Book Nook

One of my favorite things about well child exams is giving out a new Reach Out and Read book.  It seems like a small token, but I love seeing the look on children’s faces as I give them a brand new book and encourage reading together as a family.  So when my own son went for his 6-month-old check-up, I eagerly anticipated what book his pediatrician would select for him.  We had plenty of books for him at home already and had been reading with him since birth, but the message that a book as a prescription from the pediatrician sends is one that I think is important and special.

Imagine my disappointment then when my son showed no interest in books for the first year of his life.  My husband and I have a combined 18 years of higher education, an entire wall of books (literally) in our living room, and a hobby of reading at our local bookstore on Saturday mornings.  How can we have a child who doesn’t like books?

ImageThen, he finally showed an interest in books and started doing the cutest thing.  One at a time, he pulls each book off his bookshelf until he finds one of his 5 favorite books.  That’s not the cute part though, that’s the frustrating part that I have to clean up.  The cute part is that he then takes that book, walks over holding it horizontally and attempts to insert it into your mouth.  I can only imagine that this is because that’s where words come from.  This technique is then reinforced by us reading the book.  He might be a genius.

I am thrilled that N is finally showing the passion for books that his father and I share and I know that this will only grow as he does.  His early favorites are diverse, a little comedy, a little counting, and include one of his pediatrician’s Reach Out and Read selections.  I can only hope that my patients enjoy the books I give them as much as N enjoys his, and I hope their parents find the same happiness that I do in watching him make his selection, feeding me the book, and then sitting in my lap to embark on a literary adventure.

Here are N’s Top 5:                                  Image

1.  Max’s Bedtime by Rosemary Wells

2.  Happy Baby Colors by Roger Priddy

3.  123 Philadelphia by Puck

4.  Brown Bear, Brown Bear, What Do you See? by Martin and Carle

5.  Harry the Dirty Dog by Zion and Graham

Bite Size

When we started looking into daycare, we immediately eliminated centers that had a strict “no biting” policy.  Although our son was only 10 months old at the time, we had a feeling he might be a bully.  Sure, biting is a normal behavioral phase for some kids, but not all kids bite.  Our son always has a look of mischief in his eye, so we thought we should be prepared.

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Now that he’s 14 months old, it wasn’t a surprise when his daycare teacher told me there was a “biting incident.”  What was a surprise though was that he was the victim!  A not entirely blameless victim, however, since the biter did so after he tried to steal his/her food four times.  Sure enough, on the back of his arm was the red outline of a full set of toddler teeth.  Although my first mommy instinct was “which one of you little brats bit my baby,” I was relieved that the perpetrator wasn’t ostracized, as we might soon be on the other side of this situation.

While toddler biting isn’t really bullying, it jump-started my thinking about how I would handle bullies or bullying when N gets older.  The next day, I was at the Philadelphia Pride Parade and overjoyed to see the Care with Pride float, a new partnership between Johnson & Johnson and Walgreens that created a campaign to end bullying and make schools safe for all.  The message nearly made me cry, looking at the hundreds of LGBT youth around me along the parade route and thinking about the bullies they face regularly.  I thought about the bullies I saw in high school and remembered the racial prejudice that my best friend Sophia, a Korean American, and my sister, a Chinese adoptee, faced in our homogenous hometown, an upper middle class White beach community.  It’s almost too painful even to type the racial slurs that were used, or the facial gestures that were made, or the ignorant comments that were slung.  When my sister moved to Vermont and started at a new school, her principal introduced her to the gym teacher, who responded “does she even speak English?”  This reminded me that bullies come in all sizes.

In a few weeks I will start my new position as an attending physician in a South Philadelphia pediatrics practice.  Just two years ago, the local South Philadelphia High School had a period where Asian students were being bullied by Black students, with at least 30 students becoming injured, resulting in a school boycott and pleas to the U.S. State and Justice Departments.  I have had Black and Asian students from this school in my office and have discussed both sides of this dispute with the ultimate message that school should be safe for everyone.  I am reminded now to continue to repeat this message to all my adolescent patients.

