Actual Conversations with Self

As I run out the door: Wait, are these the pants with amniotic fluid on them? If I have to even ask that probably I shouldn’t be wearing them. But I don’t have time to change. So let’s just say they aren’t. GAAAH! What is that white stuff on the leg? Oh. Good. It’s just that marshmallow frosting. I can wipe that off with a towel when I get to work, easy. And off I go.

Attending

What exactly does it mean to be an attending? It seems like I get credit just for showing up. As in, here I am, attending __________________________. Procedures clinic, delivery of baby, ice cream social. I’m hoping it’s the last one.

Day of Women

Today is March 8, 2012.

It is my dad’s 54^th birthday. When I called him this morning he told me it was also International Women’s Day, and that for his birthday he wanted me to do something for the Women of the World.

Kind of a large task if you ask me but I remembered there was something I wanted to try to write. And I’ve been wanting to write it for a while.

I’m angry at a yogurt company. It might not be yogurt, actually, it could be tampons. I wasn’t really paying attention to WHAT they were advertising. It was just that the advertisement riled me up.

And I know I shouldn’t be wasting my time with Glamour magazine anyway, but, whatever. Guilty pleasures when your flight is delayed at the airport.

This yogurt/tampon advertisement I found showed a cute young woman’s face looking thoughtful. Above her head was a bubble of all the thoughts she was having. And the advertisement was about how you shouldn’t have to worry your pretty little head about ______________________, when you’ve got so much else you’re busy thinking about. (Yeah, yogurt doesn’t fit well in that blank. Probably it was something to do with leak protection. Tampons it is.)

Here are the sorts of important things this woman was thinking about instead of her tampons.

Gaah! Bad hair day!

Do I have something stuck in my teeth?

Elevator with the boss-man. Be witty.

Holy shmoley this research project is like ultra-boring.

MMMM! Fro-yo!

Ooh. Yoga. I likey.

At bar with the girls. Super-cute guy at 11 o’clock. Wink wink.

Listen, ladies. Either we are actually incredibly vapid, or we’ve been completely undersold and are somehow totally cool with it.

Where’s the outcry? I mean, probably I shouldn’t have started yelling at the magazine in the actual airport. I get it. We’ve all learned to ignore stupid advertisements/bosses/politicians because anger doesn’t get us anywhere and we’ve got bigger fish to fry. But. Are we frying those fish? I don’t even know how to fry fish. I’m a vegetarian. I’m a weakling.

I do little things to promote egalitarianism, attempting to balance out various injustices in the world. Little things like providing discounted health care to folks without insurance. And teaching my kids to respect others regardless of race/gender/orientation/religion/BMI. And not honking at drivers who cut me off. Because maybe they were in a hurry. Because I like to be understanding. And also because my horn doesn’t work.

Yeah. It’s not enough. Because those tampon people think they’ve pinned me. They think I’m going to sit in my suburban track-home all my life and contentedly buy things, my mind consumed with major concerns like whether I’m paying too much for cable television. I think maybe they’re in cahoots with major politicians.

Now, I don’t follow politics, in the gossip-column sense. I know what I believe about the world, and I research the candidates, and I vote.

But something has managed to catch even my attention recently. Women are seriously being attacked. We’re being used as scapegoats, as political ammunition. We’re left out of congressional committees whose purpose is to determine the right of companies to decline insurance coverage for one of our most rights: the right to family planning. Abortion issues aside: folks want to pretend birth control is not a basic health care necessity. Like access to birth control has not been one of the most important determinants of a woman’s health and happiness in the past 100 years. It’s right up there with antibiotics and vaccines, people. And political pundits think they can get away with calling women prostitites who ask to have that medication covered by their insurance, like antibiotics are, and vaccines. And insulin and dialysis and colonoscopies and Viagra.

What the hell, America? It’s 2012. I was supposed to have my personal space ship by now.

Many of the women I know are quietly ignoring this. And that includes me. Why? Are we afraid to speak up, to be labeled something *gasp* unladylike? Or do we just think that if we ignore them they’ll go away? And what’s up with our men, too? Are they cool with their wives and girlfriends being treated this way?

Here’s the thing, too. We womenfolk make up 51% of the population in this country. Sure, a few ladies are out there with signs. They’re applauded in some circles, ripped apart in others. I’m not going to tell people not to make signs about what they believe in, or to stand outside and protest and demand change.

