Sold

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Our next door neighbor’s house sold today. She lived in that house for almost 40 years. Now in her 80s, without any kids or family, she needed the money to pay for her care. For almost a year she had 24/7 caregivers in her home as her health deteriorated. She was still smart as a whip but unable to tend to her daily needs. She told me that the caregivers became too expensive. She could pay for them for another year or so but then what? She needed the money from the home sale to last her a lifetime – literally the rest of her life.

So many emotions from that conversation. Sadness and a sense of loss. She began to cry when she told me. She didn’t want to leave. It was her home and she wanted to stay in it. It made me think about the passage of time. She was in her early 40s when she moved in, and one year became two became four became eight…How many steps between our lives now and then?

It made me think about family. She jokingly said she was waiting for a rich granddaughter to emerge from the shadows. Aren’t we all? I think about the legacy of descendants – the good, the bad. I wonder what her relationships were like, who she loved, what she thought about children. I thought of our own parents – getting closer to that age. They still have a decade or two but soon this will be their fate. And then what do we do? How do we do what we need to do with the distance between us?

I think about the neighborhood as it was 40 years ago. We have neighbors who have lived here for half a century (or close to it) and they were the young parents (or singletons) with little ones (or not) who got to know one another, helped each other out, socialized, gossiped. And then time passes and new people move in, and neighborhoods are continuously decorated with the tapestry of these lives – one on top of the other, on top of the other. Life is a wheel, my grandmother used to say.

It feels like the end of an era. We spoke with our neighbor when we came to view the house years ago, before putting in an offer. She said it was a nice neighborhood, a quiet one. When we first moved in and I was pregnant, about to burst, she helped me prune some rose bushes and move them into a planter. That planter still stands at the edge of our driveway, roses blooming each season. She noticed one of our trees dying and alerted us to it before it could fall and cause damage. She would always tell us that our children sounded happy, that she loved to hear their joy while they played. We purchased basic essentials for her during the pandemic. I walked over Thanksgiving dinner. I answered her call and went to check on her when her health problems began in earnest – when she started to have trouble with her balance. She came to the door naked from the waist down because she had wet herself. It felt like the beginning of the end.

I’m going to miss her. I don’t know who the new neighbors will be – whether they will be a family, an elderly person, a developer who will raze the home and put up something modern, white and all angles. Change makes me nervous, but change is also the way of the world. One day, we will move. Maybe it will be in a few years, or maybe we’ll be in our 80s as well. Life is a wheel and it never stops turning.

COVID, finally

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Well, after 2+ years of avoiding COVID-19, we finally all got it.

It started innocently enough. My husband had an intense work week pulling all-nighters. That Friday evening, he started to cough. I reflexively antigen tested him and it was negative. “Must be sleep deprivation,” he concluded. Pro tip #1: antigen tests are crap.

The next day, he began to have symptoms of a gout flare. One of his feet swelled up and he was fairly immobile. Still had a bit of cough and was more tired than usual, but a repeat antigen test was negative so we chalked it all up to gout. Gout and sleep deprivation.

Sunday night he experienced chills and I began to have a slight cough. I was still coughing the next day but otherwise felt totally fine and I myself was now antigen negative (and he was STILL negative as well). However, by the end of my morning clinic, I began to feel worse. Muscle achy, runny nose – just generally unwell. So I drove myself to occupational health for a PCR. I needed to know for sure before going back in the next day for a full day of clinic. (Of note, I still wear an N95 mask + surgical mask + eye protection in clinic and was wearing all of the above when I saw the few patients I did that morning.) I decided to pick the boys up from camp early just in case. But, it turns out that I left my lights on when I parked the car, so when I came back to it after my test I couldn’t turn it on!

I had to call my husband to pick me up and deal w/ the dead battery while I went to pick up the boys and relieve or nanny. Truthfully, I was most worried about our nanny. She is vaccinated and boosted but also pregnant, and I was most concerned about her and her baby. More on that later.

When I finally got everyone home, I felt terrible. I took ibuprofen right away and lay on the couch. My husband made me soup. We somehow made it to bedtime and that’s when I got the result: positive PCR. Crap. I contacted our clinic manager to cancel all of my clinics for the week. I told our nanny to stay home and monitor for symptoms. I reached out to the kids’ camps and told them they would be staying home due to COVID in the family. Interestingly, the policy is that kids with a home exposure can still go to camp (and I definitely knew of two moms who had COVID who were still sending their kids to one of the camps), but with two positive parents, I knew we wouldn’t be able to isolate. I had also decided that we weren’t even going to try. This was probably a gamble on my part, and maybe a risky one since we did have two unvaccinated kids at the time (under 5), but I didn’t want to start a game of domino COVID, whereby we’d have one kid at home at any given time, with no childcare since we wanted to protect our nanny, meaning an even longer work disruption than just two weeks.

