinet to extend our storage capabilities a few weeks ago, I decided to actually go buy the cabinet. Where else? IKEA! The plan was that I would go get the shelf by myself, and Hubby would assembled it some other time. It couldn't be a family outing, because I was not willing to take two kids to IKEA, and also, to bring back anything from IKEA would mean that we have to plop down our backseat and therefore, no kids allowed.

However, since Hubby was so industriously working on our holiday photo, which he planned on writing about over at his blog later, I took pity on him and decided to take Aidan with me while Zoe napped.

Aidan was quite the gentleman the whole trip, he was cheerful, pleasant, cooperative, and very well related. Good times were had by all. We finally found the cabinet, the Liatorp bookcase, in case anyone was curious, and after a long hassle, finally located it in the aisles and bins nightmare in the marketplace. There was no help to be had other than my 44 inch tall gentleman, so he and I lifted all three boxes onto the big shopping cart. The biggest box was 128 pounds and 85 inches long!

As we inched our way up to the cash register, the young lady saw us saunter up ever too slowly for her, said, "Could you bring it over here?" I said, "I would if I could, but it is really heavy so I can't."

Once we paid and gobbled up our hot dog and soda (yes, Aidan had soda...), we wheeled our madness to the car. Fortunately for us, we had a spot at the family loading section, unfortunately for us, it meant EVERYONE wanted our spot. A young father in a fancy SUV pulled up and started signaling that he wanted our spot. I yelled over, "I am going to be quite a while!!!" He waved and indicated that was fine with him. So, as he watched from the comfort of his fancy SUV, Aidan and I, painstakingly, lifted our very heavy, long, awkward, boxes into Hubby's little Mazda. Only to have my fears realized:" the trunk was not going to close! And Aidan wouldn't be able to sit in the back!!!

Finally, the guy's wife rolled down her window from the back seat, "Do you need help?" Seriously?! You think?!

But by then, the hard work was done, and I said, "We are fine, I just need to go back in to get twine and tie down the trunk. You probably want to find another spot."

Then, when we came back out with twine, another SUV was waiting for our spot. Aidan and I very diligently tied the trunk to the latch, again, and again, and again, until I was certain we could make our drive back safely.

Once Aidan sat in his front seat, he asked, "What if the police finds me in the front? Will they take me away?"

I told him that he will be fine, my chivalrous little gentleman.

Thank You, Baby Jesus!

The house is quiet again, the children are asleep, phew!

After a Christmas Eve party with Hubby's extended family, we didn't get home until 8:30, and the kids didn't get to bed until 9!!! I was utterly exhausted, yet I woke up at 4 am, wishing the children would get up soon. Clearly, I was delusional.

Our Christmas morning was fun, although not smooth. The weather was stormy, there was no way to get the kids out for some physical activity before getting down to business. Aidan, of course, wanted to rip open present after present, and did not want to see other people open their presents. So he got reprimanded. Then of course, Zoe was the same, and she got reprimanded.

We enjoyed some French toast that I made from my own challah, and it was awesome. So good that I might just do this every Christmas.

Eventually, all the gifts were opened, the parents showered, and everyone was dressed. We went for a very brisk walk, brisk, because it was incredibly windy. Then lunch, then nap, and after that, it was much a blur of reprimanding children and trying to play with their presents...

We went out to dinner and it seemed like the only option was Chinese. So Chinese it was. A&Z were still just bundles of energy- they even got reprimanded by the restaurant manager: The carpet is really dirty, don't roll around in it! That was a new low: first of all, to be told by Chinese guy that we were letting our kids roll in dirt (as you probably know, Chinese restaurants are not the cleanest of all places.) Secondly, maybe you should then clean the carpet?!

Bath time was much the same: Stop this, Stop that. Don't do that to your brother/sister. Leave him/her alone. Show some respect!!!

Finally, at Aidan's story time, I was telling him about all the things we CAN talk about other than Star Wars (a parent can really only listen to tales of the clones for so long...) and Aidan started to bounce up and down...you guessed it, he got reprimanded AGAIN! I told him that he lost his story time privileges, he could read the book himself, and I would return to pray for him before bedtime.

