The bird of death, the bird of love

When I went to see B for the last time, his parents were in the hospital bed with him, his mother beside him, his father squeezed crossways at the foot of the bed. They were all barefoot and his father had one hand on his wife’s foot and the other on B’s foot and I could see how similar they were, these two sets of feet. Genetics alone do not a parent make but there is something about the uncanny likeness of parent and child that always catches in my throat. I felt tentative, worried about interrupting this intimacy, but his father waved me in, smiling. I had just finished my first call as a supervising resident on another floor and I was exhausted, pungent (can other people smell the post-call smell?), still roiling from the overwhelming responsibility that had abruptly been mine overnight. I was wearing one of C’s sweatshirts, several sizes too big, and an old maternity shirt, the middle deflated around my no-longer-pregnant belly, for luck. “Your first day as a senior resident and that’s what you wore?” B’s father quipped. I had to laugh. He had taken an unusual interest in me and his other providers and the workings of the hospital and as a result I had shared more than usual with him about myself and the challenges of residency.

It was to be the day of B’s death, the day his parents had decided to withdraw the care that was keeping his lungs expanding and his heart beating but doing nothing to reverse the irreversible damage to his brain. It is a cruel and unwarranted term — “withdrawal of care” — and it’s more politically correct cousin “withdrawal of support” is not much better. A better term might be “the hardest thing you’ve ever done or will ever do in your life” or “the ultimate act of putting your child’s needs before your own” or at least “releasing your child from the pain of futile interventions.” I was expecting the mood in the room to be very dark but B’s parents’ tears were intermixed with funny memories of their son, pride in B and in the family they had built together, and so much tenderness.  We took turns playing a little word game that B had liked to play. We talked about the course of his ICU stay, the milestones of hope and despair, the various providers they had interacted with along the way. We talked about their children, about my child, about parenthood. I could tell from our conversation that we might not agree if the topic shifted to politics (when they asked about my husband, instinct told me to go along with it instead of doing the whole “actually I have a wife” thing), but they were the kind of parents I aspire to be — thoughtful, generous, loving, engaged. As we talked, I held B’s hand. It was the first time I had touched him without a clinical purpose.

There is an inherent asymmetry to the relationship of doctor and patient. I touch my patient’s bodies along their entire length, examining their cavities and contours. I witness their tears, their anger, their caresses, ask them questions about their families, their diet and personal habits, their sexuality, whereas they neither touch nor see nor know almost anything about me. There is also an uncomfortable power dynamic related to knowledge, whereby I often understand the context and trajectory of their illness better than or before they do.  Try as I might to communicate the facts and my impressions, there is often an unbridgeable gap that is the product of the sheer complexity of the medical situation or the emotional context which causes patients and parents to receive information in a particular way. There is a certain trading back and forth of significance and anonymity. Sometimes I walk into the room of a patient I care deeply about, about whom I have spent a lot of time thinking and talking with other doctors, and it is clear to me that they have no idea who the hell I am (“I’ll have to call you back,” they say into their phone. “The nurse is here.” Proving that gender is still complicated here in 2013.)  I am one of the dozens of faces that are passing through their lives at a stressful time. On the flip side, sometimes I am stopped in the elevator or the hospital lobby by a parent who tells me I took care of their child on so-and-so floor and I am disturbed to realize that I have no memory of them. They are one of the dozens of patients that have passed through my life at a stressful time.

Then there is the awkward question of love, which I feel toward my patients but which cannot be spoken. I wanted to tell B’s parents how much I admired the strength of their love and care for each other in a time when guilt and blame could just as easily rule the day. I wanted to tell them how deeply I mourn for their son and for them. Holding B’s hand I wanted to whisper, “Go in peace, beautiful boy.” But instead I just said, “I have been thinking of you all” and hoped that they would somehow understand that I was feeling for them and with them, beyond the blood pressures and infusion rates and MRI findings.

The moment came when it no longer made sense for me to linger. I said goodbye and then we talked a little more and then I said goodbye again. I was halfway out the door when B’s dad called back to me “Be the best parent you can be.” I turned to him and nodded and awkwardly put my hands over my heart. There was nothing more to say.

I once heard a Zen saying: Live as if death is a bird always on your shoulder. No one likes to talk about death and certainly not the death of a child, but I think it’s bound up with love, especially parental love, in ways that people don’t acknowledge. The passionate, euphoric, desperate love of a parent for a child contains within it the terrible awareness of how much might be lost. If I were to face that loss, I would want to be able to say to myself, to my partner, to my child: I loved with my entire self, as well as I could.