The next 2 days were rough. My husband started feeling like crap. Not only did he definitely have COVID (he kept testing antigen negative until I finally had him confirm on PCR and that was positive), but he had a gout flare that was so bad (TWO feet affected) that he couldn’t even walk. I can laugh about it now, but it was a rough few days. Four kids 7 and under at home with only one parent who could physically participate in caring for them, and that parent (me) had fairly symptomatic COVID. My symptoms were fever (to 102.8), sore throat, runny nose, muscle aches/pains, fatigue. But, we somehow made it through those 2 harrowing days. The kids started to develop symptoms and/or become antigen positive in close succession. Everyone was positive by the end of the week. Our unvaccinated kids had the most symptoms: 2 days of fever. One of our vaccinated kids had a sore throat and one night of fever. One of them coughed twice and a had a slight sniffle, but since we were waiting for it, we tested him and it was positive.

The days were a bit of a slog. My husband took off most of the first week and even during the days when I felt like crap, I tried to get the kids outside for a bit. We could only frequent places that were outdoors, where we were guaranteed to not be close to other people. I’m sure for the kids it was quite the adventure – both parents at home, unstructured time, a loosening of rules, exploring new outdoor spaces. I’m sure one day I’ll look back at the time with rose-colored glasses. But right now I’m finding myself under a mound of work – actual job and life – with little time to catch up since I had to add so many clinics back to make up for 2 weeks of lost time.

Pro tip #2: once positive, the antigen tests take forever to become negative. I wish someone had told me this. The rules for work and camp are 5 days of isolation and you can test out after 5 days if your antigen test is negative. So like a crazy optimist, I antigen tested everyone after day 5. Well, no one was negative even close to day 5. Myself and at least one of the kids were still positive by our respective day 10s. I finally went back to work on day 11 (no further restrictions and I was obviously masked and finally positive). The kids returned to life the following week. But, wow, that was a crazy long time of disruption in our family.

And here’s the thing: the reason COVID is going around life wildfire is that no one is keeping themselves and their kids home for 2+ weeks. It was honestly really hard, and we are fortunate to have flexible jobs that allowed us the time off. But we also lost out on thousands of dollars of childcare those 2 weeks between kid camps and in-home care. That’s a lot of money. And if your employer isn’t going to give you paid time off, what option do you have? And remember, the kids were only symptomatic for 1-2 days. 2 weeks is a lot of lost time for 1-2 days of symptoms. So I imagine there will be some changes to the rules down the line – maybe now that the under 5 vaccines are approved?

Pro tip #3: if someone in your life gets COVID, don’t ask them what they need – just send them something you think they might need or want. Prior to us having COVID, I would ask my friends who were diagnosed with COVID what I could send – a meal? toys for their kids? other? Without fail, everyone said thanks and nothing. I did the same thing when we all got sick. But the sweetest surprises were from people who didn’t take no for an answer and just sent something – a lunch delivery, a homemade dinner, a sweet treat, toys/activities for the kids. The novelty of these thoughtful tokens was enough to turn an otherwise ordinary day into something special. And the feeling of being loved was overwhelming.

So now, I’m happy to be on the other side. I spent so long being so afraid of COVID, and now that’s it gone through our family I feel a sense of freedom/peace. Although I also recognize that this is fleeting because immunity post-infection does not last forever. I also feel incredibly grateful that our children were minimally symptomatic and have no long-term symptoms. Despite the adults having a bit more symptoms, we also fully recovered. And I will be forever grateful that our pregnant nanny did not get sick.

Home is

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My husband and I purchased our first (and current) home almost 8 years ago. The decision came out of a steep hike in rental costs, need for more space (e.g. not an apartment) to accommodate the birth of our first baby, and was financially possible due to a fortuitous event in my husband’s career.

We were over the moon when we bought it. My parents purchased their first home in this country when I was 14 years old. My in-laws lived in a humble house (side note: I have known my husband for 15 years and have still never been to his house because his mother-in-law is embarrassed to show it to me) and still owed mortgage until we paid it off for them before purchasing our house.

It was a blessing and felt like a huge lift. It was the most money we had ever spent on something. We felt like adults. For context, when we moved to our current location four years before the purchase, we had a negative net worth due to my hundreds of thousands of dollars of medical school debt, very little savings and zero investments. We had received no financial education from our families (this is not a complaint – we received everything we needed in terms of love and encouragement from them, and they also didn’t have the financial education to pass down to us) and they were not in a position to lend us money for a down payment. Buying this house was a big deal for us. I remember sitting out on the deck after we closed and received the keys for the first time. We sat under our fig tree and thought about the years to come.

I don’t recall what our dreams looked like then, but I can tell you that we have been so fortunate these past 8 years. After struggling with sub-fertility (my doctor’s term) due to secondary hypothalamic amenorrhea caused by excessive exercise and caloric restriction, we were blessed with 4 amazing children. I have had an incredibly successful, stable and fulfilling career with the same employer and supportive colleagues who feel like family. My husband has been able to take career risks and has taken on a variety of roles with a concrete financial upside. The equity in our home has grown significantly these past 8 years.

