11 Dear friends, I urge you, as foreigners and exiles, to abstain from sinful desires, which wage war against your soul. 12 Live such good lives among the pagans that, though they accuse you of doing wrong, they may see your good deeds and glorify God on the day he visits us.
13 Submit yourselves for the Lord’s sake to every human authority: whether to the emperor, as the supreme authority, 14 or to governors, who are sent by him to punish those who do wrong and to commend those who do right. 15 For it is God’s will that by doing good you should silence the ignorant talk of foolish people. 16 Live as free people, but do not use your freedom as a cover-up for evil; live as God’s slaves. 17 Show proper respect to everyone, love the family of believers, fear God, honor the emperor. 1 Peter 2:11-17

A pretty remarkable passage. A passage that I’m sure has been used on many (and opposite) sides of various arguments. It hit me hard about a week or slightly more ago. Strangely what the passage convicted me of was speeding. I’ve been convicted of that before but didn’t really act to strongly on it. I am not a reckless driver by any means, but I tend to always drive about 4 miles over the speed limit (not in town- on the highways and freeways). Sometimes more like 7 over, when we are driving to the airport in Boise as an example.

Historically I’ve had some tendencies toward road rage, but I think that dates back to a much more angsty, pre-Christian time in my life. From a self analysis (which is always somewhat suspect) stand-point I think I’m a pretty calm driver. So it’s not that I was feeling convicted of “rage” or aggression, literally that passage seemed to be telling me to obey the law.

So about 10 days ago I stopped speeding. Let me re-phrase. I tried to stop speeding. The very first day I was going to stop speeding I took a left onto I-95 to go to work and sped up to get ahead of the traffic coming North. I’m cruising along and look down and I’m going 8 over the limit. Just simple matter of speeding up and not CONSCIOUSLY being aware of my speed. Over the last 10 days I have been much better at it and really the last two days can say “I don’t speed anymore…for now”. But what makes this relevant is the broader application to sin in general.

To not break the speed limit I had to be constantly aware of my speed. I think sin is very similar. To avoid sin we need to be constantly in Christ and constantly striving to avoid sin. Sin is too easy in our world. Sin is everywhere on the internet. I don’t even mean full on porn surfing- even 5 minutes ago I went to the weather site I use and the advertisement on the right of the screen featured an attractive woman with a tee-shirt that did not fit appropriately. It’s easy to spend 10 seconds longer looking at that then you should. It’s easier to click the link and see “what other T-shirts they have for sale”- but that’s how we lie to ourselves.
Likewise it’s easy on internet forums to say and act in ways not representative of our God. I once belonged to a forum online through my old church and the things and beliefs that people espoused on that forum routinely amazed me- and that was on a site for and by Christians.

15 Anyone who hates a brother or sister is a murderer, and you know that no murderer has eternal life residing in him. 1 John 3:15

Yikes. We need to gird our minds and stay sharp to avoid sin- even of that of hating our brother or sister. Keep your eye on your speed if you don’t want to break the speed limit.

De-Sissification
The approximate quote from Josh: “Rowing was good for de-*&%^ification.” The word there being another word used for a cat. I’ll use the word *sissy* from now on for what Josh was refering to when he was quoting another of his friends related to the benefits of having been a rower. I am however thinking of that other word every time I use it. Josh competed as a rower at a very high collegiate level, having been teammates with Olypiads and having competed in national level competitions. He is not a *sissy* for many reasons but rowing certainly didn’t hurt. It made me again think of what *sissies* most Americans are. I can’t tell you how often people’s excuses for various things I’m advising them on could be tranlsated as “I”m a *sissy*” (if they could only realize what it was they were actually saying).

A few brief examples: 1) “Health food is to expensive” in response to my advice to eat less food. I’ll go on to argue with them that making a whole wheat sandwhich at home is the same or less money then a fast food meal and they’ll look at me like I have 4 arms. What they really meant was “I’m a *sissy* and fast food is easy, tastes good, and I’d rather watch tv after eating in the car on the way home then have to “make a sandwhich” when I get home.” 2) “I get to hungry (insert other adjective like “weak”, “dizzy”, “low blood sugar”, etc) when I try to diet.” when I advise people to try to lose weight. Again could be translated as “I’m a *sissy* and I’m incapable of tolerating any mild discomfort other then being stuffed from over eating or being constipated from my terrible diet. “Oh…and I’ll probably come see you for medicaiton about my reflux or constipation which is brought on directly from eating to much”.

