First day

First day of internship: 6am to 9pm. Dickens was on my mind all day: it was the best of times, it was the worst of times. Never have I understood the phrase as I do now.

I didn’t see E awake at all. See above re: the worst of times.

Here are some things I learned today:

— As an intern you spend almost no time with patients. I spent 10 hours of front of a computer, 3.5 hours rounding, one hour in lecture, and a total of one hour in the presence of patients. I have, however, trended their LFTs and perhaps this can replace conversation. (P.S. What did doctors do before computers? How did they fill up the hours when there were no new results flags to clear?)

— You know how they say that matter is just empty space? Well people are just stories.

Too tired to continue writing…… More later.,,,, Gotta get up in seven hours for another awesome, awful day.

Good to the last drop

Yesterday morning my body stopped making milk. I don’t know if it was the chaos of moving, the stress of starting an extremely demanding, high stakes job, or the fact that I have been sleeping for part of the night apart from E in another room in order to add some sleep to my reserve for the long nights of residency, but my body reached a minimum threshold of contact and milk demand and decided to close up shop. When I got in the car and put on my pumps (pumping while driving = how I have survived the past few months), I knew something was forever different. Thirty minutes later, adrift in the endless rows of cars in the hospital parking lot, I looked down at the empty bottles attached to the pumps  — oh loyal, maddening, tireless pumps! — and made the realization that was also a decision that my milk-making adventure was at an end. I called C and told her to save the three ounces that were in the fridge from the previous day — I wanted to give it to E myself — and removed my pumps for what will be the last time for a while.

There is no question that this is a case of my body’s wisdom outpacing my own. Time has never been more scarce and I want to spend all my time outside of work either with E, or, in the 30 minutes after she goes to sleep each night, studying to be a better doctor and writing to keep my humanity intact. Oh, and keeping some kind of live connection with my partner. These will all be daunting enough when I am on a week of seven straight days, not to mention the month of November when I will be working 28 days in a row with only one day off. In this equation, twenty minutes of washing and sterilizing pump equipment morning and night, thirty minutes of pumping three times a day, and night-time feedings do not add up to success or happiness. My job now is to be the best mother I can be under the circumstances and this necessitates that I focus on being present in every sense as much as possible, not sitting on the couch pumping or falling down from lack of sleep.

Still, I cried. Sitting there under the gray morning sky, I remembered those crazy, ecstatic moments in the delivery room when they put her squirming blue body on my chest and I felt her latch on for the first time. I remembered all the middle of the night nursings during that first month when I didn’t know anything about anything and would take E into the living room, turn on the light, and nurse her on the couch, both of us fully awake for several hours each time. I could see her in my mind’s eye, nursing while gazing meditatively at her own hand, then at me, then at her own hand again. Our two bodies have been in such contact! It defies my attempts to fully integrate it, this intimacy we have shared.

But then I was late and had to stop crying and get myself together. To everything there is a season, and in the life of a resident, it is almost always either the time to plant or the time to harvest.

I felt the urge to mark this milestone. The problem with living outside the context of organized religion (Jew-ish/lapsed Jew/can I substitute a decade of therapy for a decade of services?) is that there is just no framework for these moments in life. I googled “weaning ritual” and page after page talked about talking with your toddler about weaning and planning the ceremony with them. Does weaning belong only to the people who have been breastfeeding for over two years? Am I by virtue of having breastfed for six months ineligible to celebrate and be sad? Still there were helpful ideas. Tell the story of the child’s birth as you nurse them for the last time. Say a blessing. Plant a tree. Good ideas all.

So after work today I bought E a little plant that, if tended well, can live as long as she will. I came home and we had a little dance party (aka E plays the Casio keyboard while I do interpretive dance). I showed her her new plant and explained that I will be watering it and tending it as I nourish and tend her, with all my love, that it will be hers when she leaves to begin her adult life (but never really leaves, right??). She looked at it, agape with curiosity and skepticism, and then turned to play with her blocks. When she was ready for her nap, I put the last three ounces of my breastmilk in a bottle and took her up to bed. While she was eating lazily, I thought in a way that was both ode and prayer:

Your life is a double gift: our gift to you and your gift to us.

