Lucky Seven

Brynna's vocabulary is exploding these days, which is quite entertaining. She now sits in the backseat and sings a fairly decent facsimile of the ABCs, with stretches that actually sound like real letters.

This evening before bed, we were reading the excellent One, Two, Boo, which showed up from Deen and M at Halloween and has been a hit ever since. Like many other toddler tomes, it is a counting book, and so as I was reading to Brynna, I asked her to count the different spooky items on each page.



She started off with "one" haunted house, "two" black cats, "three" pots boiling and bubbling...and then carried right onward to the astonishment of her parents until she had finished "seven" spiders creeping!

Then she totally lost interest after "one, two" of the eight brooms. Ah, toddlers.

We did know that she was starting to be a fairly accomplished little counter, since over the weekend she was counting with Deen and we heard her say "one, two, three, four, five, blue, seven, eight," but the existence of "six" this evening came as a surprise.

So, apparently she's inherited her father's math skills. Algebra to follow shortly.

You Said It, Kid

Me, buckling Brynna into her carseat this morning: "What's it doing outside, B?"

Brynna: "RAIN-ing. YUCK-y."

(She's feeling much better, by the way.)

Fail!

This past Sunday will henceforth be known as the Great Rest-Day Fail of 2010.

It was a weekend of needing to be in two places at once—in New Hampshire for my long shift at the hospital on Saturday, and in Connecticut for my mom's birthday party on Sunday. Alex had a slightly trying day with the B: running errands in the morning and a visit with me over lunch stretched into the early afternoon, late enough that she got a second wind and didn't have a nap. Naps are as sacrosanct for a parent as they are for a tired child, and their absence is sorely missed. When I got home from work on at 8pm Saturday night, we had an hour of flurried activity, packed up the creatures, and headed south, arriving at my parents' house around 1 AM.

Brynna seemed happy to go back to sleep in a crib rather than her carseat, and Alex and I fell gratefully into bed, anticipating a nice lie-in in the morning while M and Deen entertained the B.

But at 1:30, we heard "Dada! Dada!" from the room next door. Over the next couple of hours, we were up and down with Brynna four or five times. We rocked her, I nursed her, we brought her into bed with us (twice), I changed her diaper. None of this resulted in her falling asleep for longer than 15 minutes. She screamed, she chattered, she crawled up and down the length of the bed, she stood up and leaned over the headboard, she turned over and kicked us in the head...but she did not sleep.

Around 3:30, as Brynna howled "Deen! Deen! Eeeemmmmm!" I decided to let my folks in on the fun and brought Brynna up to their room. Despite the tender ministrations of her grandparents, Brynna continued to sleep fitfully. I eventually realized that she wasn't just off her game due to the change in locations or strange driving hours—she felt really hot. And she started holding her ears and saying "ow."

So, here we were at 5 AM on a Sunday morning, several states away from Brynna's doctor, suspecting an ear infection. My father woke up enough to shuffle off downstairs and look up ER/urgent care options, and to figure out where the closest 24-hour pharmacy was (yes, I admit it, I was thinking about calling in an antibiotic for my kid, or at least some anesthetic ear drops until we could get to a doctor). We didn't even have Tylenol—I hadn't packed any because she wasn't sick when we left New Hampshire, darn it!

At 6 AM, Dad went down the street to the convenience store and returned triumphantly with their only bottles of infant Tylenol and infant ibuprofen. We squirted some into Brynna ("die-nol!" she exclaimed, before falling into a deep sleep) and the next thing I remember after that is waking up with Alex and Brynna around 8:30, my poor mom and dad having been exiled from their own bed by their ill grandchild and her too-exhausted-to-move parents.

We then took B off to the urgent care center in the next town (a much more palatable option than the city ER 20 minutes away), where we waited for perhaps 15 minutes before being escorted to a room. Brynna happily took my hand and walked down the hallway until we arrived in the doorway of the exam room, where the categorization part of her brain clearly screamed, "Doctor Alert! Doctor Alert!" and she absolutely crumpled. She was crying so hard that the poor medical assistant couldn't even get vital signs on her.

As often happens at her regular doctor, B had recovered somewhat by the time the actual doctor came in. A father of 6, he was able to win her cooperation enough for a quick and mostly tear-free exam. I did get to practice my Parent Head Grip from the other end of the ear-light, which was useful. And, in fact, Brynna did have a double ear infection.