When I got back, he was mildly weepy, and he said, "Mommy, can you pray for me, for my listening ears?" I encouraged him to pray himself, he said: "Dear God, thank you sending us your Son to die for my sins. Thank you for the wonderful things we have to eat, thank you for my sister. Thank you for giving us Christmas. Amen."

It was an incredible way to end Christmas Day. Indeed, thank you Baby Jesus, for coming to die for our sins so that we could be reconciled with God. Thank you!!!

Merry Christmas from Mommy's Parents!

Since my parents live in the midwest, and since my dad is a pastor, it makes Christmas a hard time for them to come to us, and I rather not brave the winter traveling madness, this is how we do Christmas. Until we see them next week for my brother's wedding anyway!



Thanks Pao Pao and Gong Gong!

Christmas Eve Eve

"Twas the night before Christmas Eve, when all through the house
Not a creature was stirring, not even a mouse.
Except for this mother."

Zoe went to bed at 7:15, Aidan went to bed at 8:15, Hubby went to bed at 8:30. I am enjoying the peace and quiet, and waiting for everything to finish baking.

Yup. I couldn't stop myself, against my better judgment, I have been baking like a fiend. The dough for four loaves of challah was started before dinner, it completed its first rise during dinner. After putting Z to bed, I braided the dough, and let it rise while Aidan and I made a batch of chocolate chip cookies, we then put Aidan to bed. Then, the oven was turned on, and I started the dough for oatmeal raisin cookies, and a blueberry boy bait cake. (I am using this new recipe for chocolate chip cookie that uses melted butter. It really makes a difference!)

Just think, I have used up two pounds of butter tonight. I am sure the makers of Lipitor will thank me later.

Meanwhile, all this is giving me time to think.

I met with the residents today and shared my thoughts about career development for psychiatrists. It was great to be back in the same room where I had lectures for four years, where I had lunch with my fellow residents, where I learned how to be a clinician. Strangely, the residents that did not overlap with me kept coming into the room and asking me if I was an applicant. Do I look that young?! Seriously.

The take away point for those residents, and for those medical students/ interns/ residents who read this blog: You will never find the 'perfect' job. You will find a job that suits your current needs, but needs change, and inevitably what worked well two years ago might not work for you anymore, and the key is to be flexible and to not put all your self worth in your job. Come to think of it, this point is probably useful by everyone who works, myself included. (My self worth is in the fact that I am a daughter of God. How awesome is that?!)

I was also thinking about this young person I involuntarily hospitalized yesterday. He and I are the same age, yet his life is taking a very different direction due to schizophrenia. As I watched him decompensate these last few weeks, it became obvious that he needed to be hospitalized and medicated before he ran into more problems with his life. While he needed this, and it was my job to do this, I really could do without involuntary hospitalizations. First of all, it really just ruins any rapport I have worked hard to build with paranoid, psychotic people. Secondly, it is simply a pain to do this.

When someone is sick enough to be hospitalized against their will, they need to be transported by either ambulance or police. Inevitably, the ambulance takes forever to come. With a psychotic person, I just do not have this kind of time! So then, I am instructed by powers at be to call the police and say, "This patient is violent so please come to take him away." Well, my guy wasn't violent. He was just quietly psychotic, not sleeping, not eating, not doing anything, other than listening to his hallucinations. It bugs me, that I need to cry wolf to get help. I imagine that the police would show up, and think, "Geez, these shrinks sure exaggerate. This guy is not violent at all!" And that thought would be totally accurate! Therefore, next time, when there really is a violent person (like there was a month ago, when this person pulled up plants outside the clinic and started throwing them around!) the police still took forever to get there. Seriously, better communication would help tremendously, instead just lying!

Well, everything is now out of the oven. Time to start laundry while they cool, then package them (I will get Hubby to take a picture of them tomorrow), load up the car and call it a night!