B passed away a few hours later as peacefully as possible. I will probably never see his parents again but I think of them almost every day as I kiss E’s neck  and tumble with her on the bed and listen to her breathing from the door at night and try like hell to do a good job at being her parent. On one shoulder the bird of death, on the other the bird of love.

Keep the baby alive, and other things I have learned about parenting

I visited a friend today who has a new daughter, 16 days old. The baby is extremely lovely. She looks just like her father and just like her mother and already has the capacity for skepticism which is of huge importance in my opinion. She slept in my arms for several hours and smiled in her sleep and stretched a lot and a couple of times opened her dark eyes and made contact with me.

Time changes around a new baby. There is no 11 o’clock or 1:45. There is feeding, rocking, changing, rocking, cooing, smiling, admiring, and so on and on. (There is also losing your mind from boredom and feeling worried about everything and being exhausted beyond limit, but more on that later.) I got to my friend’s house at 11am and it felt like twenty minutes had passed when in fact it was 1:15 and I was late for a lunch date. Also, I am never so much the inhabitant of my physical body as when I am interacting with a baby. Whereas usually my head does most of the work and gets most of the credit, with a baby it’s the curve of the arm, the swing of the hips, the lilt of the voice that is at work. Holding the baby today, I remembered the mammalian existence of my first weeks and months with E, moving slowly from couch to bed to couch again, constantly in physical contact with the baby, our mutual fluids running out of every seam. At the time it felt awkward, this shift from the goal-oriented-success world to eating-sleeping-humming world but now I am so grateful to have experienced it, to still be experiencing it every day with my daughter as she grows: the animal life that is only ever now.

My friend is having a hard time, as I think all new parents do, as I did. She said, as I remember saying, as I say to this day: No one told me how hard this would be! Even though I distinctly remember telling her that the first six weeks of E’s life were super, super hard, that breastfeeding was nerve-wracking and never completely worked for us, I don’t think it’s possible to hear and understand these things before you actually go through them. When people tell you “It’s totally life changing,” you don’t realize what that means: that the life you had before is over and a new one takes its place in which you have much less control and much less freedom. Given that we live in a culture in which both adulthood and success are defined by having control and freedom, this transition can be tricky. We build our identities around the work we do, the people with whom we interact, the activities we enjoy, our tastes and beliefs. When you have a child, all these things change radically overnight. Some aspects of ourselves return over time, others are permanently altered.  Added to these already stressful changes are the avalanche of mythologies and dogmas and opinions around motherhood and child rearing that can really drive a person crazy. Never had I been the object of judgmental looks as much as I have been since becoming a parent — just try mixing a formula bottle at Mom & Baby yoga class, my friends! You might as well put a lit cigarette in that baby’s mouth. All this on top of the sheer hard work and anxiety of it — the nights and days and nights of walking back and forth with the crying child in your arms, worrying all the time about whether or not the baby is still breathing, learning through error what you need to bring with you on an outing (answer: at least two of everything and if your baby eats formula, don’t forget the formula #oops! #ivebeenthere #thebabyisstillalive).

Talking with my friend today, I wanted so badly to palliate some of her uncertainty and exhaustion. I wanted to give her a full-body taste of how much better things get as you learn your child and yourself and find your voice as a parent, as your child grows and can do more for themselves. But of course, everyone has to find their own way there. In the words of Mary Oliver, “Nobody gets out of it, having to / swim through the fires to stay in / this world.” Still, there are some things that might have helped me 16 months ago, so here goes — for my friend and anyone else out there who is staring down at their new baby and thinking “This is the most amazing and perfect creature I have ever laid eyes on” and at the same time thinking “Holy shit! What have I done?!”

1) Here is the core task of parenting: Keep. The. Baby. Alive. On some days, like when you have the flu or you haven’t slept for more than 30 minutes in a row in 72 hours, this in and of itself will seem like a monumental task, but if you accomplish it which you likely will, that day has been a parenting success. Now there all kinds of more nuanced parenting tasks like cutting the baby’s fingernails (anxiety, thy name is infant fingernail clipper!) and getting on the right preschool waiting lists and teaching your child to say “thank you” and “ladybug” but you can’t always be attending to those things because you will have shitty days and that’s ok, as long as you do the things that are necessary to keep the baby alive. Aka feed it and keep the bleach in a locked cabinet.

