Monthly Archives: April 2008

The talk

S, my nine year old, stayed home from school today. He said that his stomach felt “weird”. He rarely stays home sick, he just got the honor roll again, and I was already considering playing hooky today. So, I kept him home with me.

Well, I should say, I dragged him to school with me. I don’t feel bad about it, he gulped down two pieces of sausage, a biscuit, and hash browns in the school cafeteria while chattering away. I had to pick up an HIV test from the clinic, drive it to the local Department of Health, and talk to their HIV training coordinator about training new testers in the fall.

S loves science. I told him about AIDS. He was enraptured, asking all sorts of questions. When we got to methods of transmission, I mentioned sex.

Since we are studying reproductive endocrinology lately, I have been staring at the ticking clock of the time left before S hits puberty. Literally. The bar chart of age and the different pubertal developmental changes in the male adolescent was projected in all of its 20 foot high glory at the front of our lecture auditorium during class the other day. My classmates were busy scribbling notes, and I was staring in horror at the two years left before Tanner stage 2, before I have “the talk” with my son.

It seemed to come naturally today. We talked very little about the mechanics of sex. I talked more about the timing of it, pregnancy, disease (well, that is what lead into it), and some of the social aspects and emotional issues involved. I had already been telling him about AIDS for about ten minuets at this point, and after a five minute intro to sex, he was a little overwhelmed. He told me that he wanted to hear more about it, but not now. I asked him if he would rather learn about it from a book or from me, and he said me.

Whew! Not so bad so far.

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Happy birthday!

Happy birthday, Cablegirl!

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Music Monday – Wild Sage

I miss being part of the Music Monday community, but med school has been really keeping me busy.

I had a rough morning this morning, making an effort to spend time with my kids, and they made the effort to be especially difficult. I have a final exam tomorrow, and I knew I would be spending the rest of the day studying, so I really wanted to cram in the quality time. They want to cram in the contrariness, so it was frustrating.

While studying, I was listening to Pandora radio online, which I have really been enjoying. They let you enter in “seeds” for your station, which are artists or songs. Then they construct a radio station based on your seeds. When I created this station, I put in a sort of obscure band, the Mountain Goats, a sort of recent discovery of mine. I tend to zone out and not listen to the music, but the Mountain Goats are already a special favorite I keep one ear open for, and the lyrics of the chorus in particular made me perk up:

Wild Sage by the Mountain Goats

“and some days I don’t miss my family.
and some days I do.
and some days I think I’d feel better if I tried harder.
most days I know it’s not true.”

I can’t embed, so please click to listen to the whole song.

And, here is a bonus: This Year, also by the Mountain Goats.

“I am going to make it through this year, if it kills me.”

I wasn’t sure a singer could be more elicit more emotion from me when listening than Tom Waits, and John Darnielle can, easily.

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The intimate world of medicine

No, this is not a post about Ob/gyn.

When I am in lecture and studying, I pay attention to the language choices that my professors make. Sometimes they are funny, sometimes they are amusing or annoying, based on the level of fluency of a foreign born teacher. Sometimes they are sweet.

“What is the nucleotide intimately involved in microtubule assembly?”

One of our biochem teacher uses the term “intimate” to describe biochemical interactions often, and she isn’t even the one who wrote this question. Sigh, biochem is so touchy feely.

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Swoon!

Ani di Franco had a

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Back pattin’

I am going to take some time out to pat myself on the back a little bit. I presented a paper to our journal club today. It was a research article from the green journal about uterine rupture and vaginal birth after cesarean section (VBAC). The journal club meeting consisted of two professors, one from the school of public health and one who is a retired ob/gyn, and is the faculty adviser for our ob/gyn student interest group, and a larger group of students than we have had at any research group meeting before. (Guilt works!)

It was a great discussion. Our faculty adviser is great. Don’t get me wrong, we don’t see eye to eye on everything. His idea of reproductive choice does extend to elective cesareans and abortion, but does not extend to out of hospital birth or VBAC. Well, he has done VBACs, but that was in the 80’s when they were supported by ACOG. I think ACOG does still support VBAC, but he thinks it is too big of a malpractice risk.

We did have a decent conversation in which I got to make the point to everyone in the room that they needed a HUGE pool of births to get any appreciable number of uterine ruptures. It is such an small risk, less than 1/2 of 1% in this study and 20% of both groups were augmented with oxytocin, which has been shown to increase risk of uterine rupture. Our faculty adviser, at my request, explained the pathology of uterine rupture. I wanted the journal club group to know (despite the grisly description of the risk of neonatal death and hemorrhage in the journal article) that it is not as dramatic, in the vast majority of cases, as its name sounds. It can be a simple separation of muscle tissue, and is sometimes so asymptomatic that it is never diagnosed, or is diagnosed years later after a hysterectomy, as a side note when the tissue is examined.

I slipped in that the “success rate” of vaginal birth in VBAC trials (75%) is higher than the vaginal birth rate in most hospitals in Miami-Dade county (around 50%). And I read aloud the conclusion of the article, which states that many women might find this low rate of uterine rupture to be an acceptable risk.

Oh, and back pat #2. A friend of mine who lives in Portland, Oregon, told me that this post was read, with credit to Ms. Tinfoil Hat, on a show on Portland Public Radio, clear across the continent. Wowie, I am a blogebrity!

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Tinfoil hat on? Check!

plasticsurgerybook1.jpg The natural idealist freak mom is peeking in, and pushing the med student aside for a minute here.

Uhhhh, you have GOT to be kidding me.

Here is the review of My Beautiful Mommy at Feministing:

“”My Beautiful Mommy” is aimed at kids ages four to seven and features a plastic surgeon named Dr. Michael (a musclebound superhero type) and a girl whose mother gets a tummy tuck, a nose job and breast implants. Before her surgery the mom explains that she is getting a smaller tummy: “You see, as I got older, my body stretched and I couldn’t fit into my clothes anymore. Dr. Michael is going to help fix that and make me feel better.” Mom comes home looking like a slightly bruised Barbie doll with demure bandages on her nose and around her waist.”

Uh, my goodness. I would SO be cast as the evil jealous step sister with the saggy stretch marked tummy in one of these fairy tales.

I can just imagine the subtitle: “You made mommy ugly, and the doctor fixed it!”

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