This American diffuse and pervasive *sissiness* could be cured by giving PE teachers the green light to actually push kids in gym class again. Now most schools don’t even have PE and you certainly couldn’t push a kid to their limit, in fact the 1 mile “run” is school is actually a “let the obese teens walk”. Or make all teens work for a summer on a farm. Let a farmer be their parent for a summer, *sissiness* reduced by 50% in 3 months guaranteed. Manditory 2 years of service in the National Guard after high school? Most kids need boot camp, the problem is that they need to be de-*sissyfied* before their 18. Many kids are obese before they are teens now. The wide availability of food, the sendatary life styles of their parents, and kids are often way behind before puberty hits.

Pain Tolerance
The second related idea is this: people who tell you (as a physician) that they have a high pain tolerance: probably do not. I’d say that 9/10 times that someone tells me “I have a high pain tolerance” it probably means a) I have a low pain tolerance and a moderate injury that most people wouldn’t need pain medication for or b) I’m a pain medicaion seeker/abuser/addict/salesman and I don’t really even have an injury. With that said I had been smuggly thinking in my own mind “I have a pretty high pain tolerance” though I would never say it outloud because of the above required translation.

I took only 6 of my opioid pain medications after my surgery on Monday. I was getting around petty well and felt I had recovered quickly enough that I was thinking I was pretty tough. Then I saw Kate yesterday and realized I’m closer to being a *sissy* then actually having a high pain tolerance.

She had a similar procedure surgery to my laprascopic appendectomy and took NO pain medication. She also was back to work 5 days after her surgery (which was yesterday for me and I was still moving pretty stiff). I do feel loads better today, bordering on normal at times, but I’m sure glad that I don’t have to go to work for another two days still. There’s always somone tougher then you. Being smug usually ends with you looking a fool.
Proverbs 14:22-24
22 Do not those who plot evil go astray?
But those who plan what is good find love and faithfulness.
23 All hard work brings a profit,
but mere talk leads only to poverty.
24 The wealth of the wise is their crown,
but the folly of fools yields folly.

As the evening wore on I developed increasing (right lower quadrant) RLQ pain. Around 9 PM I emptied my bladder which evoked a somewhat more significant but brief RLQ pain. I came out to the living room and was lying on the floor examining myself and telling Dorothy “I wonder if I have appendicitis” to which she responded “shut up”. I went back to playing at the computer and about 11 PM I took a shower and was starting to feel vaguely ill- like mild body aches. Dorothy has had a cold so I started hoping “please start getting a sore throat”. I was asleep for about 30 minutes when I was awakened to terrible nausea, significant chills, and somewhat increase RLQ pain. I still only rated the pain at 3/10 at the worst. The nausea is what sent me to the ED. That was terrible. I knew at that point what I had. I called up to St. Ben’s to make sure that we didn’t have a surgeon available (we didn’t) so I drove myself to St. Luke’s for evaluation.

What a strange, bordering on fun (if having appendicitis and eventually getting a few thousand $ bill can be called fun) experience being a patient. I had been to the ED once before for something minor, never for anything major. I have a vague memory of getting stitches in the ED at age 3. Early Monday morning about 1:45 AM: They got met settled in, IV placed, the Physicians Assistant came and evaluated me (listened to my heart and lungs through my gown). Labs drawn. Then I carried my IV bag to X-ray and had my first ever chest x-ray and abdominal flat plate. Lying on the X-ray table was very uncomfortable with appendicitis. It’s a very flat and hard table that they must chill to about 10 degrees. I gave a urine sample after that, which was tricky with a gown on and my IV bag slung over my shoulder. Then I saw the ED doc (also examined me through my gown). He was basically like “you’ve got appendicitis and the surgeon is on his way in”. Yup, I sorta thought the same thing. WBC was 10.5 (barely elevated), CRP was 2.9 (very elevated- a general marker of inflammation).

I also saw Garth, whom is my favorite Murse of all time (one of my favorite nurses over-all too, but that’s largely because he acts and sings and I saw him in a local show of Jekyll and Hyde and he killed it as the main role of Jekyll/Hyde- unfair advantage), in the ED. He gave me a shot of promethazine after the 2 shots of Zofran had not touched my nausea at all. I did not enjoy the promethazine. It made me very altered (keep in mind it’s now about 2-2:30 AM and I haven’t really slept). Drowsy but not exactly falling totally asleep. I was slurring my words and couldn’t think straight. I think next time I’ll just stick with the nausea. It was bugging me that I wasn’t clear headed enough to pray. I later wondered if they had given me some morphine or something too, though I don’t think so, I told them I wasn’t having much pain and didn’t need anything.

It dawned on me later that I was never afraid. I wasn’t just being tough or stoic. I knew what was wrong with me and I just simply wasn’t afraid. My personality is somewhat like that (see my post about bike racing- I had to quit doing that because I had become afraid) I don’t get nervous about much anymore, which definitely comes from surviving the experience of medical school and residency- it changes you. It also just never really felt life or death to me, I pretty much felt like it was going to turn out fine. I really never was that “sick”.

Sometime after the promethazine I saw Dr. Blair, who’s quite a young guy. He’s a very calm person, I liked him immediately. I could barely follow him because I was altered. They took me to the pre-op area, which I can’t remember well because of the promethazine kicking my butt. I had to stip down (I left my socks on) and pee in a urinal so I didn’t have to get a foley catheter. I peed all over the edges of my gown. I think I was having more pain at that point and being all altered from the promethazine, not being able to stand up straight from pain, and trying to pee in a urinal in front of people was pretty awkward. I could feel my pee from the bottom of my gown on my leg.

They wheeled me back to the OR and I vaguely was aware of the anesthesia person giving me something in my IV. I scooted over to the OR table and my next memory is about 3 hours later with a nurse asking me all these questions and me falling asleep. The nurses were turning over at 7 AM and the outgoing nurse was trying to get her work done before the next nurse came on. It was sort of comical. I’m pretty sure I asked “Is my appendix out” which is so classic- ahhh anesthesia. Then about 8:30 I really woke up. Another very strange feeling. I was really awake. I was feeling pretty comfortably tucked into a bed and knew where I was and was clear minded. No pain to speak of, no nausea. I hit the button and called the new nurse in because I felt I needed to pee. Jessica was my nurse for the rest of the day and she was very nice. Getting out of bed was awful. I’d rate it as the worst pain I’ve ever felt. What’s weird was the pain was now in the LLQ (left lower quadrant) where the biggest of the laparoscopy ports was. I imagine that pain is what it feels like to be stabbed. If the appendicitis pain was 3/10 this pain standing up was about 8. Peeing in a bed-side urinaral while a female nurse is 6 inches away was pretty weird. Trying to get the flow of urine started with 8/10 pain and a female nurse standing 6 inches away was not easy. I got about 600 cc and struggled my way back into bed. She gave me 2 mg morphine IV and two hydrocodone right after. I slept away much of the morning. I called various family members and eventually my wife and baby came to visit which was nice. Later I micturated an amazing 750 cc of urine!

I improved quickly through the morning. Getting out of the hospital bed was still a 6/10 pain struggle, but even walking or sitting up wasn’t that bad. I had solids for lunch and walked 150 feet in the hall without much trouble. I even danced a little jig for Jessica near the nurses station. Eventually I saw Dr. Blair and he discharged me home. I was home 13 hours after getting my appendix out.

I’m home now. I’m doing ok, still pretty painful moving around, but it’s a different kind of pain now, more like “man I worked out to hard” type of pain. I let myself go a little long without pain meds last night and had a weird response to the pain- shivering. Happened again in the middle of the night after I had slept soundly for 5-6 hours. Shivering for about 10-15 minutes until the pain medication kicked in. Very weird. At first I was getting a little spooked that I was having a sepsis response or something, but it definitely faded with my pain and it didn’t start until I tried getting out of bed in the middle of the night. It’s amazing how much you use your abdominal muscles. Even weird little things like passing gas or flushing the toilet uses a surprising amount of abdominal muscle.

I can’t say that I really learned much about how to be a better doctor or about how we can provide better health care at our hospital as a result of my experience. I’ll probably just have a bit more empathy going forward. I really feel for C-section patients more then before. The amount of pain I have from these little port sites, I can’t imagine the C-section incision- even more so because you want to get up and take care of your little baby. Less c-sections! Actually the one thing I think I’d like to see is a change to how we handle the call light at St. Bens. Every time I hit the call light someone (upwards of three different CNA’s and three different nurses) came in within 1 minute to see what I needed. At St. Ben’s the ward clerk hits the button to try to found out what the person needs- often the TV is blaring or there’s background noise, the person not talking loud enough, etc. I think a personal drop in by a CNA would be better patient care and patient’s would feel more responded to.

The worst part for me (besides the eventual bill) is not being able to play with Ruthie. I really can’t get down on the floor yet and I definitely don’t feel up to picking her up yet (she’s very squirmy). Just picking a shirt up off the floor is tough! I’m also sad about having to take several weeks off from Kung-fu. I was really starting to get into shape again. I imagine I’ll be able to practice some of the forms again in a few weeks, but I definitely won’t want to do anything aggressive for 6 weeks. That sucks.