2) It’s ok if it takes a while to feel fully connected with your baby. Some women pop their baby out and immediately feel connected on every level to that new person. Other people (aka: me) take a little longer. I loved E from the beginning but I was also in a ton of pain and dealing with post-partum complications for the first month. I was struggling through breastfeeding challenges and my own insecurities as a parent (that awkward moment when your fear that you are not bonding enough with your baby makes it hard to bond with your baby). Again, I loved her fiercely, but sometimes when I looked at her in her crib from across the room, I thought: Me? I’m that baby’s mother? And it seemed incredibly surreal. Then, sometime in the second month, we clicked into each other forever with a glue that will outlast time and space. For some women, it takes longer than that. But see #1 above. Your job is to keep the baby alive. The rest will come (as long as you are not suffering from postpartum depression which can throw a wrench in the process and should be treated. Take this quiz and talk to your doctor right away if your score is concerning).

3) It’s ok to do things for yourself. It’s ok to leave your baby in the care of trusted people while you eat, sleep, get a haircut, or talk to your best friend from college on the phone. Your baby needs you but not every single second of every single minute of every single hour etc. If you need to go away for a night for work or, in my case, have seven residency interviews when your child is five weeks old, it’s ok, as long as you have left your baby with plenty of its nutrient source and another loving adult. Some people believe that their child should be with them always and if this works for you, I think it is a wonderful thing. For me, it has worked best to recruit a little love army for E and she has an extended network of people who think she is the cat’s meow. This is working for us. Do what feels good and right to you but if this includes going to a movie while your best friend watches your baby once in a while, it is ok.

4) It’s ok to feel sad about things you miss from your life before the baby. It’s ok to feel sad period. It’s ok to feel bored when you are caring for your baby. It’s ok to feel frustrated with the baby when you can’t figure out why he is crying and it is ok to feel relieved when she goes to sleep and you can get a shower in and watch twenty minutes of The Wire while eating a chocolate pudding pack standing up in your towel, or you know, whatever it is you like to do. There is a lot of crapola out there about how your feelings can hurt your baby. Depression, anxiety disorder, and other mental illnesses that impair a person’s functioning can have a detrimental effect and should be treated pronto, but your average feeling cannot lash out scissor-like and gouge a hole in your baby’s future. Mothers are still allowed to have a full range of feelings, thank you very much! Do not waste mental energy feeling guilty about your feelings.

5) Come to think of it: Do not waste mental energy on guilt at all. Banish guilt as much as possible. Do you try your best to make good choices for your baby? Are you providing a consistent, safe, and loving environment for your baby? Does your baby have nourishment, medical care, and high quality child care? If the answers to these are yes, then you are doing everything you can. Accidents, illnesses, and adolescence will happen to all children and are not your fault.

4) Breastfeeding does not equal love. Breastmilk does not equal love. Breastmilk is good. It’s the best food for babies if it’s safe and available. But if you are not making enough breastmilk or you have an illness or take a medicine that precludes breastfeeding or you cannot or do not want to breastfeed, this does not mean that you do not love your baby. As a person whose first month of parenting was made 80 times more stressful and guilt-ridden by my inability to make enough breastmilk despite pumping EVERY TWO HOURS AROUND THE CLOCK, I think that it would have been better for my baby had there been less emotional drama around the issue and had I felt free to spend less time pumping and more time enjoying my baby. If breastfeeding is easy for you and it’s all going swimmingly, remember to be gentle and kind and nonjudgmental to the mothers who are struggling with it.

5) Don’t let anyone tell you what is best for you, your baby, and your family. This includes friends, co-workers, mothers, mothers-in-law, doctors, lactation consultants, books, or the judgmental voice in your head. All of these except the last two may love you and want the best for you and your baby, but they are living their lives and you are living yours. If working is the best thing for your family, work. If staying at home is the best thing for your family, stay at home. Either one will have sadnesses and frustrations and difficulties and joys and pleasures and advantages. Read parenting books and doctors’ guidelines as a way to inform your choices, but collect their ideas into a larger collage of possible options. Every child is different and no child will fit perfectly into a paradigm. Be skeptical of dogma, advocate for yourself and your child if you are worried about something and doctors brush you off, trust in your own intuition about what your child and your family needs.