The Joke is on Us

When I went to pick Aidan up from school today, his sweet Teacher Vicki asked me if we have been telling stories at home. Apparently, Aidan told his entire class this elaborate story about how Daddy pretends to be a baby, cries like a baby, and lately, has developed a diaper rash!

These kids, say all kinds of things. I just heard another kid say today at school, "My mom likes to eat my butt." And last year, "My dad says my mom has a big butt. My mom says my dad has a big pen_s." Awesomeness huh? I wonder what else the kids are saying?

With all this wintry weather report from most of the country, I am really missing everything New York. And the stores that are open 24 hours a day!

Well, we are very much ready for Christmas here! I am done with preparations, minus the potato pancakes for the Christmas Eve party, and I can't resist, some cookies. The challah. The pumpkin pie...

Auditioning...

Clearly, I am moving on to a new phase of my professional life. Auditioning.

It never occurred to me before, but when one has private insurance, one can test drive physicians. (I usually just try to discreetly avoid providers that I have had 'run-ins' with, you know, a doctor who was an hour late to our appointment and then acted as if I was wrong to complain about his/her tardiness, or a certain midwife who told me I was getting much too fat, and if everything at home was ok, if I had thought about eating less...) Insurance will cover all those visits, if one has the 'right' plan.

Just in the last week, I saw two patients who told me that I was one of two psychiatrists they would be visiting in the next few weeks to determine which one they would like to hire. At least they are up front about it, I guess.

In comparison to my paid job, where people get assigned a physician based on availability, and there is much jumping through hoops (for better or for worse) to switch providers. Therefore, at that job, my performance is hardly an issue. Besides, when people want to fire me, it is usually because I just won't prescribe stimulants AND sedatives at the same time. Like I have written before, I am not in the business of being a legal drug dealer.

This will be interesting development, I think. So far, I am one for two, and the second person, to be fair, is waiting to see the other doctor before s/he decides. It would be awesome if I can convince everyone to keep me as their doctor, but then again, there are some patients that I rather not keep...

Obviously

I am not stressed at the moment, as I have made peace with the fact that it is going to be quite busy these next few weeks. My calmness came to me in the midst of a session with a therapy patient. It was so OBVIOUS!

Just say no.

I am saying no thanks to cookie making- seriously, who needs more fat and calories?
I am saying no thanks to challah making- my relatives can go buy themselves bread.
I am saying no to more patients- the schedule is now closed for next week. You wanna an appointment? New Year's Eve, that is still open. (Until next week, when I decide that is foolish and close the schedule again.)

I want to do it all, but the price of insanity, crankiness, and irritability just would not be worth it! Instead, Hubby and I will curl up, watch a movie, take a nap, or just look at our beautiful tree, and ponder the ultimate gift of Jesus Christ.

Mildly Stressed

I am mildly stressed. My throat has not been great for the last couple of weeks... And every night, despite my fierce determination to go to bed early, once I settle next to Hubby in front of the Mac, I simply cannot stop myself.

I am now getting phone calls from folks seeking a psychiatrist everyday, now that I am posted as an in-network provider for a fairly large insurance company. That means, I am booked full this week. Most of these folks, if they decide to retain me as their psychiatrist, will be coming back next week, on Christmas Eve, to complete their evaluations. Christmas Eve. I had planned on baking challah and cookies on Christmas Eve. Drats. I need to find another time to make cookies and bake bread. Maybe God can give me a couple extra hours nightly between now and then.

We also need to choose a kindergarten for Aidan soon. How can we be trusted to make a decision for him?! And then, decide if we are going to switch Zoe's placement, maybe we would do better with her closer to home?

I called my mom to say hi, and she asked if we are packed to go to my brother's wedding. I thought I had heard her incorrectly, since the wedding is still more than two weeks away. But no, she was serious. Clearly, we are not packed. I am singing at this wedding, and that is a little stressful, since, well, my throat has been hurting and there has been no practicing. Finally, Hubby is photographing this wedding, which means I will have two kids on my own. And I have to sing?! How will I accomplish that?! Did I mention the wedding is outdoors? I don't like to sing outdoors. Nonetheless, my BROTHER IS GETTING MARRIED!