But it seems that on the whole most of us are “too busy” to do something about this trend. In perhaps the most progressive century in history, in perhaps the most powerful nation on earth, we’re accepting outright 1890’s behavior in our leaders (political, media, and otherwise.)

I’ll put it another way to try to ruffle a few feminist feathers: we’re too busy taking care of everyone else to demand what we need for ourselves.

I don’t have any posterboard and I can’t find any markers. I’m asking us to consider something simpler. We make up over half of the voting populace. We’re fortunate enough in this country to have a representative-ish government. Sure, your congressperson may not look like you, but they’re paid to represent you. When was the last time you told him or her what you think?

Because we do think.

And despite what my tampon advertisement nemeses believe, here’s what we think about:

The kids need to let go of my legs so I can go to work.

Let. Go. Now.

Where are my keys?

I’m leaving for work. I hope my kids know how much I love them, even though I have to leave every day. I hope they know I do it for them.

Maybe when they start school that will distract them.

I hope the school cares about my kids almost as much as I do. I hope they teach them things. I hope it gets better before they start school.

And when they learn stuff and graduate, it would be nice if they had jobs, too.

I hope they can get jobs.

I hope they like their jobs.

Do I like my job? Yes. I do. Mostly. It’s just hard. Not just the thinking part. It’s hard that so many people are sick right now, without insurance, without jobs, without homes, without hope.

How come I never change the oil in this car? It’s been… 3 years? Can that be right?

I totally forgot to bring a lunch.

At least I have food at home. I’m lucky I have a job, too.

If things are this bad in America, how awful must they be in other places?

Imagine if I didn’t have food for my kids.

I hope it gets better for those folks, too.

I hope. I still have it. Do you? Good. But hope is completely actionless. It’s waiting, passively, for the world to change. It’s like waiting in a castle for your prince charming to rescue you. Not gonna happen. Sounds boring, anyway.

Instead of hoping I’d be a doctor one day, I studied. I took way too many tests. I went to school for a lot of years. I stayed up all night, heart racing, feet running up and down halls to codes, deliveries, surgeries, patients requesting dilaudid. I helped people be born, and watched others die, and everything in between. I did all that. And now I’m a doctor.

We ladies know how to get things done. We start with hope, but then we do something about it. We’re good at that, as long as it’s within the realm of home, self, and work. But what about everything else that affects us? The schools, the city, the country, the world? This world needs to get some things done, folks. This world needs us.

It’s not going to happen without us.

So I’m taking all my thoughts, all my hopes. And I’m doing everything I can to make them real. Starting today.

Starting with:

I’m telling my kids how much I love them. I’m showing them I care by working for something I’m passionate about, something that matters. Something that’s bigger than I. I’m going to actively make a difference in the world, try to make it a better place for them. I’ll start by fighting for the rights of women. When the kids are old enough, I’ll explain this to them, so they know. They are the reason I need to do this, and why I need to leave them every day. One day it will be worth it for all of us.

I’m taking charge of my kids’ education. I’ll learn alongside them while they’re little, and I won’t accept mediocrity in the school system. What I can do there to make a difference, I will.

I’m changing the oil in my car. Probably.

I’m letting my government know I’m not happy. With all the focus on me keeping an aspirin between my knees I’m pretty sure more important things are being left by the wayside. Like my kids’ education. And other kids’ hunger. And lack of adequate health care. And jobs, and war crimes, and famine and rape and subjugation of women the world-over. Not cool, government. Let us fill you in on what matters. I’m not voting for you if you don’t care about what matters.

And if they don’t listen, then we need to take over. Let’s be elected officials. Let’s be presidents. Let’s get this done. We know what we need, ladies, and there’s no dragon keeping us from stepping outside this castle. Let’s go out into the world, and make it the place it needs to be. For our children. For our sisters’ children. For our men. For us.

Just as soon as I find my keys.

The Zoo

Today we went to the zoo for T.P.’s fourth birthday. Standing by the bright blue sea lion pool, I held Beastie up so she could see. She watched all the swimming. I took her little hand with all its little knuckle dimples and kissed it, inhaling a bouquet of sticky ice cream, dirt, and all the love I’ve ever had.

My heart stopped beating. My tongue was like a fat seal stuck somewhere in my throat. My eyes burned.

I thought myself 20, heck, even 2 years in the future. It will be here before I have time to breathe again. This baby will be gone, a child, a woman in her place.

