Rants from the Crib

An Ob/Gyn gone mad

Archive for the month “February, 2014”

Traveling Guck

The first time I was ever to travel to work, I was finalizing my packing the night before when my daughter came to me. She was clutching a stuffed duck.

My daughter has a long history with ducks. When she was about 18 months old, she became obsessed with ducks. Her battle cry: “GUCK! I WANT IT!” Her doting grandmamma (and Mommy) couldn’t resist picking up every duck she saw – ducks are cute, after all.

Her Halloween costume that year was even a duck. She amassed a collection of stuffed, bathtub, and toy ducks second to none. One of these was a diminutive Gund; their answer to a Beanie Baby. He was a mallard, and his name was Guck.

The night before I left, my daughter came to me clutching Guck to her. “I want you to take him with you,” she said. “So you don’t forget about me.” My poor little Stink! How could she think I would ever forget my own daughter?!

I embraced Guck and found a place for him in my backpack. From that day on, he became my traveling Guck. I remembered the gnome in Amelie, and how she photographed him at travel destinations around the globe, for her Papa who had wanted to travel. I decided Guck would commemorate my travels, and my daughter would receive Guck updates.

Guck is now exceedingly well traveled. He has been out of the country numerous times, and has trekked through every airport in the country, almost. He has survived all manner of travel mishaps: a night in the Denver airport on the floor, a stay in the hotel from the Shining while stranded in Minneapolis-St. Paul, and an extremely bizarre flaming Kindle incident while on board an airplane. (https://beadstork.wordpress.com/2013/12/20/kindle-fire-no-really/)

This gallery is dedicated to my brave Guck and his world travels – may he go on many more!

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Shooting Kids

I know, we’ve all been tempted, right? It’s not what you think. If you want to accuse me of using a sensationalist title to draw in readers, fair enough. Guilty.I’m referring to photography. I am an amateur photographer. I like to photograph many things, but one of my favorite things to do is shoot kids. Think of it as going on safari. You stalk them, you grab pictures quick when they’re not moving, and do lots and lots of deleting later.

I am by no means a pro, but I have found over the years that there are some things that can help you get good kid pictures. (Or any pictures, for that matter).

First, closer, closer, closer. I have read this advice numerous times from photographers who are professionals, and I don’t think that this can be emphasized enough. Pictures whose subject is in one corner of the photo are not good photos. They look messy, and busy, and you really can’t tell what the picture is even supposed to be illustrating. Also, all sorts of photo bombs get in there. Make sure your subject (in this case, the kid or kids) completely fill the whole frame as much as possible.

Snow Girl

Snow Girl

You will also of course need to include at least a portion of what they are focused on – a ball field, a swing set, etc. But you really don’t need to include the whole object of attention – just enough to get an idea of what it is.

Snow Fort

Snow Fort

Second, if your camera has a sports setting, turn it on. The ability to take multiple photos in rapid succession is very important if you are shooting kids in motion. If you take a ton, at least one or two of them will turn out well. If you only take a couple, you most likely will not get anything worth keeping.

Honest Work

Honest Work

If you are outside, turn that flash off. It will only delay the clicking of the shutter if you are in a hurry to get multiple photos. Often, you can get away turning the flash off inside too, if you have a good DSLR camera that can compensate with correct aperture and f-stop settings. Take a couple photos inside of the same subject, with and without flash. If the quality of the no-flash pics are acceptible, turn off the flash.

Don’t pose your kids, except maybe for a few final pictures of them all together, with a finished product. Say they are making a snowman. You want to catch as many action photos of that as possible. You can pose them at the end, with the snowman, to insure that all the kids are in the pic and facing the correct direction. Just remember that most kids quickly sicken of posing for photos. They want to be DOING something. They will soon ignore you, and the stupid faces and stupid poses will rapidly ensue.

Girl and Guck

Girl and Guck

Make as little fuss about the camera as possible. Don’t even mention that you will be taking pictures. Try to maneuver at as much distance as possible, with the lens zoomed in so that the subject is well framed, so your presence is unobtrusive. The kids WILL notice that the camera is there, and at first they will clown around and act crazy. Get a couple of pics of this – one of them might be cute. Don’t ask them to pose or not to make faces. They will soon acclimate to you and the fun at hand will soon take precedence.

Look Out Below!

Look Out Below!