But there’s a catch that others have made us feel self-conscious about and it’s this: our house is a bit over 1700 square feet. It has 3 bedrooms and 2 bathrooms. It sits on a small plot of land. This has apparently caused some concern for our friends and acquaintances. I say this facetiously, but it has been quite surprising to me how many people see it as fair game to comment on. Starting when I was pregnant with my second child, people began asking us when we were planning to move. Many people have said “I don’t know how you do it with all of your kids!”. In truth, some of those questions have been inspired by our own ambivalence through the years. What is enough space? Is there a certain amount of square footage that is appropriate to have per family member? Do we need a two-car garage? A guest room that is always open to accommodate visitors? A larger yard?

Here are the amazing things about our house:

-it is incredibly affordable, allowing us to commit a much larger chunk of our income to investments, savings, travel, helping our families, childcare and private education for our children

-it is mostly updated, with us having poured money into new bathrooms, a new garage, a new detached office, landscaping and aesthetic odds and ends

-our neighbors are normal and kind; we are used to them and they are used to us; they don’t complain about our kids making noise and we reciprocate by being the best neighbors we can possibly be

-it is very close to my job, which has allowed me to be very involved in my kids’ lives, despite having a full-time career

Some of the ways in which we have made due with the space:

-we have 3 kids in one room currently, and our youngest in a separate room

-I have an “in home” office in our new garage; when the kids are at school/camp, I work from the desk in our bedroom, but I have a place to do video visits when needed that is quiet and private. One of my friends, upon seeing this, commented that I have a knack for using small spaces, and this comment warmed my heart

-when visitors come, we give them our bedroom and sleep in the playroom, on an air mattress

And yet I sometimes hear a gnawing voice in my ear that says this home is not enough. Through the years, friends who lived in our neighbor when we moved in have left. Many have moved out of state, to lower cost of living areas where they could afford larger homes. Some have moved into larger homes in our area, having taken advantage of their home equity plus financial gains. Now that we are at a private school, many of our friends live in homes that cost many times more than ours. It is hard sometimes to come back from visiting these homes and not feel like our space is “less than”. Despite the comforts of our space, despite the nooks and crannies we are so accustomed to, there is still that feeling of “wouldn’t it be nice?”.

And just this week, my son’s friend came to our house. On the drive over my son asked him “How would you compare my house to yours?” and he responded with “I like mine better, also – it is much bigger.” Like most aspects of parenting, our children’s heartbreak hurts more than our own. I don’t want my children to feel like their house in “less than” and maybe I am just projecting here, because my son moved on to another question without comment or a second thought.

But despite these thoughts and mild annoyances, I stick to my belief that our home is perfect and just enough. It is the doorway through which we carried all four children home after their births and hospital stays. The playroom evolved from the place we held them to sleep while watching TV to stay awake to where they crawled, walked, tumbled and now play video games. I see them hug and snuggle together before bed or run around the backyard collapsing into giggles, and I know we are not doing them a disservice. They are learning to be close, to be together, to be compassionate siblings. We have great kids and I think this home has played a role.

The day might come when the kids needs more space – when they are teenagers and want to blast music and lock themselves in their rooms and hang out with their friends alone. When they’ll have real homework and need a quiet place to work. When my husband and I will need privacy for conversations. But today is not that day.

Have friends or families commented on your living arrangements? How do you respond?

Working class

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My paternal grandfather worked the grounds at a country club. I imagine the patrons of said country club going about their day – playing golf, swimming, dining, drinking cocktails – all the while ignoring my grandfather as he toiled beneath the sun, skin browned from outdoor labor, hands calloused from hard work. My parents and I would drive down the winding, tree-lined streets of this town, lavish homes behind lavish gates, only a sliver of sky visible above the vast greenery. I wondered who lived in those homes. What did they do? How did they acquire so much wealth? Did they ever speak to or acknowledge my grandfather?

There were two things that my paternal grandmother wanted more than anything. The first was to go to school and the second was to marry her first love. Neither wish came true. Her parents were poor farmers and they needed all of their children to work. My grandmother cried when they pulled her out of elementary school to tend to the farm. She would tell me this story over and over again, encourage me to get an education. I tell this story to my kindergartener now – “Your great-grandmother wasn’t allowed to go to school. Millions of children around the world are unable to go to school. You are so fortunate to have the opportunity.” Does he get it? I doubt it, but it’s an important story for me to pass down. My paternal grandmother fell in love but she wasn’t able to marry him because her older sister had to get married first. He went to fight in World War II and never came home. Her parents arranged for her to marry my paternal grandfather. My grandmother would tell me: “They put me on a boat and I arrived in Argentina and was married to your grandfather.” They were a terrible fit. They had an unhappy marriage and even an unhappier separation. She refused to divorce him, even as he lay dying from lung cancer. Catholics don’t get divorced. My entire childhood I heard two lessons on repeat – never marry someone you don’t love, education is a gift. When I think of my paternal grandmother, I think of regret.

