Our Day

Occasionally, I want to write about our life, so that even when I am senile, I am still remember these days.

Sweet Hubby let me sleep in, even though he had been fighting a cold for the last 3 weeks/months?! After we all got ready, we went to Burlingame Public Library- my theory is that people in Burlingame like to buy their books, and thus, the library is always very well stocked unlike some other libraries. Aidan wanted to get more Ricky Ricotta books, and he was absolutely thrilled to find FIVE on the shelf.

After running around the streets and the little park, we came home for lunch. Then we all collapsed, for 3 hours. (Perhaps that was a mistake, since I am now wide awake, and Aidan sounds like he is still awake in his bed...oh well, you win some, you lose some.)

A trip to Toys R Us was in order- Aidan had amassed $115! He picked out a Mars Mission Lego set, and we picked out a camera for Zoe. She loves to hold our cameras, flip through pictures, and scare her Mommy that she is going to drop these delicate things on the floor at any given moment!

Even though I thought I had made plenty for dinner, we ATE IT ALL. I shudder at the thought of feeding these kids as adolescents, considering how much I ate. I ate so much that my maternal grandfather once told me, "You really should not get second helpings, you are going to be too tall to marry Chinese."

As for what are on our minds, well, Aidan is totally looking forward to turning five. He is thinking about kindergarten and how cool it will be for him to buy lunch. He said, "Mommy, I think you should give me $5 for lunch, I will use $3 for lunch, and if I am still hungry after that, I can use $2 to buy whatever else I might need." He also seems ok with the idea of getting shuttled to a Chinese school after regular kindergarten, "You will take me to school, they will pick me up, and you meet me after Chinese school, right?"

Zoe is suspecting that she is getting the short end of the stick. After devouring our dinner tonight, while she licked on her mango cream bar, she started to frantically sign to get what I was putting into a plastic bag. All the verbal convincing was to no avail, I ended up handing her a big bag of chicken bones. When she realized that it was useless, then she wanted nothing to do with it. But I think she knows that sometimes, the three of us will sneak in things that she shouldn't/can't have yet. According to her teachers, she has a 'mature sense of humor.'

Hubby is simply working too hard and not getting enough sleep. Phat Baby is keeping him very busy, and his day job is also keeping him very, very, busy. In this economy, we are glad we currently have four jobs: his two, and for the next four weeks, my two jobs also. We are working hard, uncertain about what the economy will mean for us. Actually, we know what the economy will mean for us: Higher taxes, more expenses- so that begs the question, why do we work so hard? However, we rejoice that God is in control. He has been faithful and He will be faithful. He will take us to wherever we need to go and lead us to whatever we need to do.

Bad Sleep Hygiene

I spend a lot of time talking to patients about sleep hygiene- no TV/computer for at least an hour before bed time, definitely no TV watching in bed, no caffeine after 2 pm...etc. There is now another thing to add to the list: Do not review for oral boards in bed.

After accomplishing much for my household yesterday, and not nearly as much for 'education', I decided I would really get down to business. Down to business I did get, and horror was what I got.

The entire book of Boarding Time (seriously! The book is titled Boarding Time!) was one nightmare scenario after another of under-prepared candidates, missing the bus (I didn't know candidates get bussed around?!) and basically, failing miserably.

I. Am. Scared. I couldn't fall asleep, then when I finally did fall asleep, I woke up thinking I gotta get to studying or else it would be a waste of $1800 for registration, and probably another $1000 for traveling/baby sitting/losing my mind. Yikes.

The exam is about 3 months away, and there will no longer be studying for boards before bed. I need my sleep.

Getting Educated

I am departing my salaried position in 16 'work days', considering I am there 3 days a week, I am actually not leaving for another 5 weeks, which feels like a long time. However, I still have 6 educational days to use up, 1 day to pack up, and therefore, I will really only be seeing patients there for another 9 days. That really isn't quite enough to finish saying good-bye to all these people. Perhaps this really speaks to my own ambivalence about leaving, but I keep finding myself saying "Let's see if we can have you come back one more time." As I say this, I become like a cartoon character with thinking bubble: "Lady! Are you crazy? You don't have time!"

Indeed, aside from terminating with people, I have lots of charts to close, and writing a brief summary for each and every patient for the new doctor. For a new doctor, these little paragraphs are the best presents ever. When I started a year and half ago, Dr. D had left me paragraphs like "Somaticizer, meds do not work" and "Only getting treatment to stay in this country." These were invaluable comments gleaned from his many years working with these people. Since I haven't work these people for nearly as long, my paragraphs might not be as insightful, but I would like to think, really fun. Things like "She does best on Seroquel. Do not mess with the regimen." Or for someone with serious BO problems, "She lingers..."

I guess what I am saying is that I will miss these people and writing a little something about them is ceremonial, in that I really cement what I think about them, and it is my little way of contributing to their recovery.

Of course, the best kind of sign off is the kind that I refer a patient to a whole other clinic. Or, completely close the chart.

But alas, I have digressed. Today is an educational day. And I am getting educated. By the way, I have to turn in documentation as to how I am getting smarter, and while I am earning continuing medical education credits, I found this tid bit of information. Apparently, in California, MDs are required to turn in 25 CMEs per year, whereas ODs' requirement is higher, at close to 40 CMEs annually. Interesting, huh? Then there are states that do not require CMEs, like Colorado.  The injustice of this system! 

However, since I am home alone, I am also taking care of the house. Serious tasks like using my thermal cooker for the first time, cleaning up the play room, planning a lunch with Hubby, taking Aidan to the dentist, and of course, use Hubby's laptop while he is at work. To find recent picture of A&Z for all of you.

They are so cute, aren't they?


Last night, as I was about to fall asleep, I told Hubby, "It would be interesting if I go back to work at Fancy Private Hospital (where I worked before Z was born, and we recently had dinner with the medical director there. Dr. H is just awesome and I don't know if we are stringing each other on, but he keeps saying that when he has an opening next time he would offer me the job, and I keep telling him that we would love to consider that,) don't you think?" Hubby was incredulous. He said, "You are the only person, ever, to be starting a new job, your OWN practice, and you're talking about the NEXT JOB?!"

I blame it all on my anxiety about leaving and being on my own.

But I am also excited to be with A&Z more, to be moving at a slower pace, to enjoy the moment.

Efficiency vs. Enjoyment

I seem to have to choose between efficiency versus enjoyment, ALL THE TIME.

Do I be efficient by feeding the kids, cleaning up, bathing these children, and tucking them in as quickly as I can? Or do I enjoy it, and let them linger at the dinner table, tell funny jokes, play in the tub, read extra stories?

I think, most moms choose efficiency, most of the time. Therefore, from my N of 2, (me and Hubby), most kids do not think their mothers are funny. Because there is simply no time for moms to be funny around their children.

It is about getting things over with. (By the way, I could eat one hot dog in the time it took to ride the elevator from the first floor to the 15th floor, as a medical student. Apparently, I didn't chew my food, but I was very efficient.)

Sad, isn't it?

I am determined to be a funny mom. One that enjoys each and every moment. As for efficiency, perhaps that is something I can do without?

As for how well that is going to go, I already know. You see, one of the reasons that I do not thrive on exercising is because it isn't something you can do more efficiently, ultimately. I have started swimming again, and it isn't something that I can finish faster: I simply have to swim for 30 minutes.

I am going to count on the grace of God to help me enjoy my each and every moment more, since it won't be possible via my efforts.

For how Hubby is being efficient, and for today's picture, check out his blog.

Dear President Mugabe

Dear President Mugabe,

How are you?

Because you have been widely denunciated throughout the world, I think you would welcome this news: You're getting a new friend. Well, not exactly like you, but in terms of inflation, perhaps like you.

As you know, our newly elected President Obama has signed into law our latest stimulus package. I have no idea where he is getting this money (actually, I know- borrowing from Chinese, which is disturbing in itself...) but there will be trillions of American dollars being pumped into our financial system. To help those with foreclosures, to 'build infrastructure'- whatever that means.