My sister will be getting married this July. Hubby is also photographing her wedding, and I will also be a single parent for the duration of that wedding. It is going to be HOT... But I am really looking forward to going to NYC for it. It will be awesome. But it will be a lot of work too...

Anyway, just a little stressed.

Random Thoughts

It is cold out here in sunny California. The clouds are here, the rain drops are visiting. The kids are upstairs and relatively quiet, doing something with Hubby, so it is much better to stay down here and write about my random thoughts.

Along the line of our cabinet-less existence, we are also humidifier-less. I tossed out our warm mist humidifier a couple of months ago, because, it was absolutely disgusting inside and it seemed impossible to properly clean it. The cold mist humidifier is in the garage, and I don't want to use it again either, since it smelled funky last time we used it. I even made an inquiry to my Mother's Club, a club full of women either very knowledgeable or with too much time on their hands. Anyway, with all the recommendations I received, I still could not make up my mind about this. You see, I want a humidifier that won't turn my house into a rain forest, one that won't need filters, one that won't grow germs/fungus/grody stuff inside. Oh, and preferably less than $100. (Seriously, there are models out there for $400!) So far, I am totally out of luck. We could go the other route and buy a cheapie warm mist humidifier each winter and thus, forgo the issue of cleanliness. But that is just very un-green. Any thoughts on this?

Another item that I am at a loss about: a Christmas present for my father-in-law. What do you get for a man in his 60's, who has everything he needs, who doesn't need more stuff, and who does so much for you everyday? My FIL brings us buns, takes the kids to school two times a week, babysits if he is able, gives Aidan free Kumon lessons, and most of all, raised such an awesome man for me to marry? We are thinking an Elephant Bar gift card, or cleaning services, if we can't come up with something more interesting. Any thoughts on this?

Finally, over lunch I noticed the ridiculousness of feeding a toddler and a preschooler. We had wonton soup, very yummy, and very HOT. Therefore, there were two plates that served as 'cooling stations'. Yet we still couldn't keep up... And there were just SO many dishes to clean afterwards. Thank God for our dishwasher.

Well, I should go and check on my very quiet family. Then I am going to sit down and prepare my lecture to the residents about 'career development.' Too bad my own career is still being developed. Can we say, fraud?

Indecision

I am plagued by indecision when it comes to our decorating needs. The house, remains unpainted, except for all the test patches I have put up. As Hubby said, while he watched me do this, "We are now really committed to painting the house."

While I don't think we have a lot of stuff, it is still too much stuff for our storage capabilities. We have this Crate and Barrel cart that we bought as newly weds, (we even strapped it to the top of a rented Ford Explorer to bring it back to California), as much as Hubby loves it because he diligently assembled it, my fondness for it has expired.

This storage situation is actually the reason we started replacing our doors and now, in need of paint colors and actual paint. Yet the CB cart remains.

This evening, while Hubby busied himself with some photography equipment crafts project, I went onto Amazon to browse for storage solutions. To my surprise, I had done this same exercise in March of this year. (Not that I am surprised I had done this on Amazon, that I remember. What I can't believe is that it was 9 months ago!) 9 months later, we are still cabinet less. Such indecision... Hubby and I looked at it, measured our kitchen, said the same two things: "It is a big cabinet." "You will have to assemble it." Then we had some new thoughts. "Maybe we should get a built-in." "Then we will have to rip up the laminate flooring." "I am not doing that again." "Ok." And we walked away. Still without a decision regarding the unit.

For those of you who have been over to our house, what do you think about this cabinet?

Hand to Hand Combat

My life, at the moment, is divided into three spheres. Namely, being someone's wife, some people's mother, and on the side, trying to make some money. The balance between the three seems all the more elusive with each passing day, and thus, Hubby and I talk a lot about these three issues. I have also been trying all sorts of permutations with the three spheres. Sometimes, I rent out my children as a solution, managing spheres 2 and 3 simultaneously... just kidding.