6) Anxiety is part of parenting and it’s here to stay. The thing you love most inhabits a mortal body and then develops the capacity to move independently, to put things in it’s mouth, and finally to make bad decisions for itself. You will learn to live with anxiety and manage it. It will wax and wane with the circumstances. Current worries will pass and new ones will arise. It’s tiring but you can survive it and thrive in spite of it. You’ll maybe never sleep quite as soundly again. I’m just being honest.

Having a child is the ultimate adventure, which is a cliche, but apt in this circumstance. It is full of unknowns and good and bad things happen along the way. It’s exciting to watch a person develop and you learn a lot from accepting and negotiating another person’s total dependence. You get to see the world anew through an unjaded pair of eyes every day — again a cliche, but a true one — and this suffuses life with pleasure and meaning and hope. Becoming a parent puts an end to your childhood, but reawakens your child self. Mostly, there is the love, the massive, unconquerable, infinite love. It’s like they always say: there is nothing like it.

Here is my favorite meme of all time, which kind of says it all.

2013: The Sabbath Year

It is 8:56pm and I am in the house alone. C has taken E to Pittsburgh to visit her brother’s family. This is the first time that I have been at home and E has been elsewhere, which is a small but, as it turns out, emotionally significant variation. I have traveled several times during her life, but she has never been out in the world far away from home without me. I ache with missing her. It’s not that I want to be the sort of mother for whom separation is difficult. I want to be the sort of mother who can enjoy her alone time, who can find a measure of freedom and pleasure in the quiet glass of wine, the sort of mother I was a few hours ago at 6pm, sitting in a great new-to-me coffee shop, writing. Now I just want to be kissing my child’s belly while helping her chubby legs into pajamas. Parenthood and addiction are not unrelated phenomena.

I am sitting at my desk which is cluttered with evidence of our life: E’s body lotion which I have been having to apply each night while chasing her around the house; my stethoscope and the pediatric code card I carry at all times while at work; claritin, sudafed, and pepto bismol, because that is how we roll these days. To the right of my mouse (alert: if you find fingernails gross, this will be gross for you) is a little pile of E’s fingernails from this morning’s looney tunes mani-pedi (note: bugs bunny is an effective but very short-lived pediatric paralytic) which I didn’t have a chance to throw out before E was off to her next death-defying adventure.

When I was growing up, my mother kept a little porcelain container with my baby teeth in it. At the time I found this a little creepy and a lot disgusting, but now I understand it. As a parent, your child’s body — its every part — is suffused with your love and your worry and your desperate desire for their life. Precious does not begin to describe it. I am glad that I experienced the ecstatic, terrified love of parenthood before becoming a pediatrician. I have a lot of empathy for the worried parents of ill-but-overall-well children, and even more empathy for the parents of truly ill children. Other people complain about anxious parents, but I just feel for them. In the words of Yehuda Amichai: As for my life, I am always / like Venice: What is just streets in others / in me is a dark streaming love.

*          *           *           *           *

It’s almost the new year and I was reminded by a friend’s lovely blog post that it is time to make New Year’s resolutions. Ordinarily, there is nothing I love more than a self improvement opportunity. Here is a small sampling of the books on the shelf nearest my desk: The Seven Habits of Highly Effective People, The Now Habit, Uncomfortable with Uncertainty, Zen Mind, Beginner’s Mind (all recommended, by the way). I have been to meditation retreats. I have been in therapy. I have bought apps to keep me focused, to track my time, my calories, my money, and the books I read. I have been a vegetarian and a vegan, have eaten no refined sugar whatsoever for a period of 10 months in 2003, and have been following the zone diet on and off since 1999. I have swum and walked a lot of miles and when my midwife told me to train for labor, I woke up every morning at 6am for three months and took my whale-self to the trail along Lake Michigan. One might say that I have made New Year’s resolutions into a year-round side career.

I tell you all this so you can appreciate the gravity of what I am about to say: I feel like I am doing an okay job at life these days. My life is more crowded than ever and as a consequence I make more mistakes than ever. The pile of unopened mail has never been taller and I haven’t been to the dentist since George W. Bush was president. E’s favorite food is Kraft macaroni and cheese and she co-slept with us in our bed every night from birth through twelve months despite my intimate knowledge of the AAP recommendations on SIDS prevention. I am still bad at returning emails, only I’m even worse than I used to be. But every day I get up and drain every last drop of myself in the doing. I am a smoky fire.