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My reality is that I am raising a White male.  I often think about how I will teach him about race, gender, and sexuality.  I was guilty of believing in the “Diverse Environment Theory,” which is that if you raise a child with a fair amount of exposure to people of other races and cultures the environment becomes the message, as Po Bronson and Ashley Merryman describe in their book Nurture Shock.  I thought that the examples of bullying and discrimination that I described from my youth happened because I was raised in a New Jersey suburb, but that growing up in Philadelphia, my son would be more culturally sophisticated.  Bronson and Merryman review a number of studies and case scenarios that show that the diverse environment alone isn’t enough and that parents need to openly discuss race in order to teach children the messages we want them to learn from us and not the wrong messages that they could potentially learn from society.  The incident in South Philadelphia highlights how true this is, but also how ambiguous parents and schools can feel about openly discussing racial differences in an era of desegregation and equality.

Just as we are reluctant to discuss issues of race, we are also hesitant to acknowledge and teach young children about gender and sexuality.  I have moved these discussions into my parenting register, so that he will not only grow up in Philadelphia’s gayborhood surrounded by his Asian aunt, Black babysitter, and his parents’ gay friends, but that through our discussions he will be aware and respectful of the differences between these people and celebrate them.   My dream is that he will also know that he is free to be who he is and is safe doing so.  Before tackling these complex issues, I think we will start with learning respect for other’s food to prevent future bitings!

Carpe Mentor

Some mentors are assigned, some develop organically, and some are chosen.  I met one such mentor as a medical student, when I saw her running from meeting to meeting, patient to patient, and in between calling her daughter to find out about her school day.  She has a national reputation and balances life as a clinician, educator, academic, and advocate, all the while maintaining an equally strong identity as a mom.  Throughout residency, she continued to impress me, so as my chief year comes to an end, I figured I should carpe diem and not only learn from observing her but ask her the secrets to her success. Luckily I chose a mentor as crazy as I am and she enthusiastically and immediately made plans for us to get coffee.  I believe that one should have many mentors in their life, maybe mentors for each aspect of your life, but this person could mentor me in many domains and my life would be richer as a result.

“How did you manage to reach the level of success you have in your career and still have a close relationship with your husband and kids,” I jumped right in with the “how do you do it all” question before she had her first sip of coffee.  “It’s not easy,” she warned.  We both smiled though, because we know that nothing about being a woman in medicine is easy, nothing about being a mom is easy, so why would the combination of the two become easier.  “Ok, there are 3 components to my success that I will share with you.”  And this is her recipe:

1.  A supportive husband.  You have to have a husband who is willing to work outside typical gender roles, be an actively involved father, and have more flexible work hours than you.  Check.

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2.  Subscribe to the “Turtle Theory” of parenting.  This, she informed me, is when you spawn your children on the beach and then wave goodbye and wish them luck in the ocean!  I laughed because I thought she was kidding.  She went on to explain that she wasn’t the mom who micromanaged her kids’ homework or who was at every soccer game or tennis match.  She set expectations for her children that they would be independent, responsible, and productive.  There were a number of hilarious stories to follow of times when her kids were none of these things (like when her one daughter ate her soccer fundraiser box of candy bars instead of selling them, costing her $120 each year), but in general, she had a routine that allowed her to work long hours and her kids to become successful members of society.  This was in part due to the help of her husband, mother-in-law, and a series of au pairs (in spite of one misstep with a “hoe-pair” who slept with everyone in Philly).

3.  Luck.  She made no excuses for the fact that some of her success was due to pure luck.  She had an amazing husband, easy kids (“one was on auto-pilot since birth”), and a career that grew out of accidental opportunities that presented themselves at the right time.  This piece she admits was a crucial component to the whole story.  She knocked on her wooden desk as she said this, as if there was still a chance it could all come crumbling down.

In the end, her message was that you can be a productive physician mother if you work hard enough.  You need a village of support and to let go of the idea that you can simultaneously climb your career ladder and bake cupcakes as the school room mom.  You will miss things, either at work or at home, but she endorsed leaving work at work whenever possible to avoid that eventual creep into your personal life that comes with over-achievers and technology.  Your children will have other people in their lives that fill the role of mom when you can’t be there, and you need to be ok with that.  Most importantly, your kids will be fine and grow up with respect for your career, admiring your success, and aspiring to find their own passion like you.  She talked about how on Take Your Daughter to Work Day, her daughter met the hospital CEO, watched her mom give a speech in front of the press, and had her picture taken with the Governor, and she told her daughter that “no matter what the other girls did, you win.”  We agreed that we aren’t the stay-at-home type of moms anyway, so we need to let go of thinking that is the standard by which we should judge ourselves.

Her story may depress some of you, as it isn’t one where everything is perfect or one that is easily emulated.  For me it felt like the permission I needed to continue on my current path, a path that her generation stamped out in a man’s world, that now allows me not only to be a physician, but to be a mother, and maybe even to be better because of it.  This “hour of relaxation” as she called it, refreshed me.  “Katie, you know me.  I’m sure my kids didn’t want me around any more than I already was because I would have driven them crazy.”  This time I laughed because I knew it was true.

Bedtime stories

Some days the only time I have to spend with N is during his bedtime ritual.  It’s odd that the beginning of our day is the end of his.  We have a dinner, where some overcooked pasta, diced veggies, or broken meatballs end up stuffed in his cheeks, a sippy cup is tossed off the tray and repetitively retrieved, and I manage to pretend enjoying whatever it was I ate between all the exercise this mealtime dance offers me.  We then go upstairs for bathing, playing, slathering with Aquaphor, wrestling into pajamas, and reading a story with a bottle of milk.  While B and  I often share many of these duties, they are all precious to me.  They are the way I say, “I may have been gone all day, but I’m here now and I love you.”

As we read together, I think about the message that each book conveys and how these stories will shape the man he becomes.  Ok so sometimes we are just looking at pictures of shapes or farm animals, because he is 1 after all.  But today I spent a long time looking online for children’s books about working moms and was dismayed to find a very small selection.  A friend gave me one about a mom’s high heel shoes and while this one acknowledges that the mom leaves for work, looking stylishly uncomfortable, it doesn’t address any of the other issues around separation.  It doesn’t explain who will fill mom’s shoes while she’s gone and what that does to the structure of your day or why a mom might choose to work and how that makes each family member feel.  A friend said that N wouldn’t need a book about that because it’s all he’ll know, which is true since I went back to work when he was 6 weeks old, but I don’t think I’ll get off that easy!  Given that I have a lot of questions about this decision myself, I can only imagine that my little guy will too.

I’m still crafting my answers to all those questions, but the bedtime story I tell myself is that my working will teach him ambition, dedication, passion, sacrifice, pride, equality, happiness, and honor, because that’s what it has taught me.

Lactation Badge

I breastfed my son for one year.  At the end of the year, I felt as if there should be some award ceremony, a certificate of completion, or a badge–  some token to reward me for a year of Q3 hour wakings, pumping, sore nipples, more pumping, navigating public breastfeeding without indecency, and more pumping.  Returning to work after 6 weeks with a newborn on a vertical growth curve was challenging to say the least.  I measured my success as a mom by how much milk I was able to provide.  Because after all, I might not have been there when he woke up, or when he needed his diaper changed, or when he wanted to play, but I sure did provide him milk and some days that was my only contribution.  So I worked hard at it and that kind of hard work is usually rewarded.

In practice, I have met so many moms who repeatedly say, “I just can’t do it for more than __ months.”  Everyone has their limit, and I certainly said the same thing many times.  Sharing my own experiences though I am able to offer some hope– it gets better, it’s worth it.  It may be hard to see the benefits when you are exhausted and the months ahead of you seem endless.  Eventually though, you gain the perspective to see the reward:  that cute, chubby breastfed baby who is healthier because of you.  Some of my best memories are with his cheeks flushed, his belly full, and his head snuggled on my chest.  I remember looking at him at 6 months and thinking, I grew you.   What better reward is there than that?

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