Now, snap snap snap. Set up your photos by establishing yourself at a point distanced from them (this is where a long range or zoom lens comes in handy) and adjust focus and zoom until the kids are more or less filling the full photo frame. Test focus on one of the kids – that way the focus will be more or less established when you are ready to snap. Hold the focus, and pan after them with the camera. Adjust focus as necessary, and as soon as one turns their head so that their face is towards you, especially if they are smiling, snap, snap, snap. Stop when they turn away. Focus on a different kid if that one is faced away from you. Make sure you try to frame both kids if you have the opportunity to show them interacting, particularly if they are both faced toward you. Again, snap, snap, snap. Get ten or more pictures if you think you have a good composition. You will edit them later.

DSC_0077

Just remember, especially you older folks, that the camera you have is now probably digital. That means you have NO FILM. Back in the day, only pro photographers shot this many pictures, since film development was slow and expensive, especially if 90% of shots are discarded. My mom has been an amateur photographer since before I was born, and she is still timid about snapping multiple photos. There IS NO FILM! Your picture taking now is only limited by the size of your SD card and your patience with prolonged review and deletion of photos. Make sure you have an extra SD card – you may fill this one. An extra camera battery is also a good idea.

Be prepared later on (preferably later that day) to download and look at a LOT of photos. The kids were in constant motion, and most of them will be blurred, or the kid will have turned away at the last moment, or they may have a weird expression on their face. Or, the composition of the photo may just be crappy. DELETE, DELETE, DELETE. If you wouldn’t want to show anyone else the photo, or wouldn’t want to look at it again, dump it. The other day was a snow day and I took almost 800 photos – filled an entire 16 GB SD card. You DO NOT have room in your computer for this many pictures. DELETE. Out of those 700+ pictures I took that day, I deleted until I had less than 100 photos left. Then I made a second and third pass and got them down to less than 50, but those were really good.

DSC_0045

You don’t have to be an expert with photoshop to improve your photos. I certainly am not. Most computers come loaded with a photo processing program that is free and reasonably intuitive. All I really do is correct red eye and crop. You can accomplish so many improvements with these two edits! Never print out or upload photos to Facebook, or anywhere else, if the people in those pics have red eyes. Those photos are instantly crap. No one wants to look at vampire people. Red eye correction is super easy to do.

Cropping is the other massively useful ability. You may have a good picture, but it may have been taken from too far away, or there may be photo bombs around the edges of the pic. Crop. If you have a decent digital camera (and they’re all pretty much decent these days) the crop will still have good resolution and not be grainy. If you think the photo would be better composed if just a portion of it was used, crop. You can always undo this before you save. You will develop a feel for the most pleasing ways to crop pictures by moving around the crop box if you do it enough.

Kissy Face

Kissy Face

Hope this is helpful! Probably most of you don’t need my advice, but these are tips I’ve found useful. Happy hunting!

Shrike

When I was in residency in New Orleans, I met a remarkable boy. We didn’t have a relationship, in the normal sense, but I was deeply intrigued and felt drawn to him.

He was apparently the orphan son of very wealthy parents, and had been allegedly left with a large inheritance, enough to make him more or less independently wealthy.

Despite this beginning, which usually results in fairly useless, undisciplined people, this guy had smarts, and had gotten himself through med school and into a residency in New Orleans, where he was doing very well. That is where I met him.

I actually met him in Houma, Louisiana, a little shrimping bayou town just on the far side of the Intercoastal Waterway. Our residents were required to spend half their time there, when they weren’t working in the New Orleans hospital.

The Houma situation was as far from the New Orleans situation as could possibly be imagined. We worked there at Chabert Hospital, since closed down, called Little Charity, as it was a branch of the Catholic Charity Hospital system in New Orleans. The town was poor, the inhabitants were poor, and the hospital was poor.

The residents stayed in free apartment housing during their rotations there. The apartments were located behind the hospital itself, within walking distance, so you could stay there when you were on call. The apartments were ancient, and notable on my part for the fact that the entire ceiling of my apartment once fell in without warning, and for the fact that they had pulled a six foot alligator out of the decrepit swimming pool.

This guy and I met at these apartments. He was single, and the single residents sort of gravitated toward each other. He and his best friend, also a member of his residency program, tended to gravitate more towards strippers than to fellow residents, but I lured him in with my fabulous video game system, bought more on the “If You Build It, They Will Come Theory” than to my predilection for video games.

I got a lot of single guys to come over and hang out for beers and video games. I am no idiot. He was one of those guys, and we got to know each other during late night beer and video-fueled chats.

He was a pretty remarkable guy. He was very very bright, and good at what he did. He was also a big birdwatcher, which is an adorably geeky pastime, and guaranteed to draw me in, as my father was always a big time birdwatcher too, which made this guy instantly appealing.