Mainly, I have been messing with my work schedule. In the two years since I left residency, I feel like I have done it all: Inpatient for the insured, Inpatient for the indigent, Outpatient with the indigent, Outpatient with the insured. Of all these things, they all have their pros and cons. As much as I love inpatient work, and as good as I am at it, life style wise, it is just too hard for us. To be on call, being woken up at night, rounding on weekends... Not for me. I understand most of the physicians out there routinely do this, but not me. As much as I like working for the indigent population, the craziness of an ailing public health system can make it very unpleasant at times. Sometimes, like yesterday, I seriously was considering yelling during a staff meeting... But that is another story for another time.

Both of these options, while difficult for me, are both really important. There is a shortage of psychiatrists for inpatient services and community mental health services, precisely because the schedules are hectic and the work envrionments are nutty. (At the agency I am with right now, there are four vacancies!) Besides, I chose medicine not because I wanted to fully serve myself, but because God calls me to serve others. But where do I draw the line?!

I really like my private practice, simply because people actually GET BETTER. I like it so much so that I actually joined a network, and now, my schedule is getting filled up (which brings another issue of: What am I going to do when it is so full that I am going to need more time for this endeavor?), and I am discovering the joys and the pains of being a contracted physician.

For instance, this morning, I was engaged in Hand to Hand Combat on the phone and the internet. I spent about two hours trying to figure out the difference between certification # vs. authorization #. Then enrollee # vs. subscriber #. I thought I was going to need a sedative! Of course, I could have hired a billing service for this, which I did when I was doing inpatient work. However, as the goal is to work fewer hours and make more $, I figured I should be the billing service, if not forever, at least to figure out the system and know what actually happens (or not happen.)

What else is weird, is that insurance plans sometimes outsource the mental health portion to others. For instance, even if you have Blue Shield, your mental health coverage may actually come from United Behavioral Health. Also, these health care plans are merging all the time! Life PacifiCare is now going to join United Behavioral Health, and they are going to be called Optum.

I can't keep up with this, but I am going to try.

Authenticity

I struggle with the issue of authenticity frequently. As a blogger, I know my posts would be more interesting, if I revealed more about the drama of my life. However, these posts could also be hediously monotonous if I recounted every bit of my life. Where do I draw the line?

As Christians, we are called to live authentic lives. That my life ought to be a reflection of God's grace and mercy. One way for people to see who God is, is to see how He continuously and faithfully changes me. It becomes difficult, however, because the true me isn't very picturesque. I can be harsh, rude, impatient, whiny, and yup, essentially, act like the young children I write about frequently. Still, I am assured that because Jesus has been the Perfect Parent/Spouse/Whatever-Role-I-Am-Filling-In-At-The-Moment, I do not have to be perfect.

Life, actually, is more fruitful and awesome when I allow God to work in me instead of pretending to be perfect.

How does that translate to blogging?

For this next few weeks, I am going to reflect on the miracle of my God: who came to be in the midst of those He so loves! I am also going to try to write about my life in a way that would point to Him.

Photo Catch Up

Here we are, at the tree farm. We always ride the train while Daddy ties the tree to the top of our car.


Here is Zoe, with her furry hat. A girl has to accessorize!


Here is Aidan, with his walker. He built nearly all of it by himself!

Roller Coaster

First of all, the posting of pictures here have been scant. Yup, it is true. I am too lazy to make it happen. However, I promise, we have really cute pictures of the children dressed up for a Christmas party, pictures of the Thanksgiving meal we just ate last night- since we celebrated Thanksgiving with Hubby's extended family, we had a Chinese Thanksgiving, without a turkey. While super yummy, we missed eating the 'right kind of poultry' for this day. Therefore, last night, I whipped up Thanksgiving for four. It was very good, if I may say so myself. The children thought the cranberry sauce was the best thing ever.

Anyway, so we have lots of pictures, but none to show...

