Well, I think I'm getting in under the 6 year deadline that I set myself last time. In terms of update, family is doing pretty well, world is gone mostly to shit. I'm still assistant medical director at Exeter ER, having managed to dodge the director bullet that Nick Armellino took. I heard that in napoleonic times, during battles the bullets would travel slowly enough that you could see them coming, but because everyone was standing in rows like a bunch of assholes, if you ducked, that just meant the dude behind you would get it, which was considered the height of ill manners. But that's what I did to Nick. I did manage to get the EMS director gig, which is a much cushier job. Max is about to turn 13, in 7th grade, in hybrid school with Minecraft taking up as much of his free time as possible. Willa is about to graduate from 5th grade, and go to Heronfield Academy next year, which is $25K better than the free public school. Sam is in 1st grade, but is becoming feral so may not continue on. After school he disappears into the woods without shoes, and shows up around dinner with mud caking his bare feet and small animals nesting in his long hair. Most of the sweetness has been replaced with ferocity, but there are still traces that peek out from time to time. 

Covid has upended everything, although we just got word that kids can go back full time to school after April break, for the last few weeks of the school year. What an absolute clusterfuck remote learning is! I'm vaccinated, and my parents and in-laws have each had their first shots, but the rest of the fam is still waiting. Just had a mass shooting of Asian women a few days ago, and Chauvin's trial for the murder of George Floyd is in jury selection. So race issues are boiling over. Maybe in a good way, in the sense that the high water mark includes a lot of mainstream white moderates this time around. But also exhausting to see how far we still have to go. The Capitol riot is still fresh in mind, too, which I guess is related to race issues since there was an explicit white supremacist component as opposed to the typical implicit one. But we got Trump out of there, by the skin of our teeth, and flipped the Senate. Now we just need to get rid of the filibuster and pass the For the People Act, and we'll be off and running- maybe get some real good done. 

I'm ready to cash out and start a seaweed farm, but I guess I have to soldier on until at least our student loans are paid off. That'll be 10 more years- just refinanced last week. 

Hello Old Friend

Wow, it's been a minute, as they say. I just read through all my old posts, which was quite nostalgic. Also, almost a little intimidating- I seemed to actually have something to say, at least at times. Like, I would read that stuff even if I was my friend and basically knew what was going on with me (which I essentially am, and do). But if you don't know, aren't my friend, or just like reading things you already know, let me update you. We've moved into a Tudor on the edge of the woods in Exeter NH. I'm not saying Tudor with a capital T to be snooty- I'm actually trying to be subtly self-deprecating, since I consider myself to be anti-Tudor, or at least, anti-pro-Tudor.  What I like about this house, is that it keeps the rain off, is at the end of a dead-end, borders some decent woods (if you ignore the intervening condo subdivision, like I do). What I don't like is that it garners remarks like, "Oh, what a splendid example of the Tudor Revival, old boy," and the like. I'm considering changing the color scheme from the traditional red brick, off white and brown beams to some seriously trippy technicolor rainbow. But that would take effort, so really I'll just leave it like it is.
There are 5 of us now, and things are going pretty well. Max is in 3rd grade, plays Pokemon and goes to Tae Kwon Do, and just won a Destination Imagination competition, qualifying for globals in Knoxville. I'm still not exactly sure what the hell DI is- I think it is some kind of secret, anti-parent puppeteering thing. Willa, 1st grade, goes to ballet when she can be convinced, narrates elaborate and intricate make-believe scenarios for hours at a time, and stands the hell out of her ground. Sam, 2 yrs old and in Montessori day care, mostly chills, at least when he's not crying for his mama. Mama does restorative justice circles in Lowell and Boston. And I'm a real life, buck-stops-here, attending, at Exeter Hospital, which is essentially as good as I thought it was going to be. Mostly saving lives and stamping out disease. I accidentally zigged when I should have zagged, said 'yes' when I should have said 'no,' and ended up as assistant director of the ER, which means I have to go to a few meetings a month, and get caught up in a little bit of drama that I otherwise could have avoided. Not too bad, except that I live in constant low-level terror that Wendy, my boss, will get promoted or move away and they'll try to look to me to be the director. Which I would politely decline. Now that I've rediscovered this, I'll maybe post again before another 6 years go by.

I Came Up With That First!