Thank you so much and you are so welcome.

In Judiasm, there is a prayer that is said over the child, so I said that too: Ye’varech’echa Adonoy ve’yish’merecha. Ya’ir Adonoy panav eilecha viy-chuneka. Yisa Adonoy panav eilecha, ve’yasim lecha shalom. May God bless you and keep you safe. May the light of God shine upon you, and may God be gracious to you. May the presence of God be with you and give you peace.

I don’t believe in a someone in the sky, but I want all these things for E — blessings and safety and light and peace — especially the safety part. Please, universe, keep her safe!

E left half an ounce in the bottom of the bottle and so my last act as her breastmilk-making mother was to pour it down the drain. I like to think it was an offering.

I am the little engine that might be able to

First day: mischief managed. Earnest, kind, smart, engaged co-interns. Compassionate, committed faculty. Training-wise, this will be a phenomenal experience. Feeling extremely lucky.

Personally speaking, I’m beginning to get the lay of the land. Wake up at 5, pump on the way to work, work 12-14 hours, pump while driving home in a desperate hunger for E, hang out with her for 1-2 hours (QUALITY NOT QUANTITY, RIGHT? *strained, pleading smile*), bath, bedtime, some amount of housework to keep up my end of the bargain (see above re: quality), pumping while studying/readying/finishing work/WRITING (please, goddesses, let it be possible), sleeping 1-3 hours less than the recommended amount, then starting it all over again x 5-6 days a week x 36 months.

In the age-old debate over whether women can have it all, I am ready to weigh in very prematurely: Women can have 3-4 things that are really important to them.

Here are the things I’m going to try to preserve: My marriage. My close friendships. My current weight or a reduced weight (IS THERE NOT ROOM ON GOD’S TO-DO LIST FOR ONE SELFISH AND UNIMPORTANT REQUEST?). My sanity.

Here is what I will not give up on no matter what: E’s well-being.

Here are things that will have to be deferred: Fitness. Eyebrow tweezing. Thank you cards. Baby scrapbooking (ok, that was never going to happen). Reading for pleasure. Vitamin D via exposure to the sun. Tidyness (ok, that was never going to happen either).

I am hoping to be a really excellent doctor.

Too much to ask?

Quick! Only twenty minutes to write a poem:

Dear you

Dear you, who have mastered so much

Growling, for one,

Whose fingernails fall to the ground like tiny flint specks

as your legs flail and your gums echo your lips impotently

Are beginning to known gravity’s grab

Can be as wooed by waves of reflected light on the pond’s surface

as by a towering giraffe bowing its legs outward to drink

Can absorb with aplomb so much desperate, lunatic love

that we are not yet the masters of, your two lunging

drunk labile lovers. Avid always while awake,

small sylph, teach me how to inhabit my body

with curious fervor, no skin

can contain

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.

The shadow life

Today is my birthday. I am now the age my mother was when she had me. This feels significant, as though the major epochs of my life are framed by the major epochs of hers. I feel as though I have moved from the on-deck circle to the plate (note: I believe this is the first time I have ever used a sports metaphor. I hope it works.) and I’ve got a few chances to do things right before retiring to the coaching staff and gaining forty pounds of beer weight (unless I never lose my baby weight, in which case I’m already halfway there). Some of the basics are in place — part of my life will involve medicine, another will be centered on my partner and my child(ren). Life is pretty good, which is a worrisome state for a writer — not a lot of successful books out there called “Life Is Pretty Good” — but a happy state for a person. An age of anxiety is over and one of steady building has begun. Still, some things still feel mysterious — my creative life, my spirituality, which has gone through many iterations, my role in the larger community (e.g. the world is so beautiful and so broken! How can I add to the former and repair the latter?)