My paternal grandmother worked until well into her 70s. She worked in a convenience store – minimum wage. Storing money away for what? A rainy day? She hoarded items in her small basement apartment. You never knew what you might need. I think of well-to-do women in their 70s who go to brunch and do water aerobics and get their nails done. These luxuries might as well have been a foreign currency for my grandmother.

My maternal grandfather died shortly after I was born. Colon cancer. “From the war”, my mother would say. But was it from the war? Or was it genetic? Who knows where the cancer came from. My maternal grandfather was captured during the war and, after months in captivity, all he wanted was a peaceful life. A quiet life. The only way I knew him was through the photograph that my mom kept tucked away in a kitchen cupboard. How hard it must have been for my mother to lose her father when she was in her 20s.

My maternal grandmother was a firecracker. She was ambitious, stern and short on compliments. She would tell my mom, the youngest of three daughters, that she was too thin, too ugly, that she should spend less time “in the streets” (my mother was going to college) and more time at home. That she needed to get married and have kids. She softened in old age. When I feed my infants, I see my grandmother’s toothless mouth, mashing at her food. “Don’t worry about me,” she would tell my mom, in her last years of life. “Take care of your family. I’m okay.”

“One person’s just do it is another person’s Mount Everest.” I forgot where I read that, but I think of it often. If you grew up wealthy, it’s easy to envision wealth. It’s easy to take a chance on a start-up venture, spend months ruminating on what your next career move should be, job-hop and hope for the best. If you grew up poor, all of that seems like a wild gamble.

My husband and I have done “well”. We were fortunate to have two parents each who loved us, provided stable households, and invested what they could into our education. We both attended Ivy League colleges. My husband started working after college and I completed medical school. But we don’t have the same comfort level as our wealthy friends. Success, to us, is not a guarantee. We know much of it has been luck. We also know that money can be lost as quickly as it was obtained. We don’t have a familial safety net. There is no trust fund at the other end of the rainbow, there is no inheritance awaiting us. The next step is our journey is to support our parents as they grow older. This is our reality.

All of this to say that we have never joined a country club. I wouldn’t even know how to act. I hate having people work in our home or wait on us. It makes me feel awkward. I want them to know that I come from a long lineage of hard workers – that there is no job that is “beneath me”. Recently, an influencer got into hot water for (among other things) describing her cleaning woman as “[the person who] scrubs my toilets”. How demeaning. The sad thing is that I have heard other women use the same description when talking about their “help”. Why? Why do they feel the need to assert their perceived superiority? There is nothing wrong with scrubbing a toilet. I scrub my own toilets when needed, and I would scrub other people’s toilets if it meant I could provide a livelihood for myself.

As a mother, I hope that my children, despite the relative privilege they have been afforded, are able to stay grounded and retain perspective.

Croissants

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Yesterday, we split up the four kids. We do this every once in awhile to give them a bit more 1:1 time (or, as it happens to work out, 1:2 time. My 4 year old had his first birthday party in over a year (actually the first for our entire family in over a year), so my husband took him and my 6 year old. It was a masked, handful of kids, outdoors at a large playground, candy and cupcake get-together. They had a blast.

In the meantime, I took my 7 month old and 2 year old downtown. We parked at the train station (my 2 year old’s favorite thing to do), watched trains go by, crossed the tracks a few times and then stopped by some stores to support local businesses. We purchased art supplies to keep the kids entertained in the afternoon and perused the bookshelves for Lion Guard books (another current fave for the 2 year old). We also stopped for croissants.

Downtown, there is a French bakery that makes the most delicious pastries. In 2020, when the shutdown began, we ate at a home for 2.5 months. This was a pretty big deal to us because we do enjoy eating out. Ever since my husband and I were dating, we would go out for coffee, ice cream, cocktails, multi-course dinners – definitely a splurge. With the kids we became less fancy in our dining options, but we still ate out quite a bit – indoors, outdoors, with or without music – so it was a big change for us. In the beginning, we didn’t know whether COVID-19 could be transmitted via food preparation, and we were all so nervous (plus I was pregnant), so we didn’t venture out at all. My husband cooked dinner every single night, as well as most breakfasts and lunches. In May, we decided to eat out for the first time and went to this very same French bakery. I stayed in the car with my pregnant belly and my 3 boys, and my husband stood on line with his mask. They were letting one person in at a time. He purchased a few croissants and we ate them at a local park before riding bikes (the playground was closed at the time and the parking lot was roped off).

Yesterday was a reminder that we are moving in the right direction when it comes to COVID-19. I stood on the line (masked, as was my 2 year old) with almost a dozen people. The outdoor seating was filled to about 50%. I felt okay bringing both kids into the bakery to order. We ate on a bench near the train and I fed my 7 month old a packed up lunch (broccoli and applesauce purees) – the first time he had ever “eaten out” with me. It felt almost normal. Older kids at a birthday party, younger kids enjoying downtown. Definitely warmed my heart.