As for the desire for this stimulus to help with foreclosures, I have to go on a little bit of a tangent. Since we live in California, where most people can only afford to buy homes via jumbo loans, this essentially excludes most Californians from receiving any benefit of this, and let me not even go into should we bail people out for making poor choices. As for what is the benefit, I am not entirely clear, and I suspect, the White House isn't entirely certain either. They say that it will help with property values...etc, but perhaps property values need to be adjusted back to some semblance of sanity through foreclosures. Furthermore, I don't know if throwing money into the financial system is a sound solution fundamentally- 'we' have given GM billions but they are wanting billions more? Well we be printing money like you soon when the Chinese stop lending us?

That will bring us to incredible inflation, and for what? To be more like you and to make a friend in you? I really have no idea. Meanwhile, you might be getting a call from the White House soon to inquire about how to expedite money printing process, so that we can look like this:


God bless,
A&Z's Mom

What Is It About Today?

What is it about today? I have had 2.5 hours (4 patients) of missed appointments at my private practice. For two of the four, I have found them and they simply forgot. For the other two, I have called their mobile and home phones to no avail- just so you know, when you don't show up to see your psychiatrist and you don't answer your phone, she thinks you are 1. deathly ill, 2. suicided.

Preferably, I would like for people to just show up. The work I do with patients continues even when people don't show up, I review their files, brain storm about their resistance (are they upset and thus not coming?), and I also think about the most dreaded task of my practice: collect the fee for missed appointments. Since I can't collect money for missed appointments from insurance, I have to tell these people, who usually pay me their copays, that they need to pay my contracted rate. I shudder at the prospect of doing this, even though I explicitly tell people about this at their initial appointments: "The most important part of this treatment contract is the underlined portion, which explains my cancellation policy: If you don't cancel 48 hours prior, and you don't show up, I will charge you my contracted rate."

People usually say, "Wow, I better show up." And I say, "Yes, please remember this policy."

(BTW, I know an established psychiatrist whose policy is this: Unless I find someone to fill your slot, you still will be charged. Even if you're going on vacation and you told me MONTHS ago. I don't have this kind of chutzpah.)

The above poster comes to me from Western Australia and apparently, missed appointments keep people waiting there. For me, here in US, you missing an appointment with me means that your treatment is interrupted, and, I could have seen another patient during that time, which means food money for A&Z. I feel badly about charging for my time, however, I am sure my attorney friends do not even blink an eye for doing this. For professionals, we sell our time and someone has to pay. I much rather people just come, let me do my job, and then I will take your money.

While I can invest money in a appointment reminder system via phone calls, however, we are big people. The court does not call you to remind you to show up for jury duty, or any of its proceedings, and thus, I won't either. Use your phones, calendars, whatever! Just come in, so that I don't have to worry that you died.

Down to the Wire

The form for kindergarten pseudo registration is due at noon this Friday, and Hubby and I are still trying to figure out what to do. I say pseudo registration, because, strangely, we have to turn in our 'rank list' before we register at our neighborhood school. The city we live in simply has WAY too many kids for the schools and thus, for whatever reasons, I think, conspiracy theory is in place here, they delayed the registration process to 'figure things out.'

Anyway, Hubby and I are studying the map to figure out exactly where these schools are, yes, we haven't even been given the chance to see two of the schools yet (we are to turn in these requests BEFORE we see the schools, like I said, a conspiracy theory is highly likely.) (Moreover, I am a little concerned about how we can't just go see the schools, we have to wait until the assigned date.) Whatever.

We have come to this realization: We are very lazy folks. In looking at a school that is not just across the street from us, we are lamenting about how much time we will be waiting at the stop sign, for drop offs. Never mind that we won't be doing pick ups there- Aidan is going to go to a Chinese school afterwards, and they will do the pick up.

We are lazy folks.

Dear President Clinton

Dear President Clinton,

How are you?

Yesterday, my husband and I celebrated Valentine's Day at St.Michael's Alley, where you celebrated Chelsea's graduation. We loved the food- it was imaginative, well executed, and while we were price gouged because it was Cupid's day, we had fun none the less, especially because we got to talk without interruptions.