When we walked around outside, he was always showing me birds. He pointed out a shrike one day, on a barbed wire fence. He explained how the shrike would catch food, usually some kind of insect, and leave it impaled on the barbed wire or a twig for later consumption. I thought that was amazing.

We seemed so close to hooking up. He used to hang out in my apartment, lolling about on the carpet in a manner that seemed to me to invite me to join him, but I never did. He was too handsome, and too cool, and too rich, and I was terrified of rejection.

This guy had an amazing car. I am a sucker for awesome cars, always have been, probably due to the fact that my father revered antique Chevys, which he worked on himself. They were all V-8’s, and my first car ever was a V-8 Chevy, around 1960 vintage, The thrum thrum of that awesome engine and the amazing speed with which that immense car got off the block left me loving automotive power.

So, the guy had a brand new red Supercar (unusual and expensive enough that I will not name the model here). Even had he failed to have any of his many other charming attributes, this one fact alone would have drawn me in. He and his friend and I would cruise out to the few clubs in town, not as a date, but to go dancing, and, for them, hang out with strippers. The best part of this for me, besides the clubbing, which I enjoyed, was the fact that when he and his friend became too wasted to drive, they would let me drive the car home.

The most intimate evening we had together was, at best, an oddity; one of those strange things that happens, but I will remember it forever.

He was hanging out in my apartment, and we were listening to music and drinking beer, and he remarked that he desperately needed a haircut. “I have a Swiss Army knife,” I told him. “I can cut it.” For some strange reason, he was intrigued by that idea and thought that was a good plan. I sat on the floor with him, and cut his hair with the scissors on my good old knife, and amazingly, it turned out great. He thought that was the coolest thing ever, and told anyone who would listen at work the next day about his haircut.

I guess maybe he liked me. I was in a dark time then and had just been dumped by a 5-year emotional terrorist, and had no self-confidence to make an aggressive move. I have always regretted that I didn’t.

For years I remembered him, how handsome he was, and how smart, and his love for birds and medicine and fast cars and video games and dancing, and I wished things had turned out differently. I wish I had pushed just a little bit to see where things might go.

For just a little while, I was left pinned on the barbed wire, regretting letting of go of something that never even happened; a foolish grasshopper on a pin waiting for the return of the Shrike.

White Out: Snow On Alabama

Snow In Alabama!

Birth A La Mode; No Cherry On Top

I miss the good old days. I admit, it’s hard to miss something you never actually witnessed, although that’s how things were when I was an infant.

No one who had a baby in the early sixties remembers giving birth. When women arrived in labor, their husbands were promptly dispatched to the waiting room, and the mothers were taken to a labor room.

They would not have signed a consent to give birth. The lawyers had not yet mucked up the entire medical system. What a laughable thing, signing a consent to give birth. What the hell happens if you refuse to sign the consent? That thing is coming out anyway; I can assure you of that.

On admission, they were administered a cocktail of at least two medicines: Demerol, a powerful painkiller, in doses calculated to make one gutter drunk, and scopolamine, also called the zombie drug, because if you give enough of it to someone, they are in a trance-like state and will almost certainly be suggestible and compliant with any orders. Scopolamine also has a powerful amnestic effect: given in sufficient doses, the recipient will remember virtually nothing from the time the drug was given.

Doctors back in the day tell me that those women were still awake; they still felt pain and yelled, but they did as they were told and didn’t remember a BIT of it. My mother remembers nothing about giving birth to me. And she doesn’t seem to regret that one bit. She told me, “Well, I had some contractions, so I did the laundry and vacuumed the house, and went in to the hospital. When I woke up 2 days later, I had a baby.”

That would be AWESOME. And I say this not because I am a narrow-minded misogynistic control freak, but because the pendulum has swung WAY too far in the other direction. The change began in the late 1960’s when the hippies decided that childbirth was a beautiful and natural experience and they wanted to live every bit of it. Grudgingly, the physicians agreed to allow the husbands to be present at the delivery. That meant no more doping the patient, so now they were dealing with a wide-awake very scared little person in massive pain, because they didn’t really do epidurals back then. And then they had to deal with the baby’s FATHER (I don’t say husband, because that was around the time of free love and marriage while procreating was optional at best).

I can just imagine the ambiance. The physicians at that time would still be all male, serious as all get out, and doing things the way they were done in the 1950’s: clinical and sterile and blue gowns and drapes and sterile instruments and obedient nurses all doing things very, very seriously.