What doesn’t feel normal is that we have yet to see the grandparents. My in-laws are older and not yet fully vaccinated (although did have COVID in January) but my parents are younger and have been vaccinated for a few months now. I wish they would just fly out to us. I imagine the thought of flying during a pandemic is anxiety-provoking, but it seems pretty safe with vaccines and appropriate masking/eye protection. There’s just no way that we’re going to fly to them with four unvaccinated kids. To be honest, I wouldn’t even want to fly with all the kids if we didn’t have a pandemic to worry about. It’s getting harder and harder to talk on the phone with my mom because she spends the whole time lamenting the pandemic and saying she’d be here in a heartbeat if it wasn’t for COVID-19. And yet I have friends with parents who are immunocompromised and unable to fly because they can’t get vaccinated or because they haven’t mounted antibodies. Friends whose parents are international and are unable to take off enough time to visit with quarantine requirements and testing feeds. And it seems so silly to me that we’re still not seeing them just because there’s a flight involved. Maybe I’m being selfish and lacking in compassion here. Who knows. All I know is that my husband and I are running on fumes right now. We miss our families and will not feel like things are back to normal until we are able to see them again.

At least we can enjoy the simple things again – browsing the bookstore, spending time downtown, getting croissants. Very slowly moving towards normal.

End of an era

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I feel a huge sense of relief and a ton of positivity this week. Where do I even start?

Obviously there was the inauguration. I have never been a political junkie. My parents came from a country where there was a military coup during their lifetime, all books with dissenting political ideas were burned at their universities, and friends and acquaintances were taken from their homes in the middle of the night and murdered for having dissenting political opinions. Because of these reasons, my parents were always largely apolitical. We never put out yard signs, protested as a family, or watched States of the Union, inaugurations, etc. I myself have adopted some of this trepidation around openly expressing political opinions – especially in my role as doctor. We are so divided as a country that it seems so loaded to me to bring up politics or, more commonly, to respond to a patient’s comment on politics. But lately, due largely to the impact of social media, I have begun to wonder how much of my reticence to discuss politics comes from a place of privilege. I’m an immigrant who has been a citizen of this country for decades longer than I’ve lived outside of the country. I’m White passing, gender normative, heterosexual, educated, financially comfortable. So I have been trying to step outside of my comfort zone to be more vocal in order to advocate for others. And also, to be honest, because the events of the past four years have been disturbing beyond words – so, so, so much worse than anything I could have ever envisioned in November of 2016.

But now, there is hope. And yesterday, I sat with my two older kids and replayed some of the performances and speeches from the inauguration. The kids celebrated it at school. And I breathed a sigh of relief that my older children, now 4 and 6, would have memories of a President who is decent, humble, honorable and a good human being.

Second: this is my last week before heading back to work. I have a lot of mixed emotions regarding this. I think: this is the last time I will ever have an infant. The last time I will ever hold someone for every nap during the day. The last time I will ever spend so many hours per day, every day, every week, with one of my children. I feel a sense of nostalgia about this moment, but not necessarily sadness. As my husband likes to joke, we have done this four times – and that’s plenty! I am also looking forward to this next phase of my children growing into adults. I already see changes in my 6 year old – bigger worries, harder questions, the ability to read and digest actual novels (he is currently reading the second Harry Potter book). He is losing some of his child-like innocence.

To be honest, being home with four children 6 and under is a lot. As I always say: being a stay-at-home parent is MUCH harder than being a working parent. Yes, work is demanding. Yes, it adds a full-time job on top of full-time responsibility. But work allows you to tap into the essence of who you are. A lot is lost in motherhood – hobbies, memories of who we were pre-children, meaning outside of these small humans. For me, working is a way to hold onto a crucial component of who I am. I’m able to have adult conversations, use my analytical mind, help others in ways that are tangible, eat lunch, go to the bathroom alone, have uninterrupted thoughts, etc. I’m very much looking forward to that. But, in addition to missing the baby snuggles and extra quality time with my kids, there are two things I will miss dearly: (1) flexibility – the ability to make every last-minute school engagement without thinking about it, the ability to attend to a child’s needs 24/7 with no other obligations, the ability to run an errand for the home every day of the week, the ability to pick the kids up when they are not feeling well without having to cancel clinic, the ability to quarantine for 2 weeks without being disruptive and (2) mental space. I have been thinking about this one a lot. For a variety of reasons, I was feeling pretty burnt out before going on maternity leave. Not working has off-loaded work stress from my life (that sounds pretty obvious but it’s true!). I don’t have to worry about having a difficult conversation with a colleague, feeling disrespected by administrators, challenging patient cases. It’s hard for me to leave work at work – to compartmentalize it – especially when I have the ability to be connected 24/7 and also when I do split my workday to make time for pick-up, kids’ activities, etc. I see sick patients and I worry about how they do, and it is impossible for me to turn that off at 5pm. So I am going to see how to compartmentalize the things that I can – non-clinical work – while also feeling relieved that I have dissociated from the more toxic work environment I was previously in.