Meanwhile, Aidan and I seem to be riding on an emotional roller coaster these days. Per our family planning scheme, I ended up taking some birth control pills for a few months. It was heinous getting on the pills, in terms of irritability and lability, and it was terrible getting off of them. I found myself sobbing to a Christmas carol yesterday on my way to work.

As a side note, sometimes, women are started on OCPs because of mood disorders, such as severe PMS. However, a significant population actually can develop mood disorders because the progesterone in these pills can cause depression. While this is not a place for medical advice, I generally do not recommend OCP for mood disorders. For acne, sure. For depression, not so much.

Furthermore, OCPs can cause a decrease in libido- thoughts are that OCPs can form proteins that bind to free testosterone, which is the driving hormone for libido. Therefore, with less free testosterone, libido can be decreased. I say "can" because the relationship is not 100%. To be free of worries of conceiving might actually increase someone's libido. Alas, I digress.

I like to blame my irritability on the pills, however, there will come a day when I will be completely off artificial hormones and onto my own, and I am absolutely certain, I can still be irritable and labile. I guess by then, I will just have to blame it on sin.

As for Aidan, he hasn't been on OCP or anything else for that matter. I think he is just experiencing emotions. Yesterday morning, after we had breakfast, he suddenly realized that he had some rollie pollies that he had found from LONG time ago. He had made them a home in a plastic bowl and had fed them some leaves. Of course, they died and probably went down the drain to join all those uneaten bits of food. However, he remembered them yesterday. And sobbed that his rollie pollies were dead, while somewhat reassured that these rollie pollies probably are quite happy with Jesus, he still sobbed how much he missed them.

Then, we (I mean, I) accidentally left his beloved Hippo at school. Never mind that there were FOUR other hippos at home, he sourly missed his Hippo. "What will Hippo eat for dinner?" "How will Hippo sleep?" "Who will play with Hippo?" Hubby said, "Aidan, does Hippo actually ever eat with us?!" He doesn't. Our stuffed animals do not eat. For now.

I suppose this is the age appropriate animistic thinking... Maybe I will be serving dinner for five tonight.

Residents...

Even though I was just a resident myself, life as an attending sure has changed how I think about residents.

Residents can whine a lot. Never mind that I actually never worked more than 80 hours a week as a resident, but I think all these talks about residents are too tired to keep working is just sort of silly. Here is a little history. In 1984, a young woman died in an New York emergency room. She was given Demerol to treat pain by the resident on duty. She died, because of a fatal drug-drug interaction that Demerol has with her antidepressant (monoamine oxidase inhibitors.) So happened that the victim was the niece of a New York Times reporter who went on to investigate how this could have happened. The conclusion was that the resident was over worked and thus, made this fatal mistake. The Bell Commission was formed, and NY state became the first state to limit residents' work schedule. Gone were the 100 hour work weeks, and a limit was capped at 80. (BTW, this cap did not apply to medical students, strangely.)

As a side note, I would say, a lot of residents are not aware that Demerol has such an interaction with MAO-I class of medications. Most physicians spend very little time thinking about drug-drug interactions. Us psychiatrists, however, spend a gabillion hours pondering over all kinds of interactions. I don't know why, but we do.

Incidentally, when I was an intern on internal medicine, there was a woman who had intractable vomiting. I put her on some Phenergan. She was still barfing. I called the attending, he said, "Give her some metoclopramide." I said, "No way! There is a drug interaction with this combination." The attending said, "Nobody cares. She will be fine. Just do it." As it turned out, she was fine, as matter of fact, she stopped barfing. But like I said, nobody cares about drug interactions the way psychiatrists care.

Anyway, while I never worked such long hours and all that, but the reality is: In certain specialties, life is just that. Whether a resident or an attending, some work just simply requires someone to be working ALL THE TIME. For instance, private practice obstetrics, in a rural place. You are the only ob in town. So, you work during the day, and if anyone needs to be delivered at night, you go and deliver that baby. No matter if you had already worked 79 hours already, or 101 hours already. Just do it. You have to. There is no one else to do it. Bell Commission doesn't care!