Our first major medical situation as a family! I can’t thank my wife enough, I can’t imagine trying to get through stuff like this without her. Even just knowing that if I needed her to she would get me something without griping about it- that’s love.

Easy in the summer time

If that doesn’t work try this:
NPR article
click on the link on the left for “Easy in the summertime”

It’s a gorgeous song. It’s actually very sad. The background history of the song is that those are two sisters who’s father shot and killed their mother and then himself. That song is about that summer that it happened, almost 30 years ago. The song helped push me to think more about something I had already been thinking about: how do families get so messed up?

I look at my current family: wife and daughter, age 7 months. We so happy it’s almost ridiculous. The degree of peace and harmony we have I know can only come from God. We’ve definitely dropped into a rhythm of life that is enjoyable, sustainable and full of love. The thing I keep worrying about is: how to keep it that way. I look at families I know and there’s so much tension. I myself was raised in a somewhat chaotic feeling family of divorce and re-marry. The classic split family of my generation. It didn’t feel good around age 10-14. I really sensed that my family was sub-optimal.

I was deeply wounded when I didn’t make the little league team around 7th grade despite the fact that my step-dad had played baseball in college. We practiced exactly once leading up to the big try-out. I’m not sure that wound has ever healed completely. At times during high school I was pretty sure my wrestling coach ended up filling the roll of “father” for me: the male authority figure that taught me what being a man was.

And yet my father also didn’t kill my mother. I was never abused, I never went without breakfast or dinner. I got a Christmas every year. I had all books I wanted. Two week driving vacations across the county. Never a doubt that I would go to college or be “successful” in life. I can’t complain about my life, how I turned out, or even my relationship with my family now.

But I listen to that song and I think that aiming for Ruthie growing up with her parents not divorcing or literally killing each other may not be aiming high enough. I don’t want to aim for “well at least I didn’t molest her”. I want to aim for genuine love. I want my daughter to love me and her to know and really feel that I love her. I want to aim for her to be able to trust me with her inner thoughts. I want her to know that we are there for her and for her to think “I want my marriage to be like my parents”. I want to aim higher…and I suspect that most people do when they get married or have a child, but somewhere along the way it often goes to pot.

Bluntly I think the issue is human sin. Infidelity, greed (working too much and not seeing your kids), selfishness (a parent’s life or activities being more important to them then supporting their child), laziness, boredom, are all things that I suspect erode everyone’s goal for “doing it better”. I have to keep remembering that. As work gets busier and more expectations and requirements fall on me. As more Boards ask me to be president (I’m about be elected president of the Board I sit on). As I get more hobbies (I still want to pick up fly fishing) and resume my normal ones after having the baby (backpacking), I need to keep holding on to the fact that what I really want is loving family and loving God with those other things coming second.

This is a two part post the next to come sometime next week…..stay tuned!

Going to a basically Calvanist church the issue that has me worried is that we can come to the conclusion that we are saved and now we don’t need to “worry” about it. The problem is that Jesus didn’t really feel like that. The Pharisees are the cautionary tale. They felt confident in their salvation too. They along with the Romans, crucified Jesus in their confidence. What if we are the Pharisees?

I don’t think the Armenians totally have it wrong, which a staunch Calvanist would say is heresy, but let’s look at what Jesus has said:

Matt 7:71-27 21 “Not everyone who says to me, ‘Lord, Lord,’ will enter the kingdom of heaven, but only the one who does the will of my Father who is in heaven. 22 Many will say to me on that day, ‘Lord, Lord, did we not prophesy in your name and in your name drive out demons and in your name perform many miracles?’ 23 Then I will tell them plainly, ‘I never knew you. Away from me, you evildoers!’
24 “Therefore everyone who hears these words of mine and puts them into practice is like a wise man who built his house on the rock. 25 The rain came down, the streams rose, and the winds blew and beat against that house; yet it did not fall, because it had its foundation on the rock. 26 But everyone who hears these words of mine and does not put them into practice is like a foolish man who built his house on sand. 27 The rain came down, the streams rose, and the winds blew and beat against that house, and it fell with a great crash.”

The punch line is that calling yourself a Christian (or even driving out demons in his name) and going to church on Sunday does not assure your salvation.
Jesus says we’ll be separated based on our behavior:

Matt 25:41-46 41 “Then he will say to those on his left, ‘Depart from me, you who are cursed, into the eternal fire prepared for the devil and his angels. 42 For I was hungry and you gave me nothing to eat, I was thirsty and you gave me nothing to drink, 43 I was a stranger and you did not invite me in, I needed clothes and you did not clothe me, I was sick and in prison and you did not look after me.’
44 “They also will answer, ‘Lord, when did we see you hungry or thirsty or a stranger or needing clothes or sick or in prison, and did not help you?’
45 “He will reply, ‘Truly I tell you, whatever you did not do for one of the least of these, you did not do for me.’
46 “Then they will go away to eternal punishment, but the righteous to eternal life.”

So what Jesus do we worship? Do we worship Buddy Christ from the movie Dogma? Maybe we like the Universal Sky Fairy that my old pastor in Seattle would talk about being so popular- the Hippy Jesus that’s about [cue hippy voice] looooovvvvve maaaaaannnnn…
Or do we also worship the Jesus that returns with a sword coming out of his mouth and robes dipped in blood. The Warrior King:

Revelation 19:11-16 11 I saw heaven standing open and there before me was a white horse, whose rider is called Faithful and True. With justice he judges and wages war. 12 His eyes are like blazing fire, and on his head are many crowns. He has a name written on him that no one knows but he himself. 13 He is dressed in a robe dipped in blood, and his name is the Word of God. 14 The armies of heaven were following him, riding on white horses and dressed in fine linen, white and clean. 15 Coming out of his mouth is a sharp sword with which to strike down the nations. “He will rule them with an iron scepter.”[a] He treads the winepress of the fury of the wrath of God Almighty. 16 On his robe and on his thigh he has this name written:
KING OF KINGS AND LORD OF LORDS.

That’s a Jesus to fear and Prov 1:7: The fear of the LORD is the beginning of knowledge, but fools despise wisdom and instruction.

Or are we idolators that worship food, porn, pop stars, sex, alcohol, money, our lives, our jobs, our families, etc. Jesus again:

Luke12:49-53 49 “I have come to bring fire on the earth, and how I wish it were already kindled! 50 But I have a baptism to undergo, and what constraint I am under until it is completed! 51 Do you think I came to bring peace on earth? No, I tell you, but division. 52 From now on there will be five in one family divided against each other, three against two and two against three. 53 They will be divided, father against son and son against father, mother against daughter and daughter against mother, mother-in-law against daughter-in-law and daughter-in-law against mother-in-law.”

If there are things in our lives that impair our relationship with Jesus, then we may be worshiping idols and falsely assuring ourselves of our salvation and calling ourselves Christians. We may be lukewarm Christians ready to be spit out (Revelation 3:16). At the day of judgment we may be found to be goats crying out “Lord Lord” and getting no response.

I had the interesting experience as a physician and father a few weeks ago of having those two competing interests at odds with each other. It caused me a significant amount of psychiatric grief, something I’m not much prone to.

It begins with me taking a 4 month old child to Maui. I wouldn’t normally chose to travel to such a far destination with my child, for one reason that’s how you get kids sick. My little Ruthie did end up with her first cold a few days after coming back. For another thing: children don’t care about time zones. Their body tells them when they should go to bed and when they should get up, we try to adjust that by “sleep training them” but time zones through things for loop.

So we took Ruth to Hawaii, it’s a 1.5 hour drive to Boise, a 1.5 hour flight to LA, then a 5-5.5 hour flight to Maui. Keep in mind that as recent has a month ago my daughter cried for upwards of 4 hours straight the last time we tried to drive longer then 30 minutes (1.5 hour drive to Hailey and then several hours of crying after trying to put her to bed). It seemed daunting. The start of the trip went off without a hitch.

The thing about Ruth is that she is a social-a-holic. She loves being out and seeing people, even at the expense usually of taking a nap. I’ve joked about it many times before that no one even believes we have a fussy baby. When she’s a church she’s a smiling angel, but the drive home will be continuous tears and then nap refusal and fussy afternoon because of being over tired. So flying on the plane, and transfer, airports was constant social stimulation for her longest stretch ever. We got to Maui 4:30 Maui time which is 8:30 PM here. She is now 2+ hours over her bed time. We loaded in the car over an hour later. We clicked her into the car seat and she cried for 45 minutes straight to the resort.

Now we come to the crux of the conflicting internal emotions. We had a plan in place to give the baby a tiny dose of Benadryl to sleep when we got to the resort the first night and hopefully help her “sleep in” and adjust time zones. The doctor in me has given that advice at times and knew it to be reasonable. The father of a doted upon, precious, darling, 4 month old little girl was crying out “Poison!!!”

Let’s look at this analytically. Benadryl is an allergy medication. It’s an anti-histamine. It’s not a sleeping medication, per se. It helps people sleep because the molecule diphenhydramine blocks histamine receptors and histamine receptors are involved in both allergy but also sleep. By blocking the H1 receptors in the skin and nose it reduces allergy, by blocking it in the brain it makes you tired. It also cross reacts with another category of receptors called the cholinergic receptors and medications that do that often make one drowsy also. It’s pretty safe from a medical perspective at the correct dosing. The side effect is “drowsiness” not “life threatening coma and death in infants”.

I rarely advise it to parents as a physician because over-dosing a child on it can be dangerous and there are deaths linked to doses much higher than appropriate (for example I found an article about a day care provider using 6x the dose I used on my 4 month old on a 3 month old and it dying). I rarely advise it because I can’t be there to assure that the parents understand concentrations and dosing of medications. For me it’s intuitive what 12.5 mg/5ml means and how much 5 ml is. My typical patient doesn’t even know what that sort of formula is or how to use it. I spend a lot of my day during cold and flu season explaining how to dose Tylenol (fortunately most parents UNDER dose that and their kids come to my office with a fever of a 102 on a half dose of anti-fever medication- so maybe it’s unfortunatly).

So again, the MD in me was pretty comfortable with our plan to give our baby one does of Benadryl. The father in me was shouting internally “Kids have died!” Keep in mind that this was only like 2 weeks after I really fell in love with my daughter on the walk from my last blog post. We went ahead with it, giving her a ½ teaspoon, she spit/coughed/gagged most of it out and we put her to bed. She woke up at 4 AM and I couldn’t help but think “maybe we should have given her a little more”….

This is a two part entry based around this picture.

Part 1 Sustainable Exercise

I have been reading a book called Blue Zones by Dan Buettner about the places in the world with the longest life spans and the factors that lead to the “hot spots” of centenarians. I haven’t finished the book yet, but the thing that the book has really impressed upon me is the importance of what I’m calling “sustainable exercise”. The two places I’ve read about in Blue Zones the people are forced by lifestyle, geography, work, etc to exercise at a moderate level….indefinitely. This is very different then how I have lived most of my life. There was a time when I lived on Capital Hill that I walked a lot and the period during medical school that I commuted by bicycle. That has not been the norm and most of my exercise in my life has really been “training” for races. I’ve been in very good shape at different times, late high school I was in excellent shape. About 2-3 years ago I was in excellent shape, racing bicycles and/or running races. The bicycle racing was not sustainable for me however- see my other post about that.

I’ve been running semi-regularly over the summer and was getting back up to 5 or so miles with my weight having come down some and my fitness returning. The problem being that I would feel sore during the early part of the week, tired from work during the later part of the week and got to the point where I only ended up running on the weekend. Three days of weekend warrior running was not a sustainable program. So as I’ve been reading this book I came up with this idea of trying to just make moderate sustainable exercise a regular part of the daily activity. For me this probably isn’t going to be running. Biking maybe. Swimming (if that was available to me) would probably work, but there is no pool during the winter available in Jerome for lap swimming. Driving to Twin for exercise during the winter doesn’t seem to fit the idea of “sustainable” to me. So Dorothy and I started walking in the mornings before work. It’s about 1.5 miles round trip on the gravel road which we did every day this week so far- it takes about 30 minutes for us. The picture above was taken on Tuesday. It’s nice and cool in the mornings, we enjoy each other’s company, the sun rise and the exercise. It has been great for all of us (see part 2 below). This “sustainable” exercise will be supplemented on the weekend by much longer walks, running and eventually hiking and backpacking again. I’ll very likely get a mountain bike which I think will be sustainable exercise. I’m not sure how well this will work come winter as the temperatures get very low, but we’ll see, layers may just make this sustainable despite very cold temperatures. Maybe they make baby balaclavas?

Part 2 Scales in the Favor of Love

The picture also marks a turning point in my feelings about and my relationship with my daughter. We (Dorothy and I) have had a rough transition to parenthood. Few have seen our difficult times because Ruth seems to be pretty well behaved in public, but as recently as 13 days ago she cried for 3 straight hours while we tried to get her to bed. I have loved my daughter because she’s my daughter but honestly the joy I got out of having a child was far exceeded by the pain, inconvenience, crying, etc. The scales were tipped until Tuesday this week to “I kinda wish I hadn’t had a child” or maybe “there’s no freaking way I’m doing this again”.

Then something changes Tuesday morning. We had such an amazing walk that I had Dorothy take a picture of us on my camera phone (the one above). She was so cute, talking through 3/4 of the walk, which is mostly “ahhhhhgrahhhhhahhhhgrahhh”. The talking was punctuated by her looking up at me and smiling and then going back to looking to the side (much as she looks in the picture) and talking. For the last 1/4 she cuddled up to my chest and fell asleep. On Tuesday I could not stop thinking about her at work. I kept looking at that picture and showing to everyone. I was counting down the minutes until I could get home and see her. I worked late and got home just about as Dorothy got her to sleep and for the first time in Ruth’s life I was disappointed she was asleep.

Why the sudden turn around? Part of it is that our daughter has now been napping for about 12 days. The difference in a child from three 5 minute naps in a day to two-three hour long naps during the day, is pretty remarkable. She has been less fussy, more fun, more interactive and easier to get to bed at night. All things that have improved the mental health of our household. The difference started when Dorothy stopped drinking coffee two weeks ago today. Over-night change.

Before when people asked “How’s little Ruthie?” or “do you love being a daddy?, I’d respond one of two ways 1) those that I thought could take it I told them the truth “being a father kind of blows” or 2) those that I didn’t think could take the truth I told them “she’s really growing” which is a true statement but not quite the whole truth.

Now I can really say “I love my little girl”. A deeper love then the “I’ve decided to love and support my child (see my feelings about love in my previous blog post “You Complete Me”) that I had before. This is a “I adore my baby” kind of love. Several sagely fathers a little further down the road had told me “Just survive the first four months and it gets better”. Her 4 month birthday is tomorrow….I guess I’ll know what my advice to fathers will be.

I raced bicycles through much of residency and the affects of fatigue were incredibly evident with that. There was a 4 week criterium series in Nampa at the parking lot at the convention center. That was on Wed nights and was tough for me to make it to because of trying to get out of work, etc. I did however make all 4 races my 3rd year of residency and 2 of the weeks I was relatively well rested and 2 of the weeks I was post-call. The two weeks I was rested I got top 5. The two weeks I was post-call I couldn’t even finish, I had to “sit up” meaning I didn’t have the strength to even stay in the main pack and draft off the leaders. Amazing difference.

I was starting to feel extreme fatigue earlier this week. I was on call this last week, which wasn’t terrible but I did get called a handful of times in the middle of night. Mix that in with a few diaper changes at 4 AM and a baby alarm clock at 6 AM and you start to feel tired. I had Monday off but a meeting at 6 PM, work Tuesday and another meeting Tuesday night. I hate meetings. By Tuesday with a full day of work and another meeting staring me in the face I was starting to melt down. Friday’s (today) schedule was light on Tuesday so I had “the girls” reschedule those appointments and I’m taking the day off. So today was going to be my big day of rest and I actually went to bed pretty early last night-10:30! Then diaper change at 5 AM and I’m wide awake. Six and a half hours of uninterrupted sleep isn’t terrible for me, I do ok with that, but 5:30 is still too early to be up.

I was partially thinking about a blog post that I’ve been working on for some time about some of the differences between men and women and as I was starting to type out the title of it my wife hands me our daughter (now 6 AM) and says “She’s awake”. We played for the last hour and now she’s asleep again (she almost rolled over again today= 10 weeks, wow!). Needless to say I’m feeling fatigued and have no energy to write about something heavy and insightful. Maybe tomorrow morning….

I’m not sure how long that lasts once doctors actually get to the point where they are making the much awaited for salary. You often see them quickly get new cars, new houses, etc. I’ve always been a bit of a tight wad and not really into cars, so that sort of possession accumulation hasn’t been that much of an issue for me. Most specialist make 2-5 x what I make so maybe that’s who I’m thinking of. But I definitely feel my delayed gratification skills fading. For the first time in my life I usually have the money for what I want or need, which is a first. It makes you soft from a delayed gratification stand-point. Why this is relevant now is being a father (and really probably any parent for that matter) requires a healthy bit of delayed gratification. I mean, let’s face it, being the parent of a 2 month old is not exactly that “fun”.

There are moments of fun, my daughter is very social and alert about 1-1.5 hours per day. During that window she smiles at you, goos and coos, and it’s wonderful. Then that window closes and she will cry for an hour because she’s dying of tiredness but refuses to go to sleep. I would not trade my work for Dorothy’s work at this point. She spends much of her day calming, soothing and cooing to the baby when little Ruth not in the mood to do anything. So 23 hours a day the baby sleeps, feeds, cries and poops. Not exactly the “good life”. Dorothy actually does get some “fun” with some of the feedings and just watching her precious baby sleeping, but I’m not sure fathers are programmed that way.