We were sent off with a sticker, a toy elephant, and a prescription for amoxicillin. Brynna was very excited when I showed her the syringe full of pink antibiotic, since it looked just like the "Die-nol" that she loves. However, that excitement wore off about 0.2 seconds after I started squirting it into her mouth. She clearly detests the bubble gum flavor, and it has soured her on all the pink stuff—since getting her first taste of amoxicillin, she has screamed when confronted with Tylenol and Motrin as well. We have had limited success disguising the stuff in yogurt, berries, and other concoctions, but it's hard to convince B to finish enough of the food to be sure that she's had the whole dose of medicine.

This led to the really delightful scene in our kitchen before bed this evening, with Alex holding Brynna's head still while I alternately squirted medication into her howling mouth and stoppered her up with her pacifier. Fun times.

So, I've recalculated her dosing to twice a day instead of three times a day (I used Epocrates just like I do for my patients—this is within the range of dosing options for amoxicillin, I'm not freelancing with my kid's health), and we're starting with that tomorrow.

And Alex and I would like a do-over on our weekend, please.

The Backyard Slide

Here's B in last week's beautiful warm weather, exploring her jungle gym in the backyard.



She especially loves the twisty slide.


Did I mention that she climbed up the ladder to the slide the other day? Ahhhh!

Dinos! Part 2

Yesterday evening, Alex's company had a special night at a local science museum to showcase the visiting dinosaur exhibit. We took Brynna to partake in the nerd-fest, and she was very excited to see all of the other kids.

She bravely approached the giant T-rex head at the entrance:


When it came time to enter the animatronic part of the exhibit, however, she was a little more skeptical. She got inside this first room with the swimming dino, which was making an odd, pinging, radar-type noise, looked up at us, said "done!" and walked right back out. We tried again with her in Alex's arms, which worked better.


She did get comfy really quickly, though, and spent the next couple of hours zooming through the exhibit.




She's been screaming "Dinos!" at random intervals ever since.

Early Spring Weekend

This past weekend, my parents came up to give Alex a hand with Little B during the last gasp of my Medicine rotation (call on Friday night, then all day Sunday). The weather was glorious, so everyone spent a lot of time outside. I woke up from my Saturday "nap" (also known as "the remaining 6 hours of Friday night's sleep") to find that the yard had been raked and Alex was well on his way with re-stringing Brynna's swing.

High five, Dada, this swing is terrific!


Higher!


When we exhausted the backyard jungle gym options, we headed off to the park. Brynna loves to do monkey jumps on the way there:


There are several slides at the park, including some side-by-side ones where she emphatically directs you to your place, and then takes your hand and slides down next to you. Here she is finishing a round with Dean:

(Mom started off as "Grand" to Brynna, but that has morphed into "Dean" as Brynna has started talking more. I like it.)

There's also a much bigger enclosed slide that Brynna has been eyeing for several weeks and edging towards, before saying "done!" and dashing away. This weekend there was a raucous crowd of older kids playing tag around the jungle gym, and they were zooming down it, then climbing back up the outside. Not to be outdone, Brynna marched right up to the top, sat down, and slid on down...then did it about seventeen more times!

(Yes, that's Jasper fuzz in the lower left hand corner).

Ahhhh...

Four interns.
Three partners.

Tasty food, good wine, excellent company. All of us freed for 2 weeks from the tyranny of overnight call.

It's almost like being a real person again.

Die, Mama, Die!

No, Brynna has not screamed forward to teenager-dom. The frequent yells of "die!" around our house these days mean one of two things.

The last few evenings, it has meant "slide"—B wants to go into the backyard or to the park so that she can go on the slide. And from the moment we set foot in the house after work, she lets us know in no uncertain terms that "slide" is her master plan for the evening.

On the weekend, it usually means "chai." She loves the chai that is my caffeinated beverage of choice, and on lazy weekend mornings, her favorite thing is to share a mug of it with me.

What's For Dinner?

The weather has just been gorgeous the last two days, with warm sunny evenings that I am actually home in time to enjoy, thanks to the springing forward of the clocks. The combination of two idyllic evenings playing outside with my family and the knowledge that this horrid Medicine rotation ends on Sunday has really given me a lift.

Tonight, we were heading home from the park in the just-gathering chill of dusk, with a muddy Jasper and laughing Brynna, when I said to little B, "are you hungry?"

"Yes!"