There was a time (aka B.C.E., Before the Coming of E), when I devoted time every six months or so to revising my personal mission statement a la Franklin Covey. My mission statement used to extend over two pages. It featured nine separate roles and my goals for each role. It had specific line items for physical exercise, eating well, keeping the house clean, remembering birthdays, meditating, swimming, writing, keeping up with my photography hobby, communicating with my in-laws, sustaining positive mentoring relationships, being a good sister, traveling, and acquiring more scientific knowledge.

Now my mission statement goes something like this:

Be the best parent and partner I can be. Be the best doctor I can be. Try to write as much as I can.

That pretty much covers it. Everything else is extra credit. I have neither the energy nor the time to improve myself. I am just going to have to make do with the me that I already am.

In Judaism there exists the tradition of shnat shmita, or the Sabbath year. Every seventh year, a year of rest and remission is to be observed. Debts are forgiven (here’s looking at you, Sallie Mae). Slaves are freed (here’s looking at you, ACGME). Fields are allowed to go fallow. Planting and harvesting stops and everything that does grow is “hefker” or ownerless, free to everyone. Basically, the machinery of human commerce reboots. The practice is still observed by religious Jews (though notably not by credit card companies). The last actual Sabbath Year was 2007-2008, so the next official one won’t be until 2014-2015 but I’m thinking we may need to move it up a bit and reframe it in more personal terms. It’s Shnat Shmita, my people! Perfectionism is out. Interdependence is in.

So I invite you to join me in resolving not to resolve, in being self-aware but yet filled with humor and gentleness. Let us be no thinner and no more organized. Let us validate ourselves and each other because we are working hard and trying our best. Let 2013 be the year of consolidating our strengths, asking for help when we need it, and setting realistic expectations. Let us view ourselves as we view our children and/or dearest friends: with love and admiration and tenderness.

Happy New Year!

*          *          *           *           *

Epilogue to maternal loneliness: C just sent me this picture of our little E, delighting in the company of her cousin in Pittsburgh. He’s her new bestie, basically. She looks so grown up — it blows me away! She’s having a fabulous time and building the relationships that will sustain her long after her Baba and I have left this life. Meanwhile I am about to go to bed so I can wake up at 5am and go take care of 17 other babies who are just at the beginning of it all. There is much to be grateful for.

E and A

Long time no

I haven’t posted in over a month. Every day, after I have worked from 6-6 or 6-7 or 6-9, driven home, bathed and put Little E to bed (on the days when that is possible), I am faced with a “decision”: stay in bed or get out of bed and try to do something. Invariably, E has placed her tiny hand across my arm as I hum our bedtime song over and over again and I am so deeply exhausted that there is really no decision. I slip into the comfort of sleep leaving the rest of me fallow for yet another day. The sleep I get from 8:30pm-midnight beside my baby is the sweetest and the only reward I have these days and I am reticent to give it up, even for just one day, to get my shit together in life’s other domains. And so: no writing. No responding to emails, no exercising (I am about as strong and vital as a bowl of tapioca pudding these days), no doing writing for the research projects that I am still ostensibly participating in. Just sleeping, waking, working, and doing whatever small amount of mothering I can do in the hours between.

It is hard to know whether to tell the truth about internship. Doing so seems like a betrayal, but of whom? As in any hierarchical culture (think: the military), there is an unspoken taboo against speaking out about how it feels to be at the bottom of the pile. We instinctively identify with the system that we are trying to enter and to speak about its flaws is to risk being exiled from it. The first rule of intern year is: You do not talk about intern year.

But, I did not join the military or fight club. I decided to become a doctor, a healer, a person tasked with the care of those who are suffering. And right now, I am exhausted, uninspired, and in an unhealthy place physically, spiritually, and emotionally. I find myself wondering about the merits of the current culture of medical training, whether it produces the kind of doctors we want caring for us, whether it is the system or me that requires reform.

So here’s the truth about internship: It’s really, really hard. I have never felt so exhausted, so consistently pushed past my limits. After a lifetime of working to cultivate an open heart that is strong enough to face suffering, I find that I have to encase it is armor just to survive the days. There is just no time to process and integrate everything that I am experiencing. Instead of being wiser than ever about people, I am less and less wise, harsher, more judgmental, and less patient. I am in constant physical pain, unable to do the exercises and get the rest that I need to keep my back healthy. I resent my job every day because it does not allow me to be the kind of parent and spouse that I want to be. I began this path hoping to become a strong warrior, guide, and advocate for those who are suffering and now find that I am the person who is suffering, who is in need of guidance, of compassion, of healing and recovery. Perhaps this is the deeper intention in this training model?