We could see why you and Secretary Clinton chose this spot- it was easy to secure (one room dinning room) and difficult to get away (lots of traffic on University to get to the highway.) All jokes aside, however, I do wish that my Hubby and I will eventually have the greenbacks to host a lovely party for our children there.

I have been wondering, if you are growing weary. These days, there is more bad press about Greenspan and how his policies led this country to this deep recession. Will there be a day that they will tie your leadership to all this?

Well, I need to get going since the little one will be up from her nap soon, and I still have to figure out if I want to spend $200 on a thermal cooker, it looks like it is all the rage. I sometimes wonder, why do I bother working so much when I end up spending money to support my working habits? And that is even before I gripe about the AMT. Anyway, good luck to you and your family.

God bless,

A&Z's Mom

Dear President Bush

Dear President Bush,



How are you?

Actually, I am not quite sure if I should address you as above or Former President Bush, or if there is a more proper title for you. Alas, I guess that is simply another indication that this letter should have been authored long ago.

I have been thinking about the various issues I want to discuss, ever since I heard about your decision regarding vetoing the Congress' bill to rescind a pay cut for physicians. Why was there even discussion of a pay cut for physicians? And why would you block maintaining the current pay scale? MediCare already pays physicians very little and to make another 10% cut?! Who would be left to care for the elderly and the chronically ill? When I visited my very ill grandmother in the hospital a few years ago, his neurologist told my mom that he was essentially 'volunteering' in his care for elderly patients. That after taking time away from seeing other privately insured patients, making the drive to the hospital, that in the end, he probably would collect about $60 for at least 1.5 hours of his time. While not truly volunteering, do you see that MediCare's poor reimbursement does indeed make it totally not worthwhile for providers? Alternatively, I suppose physicians could make money via volume, which would still equate to substandard care. I could not understand your rationale at all!

Moreover, while we voted for you to be elected, I often felt you were SO VERY stubborn. Only time will tell if your laser beam focus served our country or not, but certainly, it must had been quite lonely. What was it like to be in your shoes, I wonder? Did you read about all the negative press? How unpopular your actions were?

Finally, according to the authors of Good Night Bush, you had said that The Very Hungry Catapillar had been your favorite book as a child, however, this book wasn't published until your adulthood?! Were you making stuff up? If you were, what else did you make up? I hope you can understand my concerns.

Well, I hope you're doing well, although I cannot imagine that you would be collecting speaking engagement fees in the millions, like President Clinton. No offense, but I can't think of any non-religious organizations that might pay you...

Therefore, I wish you a restful and quiet retirement. Please, do send my hellos to your lovely wife and daughters.

God bless,
A&Z's Mom

Cracks Me Up

Aidan went to a birthday party yesterday, where Shrek was also a guest. After I picked him up (it was a BIG boy party, I got two hours of free baby-sitting!), I asked him: "What do you think about Shrek?" He said, "Mommy, it was weird, he didn't bring Fiona."

On our way home today, he was asking for this and that and this and that, and I told him: "Honey, you have been asking a lot. You need this, you need that. I would like for you to sit quietly for a little bit. Do you think about what mommy needs?" He replied, "You need a break."

He is SO cute.

Sorry, no picture today, I gotta go rest.

Dear President Obama

Dear President Obama,

How are you? I hope this letter finds you well.

Previously, in a letter to your wife, I had asked her to consider the plight of working mothers. Today, I am asking you to consider these concerns.

I am very concerned about your use of language. For a man as accomplished as you, I find it rather odd that you used the word 'screw' in your interview with Ms. Katie Couric. Screw is a word that should only be used in reference to a screw driver, or literally, putting two things together via that piece of metal. Screw, should not be used in place of 'make a mistake.' Frankly, in case you are not fully aware, 'screw' is often a replacement of 'f.u.c.k.' If our President is using such an euphamism, how can we expect our children to speak proper English? Perhaps you're trying to sound like a regular American. However, you are NOT a regular American. You are a leader, and please, speak like one.