I say all this, because just recently, the commission had further decided that 80 hours were still way too much.

And, the residents at work have complained that if the inpatient attending scheduled changed, they wouldn't get adequate supervision. Never mind that the attending schedule needed to change because the department needed to cut half a million bucks or else there would be no department left. Furthermore, people! You are a resident! Not a medical student. Figure it out! Call the attending if you need to. You don't need a baby sitter that is with you all the time.

Like I said, my sympathy for residents have dwindled very quickly since I became an attending.

Partying at Other People's House

I love going to parties at other people's houses.

1. I don't have to make anything. We bring something with us, after all, we don't want to be rude. But a bottle of wine is easy to get these days. BTW, the last time I bought wine, I didn't even get carded. Dude, I am getting old.

2. I don't have to clean up. We went to lovely ML's house over the weekend. She and Aidan have been buddies since they were about 8 weeks old! ML's parents are very generous and kind, and every year, they have a huge Christmas party. We love the assorted food they serve, and unfortunately, it always looks like a lot of cleaning up would be required. But hey, not my problem!

3. A&Z are now old enough that we can actually talk to our friends, and make new friends! Still, it is hard for them to get food themselves, since a lot of big people usually hover the table and these little people have a hard time getting in there. But still, I no longer have to keep a crawling baby away from fragile items, like the tree.

So, I am on the prowl, to get us invited to more parties. There is one next Friday, but we will have a sitter for that so there would be even more partying for us. Then there are these parties with our relatives, I need to get them to invite us... That is going to my project for the next couple of weeks!

Peanut Gallery

My dear faithful readers, by now, you probably realized that I am the epitome of a Peanut Gallery. I would be the one to throw peanuts at performers to hackle them. Back in college, a bunch of us always referred to our group of ladies as the Peanut Gallery. For instance, "Where is the peanut gallery?" "Have you seen the Peanut Gallery?" We were like that, endlessly disagreeing with one another.

So, with the news that the treasury is exploring the possibility of lowering mortgage interest rate to 4.5%, I have to give my two cents, as a member of the Peanut Gallery.

Hello!!!! Have we learned NOTHING from the bubble? What would this do, convince people to thinly stretch themselves and buy a house when they could be losing their jobs? Or convince people to refinance so that they would have money in their pockets, thus they have 'savings'? And to spend those those savings? Since when is the government in the business of giving people money? Oh wait, that is the purpose of government these days.

And for the Big Three, a bailout is just a band-aid. These factories are inefficient, labor costs are astronomical, pensions are impossible to keep up with, and hmm, the cars are just not competitive. And how is making them DRIVE to DC of any benefit, other than the ruse of 'we are being economical'? They already have their corporate jets, it saves them TIME, time that they can use to brainstorm ways of digging themselves out of a hole (euphemism for lobbying)! Instead, they are going to sit in cars for 10 hours (hopefully, their own brand of cars...) and do what? Get motion sick? If the government would just fix the misery of flying on a commercial jet already, maybe they wouldn't have had to acquire their own private jets! (Ok, ok, they probably used to throw big parties on those planes, but you know, if I could fly a personal jet over flying any of the airlines available at SFO, I would take the personal jet.)

I understand that the government can't do anything, since, well, the economy is awful. Housing prices are sinking, people's 'savings' are all gone (but if it was equity in the house, one can argue it was never a 'real saving' anyway!) Also, if the Big Three were to go under, that would create serious problems, not just the unemployed auto workers, but all their suppliers, the towns...etc.

However, it is MY job, to hackle my government. God bless America and our freedom of speech!

Side note: Aidan has been wonderfully behaved today. Zoe has stopped begging for food while I am trying to make dinner. And, I have decided to not continue with swimming after this block. Furthermore, I am now roasting all kinds of stuff. Turn on the oven, throw stuff in, leave it for a long time, and voila: Dinner. All this will give me time to hackle more people.