Medical residency was at the start designed for unmarried men who committed to live in the hospital for the duration of training, hence the term “residency.” There is much nostalgia in medicine for the time when the ardent mission of medicine was all-consuming. There is certainly precedent for this kind of professional training. In prior times, apprenticeship in many fields required a period of servitude to a master, often of a live-in nature. Perhaps the gravity and complexity of medicine requires a period of complete 100% commitment in order to master. In which case, perhaps 32 year old people who are also parents and spouses are simply ill-suited to the acquisition of this profession.

But then I think of all the other people in the hospital–nurses, psychologists, chaplains, radiology technicians, the list goes on and on. These people are all protected with respect to the amount of time they are expected to work. In fact, it would be considered unsafe for many of these people to work more than a certain amount per day or per week or per month. How exactly are doctors different? Are we immune to the effects of chronic exhaustion and life deprivation or do we just think we are? I get that doctors are the people who have to made difficult decision and judgements in the toughest moments for very sick people. I get that some training under pressure is necessary to be able to rely on people to consistently make these decisions correctly. But does it have to be so relentless for so long?

I challenge myself to think of a better training model, but to be honest, I am simply too tired. My brain is in survival mode. I guess the best thing to do is to keep my head down and keep going day after day, and hope that when it is over, the person I was is still in there somewhere, ready to care and feel things deeply again, ready to find a sustainable balance between service and self-care.

Sadsad. Sweetsweet. Rinse. Repeat.

There is no time to write, but if I don’t write I will never write!

Here are the updates: We drove for ten hours through the driving (never has the adjective been more apt) rain. We rocked the baby to sleep in the bathroom of an Applebee’s in Angola, Indiana. We arrived at a our half-way point at 4am and spent a lovely, tired day with loved ones. We drove through eight more hours of driving rain and arrived at our destination at 1am. We slept on the living room floor with our baby with nothing but a twin futon, one pillow, and a comforter for one night. All of this was fun and also the worst, like giving birth. An adventure.

Amidst this, I developed a case of sciatica that made one out of every four steps onto my left foot excruciating. While boxes and chaos threatened to engulf us, I had to rest and do nothing. My partner had to do everything. She is a hero. I knew this before, but now I really know. Faced with a major interruption in my ability to function, it became all the more clear how critical my functioning is. A) I need to start residency so that we can eat and pay rent and B) taking care of a six-month old involves uncountable acts of bending and lifting. When these are impossible, parenting is reduced to baby talk and back pats and these do not go very far against hunger, boredom, frustration, or fear.

Then E turned six months old. I am so in love with her, it feels like my whole being is a pile of wood that is aglow with the warmest campfire ever. But in a good way, like in the Bible when the bush burned but was not consumed. Sometimes I still cannot believe she is! She has mastered sitting, and growling like a bear, and using a toy to knock down other toys.

I had to take steroids for my back, so I’ve had to dump down the drain every drop of pumped milk for five days. Without her nursing, the milk is dwindling, which makes me sad.

I’m feeling better. We’re half unpacked and certain corners of the house look great. We’ve had visits from two dear friends. It’s good to be back to a coast where people you love might pass through your city. Tomorrow is my last free day before residency.

Here is the thing I want to especially take note of: There is a new emotion. It is the excited melancholy that accompanies the baby’s growth. As I watch her sit and scoot and go about the newly busy business of her day, I am ecstatic — for her because her world is exploding and she is so much more the master of it, for me because caring for her is such hard work and these milestones bring the promise of freedom from that work. At the same time, I grieve. Where is my little baby? I miss the intensity of our initial intimacy, the way she felt in different positions against my body in her smaller form. I realize that the process of birth and growth can only serve to increase the distance between us. Our starting point was a perfect intimacy — her fingers played the crests of my hip bones in the night and my heart beat was her thunder. Now she lunges from my arms to her grandfather’s arm, towards a shiny object on the floor, towards her other parent. As I give her over to her desired target, I both ache and am relieved.

Suddenly I am aware that as a mother I am working myself out of a job. See above re: bittersweet. Sadsweet. Sadsad. Sweetweet. Rinse. Repeat.