This gets me to thinking about a quote I read in a book once about how there is a shadow life apart from the visible life of jobs and family, a shadow life of dreams, impressions, sensory experiences, inner visions, desires, and unspoken aspirations, a life whose successes or failures can be totally separate from those of the visible life and can be even more important to the happiness of the individual. I am beginning to think that this is where the fire is, what you run from, but hopefully eventually run towards. This is not to say that the visible life isn’t full of deep satisfaction, delight, comfort, and insight — it is! It is where the purpose and structure can be found. But the shadow life is the one you come in with and leave with, the life that belongs to only you. It is the life that no one can take away, even in the midst of tragedy and brutality. In this life there are no value judgments, only experiences. This life can intervene in the visible life for ill — desire that leads to infidelity, obsessions that interfere with work, addictions that drain resources and energy — but it can also be the catalyst for all the most meaningful things — love, creative production, innovation, resistance in the face of injustice.

As this new year begins, a year in which my visible life will be very crowded and demanding, I feel ever more drawn to the shadow life, to the life of experience and the experience of life. The assumption is usually that increasing age brings less and less engagement with the shadow life, but for me the opposite will have to be true, since my younger years were full of worries and exams and practical reasons for not doing many things. With every year I am more fearless, and thus ready to run straight into my own being with curiosity and without judgment. What will happen? I can’t wait to find out. Growing up is so suspenseful….

I used to write poems. I used to write a poem every year on my birthday. Ok, I only did that twice, but it was a good idea. So here goes. It’s 11:33pm, so I have 27 minutes. I haven’t written a poem in over three years, so it seems like a good idea to write one quickly, right now. After I write it, I’ll want to erase it and this paragraph but I won’t.

vanishing point

I looked over a candle
at you                         nothing an opera glass couldn’t see
could be seen                             except you
looking back at me                                     and finding
a point of orientation
in the space between a flame and the sky

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:

Mothers are nuclear fission

Here’s what I mean: they make energy out of nothing for years and years and years. Here’s what amazes me about my mother: She is trying to heal the world by loving. Why don’t we all do this? But back to nuclear fission. Mothers give and give and give. How do they do this?

Today is the day on which mothers are celebrated and I want to think out loud about the importance of mothers and their alchemical, energy producing powers. I recently became a mother and the experience was less one of self-transformation than one of giving my body up to a much more efficient and high-functioning inhabitant. When it is 7am and I have slept for three non-consecutive hours and I am bathing my baby and washing between her tiny toes and remembering to talk to her about all her body parts as the developmental experts recommend, I am amazed. Who is this being who does and knows and keeps going? Who is this mother that I am? When I speak about the power of mothers, it is not an act of self-congratulation — the procrastinating, stagnant, anxious me is still doing the writing — but one of amazed spectatorship, at myself and all the other women who have become totally and permanently reliable. May the alien invasion never end!

First, I think of my mother, from whom I learned what it is to be fierce in love. Here is the image that surfaces: Calling my mother in the middle of the night some semester of college before my first final exam. I am in tears. Why? I don’t remember, but something along the times of: I don’t think I can do it. What am I doing? Who am I? In other words, the easy stuff. My mother, though awakened from deep sleep, is instantly wise. Somehow she makes herself bigger than my fear and self-doubt. The embrace of her being-there-for-me untangles me. I don’t remember what she said, just that when I got off the phone, I felt more capable. In this case, cliche says it best: I could not have done it without her. Where “it” is my own becoming.

When I was pregnant with my daughter, I wondered: How can I do as good a job at this as my mother did? When my daughter was born, I realized how physiological mothering is. When she cries, my body rises to meet her. My heart rate goes up, my blood pressure rises, I am sharpened and primed. Also, mothering teaches you how to mother. It is not like instant soup. As she grows into a new phase, I am at first awkward, then comfortable, then agile, just as she is ready to morph again. As her repertoire of capabilities grows, so does mine. And retained within both of us is the memory of all the stages that have come before. As a mother I know her becoming because I have witnessed its every wrinkle and crease. Nineteen years from now when the phone rings in the middle of the night, if I am able to comfort her, it will be because I will have comforted her so many thousands of times before.