My Own Richter Scale

The Richter magnitude scale measures the seismic energy that is released in an earthquake. It is not a linear scale, but an exponential one, meaning that a 7.0 scale is 10 times as powerful as a 6.0 scale.

I have my own Richter scale, set to measure my wrath. Similarly, it is also an exponential scale. On a scale of 1-10, 10, of course, being the end of the world as I know it, I am afraid I unleashed something this evening.

I am just exhausted. A&Z have worn me out. Cooking meals have worn me out. Going to work is killing me softly and slowly. I blame all this on Thanksgiving: taking a few days off, letting my soul and body experience relaxation, only makes it nearly impossible to return to normal programming. (Of course, there is also the topic of sin...)

Furthermore, Hubby's day job is very busy these few weeks and so he has been getting home towards the tail end of dinner. With our three activities for Aidan, Monday=Kumon, Tuesday=Swimming, and Wednesday=Ice Skating, and Thursday=My private practice, possibly working late... I am just totally worn out.

But no, I set my goals high and decide to make two dinners in one hour upon getting home today at 5. The menu for tonight: teriyaki salmon, vegetables, potato pancakes, corn on a cob and brown rice. The menu for tomorrow night: pepperoni pizza. This would have been manageable had I decided to use some ready-made items, but nope. My plan called for all things from scratch, except for the pepperoni.

Added in there were some episodes of misbehaving children. Aidan refused to do any activity, not even Lego, but only wanted to lay on the floor and torment his sister. Zoe decided to whine and beg for food while I was trying to make dinner.

Good grief. I thought I had accidentally pureed my brain.

The floor plate of my soul had its final shift when Aidan disobeyed just as we were about to leave for swimming. Then the quake happened.

In my opinion, the quake was about a 4. Judging by Aidan's face, I think he felt the quake was about a 7, or maybe a 10.

Let's just say that he rather stay in time out for 40 minutes rather than getting in the car with me to go to swimming for 40 minutes.

Wow. That's something, isn't it? I am not sure a good thing, but something!

We talked. Hubby talked with him too. And in the end of all that, I asked him, "Honey, so what should Mommy do when you disobey again and again?"

Aidan said, "You should hit my hand."

Me: "Do you want me to spank you when you disobey?"

Aidan nodded his very serious and sweet head.

I guess, at some point, getting spanked is way better than experiencing the quake of a lifetime.

As for me, I need to do something about meals, activities, and my sanity.

But we do have two very lovely pepperoni pizzas for dinner tomorrow...

Back to Work

Alas, fun is over. Back to work.

I have a secret: I am a procrastinator. Specifically, I am a procrastinator over disability paperwork. It is terrible. Imagine, you give your doctor these papers because you need money, but she sits on them and does nothing. (For the record, I think my turn around time is still excellent, far better than primary care providers.)

There are a few different disability paperwork out here in sunny (except for today) California. There is the State Disability paperwork, which in general is fairly painless. For people to claim this disability, they have to had paid into it within one year. Which for my salaried job, is unlikely.

The most common form I have to do is the Social Security Disability paperwork. I hate this stuff. Usually, I can get by without writing anything and just send the entire chart.

There is also General Assistance. Again, not too long but tedious.

Of course, for my chronically out-of-work people, the State has been scrutinizing all these applications and more often than not, I get additional paperwork. I HATE THIS STUFF!

Especially the part that requests my opinion about how long this disability is going to last. Well, for a woman with a personality disorder, I am thinking life. However, the form specifically says that 'forever', 'unknown', and 'indefinite' are not accepted answers. So, I usually write for about 3 months. Knowing, that in 3 months, I will have to do the same, stupid, lame, time-consuming, paperwork again. ARGH!

Besides, all those forms are biased against psychiatry. My patients are all able bodied, they can push 30 pounds, they can stand, they can use their right hands, and their left hands. What they can't do is to get along with people (usually the reason why they are out of job in the first place). Which box do I check off?!

Besides, the economy is so bad that even 'healthy and normal' people can't get jobs, what possible jobs are left for my patients?

Sometimes, like today, I work in vain.