"What do you want for dinner?"

"RAISIN!"

"OK, what else do you want for dinner?"

"CHEERIO!"

"OK, what else?"

"DONUT!"

Oh, you and me both, kid.

Dinner Table Conversation

We were all sitting at the kitchen counter having dinner a few minutes ago. Alex and I are feeling pretty good, because look, we're all having dinner as a family! We're going to have trusting relationships and no teenage drug use and all of those nice things. At least until Brynna gets old enough to read on her own, at which point we can all default back to reading at the table.

Brynna: DONE!

Alex (looking at me, desperate to extend the few quiet moments that we are enjoying): We could feed her a few shriveled up grapes to jolly her along...

Brynna: RAISIN!

Alex: oh, come on! She can't possibly have understood that.

Brynna: RAISIN!

Alex: Seriously?

Brynna: RAISIN!

So now we're sitting here, and Brynna is eating raisins. And giggling.

Bye!

Brynna sometimes likes to unilaterally declare a game of hide and seek. When an opportunity presents itself, she'll say "BYE!" at the top of her lungs and try to hide away. Perhaps it's just dashing around a corner, or maybe squeezing behind the couch. She certainly thinks she's good at disappearing. The payoff, of course, is when we start wondering aloud "Where's Brynna?" and she gets to leap out, triumphantly. Either that, or we have to hunt her down and chase her - that's nice, too.

Tonight she decided that this box would be a decent hidey-hole. BYE!

In

Perhaps it is some conceptual, developmental milestone that she hasn't reached yet. Perhaps it is something about the pronunciation that makes one easier to say than the other. Maybe she is just picking up Latin. Whatever it is, Brynna uses "in" to mean both in and on.

Usage 1:
The rocks are in the (partially disassembled) Zebra.

Usage 2:
The rocks are back in the box.

There's probably an "into" usage in there as well, but it is difficult to discern. She is only just now putting two words together into a sentence ('ight on. 'ight ow."), so we can't yet tell what declension she's using with her nouns.

Science Cookies

This could fall into the "some people have too much time on their hands," except it's so cool. I'm tempted to give it a try. If I had some time. And steadier hands.





Tons more examples of confectionary awesomeness can be found at the Not So Humble Pie blog: here, here, and here.

Then there's also the petri dish soap bars.

Work It

So, I haven't written much about work this year. Mostly that's because I'm there all the time, exhausted when I get home, and don't want to spend any more time thinking about it. And partly it's because I know most of you really just want to see pictures of Brynna!

8 months in, I am a much better doctor than I was 6 months ago. Intern year is the steepest learning curve of a doctor's entire career, which is exhilarating and draining in about equal measure. I have learned a ton...and the number of things I don't know is still staggering!

I'm currently in the middle of a 6-week block of taking care of adults who are in the hospital, which is my least favorite rotation. The patients can be very sick and/or psychosocially frustrating, and there are a lot of weekend hours. The other day I was reading the local paper and turned to the obits to see not just one, but two of our recent patients. There wasn't anything I could have done differently for either (and I already knew about both deaths, having pronounced one of them in the hospital), but jeez.

Things have also become a bit more emotionally draining over the last couple of weeks because Brynna has taken to screaming "mama! mama!" hysterically when I get out of bed in the morning, even if we've nursed and snuggled for a little while. She calms down pretty quickly, and if she and Alex make it downstairs before I leave the house, she waves goodbye happily enough, but it's still not very pleasant.

On the other hand, I got a hug from one of my favorite patients when I saw her in the outpatient clinic last week. I love having my own panel of patients, and am now starting to see some faces repeatedly and really get to know people. That continuity is the reason I chose family medicine, and I am loving watching people's stories unfold over time, and getting to know families as a complete unit. I have gotten several nice compliments from patients recently about how they really feel like I listen to them and try to help them, which always brightens my day.

Our residency talks a lot about the doldrums of February of intern year, and generally my whole class is bearing up well. As alarming as it is to think about becoming a senior resident in July, responsible for supervising the incoming residents, I am also very much looking forward to a better schedule with significantly less call. Alex is too, of course—because my hours essentially become his hours!

Despite occasional (OK, fairly frequent) fantasies of teaching yoga, being a bioethicist, or working as a paramedic—y'know, jobs where normal hours are 40 a week, not 80—I think I'm doing the right thing in the the right place. But I still desperately desire more sleep and more time with my family.