Another concern is about this stimulus package. With the terrible employment numbers that came out today, the Dow actually rallied based on investors believing that the bad numbers will force you, and other politicians to pass the stimulus package. Isn't that concerning in itself? Frankly, I think using this money to build golf-courses, to buy Harley-Davidsons (as requested by mayors everywhere in their attempts to get their share of this stimulus package) is odd. Perhaps building a golf-course would create jobs. However, it also creates waste. Who is to say that contractors won't try to inflate their bids? Oh, I forget, you will appoint people to oversee these projects. But seriously? That would just be creating more middle managers. Frankly, I can live without middle managers.

What I propose is this: Tax cuts. Tax cuts for small businesses, businesses that run very lean operations, that have little waste. Businesses that create jobs. Businesses that build a community. Furthermore, tax cuts do not require middle managers to oversee them.

Also, you need to stop smoking. It is NOT good when I see a photo of you looking like a teeny bopper flicking a cigarette on the sidebar of my facebook page. It sets a bad example for Americans everywhere, especially when smoking and obesity are two huge reasons why our healthcare costs are astronomical.



Finally, what is going on with your family getting first dibs of the J. Crew products? Why is it that I see your lovely family dressed in J. Crew clothes that won't be in the store until late this fall? You know, Michelle's gloves, the girls' coats. But I forget, you are a Presidential family, which brings me back to my original point: Speak like one, please.

Well, I have lots of other things on my mind, so when I get around to it, I will send in the next installment.

God bless,
A&Z's Mom

Too Many

I am just exhausted.

Last night, I slept poorly, thanks to Nip/Tuck (just finished Season Five- oh my, the lives these two surgeons lead!) a screaming toddler, and two rounds of this.



I don't know why, we hear a lot of the sirens in the middle of the night. Alright, a lot, as in once every other month or so. I hardly ever heard the sirens as a kid, so my theory is that our 'little' town is just too densely populated. We ought to move into the woods, and find a house for storage for the aforementioned exercise ball. Hubby is not biting this theory, however.

After a day of private practice, I realize that my postings here may be on the decline- I just do not allow time for writing creatively while I am the boss! Besides, all these patients show up and so, I can't count on no-shows like I do at my salaried position.

A Circumstantial Thought

I am sitting next to Hubby, while he works on his photography stuff, I am theoretically updating our budget. Pulling up the file from the computer, there is no copy of the household budget for 2008, or 2007, for that matter. The most recent budget is from 2006. Never mind that it is now February, and I am working on a budget. Moreover, why we even bother with a budget is beyond me, since I have no idea how much money we really make, or take home. We don't know how much money we ever make because, well, I have never really worked all year, at a real job. Yup. My income changed every year because the salary changed every year as I moved up through residency. Then, who can really predict how much I would moonlight? Then, I would go have babies, and take six months unpaid leave. Then I would have a real job. Then I would be in transition from a real job, to being my own boss. I might as well be asking A&Z how much money they think Mommy should make. There is also the problem about taxes. With AMT in the equation, we have no clue how much taxes we will owe, so of the greenbacks we gross, who can really tell me how much of that will be ours? Apparently, no one, since the tax laws are constantly changing. As evidenced by last year's tax season, the AMT calculations kept changing even after the forms were printed.

Why do I bother with a budget then? Well, I am curious to know how much we can save. That's right, we are going to save money this year! For what? For THIS!



Last Thanksgiving, Hubby noted how sore his back was, and how a yoga exercise ball would help him to stretch and strengthen his core. Feeling so generous and clever, I went out and in my madness between all the stores I scored this bright blue exercise ball for him. What I didn't think about was the obvious: Where would we store this thing!

These days, this ball rolls around our living room, when I get around to it, I shove it in the bathroom and close the door, to pretend that I don't actually own this ginormous, space hogging, absolutely not biodegradable piece of plastic. Clearly, we need a storage room for this ball. And therefore, we need to buy a house that comes with a room for storing a yoga ball. And thus, we need a budget to save for this ridiculous need. And like I said, this is quite a circumstantial post.