And in the middle of all this would be the father of the baby (which we heretofore will refer to as the FOB, which is what we call the biological paternal unit, even on the chart, because it gets rid of all need to establish whether or not the patient is married, or if the guy in the room is indeed even the one who donated the DNA, or just some new guy). The FOB would be intoning things like, “Just stay groovy, baby. We want the little dude to have a peaced out aura. Like, so, you probably shouldn’t be screaming and stuff.” At which point, the woman in labor would probably do what all women in labor do at this point, and scream, “Shut the hell up, and get this damn thing out of me!” Hispanic women in labor scream this in Spanish. It is universal.

And then IT happened. After the major adjustment made by the obstetrical community, and the drastic move of allowing fathers in the birthing room, the slippery slope began. The logic being, well, if my FOB can’t be here, can my mom be in here? Which then extended to, well, if my husband or my mom can be in here, can they BOTH be in here?

And that is when stuff just fell all apart. It became anarchy. Allow me to describe a common scene when I enter a labor room: the patient is in the bed, hanging out comfortably with her epidural. Her boyfriend is in the bed with her. The mom and the mother-in-law are both there, because if HER mom can be there, then why can’t mine? Grandma is there too, over in the corner, reeking of gin. There is some young girl with low rise jeans and her thong hanging out sprawled in the recliner meant for the FOB, and her boyfriend is sitting on the armrest. We are not sure who she is but we think she might be the patient’s half-sister. It is explained with some giggling that the boyfriend in the bed is, well, not the FOB, because the FOB is in jail right now, but he didn’t do anything. There is someone’s toddler on the floor. No one is watching him; his diaper is dirty, and he is fondling the patient’s foley catheter bag.

When I enter the room, there are cries of, “Who’s that?” from the imbeciles who arrived late, and from those in the know, cries of “Hey doc, has she done dilated yet? Can we have this baby now? We done waited a long time!” I announce that I am going to examine the patient. Nobody moves. I pointedly say to the patient, “I am going to uncover you and check your cervix. Would you like anyone to step out?” The patient shakes her head. Over from the corner, where it emerges that the patient’s own father is lying on a sleeping bag on the floor, the father yells, “Naw, I done seen it before! Done changed her diapers all these years!” Again, no one steps out. There is a mass craning of necks (from the ones NOT passed out) and they all wait eagerly for the verdict. This is better than reality TV for them. We get more visitors yet on days when there is nothing good on cable, and they’ve already seen that episode of Duck Dynasty.

Now you may ask, why do you put up with this? The answers are multiple. First, this is now part of the birth culture. These people have already attended multiple other labors and would not understand why they were not allowed to hang out for this one too. Second, most of the time, they aren’t really hurting anything; they are just being picturesque and inappropriate. If they are really in the way. I will boot them out. If they are upsetting the patient in any way, we will boot them out, with the help of Security (or the police, if need be), and yes, I cannot begin to enumerate the number of times cops have been called to drag out feuding potential FOBs or belligerent family members.

The other reason for the tolerance is this. All these clowns seem to reduce the anxiety level of the patient and FOB by distracting them, and they are not staring at the baby monitors and pushing the nurse call button multiple times and yelling down the hall, “Hey, the baby’s heart beat done went down!”

Also, we are not nearly as tolerant at the births. After all, birth requires focus. And there can be complications of a birth, certainly, and you don’t want a room full of panicky bystanders with camcorders getting down every second of it. Most hospitals allow two guests at pushing time, usually the FOB and one of the moms. If the patient and family are well behaved, I may allow one more, so we have, say, the FOB, his mom, and the patient’s mom. I reserve the right, at any time to boot everyone out.

Everyone who has been shooed out into the hall for the pushing phase now gathers in the hall. Despite multiple warnings from the nurses, they ooze back out of the waiting room and materialize right outside the door. From out in the hall, we hear audible speculation on what is happening with each scream that is heard. Usually, there is a pool for the weight of the baby or the time of birth. Wagers are cast. I have literally exited the labor room to get something during the pushing process and had people who were pressed up against the door actually fall halfway into the room.

The plague of locusts is rousted one more time, hopefully timed so that the poor girl gets some privacy during the birth and her creative swearing and screaming may not be heard. I hand over the baby, give my congratulations, and head out to the desk to do the paperwork.

After the paperwork is done, I usually swing by the room to make sure everything is stable and mother and baby are well. At this point, all the starlings have come back to roost and are perched on every available semi-horizontal surface and playing Pass the Baby. The TV is blaring. Multiple cell phones are in use. Pictures of the baby and the bleary-eyed mother are being uploaded to every single social media site known to man. I can barely see or speak with my patient because the room is so full of family, friends, and random acquaintances who may have just wandered in.

