Our first pediatrician interview

After work yesterday, Sarah and I visited a pediatrician in Rockville, just north of our house. We hadn't discussed it much, so I don't think either of us knew what to expect. The parenting class we took at the hospital provided us with a list of questions we should ask and friends had also suggested some questions to ask and things to look for, so we were more or less prepared.

One thing I read online was that there should be two separate waiting rooms--one for well kids and one for sick kids, to prevent spreading germs. This small practice did not have to separate rooms, and the doctor later justified this by saying that the kids don't actually spend a whole lot of time with each other because they get them into the exam rooms quickly. After sitting in the waiting room for a couple minutes, the main doctor in the practice came out to greet us. He then gave us a tour of the rest of the office.

They have five exam rooms, and a small lab. Each of the two doctors in the practice has a small office and there's a little break room in the back. There are two nurses on staff, and they both seemed very nice. At least one of them mentioned dogs in bio, and Sarah and I always take that to be a good sign.

The doctor gave us an overview of the services provided in their office. Because of financial and logistical reasons, they do not perform more than three different lab tests in the office itself. They work primarily with Quest Diagnostics. (This is a bit of a concern because those big labs can barely handle adults... Not sure how they would do with a baby or kid.)

Both doctors were really nice. We met one only briefly, and spent more than an hour with the main doctor. The two of them had worked together in a large practice before the main doctor started his own. Philosophically, the practice jived with our approach--conservative, but thorough. Having dealt with our fair share of illnesses, we're big researchers (I probably get this from my mom, whereas Sarah comes by it naturally) and the doctor cautioned against un-judicious (that a word?) use of the internet, but appreciated our desire to have informed conversations with him.

The risk with a small practice is responsiveness--what happens in an emergency? The doctor reassured us that all after-hours calls go to a voicemail system that immediately pages the doctors. He indicated that he won't return calles between 7pm and 9pm so he can have time with his family. In the case of a true emergency, he said, we should be going to an ER anyway. I didn't have a problem with any of this.

The benefit to small practice is consistency of care. We've had a little experience with this. A few years ago, Timber was diagnosed with bladder stones, eventually requiring an operation. We had been taking her (as well as our other pets) to a large vet hospital in northwest DC, and we pretty much saw a different doctor every time. The first doctor we saw did not diagnose the bladder stones, and it wasn't until we took her back a second time (maybe a third?) that another doctor finally zeroed in on the problem. With a large practice, the care can be inconsistent. Worse, you could get conflicting opinions from different doctors.

With a small practice, of course, the care will be much more consistent. The two doctors in this particular practice seemed to be in sync with each other.

Sarah laid on a few more difficult "tests", and I was proud of her. She asked about rare conditions that I have, to see how well-connected the doctor is. If he could name a handful of specialists, we'd take that to be a good sign. He did so without batting an eye.

Our overall impressions were good, and if we didn't see any other doctors, we'd be happy to go to this guy. We're meeting with a large practice this afternoon, so we'll see if that changes our inclination toward a small practice. This practice is well-known, endorsed by some friends of ours, and is probably the closest to our house.

Time Rushes By.....

The rate at which time is rushing by at the moment is a little alarming. On the one hand, there are all of the things that need doing and the nervousness about the birth. Then on the other hand there is the arrival of this new person in our lives that we are so excited about. So as time goes by, it is definitely a strange mix of feelings that bubbles to the surface.

The list of things to do just seems to get longer and longer. However, we knocked a big one off the list last weekend - our friends Peter and Kassie came over and basically got the nursery painted for us and put up the molding we needed. They also helped us pick up the nursery furniture, which we were not expecting and it was a great surprise. So whilst the nursery is not finished, it took a huge step forward and we couldn't have done it without them. Dan built the furniture the next day and got us even closer. (There are pictures at Flickr) The fact that now we could basically get some sheets and diapers and we would be ready, is a big load off my mind. Of course, there is the crib bedding that needs making - which I am working on this weekend - and then the decorative items that need adding. But the bones are there and that is really exciting.

When Peter and Dan were putting the furniture into the truck, I had this sudden moment where it became very real that we were actually having a baby. It was not some figment of our imagination, my belly wasn't just getting bigger because I was eating too much....it was really happening. I had had this realization earlier in the week when we were at the baby care class. However, in that context it was more like a "deer in headlights" feeling - we're having a baby!?! I hope we can handle it!?! The really nice part about the feelings I had last weekend was that it was this flood of wonderful motherly instincts - I was really happy - weepy, but happy. :-) The reality sunk in but in a joyous, excited, rush of emotion sort of way. Our babe is really coming! Yay! :-)

"His Little Arm"

Sarah and I took a parenting class last week. It covered the basics: changing, bathing, swaddling and carrying the baby. Whenever the instructor referred to the baby, she preceded it with "his little," so foot became "his little foot" and hand became "his little hand". Although it was endearing, I did get a little uncomfortable when we started discussing certain parts of "his little" anatomy. You know you're ready for parenthood when you can sit in a roomful of strangers and ask about poop and circumcisions and aureoles without batting an eye.

Anyway, Sarah and I made a few observations about the crowd. First, we must have been the youngest in the room by a few years, and we're in our early thirties. Also, everyone was much closer to their due date than we are. We're about two months out, and most couples were a month or six weeks. Some people were less prepared than we are (no crib, for example), so we came away feeling like we were in pretty good shape.

The class consisted of about 2 hours of lecture and 30 minutes of watching videos. The first video was on newborns. They don't really look human, so this was to get us accustomed to their alien appearance and disgruntled demeanor. It's as if they'd just landed and realized that things were much better where they came from. In the video, there was lots of footage of washing birth-gunk off babies. Despite these efforts, they still didn't look human. They just looked like clean, angry aliens.

In this video, they talked about how babies could smell their mother's milk almost right away. As someone without a sense of smell, I became very much aware of this aspect of parenthood that I would be missing. Besides garlic cooking in olive oil, the smell of babies is the one that most people comment on. (Popcorn comes in third, but that's not important right now.) It seems strange that I won't be able to smell my own son, and it's an aspect of bonding that I'll miss. Will it affect my ability as a parent? I doubt it. It seems like a very little thing compared to everything else that parents and babies do to bond.

It's possible that my son will inherit this condition from me, too. Anosmia--the inability to smell--is thought to have some implications for a person's capacity to function "normally", in subtle but important ways. Some people think that people without a sense of smell struggle with food because they don't have smells to trigger hunger. (Personal experience with "sympathy pregnancy weight" points to the contrary.) Others believe that anosmics can't form deep relationships because there's a smell aspect to attraction and bonding. Anosmics know better. After nine great years of marriage, I'm inclined to believe that this is what people tell themselves as consolation for having to smell things like garbage, litter boxes, and cleaning chemicals.

The second video was about how these little aliens attempt to communicate with us by contorting their faces and making noises like malfunctioning cell phones. Much of the video offered suggestions on how to engage with babies not only through touch but by making sounds. Babies respond well to human voices, especially those of their parents, who they've been hearing for weeks while in utereo. Speaking directly to them, mimicking the sounds they make, singing, or even listening to grown-ups talk to each other have benefits for babies because it stimulates their little brains. Since they don't have full use of their eyes in the first few months of their lives, babies depend on sound to learn from their parents.

During this part of the video, there was palpable discomfort in the class because the couple sitting in front of us was deaf. Two interpreters had been taking turns translating the instructor and the video for the benefit of this couple. The emphasis on engaging with your baby through sound felt inappropriate, and focused on an aspect of parenthood that, frankly, made the smelling thing look positively trivial. In high school, I'd studied a bit of sign language, and I watched the interpreters during this part of the video. You didn't have to be fluent in sign language to understand that this was difficult for them.

Sarah and I couldn't see the deaf couple because they were sitting directly in front of us. Their body language, however, didn't indicate any awkwardness. Of everyone in the class, they may have been the most comfortable with the situation. It's ridiculous for any of us to think that either (a) this couple hadn't already thought about this from every possible angle, or (b) that they even cared about what hearing people thought was important in rearing a child. The class will come to an end, but parenthood is forever. It's only about swaddling and cooing for a year or less. The class--for us, for the deaf couple, for any of us--is just a push to get us going, an assortment of skills that we likely already have, or can easily muster. It's a glimmer that though they look like angry little aliens, they're really just little people who are desperate for the same things that we are, and don't really care how they get them: food, understanding, and affection.

NY Baby Shower

NY Baby Shower Family 2
Originally uploaded by brownorama.

This weekend, Dan and I went up to NYC for an early Passover dinner with his family as well as a baby shower thrown for us by Dan's mum and sister. The shower was on Sunday. We had a great time. There were lots of people there including two of my friends from college - Moira and Jo - who came with their new babies. It was a couples shower. So not your typical baby-related party. But Dan has been so involved with this pregnancy and the idea of throwing a party without him seemed mean. So we had both men and women there. I felt it worked and had a really good time. Kudos go to Zora (Dan's mum) and Lisa (Dan's sister) who organized it all and got the invites out and the party all ready. I hope that a good time was had by all. I know we really enjoyed it. For a full set of the pictures from the shower, go to Dan's Flickr account Everyone who was at the party is up there, along with some pictures of the setup and family.

We are holding another baby shower in Washington DC in slightly less than a month. So this is just the first of the celebrations. But it was nice to start things off on a beautiful day in New York City with Dan's family.

The best $150 we ever spent

Baby in 3D!
Originally uploaded by brownorama.

Baby Insight has an office in Potomac, Maryland, right up the road from our favorite nursery. It has two rooms: a reception and an ultrasound room. The ultrasound room doesn't look like any doctor's office we've been to. It's about 12 feet on a side, and besides a high-end ultrasound machine, the room was equipped with a couple couches, a nice rug, and a projector.

Sarah settled into the ultrasound routine. We've done enough of these where we know the drill. Before we knew it, a picture like this one was on the screen in front of us. And in that moment, the rush of parenthood was upon us.

The ultrasound tech was great. She spent a lot of time on the face, but then looked for feet and hands. People sometimes bring family to watch the ultrasound--hence the couches--but it was just us. Despite that, we could hear the chorus of "awww, he's cute..." The interminable conversations began: Holden lips? Brown chin? And just whose nose is that anyway?

After gathering 30 minutes of video, we received a DVD, complete with a soundtrack of our chosing. (Ella Fitzgerald love songs, for those interested.) They printed three sheets of photos for us, and gave us a CD of about 20 pictures.

We sent a few pictures to the family around the world, and there was much excitement.

As I approach fatherhood, I realize that I'm desperate to know who this person is. I'm almost addicted to the pursuit. Every kick and every movement in utero, every sonogram, every heartbeat, every 3d-rendered photo. These are all means we have developed to get to know our children before they even know themselves.

I've always believed that our pursuits in life are focused on one thing: to be understood. We have this psychological need to be the object of sympathy and empathy, and there's no greater frustration than not being understood. As a neo-father, I'm realizing that I want to understand our child as quickly and as much as possible, because I never want him to feel alone or separated from the world. I want him to know that he can always come to mom or dad if he needs a sympathetic ear.

This little picture of him, built by software inside a machine worth thousands of dollars, is priceless because it takes me one step closer to knowing him.