Monday, October 20, 2008

Perfect Fall Weekend



This is our last weekend in Northampton. Delia had a great time jumping in leaves and riding her bike. She is asking a lot of questions about the new house, such as, " New House have beer?" Always focused on the important issues.

Delia woke up before sunrise today and in trying to convince her to go back to sleep, I asked her what time it was. "Early o'clock."

Sunday, October 12, 2008

Happy Columbus Day





It has been a picture perfect New England Fall weekend. Delia is enjoying playing "soccer ball" in the backyard and can even dribble! Our friends Aida and Sebastian came over to play after a 22 mile (!) bike ride on the bike path near our house.

We had a very successful tag sale this weekend and feel great after the purge. Delia was a great salesman- she told one customer that he "plobaby needed a bookshelf." How could he resist?

Monday, October 6, 2008

Long time, no see





These are some of the latest Delia photos.

We are a family in transition at the moment- Alan has moved to Geneva, New York for his position at Hobart and William Smith Colleges, and Delia and I will join him in 3 weeks. The separation has been hard on all of us, but Delia seems to weathering it with only minimal trauma. She gets to spend a day a week with her grandparents (which everyone loves) and is happier at day care when she's not there full time.

Delia's verbal skills have improved exponentially over the past few months. She likes to "hang out on the couch" and to "go upstairs and check out what's going on." She's working on using "probably" correctly and I don't have the heart to correct her pronunciation (plobaby).

Alan likes his new job so far, but he's adjusting to teaching men. His classes have been small and the faculty very supportive which has allowed for a easy transition...and enough time to get the new house in order. Our new place looks like Elliot's house at the end of E.T (does that date me?)- covered in plastic and machinery. By the time we move in, we hope to have all the wood floors refinished and all the rooms painted. I can't even picture it without the shag carpeting and plaid wallpaper,

I am overwhelmed with the minutiae of moving, which doesn't allow me the time to reflect on what we're leaving behind. I am moving without a job and I am a bit unclear of what my options will be. It will be a big change to go from overdrive to second.

Monday, March 31, 2008

Yogurt: the organic styling product

A week of firsts and lasts


This was a big week in the van Eaglegiessen household. Delia used her potty for the first time, which was a surprise even to her. She was a little traumatized by the whole experience, but climbed back into the saddle (so to speak) the next day. This week was also the last time Delia nursed. That news will probably shock many of you that we nursed this long and shock others that we are quitting so early. It seemed like the right time for both of us and given the ease of transition, I know that it was.

Delia is now making 2-3 word sentences, wielding a fork with finesse and riding Stuart whenever possible. She is very excited to have 2 new cousins this summer.

Sunday, March 16, 2008

You know you shop at Whole Foods too often when...


your toddler daughter catches sight of a bag of nachos and yells "Newmans!" She prefers the fig bars, thank you very much.

MommyDaddy


A few weeks ago, Delia was playing with one of her baby dolls and I told her she was a good Mommy. She responded, "No. MommyDaddy," pointing to her chest. My unbiased interpretation is that she sees Alan and me as a seamless parenting unit with no real division of labor. Just the way we'd like it. It's when she says things like "MommyStu" that I start to worry.

Geneva, here we come!


You may be entertaining fantasies that I have taken a job with the World Health Organization or something sexy like that, but alas, it is nothing so exciting. Alan has accepted a position in the chemistry department at Hobart and William Smith College in Geneva, NEW YORK. Geneva is located at the northern end of Seneca Lake and is apparently known for Sauerkraut Days and The Geneva Whale Watching Festival (a setup for major disappointment). The town is hailed at the Lake Trout capital of the world and the lake is the second deepest in the country. We visited a few weeks ago and seeing any small town in the middle of February in order to get a sense of the place is an exceedingly bad idea. It was bitterly cold, covered with dingy snow and the only people out were the smokers standing outside of bars. We did have a lovely dinner with Alan's future colleagues who painted a more positive view of the town and were enthusiastic about their neighbors, schools, and cultural offerings.

It has taken me about a month to wrap my mind around the move and all of its ramifications. I think in the end it will be a good thing for Alan and the rest of the family. I grew up in a small town and realize how much they have to offer. (Tired of the public vs private school debate? Move to a place without private schools!) I am reaching the end of a decade of obligations related to medical training and its costs and am feeling a little lost now that I have lots of choices. Luckily, the combination of Alan's job stability and a low cost of living gives me the flexibility to figure out where I want to go next. All of my mental meanderings seem to return to knitting and goat cheese.

Sunday, January 20, 2008

Mea Culpa


We've had a tough weekend in the van Eaglegiessen household. We tried to go to dinner on Saturday, but Delia wanted no part of it. I guess I should rephrase that. She did want part of the walking around the restaurant smiling at everyone and pushing her toy bus on the floor, but she had no interest in actually eating. There was only so much of "All Done!" that we could tolerate, so we scarfed down our meals and were out the door in 20 minutes.

After a great morning with some friends, Delia decided that she didn't want to take a nap today. This was quite upsetting to her parents (even though Delia was in a fine mood), as we really enjoy a relaxing cup of coffee and an hour or two without the demands of a toddler. We tried the crib, our bed, a mat on the floor, with the dolly, with the floppy pig, with the Grinch, in the dark, in the light, with music....you get the picture. I realized we'd reach a bad place when I was making up lullabies with lyrics like, "You make me hate my life sometimes" and "I wish I was at work." Eventually, in a moment of clarity, we gave up. We were all much happier once we realized who was actually in charge today.

Wednesday, January 16, 2008

A week of reflection on primary care

As you know, I think a lot about our health care system and how best to fix it. I try not to get overwhelmed by the day to day frustrations of the job and to see the bigger picture. Here's what I observed this week:

Day 1: The American Board of Internal Medicine has proposed a new designation for internists- Comprehensivists. People who receive this designation are supposed to be expert diagnosticians, communicators, facile with technology, team leaders and have an office that provides accessible and efficient care (the latter eliminates me). One must complete additional training and testing for this title, which, by the way, does not lead to better reimbursements or higher pay. What it does give you is a title other than Primary Care Provider or General Internist, which are no longer garner respect. Even internists don't want to be internists anymore.

Day 2: I read an essay from a geriatrician about the high rates of peptic ulcers in older folks associated with anti-inflammatory pain medicines. He notes that gastro-protective medications are not offered by Medicare plans, are prohibitively expensive, or require massive amounts of paperwork that primary providers don't have time to do. So the elderly suffer and have complications that are way more expensive to treat than giving the right medicine in the first place.

Day 3: Governor Deval Patrick announces a cut in Medicare reimbursements in the commonwealth of Massachusetts to make up for a budget deficit.

Day 4: The front page of our local newspaper carried a story about the shortage of primary care and mental health providers in western Massachusetts and Cape Cod. The state is trying to encourage state medical schools to promote primary care and is planning on giving loan reimbursements to those who choose to practice here. Massachusetts has one of the highest doctor to patient ratios in the country, but this is due to the large number of specialists in Boston. The Secretary of Health said that we have to show medical students that primary care is a rewarding career. See number 3 to see how the Commonwealth really views primary care.

Day 5: I read an article about incorporating meditation and mindfulness into primary care to avoid burnout. This is an eight week program designed to help PCPs survive the stresses of their job and deal with difficult patients. The article noted that most docs sleep less, eat worse, and exercise less than their peers. They also spend less time with family and have, on average, ONLY ONE FRIEND apart from a spouse.

Day 6: There was an article about lawyers and doctors in the NY Times a few weeks ago. The gist of the article was that these professions are no longer as respected or desirable as they once were. These jobs require more work and more training than many people can stomach today and the pressures to keep working longer hours are drives people away. One MD was quoted as saying that every so often he needs to call in sick on short notice and spend 24-48 hours in bed. He does this when he feels an uncontrollable urge to punch someone. You can spin this one two ways: either people are losing their work ethic or they are realizing that family/personal time is too important to sacrifice.

Day 7: "Safety Net Providers Being Stretched to the Breaking Point."The title says it all. This article comes from Internal Medicine News and notes today that safety net providers (aka community health centers) are taking on more of the burden of primary care. Since 2001, the number of patients increased by 60% and I would guess the staffing at the centers hardly increased at all. CHCs are often located in areas without specialty care or mental health services. The number of mental health visits to CHCs has doubled in the past 5 years.

Sunday, January 13, 2008

A New Year and Delia's ready for anything


...well, except for weaning. We decided to cut back on nursing in January and eliminate our morning feeding. The first few days were rough as I heard Delia screaming, "Mama! Mama!" as Alan headed downstairs with her for breakfast. The day care commented that without her "morning coffee" Delia was irritable and clingy. However, being the resilient child she is, she bounced back and was her normal cheerful self over the weekend.

My parents came up to celebrate my mother's birthday today and it was a busy day for Delia. She was really worn out after dinner and cuddled on the couch with me as my parents gathered their things. She was zoned, ready for bed and her ticket to dreamtime was oh-so-close. Yet she seemed confused and a little unsure about what to do. Delia's never been breast-centric, but she groped and whined a bit, then pulled my shirt down nestled her face into my cleavage and blew the biggest raspberry ever.