So this is where we are. It is a far cry from the calm, controlled circumstances in the 1960’s, and all dignity pretty much seems gone from the process of birth. So, I feel I can hardly blamed for being nostalgic for the good old days, where the dads were out pacing the waiting room with cigars, and the moms were pliant and drugged to the gills. There is a happy medium somewhere between where we are now and where we were then. But since when does mob mentality settle for happy medium? We’re just another reality show.

Weekly Photo Challenge: Selfie

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Honor At Bat

Honest Work

Honest Work

I was very dismayed this year to learn that we have to buy my daughter a new bat for softball. This is not because we can’t afford it, or because I mind that she might have outgrown the last one, or because I don’t believe that softball is a worthwhile pursuit.

She has been playing softball for 4 years already. She is 8. They start them young here in the South, where softball is one of the biggest sports for young women. She plays in a city league in our town, which has a population around 70,000 people.

The league is a pretty big deal. Girls sign up, go to softball clinics, and are drafted onto teams, of which there are about 6 per age group. The coaches look out at the clinics and tryouts to try to get the best players for their teams.

My daughter is a very good player. This is my unbiased opinion, based on the fact that my husband, who is a very good athlete, says so, and on the fact that my daughter plays pitcher or first base because of her speed and catching abilities, which are well beyond most of those in her age bracket. She is also one hell of a batter, and hit a good number of home runs last year, once two in a row. In fact, she was the most valuable player on her team last year, and she had just moved up to a new bracket and was the youngest on her team. I know that she was important, because on the rare occasion that we had to inform her team that she would be absent a game, people would begin to groan and roll their eyes and say things like, “Well, there goes THAT game”.

But this year after signups, my husband came home and announced that we would have to buy her a new bat. “Well,” I said, “She has grown a good bit since last year, so I guess that makes sense.”

“The bat is not too small for her,” my husband said. “It’s still the right size.”

“Then why do we have to buy a new bat?”

“They have tightened up the regulations this year,” my husband informed me. “Apparently there were some problems last year.”

“Oh,” I said. “I guess they want to standardize the type of bat.”

“Well, sort of,” he said. “There were multiple infractions last year involving bat tampering, and many of the parents complained. These new bats are tamper-proof, and everyone will be required to have one.”

I pondered this. Bat tampering? “Isn’t that what they do in the major leagues to add weight to the bats to give the batters more hitting strength? I know that’s a big infraction.”

“Yes,” said my husband. “That is what was happening.”

“My daughter is EIGHT,” I told my husband. “Eight. Who the hell tampers with an 8 year-old’s bat? This is a damn city league. They start them out at 4 years old. Do people tamper with their bats too?”

“Possibly,” my husband said.

“Oh,” I said, mustering my best sarcasm, “I suppose the pro scouts are at those games already.”

“As a matter of fact,” my husband said, “They are. This league goes up to 12 years old and by that time, the college scouts are out there.”

You have got to be FRICKING kidding me. College scouts? At a small town city league tournament? Weighting bats of prepubescent children? Tweens with tampered bats, on the off chance that a scout might spy them?

And that doesn’t begin to touch what this is doing to these kids. Never even mind the fact that this game is supposed to be fun for the kids, to learn team play and fairness. When a child is told, “Just a minute, before you go start this game, your Uncle Bubba has to fix your bat so you’ll hit harder and win,” they are being told, no this is NOT for fun. Nothing is for fun. Everything is soooo important. Everything you do. And we grownups are relying on you, you’re our sweet little cash cow. You’re gonna pay for college and make us money and fame, and keep us comfortable in our old age. The kid learns to cheat, scheme, feel that they are outside the rules, which are just made for breaking. And they learn young that they are being used, as an asset, rather than being treated to a fun game. That kid’s childhood is gone. They become an unwitting adult, lying and cheating and trying to sneak to the top. Never mind practice. Never mind innate ability. It’s all about clawing to the top.

I am a gynecologist, and in my line of work, I maintain that there is very little out there in the realm of human behavior that can surprise me. I am constantly proved wrong. You would think I would learn.

This shocked me. And horrified me. And several days later, I still cannot get that conversation out of my head. Bat tampering for tweens? What the hell next? Are the parents shooting up their 12 year-old daughters with steroids too? At this point, I would put nothing past anybody.

I know this makes me look old, but all I can think is, what is this world coming to? I heard my parents and my grandparents say this all the time, and here I am saying it. Maybe I am conservative and old-fashioned, but in my mind, anyone who would tamper with an 8 year-old’s bat in hopes of throwing a game or getting their kid scouted should go straight to hell. Do not pass home plate, do not collect $200. I didn’t think I could be shocked anymore. But believe you me, I am shocked. And outraged. And saddened. And there is nothing to do but buy the bat.

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