So the alchemy of motherhood is due to physiology, to repetitive practice, and to paying close attention. But even greater than these is desire. My desire for my daughter’s well being is the fiercest desire I have ever known. It recasts every other desire I have known — for success, for food, for approval, for sex — as a mild whim. I am a tempest of want and the object of that want is the safety, health, and happiness of this little person. Desire keeps me lucid. When I am washing my daughter’s toes in the dawn light, when I am rocking her and rocking her and rocking her to sleep, when I am checking on her every ten minutes to make sure she is breathing as she sleeps,  it is my desire for her life that moves me and multiples me, that explodes me into more than myself.

So here’s to mothers, who desire us — first into being, and then into life, and then into living. And here’s to the mothers we have become. Who knew we would one day be so fierce and so capable? And here’s to our children, the catalysts.

In medias res

There is nowhere to begin but in the middle.

In two weeks, we will be moving across the country with our five-month-old so I can start my residency in pediatrics. I will go from spending all but twenty hours of my week with my daughter to spending eighty hours a week at work. My partner, who has been in graduate school thinking about art full time, will become the primary caregiver. We will be in a city where we know no one. Clearly, this transition will be seamless.

Now you might be thinking: Surely, you knew this day would come. It’s not like I had one too many drinks in Vegas and woke up with a medical degree. I went through a six-month application process to secure a residency spot and six months of fertility treatment to become a mother — no surprises there. So yes, I did know this day would come, in the same way that you know death will come. But as with death, you always feels like you probably have one more day.

When I was thinking of having a baby, I asked every woman I met in medicine who has children when is the best time in training to take the plunge. I even met a woman who had had a child in medical school, one in internship, one during fellowship, and one as a new attending — a one-woman data set. The consensus from everyone was threefold: There is no good time. Not during intern year. The best time has already passed. So we decided to go for it during a gap year between medical school and residency. I looked around at all the residents, fellows, and attendings in the hospital with their breast pumping bags and I figured “If so many people are doing it, it must be possible.” And so is born hard-won-wisdom #1: If everyone is doing it, it is probably possible, but no one will tell you the truth about the costs. Because women are rarely honest about a) their weight, b) how much childbirth really hurts and many other puerperal realities (more on that to come), or c) how &*%@ing overwhelmed they secretly feel (more on that also to come).

So now we have an absolutely stunning daughter, and I say this with all the objectivity of a mother — I mean pediatrician. She is a happy, curious, active child who miraculously fit in from day one with the rhythm of our family. She can really work a room–lighting up everyone in her path with her full-face smiles and piercing, wise-before-her-years level of awareness. (Where she got this natural social talent, I cannot tell you — yes, over here, I’m the one asleep on the couch because I drank half a beer too quickly.) In short, Little E is a gem. When they say “It’s all worth it” (second only to “They grow up so fast” in terms of aphorisms most often heard as a new parent), they do not lie.

To put it simply: I do not want leave her to begin residency. I REALLY do not want to do this. It feels unnatural, violent, insane, like traveling back in time to have dental work before novocaine. But there are other simple truths: I am in a hole of student loan debt that only a medical career can fill. And more complex truths: I love working. I love medicine. I am at my best when I am in the hospital, and then better as a mother when I come home — sharper, softer, more able to attend, more grateful and humble and in awe. I miss her so much when I have to be away, but feel restless and unused when I go too long without exercising my doctor muscles.

I don’t know what the right answer is to this conundrum, just that for the moment, I have to move forward and try to give myself as fully as I can to both endeavors. I’ll be honest: I don’t know how I’ll do it. I don’t know if I’ll be able to do it. It’s not that I doubt myself, just that I can’t imagine it. But soon enough, there will be no need for that–the pendulum of doctor-mommy will be released and I’ll either be swinging it, or getting knocked repeatedly in the head. I hope you’ll join me on the ride. I promise to be honest about how great it is and how much it sucks.