Very Happy

This may seem silly, but I am quite pleased with my list of "25 Random Things About Me." You know, that silly tag game on Facebook.

I found my muse in emilymr and crafted my list while at work.

Here you go, for my non-facebook readers.

1. I am really going to miss blogging and doing facebook while I am at work. Once I leave this job, as my own boss at private practice, I cannot possibly let these bad habits continue. Productivity, here I come!

2. I am so happy that my siblings will both be married by this summer. I can't wait to hear about their joys of being married. Of course, I will welcome tales of "can you believe what s/he said?"

3. My dad used to help me with math and science homework. He would always say that I needed to review my basics, and he would launch into this long lecture about this theorem or that theorem while I studied his alopecia. To this day, he can't comprehend how I managed to move beyond trigonometry. Frankly, I can't either.

4. My mom used to make sludge for lunch. Those were the pre microwave days, and she wasn't going to heat each thing up separately. Therefore, she reheated the soup, then threw in rice, stirfry, whatever we ate the night before. If we had fish the night before, it got a little tricky... The food always looked the same, yet always somewhat different. She valued time much more important than food, obviously.

5. I used to shake my little sister's bed and scream "EARTHQUAKE" to scare her.

6. I once waited in the dark for my brother to come out of the shower, then I jumped out and scared him to death. He was naked. Awesome.

7. Before I dated Hubby, I was determined to date a member of the Claremont Cycling Team. Have you seen those outfits? (Hubby was the captain one year.) To be honest, it was kind of awkward, to try so hard to avoid the area below the waist.

8. I am clearly congested and sick today, because I am so disinhibited.

9. I got my one and only traffic ticket as a senior in college. I was speeding, and I PASSED the cop.

10. I sell a lot of stuff on craigslist. I throw away a lot of stuff, stuff that Hubby still wanted and needed.

11. I do my Christmas shopping the day after Christmas. Then I store it all in my very lovely storage closet in the garage. I take it all out the day after Thanksgiving and admire my own good taste.

12. I once held a patient's hand so tightly that he had to ask me to let him go. I was more scared than he was, and he was getting MAJOR surgery! He also didn't actually want me to hold his hand. He gave me a weird look when I asked him if he wanted to hold my hand.

13. I made myself faint once while I was retracting someone's bowels. I was SO bored. Better to pass out and get sent to the lounge.

14. Despite my intense fears of reptiles, I had to live with a snake for 8 weeks in the summer of 1999. Phobias can be overcome. (However, once I moved out, I lost that ability to tolerate these beasts.)

15. Once I compiled our registry for our wedding, I became obsessed with wedding registries. Other people's registries. People I didn't even know.

16. I thought about becoming a home economics teacher in 8th grade.

17. In 9th grade, I made a model of the female reproductive system for extra credit.

18. I made a baby swallow her own spit-up when I rotated through pediatrics. She looked like she had stuff coming out of her mouth, and I tilted her just so and she swallowed it back. The nurse exclaimed, "What are you doing? You just made her swallow her own vomit!" I thought I was doing her a favor.

19. My favorite thing to do in NYC was this: Go to Redeemer for church, then lunch with friends, then walk around town with Hubby until late. Sometimes we went to the Met, sometimes we just walked around aimlessly.

20. I played the violin for about 5 years. Then I stopped formal lessons, and then I forgot how to play it at all.

21. I studied voice in college. Then I went to med school, and now I try to croak out some music for my children.

22. I played the piano for my entire childhood, even thought about studying it again in college. Now, I only play songs from Les Miserables.

23. I forgot to pack an outfit to wear underneath my med school graduation gown. Rather than going in my underwear, I bought a dress in 10 minutes.

24. I make excellent hot cross buns. Before I ice them, they look like breasts. Like I said, I am rather disinhibited today.

25. When I feel really stressed with my kids, I will remind myself that I will only be 47 when the nest empties. That is only 16 years. That is like doing med school four times. Or residency four times. Or med school and residency twice. I can do that. No problem.