Because of my back, I can’t rock E to sleep anymore, so she has learned to put herself to sleep. As I watch her on the monitor make her several turns in the bed before settling, part of me is cheering her on, part of me is so grateful for the extra thirty minutes of time in the evening, and part of me, irrational and dysfunctional though it may be, is wishing that she will cry out for me so I can rush in, curl my body around hers, and sing her to sleep. But instead she babbles to herself a few times more, curls into her favorite position, and falls asleep.

Parenthood and creativity: Try this at home!

First of all, let me say this: all this hubbub about the pros and cons of attachment parenting seems misplaced to me. The working-outside-the-home mothers up in arms. The working-in-the-home mothers up in arms. The feminists up in arms. The attachment parents up in arms. The breastfeeding advocates up in arms. Whose arms are going to be left to rock all the fussy babies? In the words of Anne Lamott: Do we really have that kind of time? Is this the most pressing issue at hand? Can’t we just call parenting parenting, admire everyone who is trying to do it well, and leave it at that? I am reminded of an insight I had back in Jewish day school, when there was much made of whether or not one child or the other came from a kosher home. I remember thinking: Do you think the cattle cars are going to stop to ask? (Forgive the macabre here, but when you grow up as the child of a child of holocaust survivors, the holocaust is an acceptable metaphor in almost any discussion–would you like some tea with your Mengele reference?) Which is to say: Do you think that something as deeply evolutionarily conserved as mothering and growing up from infancy to adulthood is going to be thrown off the rails by the failure to use or overzealous use of a sling? No. Let’s focus on the big stuff (disparities in education, childhood obesity, environmental destruction) or at the very least, the useful stuff (how to worm compost in your kitchen and how to get out of credit card debt are current personal favorites).

But that’s not what I’m here to talk about. I’m here to talk about a concept that came up in conversation recently, a concept that chewed it’s way right past “fear of peeing in public” (do your kegels, ladies) to the inner circle of my mental life. The concept was: Being a primary parent is incompatible with doing creative work. As the person currently doing the primary parenting (for three more weeks), my first thought was: I can still do creative work! And my second thought was: Do I still do creative work? (Note to self: Indignation and self-doubt are more related than you might think).

Creativity carries a double entendre in the life of a parent who is also a creative person. Having a child is considered by many to be a creative act and the creative process is often likened to a pregnancy. Now that I am a parent, I am skeptical of this metaphor. Is a child the same as a poem or painting? As the people who “make” babies, can we be credited with their creation? This does not feel true or right. My daughter is a separate person who I have welcomed into the world through the door of my body. We are going to be hanging out a lot and I’d like to help her discover herself, but she is not going to be a product of my intentions or dreams. Nor is it her responsibility to earn validation on my behalf. Before I became a parent, back when I thought there was something poetic about the idea that having a child is a creative act, I asked a friend if he felt that having a son satisfied his creative urges. “Parenting my son does not absolve me of the responsibility of writing.” In other words: You’re not getting off that easy!

I don’t know why, but becoming a parent has made creative work feel incredibly urgent. If I don’t dream and think and write to understand myself and the world, I fear that I will be lost to the day-by-day intensity of parenting. Having a baby feels like someone has hit the play button on the pause of young adulthood and I can now see the close parenthesis of death getting closer and closer in the distance. All of this urgency is curing a life-long case of perfectionism. Good enough is good enough these days. Good is good enough these days. Done is even good enough these days. Et voila: Sleep deprivation has a silver lining.

A smart older woman once told me “I used to be afraid of death. Now I am afraid of not fulfilling my potential.” Now I know what she means. Time is short! There is so much laundry to be done! Don’t forget to do the hard work of being yourself! Now that I have a daughter, the stakes are even higher, because I want her to have a mother who is happy and self-realized. In my case, writing is part of that.

So I’m trying to commit to being a creative person in the midst of parenting (and being a medical resident — I know what you’re thinking: This plan is fool-proof!). My partner — a fiercely productive creative person — always reminds me that being creatively productive is a matter of prioritizing, so I’m going to try to do that. Maybe dishes are left until tomorrow sometimes and a few paragraphs get written. Maybe a thank you note or two (or twelve — sorry friends and family! I love your gifts and am really grateful, just also really tired and covered in spit-up) languish for a while and a couple of photographs are taken. Over time, perhaps it will add up to something that can be shared and discussed and built upon.

If anyone would like to join me in a pact of parental creativity (like a work-out buddy, but more solitary and intermittent) — I’m game! We can make goals, and hold each other to them, and then be endlessly forgiving when things take longer than planned, and check in and inspire each other once in a while. Email me: