Handstands and Motherhood

It was a fairly typical Monday afternoon. My three boys tumbled off the school bus just before three o’clock, suppressed energy from a structured school day emanating from them like skin sweating an overindulged garlic meal.  They careened wildly into the house, shouting & shedding coats and boots and hats. The peace and serenity of taking care of a curly haired & lashed preschooler was lanced like a carbuncle and the pus-like mayhem was about to begin.

Afterschool snacks were the first order of business. Apple slices & yogurt were initially rejected but then begrudgingly consumed. Unfortunately, being a pediatrician’s offspring really does mean trying to meet that daily goal of five servings of fruits & vegetables per day and four servings of calcium & vitamin D. As my 7 year old would mutter, “A real bummer.”

Orchestrating an independent 4th grader’s homework (his accelerated fifth grade math problems necessitated MY use of a calculator) and then actively participating in a 2nd grader’s reading comprehension worksheets and multiplication flashcards was a sprint towards the extracurricular finish line. Sight words for my kindergartner were drilled. Books were read and the backpacks were repacked. This frantic homework dash is purely self-induced of course. Certainly no one forced me to sign my kids up for a myriad of activities. My daughter did not need to take dance class, gymnastics, a nature class and Taekwondo. My two older boys did not need to add thrice weekly swim team practice on top of their 5 classes per week of Taekwondo. The boys did not need to be musically stimulated with piano lessons.

Be that as it may, I was racing to chauffeur the four kids to 3 different extracurricular activities. I also had to squeeze in a packed home cooked meal for the two older boys while their younger sibs were at Taekwondo. Honestly, there are some foggy days when I just want to swing by Mickey Ds and succumb to the convenience of fried salty processed hamburgers and french fries. However, I have not yet broken down. Most likely this is because of the memory of bumping into a patient family at a McDonalds’ in Breezewood, Pennsylvania (200 miles away on a family trip enroute to Washington DC) and being told by the father, “See, our pediatrician feeds her kids McDonalds so it’s definitely okay!” I didn’t realize that an annual McDonald’s visit made me the pediatrician poster child for fast foods!

Consequently, I was a harried tired mother with insignificant first world problems, all of my own doing. I was feeling fractious and grumpy, like a toddler who had the post-nap crankies. My children were stoking my mental furnace by bounding about the house, gleefully screaming and wrestling like hyenas near the Christmas tree. They blithely ignored my initially patient requests to start getting changed into their Taekwondo uniforms. Instead, they were pushing each other around, wiggling like puppies and leaving messes in their wake that I had tidied up minutes before. And as always, I felt like I was going to lose it. The clock was ticking, the extracurricular activity was awaiting and the kids were oblivious to my ballooning temper. I felt my blood start to simmer and fizz like magma.

As a pediatrician, I am very patient and indulgent of my “kids” in the office. Unfortunately, a lot of the patience seems to dissolve when I parent my own children. My kids know what buttons to push and usually I can manage to remain calm when one or two buttons are detonated. It is when the third or fourth child is caterwauling that my temper overwhelms my composure. I counsel myself on all AAP recommendations regarding the discipline of children. I recognize my own parental vices and have made daily resolutions to be more patient and understanding of these four darling hellions. But more times than not, I don’t always succeed. Today, while the kids were squealing, somersaulting and parachuting about my house, I decided to try another approach. I started practicing ujjayi breathing that I use in hot yoga class and then did a handstand for 60 seconds. Amazingly, afterwards I felt calmer with this inversion and the emerging strident tone in my voice was quelled. Frankly, I was thrilled. I found a new outlet for my daily frustrations of raising four strong-willed  opinionated children.

I have already done three handstands tonight.  But no yelling.

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The Bravery of Children

I am lucky to witness the bravery of children every single day while I am at work.

I was working my Thursday evening clinic, hustling to see my patients in a timely manner. The afternoon and evening passed by rather uneventfully. Many well child care examinations and a sprinkle of otitis media, strep pharyngitis, chronic cough, molluscum contagiosum rash and atopic dermatitis. Pretty basic pediatric fare, which my fellow colleagues and I could treat on autopilot.

One of my last appointments for the night was weight loss. I eyed the complaint on my schedule with a slight grimace. Weight loss could be anything from eating disorder to celiac disease to inflammatory bowel disease to hyperthyroidism to liver or kidney dysfunction to new onset diabetes. The diagnostic possibilities abound. My pre-teen patient greeted me with a sweet outgoing smile. We discussed the stability of her chronic heart condition as well as her 8 pound weight loss over the past 2 months. For a lithe girl, eight pounds was twelve percent of her body weight. Her family had reassured me that she had been eating in a much more healthy manner over the past 3 months, exhibiting an increased appetite at meals and cutting down on sweets and junk food. When I questioned them about urinary frequency, they mentioned increased trips to the bathroom the previous week, which seemed to resolve by the beginning of this week and denied increased thirst. I advised some very simple tests: a urine dipstick and a fingerstick to check blood glucose. Unfortunately, the diagnosis was made quickly. My patient was spilling significant glucose in her urine and had a one hour postprandial blood sugar in the 400s. Luckily, she had only trace ketonuria and was not in diabetic ketoacidosis.

Even after years of relaying bad news to patients and their parents, I will never shrug off the sting of a negative diagnosis. I told my patient and her family directly and simply, “You have new onset diabetes. We need to admit you to the hospital for further testing and education.” I will never forget the crumpling of her carefree, innocent, happy face. She was a bright girl and understood that the diagnosis of diabetes was not inconsequential. She immediately understood that there would be changes in her young life. She whispered softly, “It is just not fair.” A pristine tear rolled indolently down her smooth cheek. In that moment, my heart splintered a little bit too. She had already learned to live with a chronic heart condition and now added diabetes to her medical problem list.

Fortunately, her protective tiger mom and grandmother swooped in to envelope her in a tight, loving embrace. They rubbed her frail back while tears were streaming down their own anxious faces. I briefly discussed my plan for the night with the family and asked if they had any immediate questions. I then stepped out of the exam room to work on admitting her to the hospital. During this time, I could hear deep sobbing coming from the exam room, likely from all three generations of this strong family.

When I returned to the exam room, I crouched down on the floor next to my sweet patient and gently lifted her trembling chin. I told her, “You are so strong and so brave. I have seen you overcome many tough things. This does not change who you are as a person. You are beautiful and smart and funny. You have an incredible future ahead of you. You will live a good life. We need to get you to the hospital to give you all the tools to continue to live a good and happy life.”  And my brave sweet patient nodded and I witnessed in her eyes a strength that she pulled from deep within. Her sobbing abated and her trembling stilled. She was like a courageous warrior going into battle. She returned my hug firmly. When she walked out of my clinic that evening on her way to the hospital, her narrow shoulders were straight and her back was erect. Her valor and spirit were up lifting.

All my lionhearted plucky patients battling cancers and chronic diseases are truly my heroes. They exhibit such mettle and moxie and set such staggering examples for their peers and adults alike. They learn to persevere and do it with such grace and optimism. Due to my profession, I learn so much from my young patients’ every day and admire their fortitude and that of their stalwart families.

New Year’s Resolutions from a Wacky Mother

A Wacky Mother’s New Year’s Resolutions 2013:

1) Remain normotensive. Others would say, “Don’t sweat the small stuff.” This is a trite phrase I commonly recite to myself when my little ones are using green marker to draw on their stuffed animals or antique white bedroom furniture or blue crayon to create a masterpiece on the carpet in our office. I can feel my blood pressure rise when the older boys are bickering over Legos. I have told myself to get a grip countless times in the past 8 years of motherhood. Living in a scary world of school shootings, childhood cancers, accidental injuries, I know I should feel grateful to have my kids around to wreak havoc to my house and mind.

2) Keep a dirtier house. I like to keep my house meticulously clean, tidy and mess free. Often times as I am cleaning, my Tazmanian devils are creating more mayhem and disarray at a faster rate than I can clean!  However, every moment I am cleaning or straightening is a moment I am not actively mothering. My kids won’t remember living in a clean house when they are older, they’ll remember playing chess/Legos/dolls or reading books with their mother.

3) Smile more frequently. I have noticed that sometimes when I purposefully smile at my children, they will flash me their reciprocal smiles. They may also suspiciously ask, “Why are you being so nice to me?” or “What’s with the weird smile?”

4) Count to 10 before saying anything negative to my children. I think I may have inherited my grandfather’s legendary volcanic temper. The kind that simmers and bubbles and then overflows when the pressure reaches a certain level. Anger is only a useful or productive emotion when harnessed in a positive way.

5) Be as patient with my children as I am with my kiddos at work. I am measurably more patient with my clinic children. Typically if my sweet pediatric patients are acting feisty, it is because they are out of their element. They may be febrile and ill or anxious about impending vaccinations. I try to approach my patients gently and try to be understanding of their fears and frustrations. Conversely, I need to translate this serene tolerance to my four spunky children at home. It seems unfair to my little ones that I save my equanimity for my clinic patients and then sometimes unshackle my ire when I am at home. All children deserve consistent benevolence, especially from their mother!

6) Travel unconventional journeys with my four children. Walt Disney World and the beach are cute and sweet in their own way but not at all off that beaten path. I want to take my kids to see the  natural wonders in this world. I want them to understand there are other possibilities outside of suburbia. Parenting can be difficult at home or in travel, but the amazing memories created can be so much more vibrant than a prosaic home routine.

7) Dance daily. My kids like to take showers in our master bathroom. Several times a week, we will turn on the iPod in the bathroom and dance to Led Zeppellin or PSY or Jason Mraz while each child is showering. Some days I am exhausted at the end of the day and just can’t get my mojo on. My dumplings become so disappointed when they can’t dance naked in the privacy of their own house. There will likely be a time (sometime in the near future) when they also won’t want to dance with me anymore or realize that I am a truly terrible dancer. Right now, they actually think I am funny and have good dance moves! I need to take advantage of this time!

My resolutions are probably pretty basic or simple and I likely should have been doing them all along. But sometimes when I get stuck in the mire of working, rushing, cleaning, I lose sight of enjoying. Happy New Years!

Little Germaphobes

I have very likely molded my impressionable young children into germaphobes.

Growing up in the 1970s and 1980s, I had no idea about microorganisms and their nasty effects. Naturally I washed my hands after using the restroom and kept up with my personal hygiene. I am sure as a little girl I didn’t have any qualms about scooping up a dry piece of food that had dropped on the floor and popping it right into my mouth. Perhaps I thought twice about eating something wet or moist that dropped on the floor. Perhaps not. My idea of cleaning up my family room was tossing all untidy objects like balled up socks and scraps of paper and pencils behind my couch. I likely pressed my round little face up against many a germ-laden window or mirror, touched a handrail and then rubbed my eyes or stuck a finger in mouth after touching my feet. I probably touched my lips to a telephone receiver in a hotel or at a public library before the days of personal mobile phones.  I’m sure there were countless scenarios in which I would have cringed at my unsanitary young self.

Unfortunately after taking microbiology in college and medical school, engrossing myself in the science that demonstrates the ingenious techniques that bacteria, viruses and parasites used to mutate and reproduce. Microorganisms are amazing and can develop resistance to antibiotics, anti-virals and anti-parasitic medications. Subsequently, I started becoming a bit of a germaphobe. As I have witnessed the noxious effects of Rotavirus, Coxsackievirus, Respiratory Synctial Virus, Group A Strep, Norwalk virus, Parvovirus, Cytomegalovirus, Ebstein-Barr virus, Staph aureus (the list really goes on and on), I wanted my kids to avoid some of these pesky viruses and bacteria as reasonably as possible.

For several years, I found myself scolding my poor children when we were out and about in the world at large. I shuddered when we were at Disney World and my preschoolers stuck their fingers in well-chewed pewter colored gum adorning the Dumbo Ride. I flipped out when I saw them sucking on the handrails that encountered many unwashed hands and shoe soles at Soaring in Epcot. The cilia in my ears were shivering when I noticed my little ones rolling around the hotel carpet floor or rubbing their sweet clean faces against the comforter cover that likely housed semen and incubated MRSA. My husband and I felt our blood pressures skyrocket when the kids greedily pressed their lips or tongues to the faucet of many a public drinking fountain. I remember limping (in the midst of a reactive arthritis flare) and chasing my 2nd son when he was a toddler, around a Toronto restaurant while he attempted to stick a dropped ice cream spoon into his mouth, oblivious of the hair and lint stuck to said spoon.

However, over the years, my husband and I started to come to the realization that we needed to take a step back and regroup. AKA GET A GRIP! Constant reprimands over a little dirt were tiresome and laborious to say the least. We also realized that our kids weren’t misbehaving in the hygiene scenario when we traveled. We likely were. We noticed so many other children doing much worse repugnant acts while their parents were oblivious to the germs abounding. But the key fact was that these parents and kids were happy and probably healthy in their slovenly ways. And truly were my kids really avoiding that many bouts of acute gastroenteritis or strep throat or rhinovirus? We have learned to pick our battles over truly disgusting encounters and slightly disgusting scenarios. Now, I won’t even flinch when my kids drop food on the floor and then pop it into their equally bacterial laden mouths. I take a deep breath when they are rolling around unsanitary floors. After all, they are just arming their immune systems and desensitizing themselves against future allergens.

Nevertheless, old germaphobes do breed young germaphobes. My children are fastidious in their hand washing. They don’t like getting their hands sticky or dirty. Sometimes it is to the point of cracked skin on their sensitive eczematous hands! The other week, my 6 year old was terribly upset because just after taking a shower, his little brother and sister “smeared their dirty faces and hands” on him, and they had not even bathed yet! While eating dinner, my 4 year old son had dropped food on his underwear (that is a story for another day) and refused to eat a perfectly good piece of vegetable because of cross contamination! Several months ago, my 8 year old was inordinately disturbed when he had a cold sore on his tongue which we explained was due to a virus. He always uses a paper towel to turn off public restroom faucets and open restroom doors. As parents, we do certainly reap what we sow. Hopefully, since my children’s ideas of germs are terribly inconsistent, they can be easily swayed towards a moderately feculent but happy existence.

Twenty Angels in God’s arms

All of America is heartsick over the news of the Connecticut elementary school shooting. Undoubtedly, every parent feels nauseated and chilled by the evil story that unfolded. As a mother and a pediatrician, I am having a visceral reaction to the loss of TWENTY beautiful innocent lives as well as the adults who succumbed to a mad man’s rampage. When I saw the news on CNN and ABC, I felt doused with icy water and nauseated to my deepest core.

I think I can speak for most pediatricians in my expression of the horror and futility racing through our vessels when we hear such stories. This act of violence and evil counteracts the very premise of our medical practice or vocational mission: to promote the happiness, health and well being of a child. We know how hard it is to raise children, we’ve been in the trenches with all our patients’ parents, and also getting pretty muddied in raising our own children. The initial 4-6 months of sleepless nights (up every 2 to 3 hours to nurse a fussy gassy baby) can dry up the bone marrow of even the most robust parent. When the respite of sleeping through the night finally happens, teething starts. