The Three Amigos

 

  

Greetings

My children all have some wonderful attributes. Sam is the eternal snuggler. Caroline has a silent strength that can make seasoned crusty Marines tremble.  But I think one of my favorite things in the entire world is the way my eldest greets me.

I think it has a lot to do with the fact that Jackson doesn't have a filter.  Nary a wisp of a sieve exists between the thought in his brain and the look on his face.  Since the moment his prefrontal cortex had its first thought, the real-time pop-up video took the guess work out of whether he was happy, upset, scared, worried, etc.  Unlike his siblings who would contemplate their situation (i.e. an atrociously dirty diaper) prior to voicing concern, Jack would only need to get the idea that a poop might be imminent and the kid was whaling to rival a 4 alarm fire.  And heaven forbid you woke him from sleep.  That split second of total disillusion that most of us sit calmly through plays out in 3D right in front of us.  Fortunately, every yin has a yang.

He has been in daycare since he was 8 weeks old.  So for almost 5 years now, I have had the utter joy of picking him up after work more days than not.  At first, I would sneak quietly into the infant room so I could see his face before he heard my voice.  One little word from me and he would flail around in an almost-painfully happy snow-angel dance until I would pick him up.  Once he was mobile, I would stand in the doorway and call his name, marveling at the lightning speed he would gimp-crawl to me.  As a toddler, he would very literally push other children out of his way, lean his head into the wind, arms back like a tail, and run at breakneck speed all the while screaming "Mommy!!!" as if he hadn't seen me in years.

And, today, my sweet Jackson didn't let me down.  I've been away at a conference for 4 days.  The kids have been with some combination of Matilda, Gigi, Nana, and Bud having the time of their lives.  I happened to get back to the house before they arrived and watched through the window as Jack scurried out of the car like a spry geriatric man and shuffle to the front door with a look of absolute and total elation.  I opened the door and he literally jumped straight up into my arms, squeezed the stuffing out of me, and said "Mommy, I missed you so much! I have to tell you all about my breakfast with Santa!!"  If it wasn't just so adorably genuine, it could come across as a very cheesy 1980s movie scene.

One day, the way he wears his heart on his sleeve will very likely break mine.  But for now, having someone be so joyously excited to see me *every* *single* *day* is the best therapy money can't buy.

Candy or Bust!

Today's festivities will commence at dawn and run well through sunset and into the wee hours of the evening.

The sugar high may last for days.

Tattooed on my Soul

Great song came on the rotation when I was pulling into work today. Had to just stop and sit and listen.

--

True love will never fade

True love will never fade

True love will never fade

True love will never fade

True love will never fade

I wonder if there's no forever / No walking hand in hand

Down a yellow brick road / To never never land

These days I get to where I'm going / Make it there eventually

Follow the trail of breadcrumbs / To where I'm meant to be

To where I'm meant to be

I don't know what brought you to me / That was up to you

There's so many come to see me / Who want their own tattoo

I fixed a needle in a holder / Laid my hand upon your spine

And there upon your shoulder / I drew the picture as your sign

When I think about us / I see the picture that we made

The picture to remind us / True love will never fade

True love will never fade

True love will never fade

True love will never fade

I worked the rowdies and day trippers / Now and then I think of you

Any which way we're all shufflin' / Forward in the queue

They like to move my operation / They like to get me off the pier

And I dream I'm on a steamer / Pullin' outta here

When I think about us / I see a picture that we made

The picture to remind us / True love will never fade

True love will never fade

True love will never fade

True love will never fade

True love will never fade

True love will never fade

--Mark Knopfler (2007)

Big Burger Daddy

I am what you would call a Burger Aficionado. I consider the cheeseburger to be America's finest culinary creation of all time - meat, bread, cheese, condiments, even some vegetables from time to time - all in one easy to hold, easy to eat package that when executed properly is the size of a small melon. I can recall a time in my life when I ate a cheeseburger for breakfast, lunch and dinner - all in the same day.

So I was unsurprisingly excited to hear through the grapevine that Greensboro's "Big Burger Spot" was in fact "the finest Burger in town." This was not rote advertising, but rather the considered opinion of several well-respected members of the Greensboro Burger Aficionado Underground.

WE WANT OUR BURGERS!!!

Tucked away into the side of a gas station convenience store building, designated by unassuming signage and awning tastefully done up in a neon-green-and-hunter-safety-orange color scheme, this is truly an out of the way gem. The Big Burger Spot features, well, Burgers - but not just any burgers, grilled meat on bread with cheese executed to perfection. yes, you can get it medium rare (beef is never frozen); yes, you can get a bison burger (that's what I had); yes, they have a dog-friendly outside dining area that features murals of customer's favorite pooches (and some cats). The dogs with halos are off chasing the big beef bone in the sky. A mix of Michael Jackson, Waylon Jennings, Cher, and the Avett Bros. blares from the outdoor speakers, and the owner brought out  sample pouch of homemade organic dog biscuits for Dean-o. This is the essence of Am-bi-ance. The line stretches out the door from 11 in the morning to 2 in the day, and the food comes out on hammered aluminum plates - this is basically the Burger version of BBQ-heaven 12 Bones in Asheville.

This is just plain old good-eating. Doc's Pimento Cheese Burger disappeared in a flash, the kids all cleaned their tin plates, and Matilda's Classic Bison Burger had to be shared among several still-hungry mouths. The fries are good, the tea is good, the sun was shining. Life - and food - doesn't get any better than this.

The Many Faces of Sam

This guy cracks me up:

 Sam has recently taken a cue from Big Sister Honey Badger and has started throwing his "mean face" around to voice (silently) his displeasure at someone or something. This makes for a very comical transition from time to time, where he goes from jolly to "mad." The really funny thing is the last little tweak he does with his eyebrows, to really push it over the edge:

But then we get the old Sam back - mowhawk hair and yelling at the top of his lungs for Mom- My. Even though he's sitting in her lap. Because when he's not, he's running his little bow-legged stomp run to get there. 

Sometimes there is even room for Big Brother.

What you need to know about your friendly road-weary MD

Today was a hard day at the office. Most days I feel like I do help people feel better. But today was one of those days when each door opened to another person peering at me through suspicious eyes, ready to tell me how much I didn't know about their condition or how my motives were somehow not aligned with their best interest. So, I have created a list of things you people just need to know. Because I don't think I can survive too many more days like today. 

1) Please do not ever say to your doctor: "I know you're a doctor but I know my body better than anyone." Until you can tell me the difference between a bacteria, a virus, a parasite, an allergen, and an antigen or describe the process of oxygenation of hemoglobin including the transportation across alveoli or describe the process of sodium secretion and reabsorption in your kidneys then I can assure you, I do know your body better than you do. And speaking of that...

2) Do you really think doctors would train for a decade, incurring sometimes hundreds of thousands of dollars worth of debt, and shave years off their life through sleep and social deprivation only to learn something they could have just researched on the Internet? Perhaps all of the training we go through gives us a bit of perspective and knowledge that you just can't possibly read on WebMD. Until you can walk me through the design of a randomized double-blinded control trial, sensitivity, specificity, and statistical significance, then give us a little credit.

3) Do not make an appointment with a doctor if you do not plan on taking his or her advice.  And for goodness sake, don't keep going back to that same doctor over and over again if you are not going to trust her. It is a waste of both of our times.  

4) "All natural" and "prescription" do not make things inherently good or evil. Cyanide is all natural and will kill you. Antibiotics can save your life but they can also kill you too. All things ingested (which includes everything swallowed up to and including food) have side effects. The key to healthy living is weighing the risks with the benefits and determining the best course of action with the most information you have at the time. Remember the point of consumer marketing...to make a sale.

5) And speaking of that, let's talk about Big Pharma.  The times of drug companies being able to woo doctors with trips to fabulous places or nice swank gifts is over.  The only thing I get from drug companies is samples to pass out to patients (which means I give away approximately $5000-$10000 PER DAY) and lunch for my staff three days a week. In exchange for that, I agree to listen to drug reps drone on and on about how fabulous and superior their product is.  Sometimes, when I've had enough coffee, I'll fire enough questions at them to make them realize they are trying to educate me on something I know much better than them but generally I just smile and thank them for feeding my staff because well-fed nurses make happy nurses and that makes happy patients which in turn makes happy doctors.  Perhaps the major problem with today was the lack of food.  I digress.  Drug reps cannot give me so much as a tissue to blow my nose and while they know how much I do and do not prescribe their drug, I could not tell you what drug any of them peddle despite seeing some of them on a weekly basis for the last 3 years.  That is all to say, when I prescribe a drug to you, it is not because their is a kickback to me.  It is because I think it is the best drug for you, weighing your other medical problems, your lifestyle (i.e. do you work alternating night and day shifts so a medicine that needs to be taken on an empty stomach at the same time each day just isn't going to work for you), your insurance, and your financial situation.  Yes, if a branded medication has a pretty sweet coupon card, I may choose that first if it ends up costing you less than a generic.  But let me be clear.  I do not get any kind of reimbursement from drug companies or pharmacies.  So please do not accuse your doctor of being in cahoots with anyone.  I can assure you I rather despise your insurance company and Big Pharma probably as much as you do, but likely for much different reasons.

6) Antibiotics.  Similar to as above stated in #5 in that I have absolutely no financial incentive to prescribe meds, I also do not have any financial incentive to withhold them.  Take a big breath and hear me out on this one.  Just because you are sick does not mean you have an infection that an antibiotic will kill. And just because you were sick once, or even 10 times, and "an antibiotic worked for me then" does not mean it will work for you now.  Nor does it mean it even worked for you then, as most of the time you would have gotten better anyway and the antibiotic was started about the time that upswing was taking place. I know a thing or two about bacteria.  I would never go to my mechanic and say "I know you are telling me my brakes are bad but I can assure you, I know my car much better than you and I am certain the reason my car will not stop properly is because the tail lights are out.  Replace them and leave the brakes alone." Any good mechanic would send you packing.  Unfortunately, since you can sue me, I can't be so blunt.  Nor do I have enough time or energy in my day to explain the difference between a bacteria and a viral infection to 20 people times 5 days a week times 52 weeks in a year. Truly, it would just be easier for me to give you the antibiotic that will not fix you and could possibly kill you (we will save malpractice lawsuits for a different days rant) but, as a physician, I am charged with antibiotic stewardship.  Antibiotic resistance in this world is growing at an alarming rate. We are already seeing bacterial infections that are 100% untreatable.  This is caused by overuse, and more importantly, improper use of antibiotics.  i.e. You have a cold. It is viral. It has to run its course. I know you "don't have time to be sick" but that's something you'll have to take up with Mother Nature because I left my magic wand at home today and I'm not going to replace your tail lights because your brakes are broken. See #1.

7) If there were a safe pill that would easily make you young / thin / live forever, don't you think all doctors would be prescribing it and also owning stock in whatever company was making it?  We aren't and we don't so please believe me that it doesn't exist.  If you want to be as healthy as possible, only eat what you can grow or kill.  And spend the energy actually growing it and killing it.  That will solve most all of your inability to lose weight.

8) You cannot describe any bodily function or odor or fluid that will embarrass me so please don't waste the energy fretting about that.  Foamy urine or foul smelling poop or anal leakage hasn't made me blush yet.  Doubt it ever will.

9) If every doctor you've ever been to along with the CDC, the NIH, and most public health institutions strongly encourage you to get a flu shot, do you really think we're just saying that for some type of financial gain?  If so, please reference #5.  Not only are we trying to save your life or at the very least about 7-10 days of your absolute misery, we are (more importantly) trying to save all the lives of the people in our community much more susceptible to dying from the flu than you (like my children and my mother).  It's called Herd Immunity.  It's one of those things we learned in medical school. Again, reference #1. Get your flu shot. (And by the way, if you truly want to look like an absolute idiot to a physician, just say "I don't get flu shots because they cause the flu." Yes, Chicken Little, the sky is falling.  But only on you.)  

10) There is not one single stinking thing you can tell me about smoking that makes the fact that you continue to do it anything other than you willfully trying to kill yourself.  Period. 

11) I don't do my job for free.  I am paid well for my time.  But I am not paid as well as you think I am so please refrain from using phrases in my office such as "Well, you couldn't possibly understand because you're a doctor" and "clearly you don't have to worry about money"  and "I wasn't as lucky as you to have the chance to go to college."  Not only does that make a lot of assumptions about me (and we all remember that to assume makes an ass out of u and me) but it also completely disrespects how hard I have worked to get where I am.

I am sure the above won't change many minds out there.  But if, at least, you can go into your next office visit with a little less animosity and a little more humility, I think the visit will be so much more productive for both of us.

End of rant.  

High Flight

One of my favorite poems is the landmark verse set out by John Gillespie Magee, High Flight - I don't know if I should have been a fighter pilot instead of a grunt, or used my GI Bill to get a pilot's license rather than an LLM. But I sure would like to experience this one day:

Oh! I have slipped the surly bonds of earth,
And danced the skies on laughter-silvered wings;
Sunward I've climbed, and joined the tumbling mirth
Of sun-split clouds, -- and done a hundred things
***

The kids got a taste of this today at 5NC3 - the Gilliam-McConnell Airfield just outside Carthage NC. Runway 13/31 was very active around lunchtime, and for good reason. Just 20 yards off the tarmac sits a third-generation BBQ joint called Pik-N-Pig, hickory smoked pulled pork, fried pickle chips, and Co-Cola Cake. Yum.

Jack and Caroline and Callie really got a kick out of watching the planes come in and out. And playing cornhole.

And riding in the "Flying Pig" amusement ride.

Sam and Emma mainly just enjoyed the food. I have to say, I enjoyed it all.

Cheese!!

Birthday love

My sweet aunt's birthday is tomorrow.  It's been a tough year for her and the one thing she wants most right now is sadly not something I can give her.   Next to my mother, she's the strongest woman I know and will come out a better person on the other end.  In the meantime, I tried my hand at putting my love down on paper so she can feel it every time she looks at it.

Happy birthday, Aunt D.  

My trio

My Boy

I love this guy to pieces:

 

Sunny Days

We just spent a week at the beach. With three small children. And we loved it.

In what was possibly the most enjoyable vacation since Costa Rica '08, all 13+ of the Greater Shaw Clan traveled on the annual pilgrimage to historic Pawley's Island SC, arrogantly shabby, home of the Grey Man, land of sun & surf but with none of the crowds of Myrtle or the uppityness of Wild Dunes. We have been going to Pawley's for about 23 years - hard to believe - and every time it feels like a little sliver of home. There are those that would argue it is better to rent than own at the beach, gives you the flexibility to go when and where you want. But there is a counter argument of the value of permanence, of tradition, of timeliness - of having Bud's grandchildren play in the same sand and on the same stairs that Jupe's grandchildren once did. Regardless, this is where we go, and it suits me just fine.

This year, in addition to our 13+ (Jim, Janet, Stephen, Kim, Jack, Caroline, Sam, Sara, Pete, Sidney, Alex, Drew, & Anna+), Granny had a whole host of Other Shaws down for the big celebration. Bob and Sue, Kena and Robin and Audrey, Rachel and Dave, Dee, Jere, even Tim Debbie and Roberta for a day.  So the Other Shaws stayed at the big house this year, and the Greater Shaws holed up in some very nice condos at the Pier Village - which worked out great. The kids loved having the pier and the pool in addition to the beach, Mom and Dad got a great cabana for some shade, and we could not have been closer to the beach. Nearly as important, in our condo at least - all of the kids slept through the night for the most part, despite all sharing the same bedroom. Actually, I think they kind of liked having their own little den of iniquity, and Sam definitely liked being able to wake up and see his siblings. 

On Sunday, once everyone was down and settled, we celebrated Granny's 90th Birthday. 1923 she was born, and she is still dancing and flitting around and smiling and laughing as if she was still 21. The party was a blast, it was great to see everyone and we had a huge shrimp boil and all the cousins (from three different generations) loved running around together. 

 

Robin and Rachel put together matching t-shirts for everyone, and Anna and Drew brought our koozies that said "Shake your hiney, Granny's ninety.". In particular it was great to see Tim and Debbie and Roberta, who we definitely don't see enough and who are boatloads of fun. We also got to celebrate Caroline's Third Birthday, and had a baby shower for Anna and Drew's new bundle of sex-indeterminate joy.

I was amazed at how much fun the kids had, and how agreeable they were. They really got used to playing on the beach, getting suited up and greased up and heading out in the sand and the water. Caroline did great, floating way out beyond the breakers with Dad and I, and seemed to show a lot of potential as a little fish. I think once Caroline figured out she could jump off the side of the pool with enough floaties to pop back up like a cork, she must've done 200 cannonballs.

Jack loved building sandcastles and then jumping on them, or finding shells with Nana, or darting in and out of incoming waves like a little plover. Put Sam in a big hole full of sand and seawater with a shovel and a bucket and he was good to go for at least an hour, until he noticed the breakers and started running headlong into them. Sunscreen and rash guards worked great, no one got burned or even a little more than a light tan.

Once we'd had enough on the beach, we'd roll in to the pool and grab a snack and jump and splash. The first couple of days, we skipped naptime and tried to push through to dinner, thinking that would buy us a better night time experience. But after a few days, the older kids started dozing off in weird places and we brought naptime back for everyone. That way Doc could nap and it gave me some time to catch up on work stuff, which was unfortunately very crazy at the time. Next beach trip, I hope to just unplug and not worry so much, but this time there was just too much stuff going on at the office.

 

We got to go to the hammock shops and eat fudge and get silhouettes, and all the middle cousins (i.e. young adults) took off to Georgetown one night sans rugrats to enjoy the fine dining of The Rice Paddy. We got to take the boat out a bit, and fish from the pier. And you would not believe how easy BOTH car trips were for our crew (although I know Sara and Pete had a little less fun on I-95).

I really love our family, big and small. What a good vacation - one that actually felt like a vacation, and one that no one wanted to end. I can't wait to go back.