Third: I received the second COVID vaccine. I am so so relieved by this. I will, of course, continue to use PPE at work and masks when out in public, but I feel so much better knowing that I will be somewhat protected against COVID, especially when seeing positive patients or those who are being evaluated for active disease. My parents have both received one dose of their respective vaccines (they work in healthcare) and my brother and parents-in-law recently recovered from COVID, so I am hoping this all means that we can have some sort of reunion later this year.

Finally, I have restarted on of my favorite past times: reading. I am on my fifth novel this month and have been working to actively carve out time to read each day. Of course, this will be somewhat compromised when I start working, but I am hoping to keep at least 50% of this reading productivity. Reading brings back such great memories for me of reading during childhood and I think it’s so important for the kids to see me reading as well. It has also provided some much needed escapism during a year that has afforded such few opportunities for activities that remind us of normalcy.

Here’s to the end of one era and the beginning of an even better one.

Vaccinated

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I received my COVID-19 vaccine today. The Pfizer one was offered to me and I took it. I feel a bit like I did after Election Day this year – ready for a big sigh of relief.

I still remember how we stumbled around COVID in the early days of the pandemic at my hospital. We weren’t quite sure what the precautions should be. When my first patient showed up, having just flown in from China, I went into the room alone, wearing an N95 mask and gown. But we still didn’t wear masks or eye protection in the workrooms and all other patient encounters were routine protocol. I remember the first time a COVID test was run on a patient I had seen on the inpatient service. My colleague called her daughter’s school and they asked her to pick her up. I was so worried that I had been exposed and would be exposing my whole family. Fortunately, that patient tested negative. I remember clinics shutting down completely and being converted to video. A few patients still wished to be seen in person and I would go in to see them. I brought my own Lysol wipes from home and wore scrubs every day. Hair up, N95 on, surgical mask over the N95, face shield in place. I would avoid my children when I arrived home and jump straight into the shower. I was so worried that I would contract COVID while pregnant – so worried that I stopped seeing patients at 34 weeks and took a full month of prepartum leave. At the time, all of these precautions seemed temporary and we thought we’d be up and running full throttle by the summer. And yet, here we are 9 months later.

One disclaimer here is that I am primarily an outpatient physician. I see oncology patients and do round regularly in the hospital on our consult patients, but I am not on the front line (emergency room, ICU, COVID units, etc.). I am in complete awe of the physicians, nurses and hospital staff who have been on the front line this entire time. I do not have it in me to do what they did. My patient population is primarily healthy, but there was still so much fear around pre-symptomatic patients coming to clinic, colleagues coming to work before diagnosis, etc.

All this to say that getting this vaccine was a big deal for me. It was a sign of hope – hopefully the beginning of the end. Although I plan to wear PPE the entire time I am at work, I feel reassured that I am less likely to contract COVID if I am exposed. Although we don’t have the data, I am also hoping that this means I am less likely to transmit COVID if exposed (again, this wasn’t studied, so we won’t know for some time). I am still nursing but decided that the risks to my infant of getting COVID were greater than any theoretical risks related to vaccine administration. I hope that by the time the general public has the opportunity to be vaccinated, we have more information to power the decision-making process. I am not the type of person who jumps on the bandwagon for new therapeutics, but as I always tell my patients who are interested in a new therapy or intervention – you have to weigh the risks against the alternative, not the ideal. Do I wish that we were not in the middle of a pandemic that has kept us away from our families for the past 9 months, kept my kids out of school for much of the year, led us all to wear masks and stay 6 feet apart and completely crippled our social interactions? Of course. But the fact of the matter is that we are in the middle of a pandemic and I will be working through it. It made sense to me to add a layer of protection by receiving the vaccine. And hopefully this truly is the beginning of the end and we can start moving towards relative normalcy sometime in 2021.

Merry

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Yesterday, I asked my husband what was on his agenda for work and he responded that it was a “thinking day”. A day to reflect on strategy, innovation, next steps. To be honest, it sounded glorious. A whole day to just think about something unrelated to the home.

Right now, I am enjoying a bit of quiet, thinking time. My oldest three children are with our nanny and my youngest is taking a nap with me, in the carrier. I have decided to return to work next month and am feeling incredibly conflicted about that. On one hand, I really miss working (I’m a physician). I miss my patients, I miss my colleagues, I miss teaching, I miss having adult conversations and I miss being able to THINK – about diagnoses, patient messages, treatment options, research, etc. On the other hand, the flexibility of my maternity leave has been a godsend – especially during this incredibly tumultuous year. In the morning, I don’t have to wake up before the children do to get ready for work. I can let them wake me up, sit with them while I drink my cup of coffee, stay in my pajamas and play. With school closed during this holiday break, we have even less obligations since I am not rushing to get the kids out the door in the morning. This flexibility allows me to be available at the drop of a hat when the school calls because someone is sick and needs to be picked up. If we didn’t get to errands on the weekends, I can run them any day of the week. I can take the kids to appointments whenever they need to go. Honestly, the flexibility is what I will miss the most. Even though my schedule is incredibly forgiving for full-time work, it is still a schedule. It is not easy for me to cancel a full day of patients because I hate letting my patients down (especially when they may have waited months for an appointment) and I hate creating more work for my colleagues and administrative staff.

I have really cherished the time I’ve been able to spend at home with my children this year. 2020 has been an incredibly unpredictable year and, at times, incredibly challenging. But I feel so fortunate to have had this time, and I will hold on to these memories as I transition back to work in the new year. One lesson I’ve learned is that quality is much better than quantity. When I have been home all day with the children, it is impossible to have fun activities planned all day long and to engage with them fully at every moment (especially when there is cleaning to be done, food to be cooked, etc). I feel confident that I can still incorporate a significant amount of quality time with each child when I return to work.

So I will spend these next few weeks cherishing each additional unburdened minute with them and reflecting on how to incorporate more of that time into a busier future. And I will also be looking forward to returning to a sense of normalcy – for myself – through my career.

Phase two

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My husband is back at work this week. It feels like the end of a chapter – 3 months in, past the harried days and nights of the newborn stage. For weeks, my husband and I took turns holding the baby days and (some) nights while the other tried to “get things done”. Usually things were a shower, cooking a meal, tidying something up. In the mornings, we tag teamed to get the older kids dressed and set up for virtual school or out-the-door for in-person school. He held the baby in the car when I had an appointment. I held the baby in the car while he went into the store to get groceries. We ate lunch together (and if we got take-out, this was also eaten in the car because of COVID). One of us would stay home while the other drove to pick up the older kids. When we were less sleep-deprived, we checked off some items from our to-do list. We also watched movies, TV shoes and read books. We took walks around the neighborhood. I feel very fortunate that he was able to take 3 months off this time. We talked during the day about our kids – adult conversations, something we can’t do when 4 kids are in the house. This hasn’t been the case after every baby’s birth, and I can tell you that the toughest postpartum period for our marriage was when our third was born. He kept working because the baby arrived 2 weeks early and he had some things to wrap up at work. Then, because we had family help, he decided to save his leave for when I returned to work. But it was hard. As the only person who could help me overnight, he would stay up and then be tired for work. I leaned on him to help around the house as well and this was an added responsibility for him. In sum, I am grateful for this time we had together, and also feel a bit sad that we are closing the chapter on our newborn days. But, as my husband would say, “we’ve done it 4 times. I think that’s plenty!” And he is certainly right about that.

So this week, I am adjusting to our new normal. He’s working from home and I’m in charge of getting the kids ready in the morning, driving them to school, tidying up, planning meals and spending time with our littlest one during the day. I, again, feel incredibly fortunate to have this extra time with my baby. I also have to admit that this is the hardest part of maternity leave for me, because I do think there is an imbalance in our marriage when my husband works and I do not. It is especially exacerbated during COVID since I have no alternative social outlet at the moment. I take great pride in my career. I love working with and helping my patients. I respect the trust they have in me and think about them when I’m not at work. I also have amazing colleagues and feel so indebted to them for keeping me safe during my pregnancy and covering my patients while I am out.

As I start planning for my own return, I am having a hard time deciding what to do. I am worried about going back to work during the winter COVID surge, but also feel that it is my duty to do so since I have “sat out” the past few months. I am concerned about committing to a schedule since the kids’ schedule is so up in the air. There are potential quarantines if any of the children or teachers in the classes test positive, and the kids have also had to stay home for a myriad of “symptoms”. Once, my 4 y/o had a temperature of 99 and “was not acting like himself”. Another time, my 6 y/o thought he might have felt a sore throat but it was gone by the time my husband went to pick him up. He still had to come home and get a COVID test (it was negative). Yet another time we quarantined at home for 14 days because our 2 year old was exposed outdoors to someone who later tested positive for COVID. I very much appreciate how cautious the school is – so far they have had no COVID cases – but it also throws quite a wrench in any plans to work as I so hate having to cancel patient appointments. So, basically, I am now having to deal with COVID reality for working parents. I have had a reprieve during leave and it was immensely helpful during the start of this crazy school year, but now I find myself incapable of being decisive on what 2021 should look like.

For now, I am trying my best to set up some sort of schedule for my remaining days at home while mulling over the return-to-work possibilities in my mind. I am enjoying these last few weeks of snuggles because this is our last baby. Maternity leave seems like a slow uncoupling, in preparation of returning to work. First, there is the full immersion in your newborn – he is held in arms all night, worn in slings or carriers all day, nose to sweet-smelling newborn head. I am there for every minute of his day – obsessing over details like wet diapers, hours of sleep, when he last nursed and on and on. Slowly, there is a move towards (relative) independence. Trying to get him to sleep on his own at night. Working on a morning schedule – now so that he can join me on the car ride to drop off his brothers and later so that I can feed him before heading into work. Soon I will have our nanny hold him for longer stretches so that he can get used to her and her to him. We’ll try a bottle while I pump (we have never followed the “introduce a bottle early” rule with our infants. I know it’s not recommended but so far we have not had issues and it honestly just seems like more work). Maybe I’ll run an errand without him, leaving him home with my husband. And that’s how we’ll transition from spending almost 24 hours joined together to my being away during the day. Again, I am fortunate: I work full-time, but my hours aren’t terribly long. I don’t have to be separated from him at night. I have the option of doing some of my work from home. Despite this, it is clear that this next phase is bringing me closer, day-by-day, to being away from him for longer stretches of time. And even though it is a choice, it is still hard.

Gratitude

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If you had asked me this time last year what 2020 would bring, I would have never predicted any of this. A global pandemic, working from home, our children out of school for months, wearing an N95 and face shield to see each and every patient, Zoom classes for a 4 and a 5 year old, walking around downtown wearing a mask, a scarcity of paper towels and hand sanitizer, not seeing our families for months…it seems surreal reading those words back, even though they are things that actually happened (and are happening) this year.

Someone shared this image with me today and it seemed so fitting to read on Thanksgiving Eve. As an adult, I recognize that this holiday is not the idyllic pilgrim/Native American bonding fest that I learned about in school. It also wasn’t a huge holiday in our home. We were immigrants, my parents disliked turkey and I was a vegetarian, so we only really started celebrating when my younger brother was in school because he found out that all of his friends were eating turkey! But through the years we have come to define this holiday on our own terms. At the very beginning of our relationship, my husband and I celebrated at his aunt’s home, a family tradition for them and my first introduction to the extended family. We would drive or take a bus to see our families. Once we moved out West, we enjoyed a number of Friendsgiving festivities, since the holiday break always seemed too short to fly out East.

This year, we will be celebrating alone as a new family of 6. We are ordering a traditional Thanksgiving meal, because the thought of cooking with four little ones running around and no one to entertain them is too much. We’ll surprise the kids with gratitude lists – a compilation of why their parents and siblings are grateful for them. We’ll watch the Macy’s Day Parade, run our own Turkey Trot (a 1 or 2 mile loop around the neighborhood) and choose toys to donate to a local school district. I feel more fortunate than ever to have created this sweet full nuclear family during this incredibly tumultuous year.

While compiling photos for our 2020 photo book, I began to see our adventures this year in a different light. So many photos of the local park, where we went for days upon days upon days, because it was close to home and had bike trails and few people – the place where our then 1 year old learned to ride his strider bike like a champ. Photos of us walking, biking and scooting around the neighborhood – devising different routes to spice things up. The countless workbooks and crafts we coordinated for the kids to do – so many pictures of them gathered around the dining room table working on one thing or another. The forts and pillow creations and countless games of “lava”. The bounce house we finally caved and bought, and how when the wildfires were raging we set it up in our living room to get the wiggles out. The summer weekends spent in an isolated area of the beach, the kids first venturing timidly to the water and then donning wetsuits and bodyboards so confidently that we had to move them to a beach that was safer for little ones to swim in. Reimagining birthdays – photos of home decor, cakes, presents. The time we celebrated the birthday of two stuffed animals in our home just to have an activity for the weekend (also learning that stuffed animals are now called “stuffies”). The boys spending most of the day half-naked in the backyard, doing all sorts of water play and venturing over to the “hot side” of the house to have their picnic lunch. A first day of school photo in front of a laptop and a white board when our oldest child’s school launched a virtual curriculum at the start of the year. So many great memories that warm my heart.

Like most hard things, the photos show only the good times. Missing from them is the fear as COVID-19 spread to our community. The uncertainty at the hospital – when do we wear masks? How do we screen patients? Will we run out of PPE? Seeing patients while pregnant, hoping I wouldn’t get sick. Coming home and showering immediately before allowing the kids to come close to me. The disappointment as we canceled trip after trip – wiping away tears when our children cried to see their grandparents. The fear of having to go to the ED postpartum and worrying about exposing my 3 day old to COVID. My oldest saying “I’m so sick of coronavirus. I’m tired of hand sanitizer and wearing masks. I wish things could go back to normal.” The weight of trying to make everything okay for your kids, when things in the world were so far from okay.

But we have been lucky. We have not gotten sick. Our parents have not gotten sick. My husband and I still have our jobs. We have not suffered financially. Two of our children are able to attend school in person. I am immensely grateful for all of that and more.

So this Thanksgiving, I am choosing to reflect on the positive notes in those photos. Years from now, that is ultimately what I will remember the most. A special time when all 5 (and then 6) of us were able to be safe at home together. No school, working from home, then maternity and paternity leave. A special time to bond while our children were young and wanted to spend time with us. My goal for the next few weeks, in anticipation of returning to work, is to enjoy these moments as much as possible. As difficult as they can be sometimes, I know that I will miss them immensely when they are gone.