My special “daddy bonding time” as designated by mommy is bath time. Bath time usually sounds somewhere between a siren going off and a hysterical hyena as my daughter bawls through the entire thing. Not exactly “fun”. I think my baby stinks a little bit because I find excuses to not give her a bath because 15 minutes of solid bawling is so un-fun for me. Being a parent requires a significant amount of patience. That’s not something I’ve usually been accused of having in abundance. When I try to get the baby asleep I frequently pass the baby off to Dorothy 5 minutes before she goes to sleep but at times I just don’t have that last 5 minutes in me. I also really think that the baby falls asleep for Dorothy better than me, though Doro doesn’t agree with that.

I’m looking forward to tea parties and taking my daughter out on errands when she can talk and tell me stories and play games. I’m looking forward to cuddling, playing basketball, looking at grasshoppers in the yard, playing catch, reading books, all that “fun” stuff. This part….is about patience and delayed gratification. I’ve been dusting off my delayed gratification but it’s tough, I thought I had put that behind me. Dorothy wants to do this how many more times?!?

Pride or more specifically “to be proud” is a difficult concept for me. Two very different definitions of proud that I will elaborate on here (from dictionary.com):
1.
feeling pleasure or satisfaction over something regarded as highly honorable or creditable to oneself (often fol. by of, an infinitive, or a clause).
2.
having, proceeding from, or showing a high opinion of one’s own dignity, importance, or superiority.

Biblically the word “proud” is never used as a positive. In fact it’s almost always used to describe those upon whom God’s vengeance is due. Pride is the root of most sin. It is the sin I suffered mightily from before conversion. The definition in view here is the second, “opinion in one’s own dignity, importance, or superiority.” When one thinks of oneself as higher then God, we face judgment.

Biblically the closest I’ve found to the first definition of the English word “proud” is the word “pleased” as used in Matthew, Mark, and Luke to describe how God feels about Jesus (from Luke3:22, King James): “And the Holy Ghost descended in a bodily shape like a dove upon him, and a voice came from heaven, which said, Thou art my beloved Son; in thee I am well pleased.” Strong’s defines the word used there for “pleased” (εὐδοκέω in Greek) as “to think well of”. Though I suspect, just from the context, that this English definition might not quite capture the strength of how God feels about Jesus. I think this type of “pleased” is probably a type of righteous pride. It’s proud that wouldn’t be deserving of judgment because it’s really a type of love.

In the 10-15 minutes before the birth of Ruth Hazel when Dorothy was really suffering and starting in her words to “freak out”, she kept saying “I don’t know” over and over. I knew that birth was imminent that one or two big pushes would result in the birth of our daughter. The pain was very intense for Dorothy and I could barely help her because I was starting to cry so much. As our daughter finally broke through and was finally born I wept to the point of almost sobbing. Dorothy looked in amazement the pain already gone (at least temporarily until her doctor began to clean up her birth injuries) and kept saying “Oh my gosh” and then the baby was on her chest she kept saying “Hi honey, oh honey”. I continued to cry so much I could barely see her. Later I realized that feeling that brought the tears was joy, to a degree, but the overriding feeling bringing those tears was pride, the first definition, the εὐδοκέω, for my wife. She had suffered at times mightily for almost 8 hours and already loved our daughter and had forgotten the suffering just moments after the birth.

I can’t recall ever feeling that way about anyone or anything. I certainly have never had εὐδοκέω for anything I have done in my life. Of any of the many “major” graduations I’ve had, getting a first job, buying a first house, I’ve felt thankful and I’ve felt relieved, but never really felt type 1 proud. The closest I’ve probably come (at least to my sleep deprived memory) was when my mother finished her 3 day 60 mile walk at age 50. The crowd, a packed stadium actually, was roaring for all these (mostly) women and I knew how my mom would be feeling down on the field as she entered the stadium and I felt a lesser degree of the εὐδοκέω at that moment for her.

Now over two days out from delivery I’m still somewhat choked up at times with type 1 pride for my wife. Being sleep deprived for 3 straight days helps make me more emotional, for sure. Today I have love for my wife like I haven’t felt ever, because of this amazing sense of pride in her. The picture below I think is tied for or perhaps even the most beautiful picture I have of her, the other being 1-2 amazing pictures of her from our wedding day. Now along with that love and beauty I have in my wife I have the same for my daughter. I now have a real “family”, which is such an amazing feeling. I am the proud papa.