Dammit. No crying next to the sea lion tank, okay? I’m pretty sure that’s a posted rule.

We moved on to look for wallabies. I spent the next 30 minutes, in those exact 30 minutes. And that is the best thing I did all week. My proudest achievement. I was there. Fully there with my kids.

The wallaby was missing, though.

Love and Blood

I went in early to work today. I needed to look at as many diseased cervices as I could find in a textbook before 8am. At 8 procedure clinic would start and I’d be supervising the Superstar. On the docket were 2 lipoma removals, 2 colposcopies, and a punch biopsy.

I wasn’t sure if I remembered how to do any of these things, let alone supervise them.

See, a colposcopy, for example, is about two things. Thing 1 is sheer awkwardness: setting up cameras and screens in front of a nervous, half-naked woman. Then you spend another grueling 20 minutes finding a speculum and adjusting the camera and adding a filter and zooming in and clumsily knocking the camera over and contaminating the biopsy tray and asking for another and adjusting the light and the camera again, between the mortified woman’s legs.

“Oh, sure, just like at home,” our nurse JHot said when I explained this to her (she lamented never having watched one. For reals.)

Thing 2 is pure pattern recognition. Mosaicism, leukoplakia, bridging. Immature metaplasia. Punctation, nabothian cysts, papilloma. Decreased uptake. Ulcerations. Algorithms.

I’m better at thing 1.

Thing 1 is all about finesse. Thing 2 takes frequent, repeated exposure. Hard work, at that one thing. Studying with your eyes, as much as with your mind. But I’m willing to put in the work.

The good news is, it went well. In an hour I brushed up just enough to know what to biopsy.

Also, I’m good at surgery. Relatively, I mean. I had forgotten this about myself. I’m not a surgeon because instead I trained to be a family doctor. I just mean I have the aptitude. I know how to handle the tissues. My fingers know what to do.

If I’d done surgery maybe I’d be a better surgeon than the family doctor I am today. Maybe I’ll try not to think about that too much.

I watched the Superstar cut through the epidermis overlying the lipoma. I told her to hold the knife a little different. She obliged. Dermis. Connective tissue. Fat. She dissected. I dissected. We got out fancy instruments. We uncovered the fatty tumor, used a clamp to lift it and found the tissue plane between it and the fascia below. 

Then it was out in a satisfying glump. We closed the wound with two layers of stitches. I showed her ways to hold the skin, to produce better tissue eversion.

Blood and tissue equals gore, but surgery is heady. How many nights did assisting on a c-section awaken me from half-sleep? Blood means business. It narrows the focus to the present, life and death, meanings therein. It’s messy and euphoric. Once I even got cut in surgery with a scalpel, and I didn’t notice. Only when the Dragon asked “did you just punch me in the scalpel?” did I realize I was bleeding into my glove.

I like it, and I have something to offer in teaching it. Relatively speaking, of course.

That felt good.

I finished clinic early (for me) and stopped by the hospital on my way home. My  patient had delivered the day before.

She’s the one I worried about, with possible cholestasis, then liver issues, then renal insufficiency vs atypical preeclampsia. I wanted her delivered sooner, but couldn’t pin a diagnosis on her. Plus she was going to try a VBAC.

She didn’t make it. When her bag of waters broke, there was meconium and the baby’s heart rate went down for a while.

The love of her life had left her when she became pregnant. “I guess he wasn’t ready for the responsibility,” she told me. When she was about to have her baby, though, her mother drug him to her bedside as she writhed in pain without an epidural and people ran in and out of the room. He went into the c-section that ensued, watching the blood that poured onto the floor. “Mom thought he deserved a front-row seat,” she told me.

Her baby rests now, on her chest. He doesn’t want to leave her, not for a moment.

Last year in the worst of times G.B. told me I didn’t know how to love anymore. I spouted off something angry and doubted myself for days. He was wrong. I do know how. But love is not what we’d believed it to be, maybe. Love is blood. Love is war. Love is backbreaking, work in the trenches, elbows deep in carnage, debt, dirty diapers. Love is a clear blue sky torn through with screaming missiles, fire sweeping the fields, children cowering in tents. Why else does cupid shoot you in the heart, but that you may bleed?

Blood is love. It is not all of love. But what else but love and blood, rushing through our veins, keeps us alive?

Fatty tumors. Blood-stained babies resting over Mother’s heart. I’m going home now, to all those I’ve bled for.