First it was fart-absorbing cushions. I was going to call them "First Date." They were to absorb and deodorize flatus while also muffling sound. I figured people would buy them to put in their cars, where a stray SBD could kill a budding relationship faster than ordering anchovy-onion rings on a first date. Then I read about some Australian company that was making fart-deodorizing underwear. Crap! Today I see that someone is publishing a book, out of Purdue University Press, called "Walk a Hound, Lose a Pound." Totally lame title notwithstanding, that was my fricking idea! I thought of the dog-walking weight loss plan a couple years ago. Now, I'm no patent expert, but maybe if I put the rest of my ideas on this public blog, then I will have some claim to royalties in the future? No, you say? Instead people will just steal my ideas from here and develop them for their own enrichment? Well, fine. I'm not doing this for money, anyway. I really am in it for the good of all humanity. And bragging rights. So here goes: along the fart line of thinking, what about an exhaust pipe for farting in tents? Just some backpacking-grade lightweight tubing with a bag valve mask on one end and a little battery-powered fan, and you could run one end out a crack in the door. Pure gold, if you ask anyone who's ever been stuck in the backcountry weather for a day or two. Nerves are already wearing thin without freeze-dried broccoli farts poisoning the common airspace. Next: in the weight-loss line of thinking, how about an "advanced weight loss program, for those who have graduated from the standard plans." This plan would give you badges, or colored belts, or certification cards, or some shit. Like those ice skater badges, or karate belts, or YMCA swim lesson levels. "1000 more crunches to advance from Eel to Tadpole!" That kind of thing. People love to get credentials, and little merit badges, and all that shit that makes them feel superior to everyone else. Put them on the "advanced" track to become "expert" weight losers and they'll stay motivated because they'll think they're special. I was going to combine this book with the dog-walking book, but now that plan got dunked in shit. Then I've got a couple medical ideas. Why do the respiratory therapists always use that crazy split piece of tape to secure endotracheal tubes? How about a velcro strap that goes around the head and fastens easily and quickly and securely around the ET tube? That one could be my retirement fund, so don't steal it. Then in neurosurgery, when they're putting in the deep brain stimulation wires, they have this machine that advances the needle by the micrometer- a tenth of a millimeter- because the shit needs to be pretty precise when you're poking around in someone's noodle. Then, once you've cranked the needle exactly into place over the course of an hour (crank a micrometer, zap, see if Parkinson's tremor goes away, repeat a zillion times), there is this cap that has to go aroud the needle to secure it perfectly. But you have to take the introducer machine off to get the cap on. So you just have some medical student pinch the wire in his/her fingers while you slide this big ass machine off the precisely placed needle and then snap this cap on it. Pretty stupid, huh? I mean, this isn't rocket science- it's just brain surgery. My machine would allow you to put the cap on before having to take the calibrating machine off, completely cutting out the medical student with their physiologic tremor jiggling that fishing line around in someone's deep brain.
That's all I've got for now. Stay tuned.

Rabbit Hole

I've just been putzing around on the interweb, and I couldn't help but be struck once again by how fucking incredible this place is. In about 20 minutes, starting at the New York Times, I went from an absolutely insane baby-swinging video, to a blog post about never being too poor to have kids, to a wikipedia search about Loch Lomond, to a JAMA article about new research indicating that cell phones activate brain metabolism which could potentially lead to cancer. Especially that Russian baby "yoga" video- first off, I was not as horrified as apparently most parents who watch it are. I did find myself wondering about shoulder dislocation and nursemaid's elbow in a 2 week old, and the fact that the kid seemed to be crying at one point (Lena Fokina, the woman doing the actual swinging in the video, says the children do not cry, but rather remain silent or laugh. She runs a family freediving clinic in Dahab, Egypt now, and the baby from the video is perfectly healthy, even "precocious," according to her dad). However, my emotions tended to run towards fascination rather than repulsion. And I felt particularly validated toward the end, when Lena seems to be trying to get the kid to lock his knees so that she can balance him in a standing position on her palm! Sound familiar? Maybe I'm not as crazy or foolhardy as you all thought! Then again, look who I'm allying myself with...

Quickie

I'm in Portland ME, site of my future residency. Mark my words. Doing an ER rotation here and living in a dorm room across from the hospital, which is nice and at the same time awful because I'm away from the kids and wife. Update on the chilluns: Max is a real little boy (not like, he was a puppet and now he's real, but more like, he fits the stereotype of a little boy), and Willa is an amazingly chill baby girl. Max can throw and catch, if you tell him to get ready and toss it perfectly, and he loves to run around and say he's playing football, baseball, and soccer. All at once. And he frequently mentions that ball players "fall down" as he's falling down, which is not that adaptive if you're talking about baseball or soccer. And football is moot because he's not allowed to play that one, no exceptions, just like he's not allowed to vote Republican. Anyway, he's a blast to hang out with- so active and coherent and intelligent. He loves to ask "why?" to everything you say, but I think that is a great question. Willa is adorable and spits up all the time, no matter how long it's been since she's last eaten. But really the only thing you need to know about her is that she sleeps through the night. Like, 8 hrs, pretty consistently. She's just starting to coo and smile, so she's growing on me, but I maintain that babies are basically horrible for dads until they are about 6 or 8 months old. Admittedly, that is based on an n of 1, so maybe Willa will buck the trend.

School's going well for me, I think, although I do feel stupid fairly regularly on these away rotations when I don't know what the hell I'm doing in the ER. I've got a bunch of interviews coming up this month and the next, and after that hopefully 4th year will get a little more relaxed. It's been intense this year, with 3 in a row ER rotations where I have to be constantly "on," Willa's birth (although I didn't do much and besides, she was born easily), and the Ironman. Ma just got her DCIS cut out, along with the rest of her breast. But, if you look at the results of all these things, the rotations have gone well, Willa's a gem, I finished the Ironman, and Ma's cancer was the good kind. So all's well. I'll try to keep you better updated.

What Max's Up To

He walks. For about two months he's been walking with more and more confidence, getting faster and going farther every day. He says: dada, mama, dog ("doh"), cat ("cah"), bike, car, turtle, squirrel, helicopter ("gagagagr"), water, nana, and Yankees Suck. He can point to his nose and his ear. He loves to get tickled, and he absolutely adores swimming. At the pool, he charges into the kiddie pool, falling under the water, and then gets up and continues the charge. He's like Cool Hand Luke boxing Dragline. His lips turn blue and he shivers uncontrollably, but when you pick him up, he just says "uh uh uh" until you put him back in the water. He sleeps through most nights, takes a morning and afternoon nap, and is an all-around great kid.

Max News

These days he crawls around, faster every day. He only started maybe two weeks ago, and already he's starting to really move. Although, what he is truly interested in is walking. Even before he was crawling, he was pulling himself up to a stand, which he has now combined with taking a finger from each of your hands in his, and walking around with big, straight-legged stomping steps while you hunch over. When he sees something interesting, he'll let go with one hand, pat the object a few times, maybe even put both hands on it if it is high enough, and then without looking, absent-mindedly grope about in the air for where your hands should be awaiting his grasp, so that he can continue on his trek. It is very cute. Less cute is his tendency (fading quickly though it is) to pull himself up on something- say, the bread machine or the sewing machine- stand there for a few moments slapping the thing and acting pleased with himself, and then accidentally pushing hard enough to tip over backwards. He'll teeter for a moment at the top of the arc, like a rooster egg not sure which side of the roof to roll down, and then go over backwards. Except, instead of going over backwards sensibly, say by bending his knees and plopping onto his butt or putting his hands back to break his fall, he goes stiff as a board, hands at his sides and arms rigid, scrunches up his face and kind of trembling like the Lemmings who shout out "Armaggedon!" before blowing to bits when you nuke them(this is a video game where you herd lemmings from one side of an obstacle course to the other, in case you lost the drift there...). Then over he goes, and because his back is slightly arched, he leads with his head and ends up smashing his occiput onto the hardwood, or linoleum, or thin scrap of carpet, which makes him quite unhappy. Often we would only find that he had figured out a new object to pull up on when we would hear the sound of a small head dropped from a height of 30 in. onto a hard surface, followed by a pause, followed by screaming baby. Ever since I had "seizure activity" secondary to the umbilicus being wrapped around my neck, it has been important to have a brain damage story to brag about, so I guess this is Max's.
He's not really saying words yet, but he does jabber quite a bit. And he hasn't picked up any signs, perhaps because we are a bit inconsistent in our use of them with him. We're not in any rush for him to start talking, or naming things- I'm sure it will come in time, and meanwhile, it's nice to let that little brand new baby brain crank without trying to mold it with flashcards or computer games or Baby Einstein videos. Max seems very curious, and we try to let him explore the house with as few restrictions as possible- pretty soon he will have explored every floor in the house with the back of his tiny head!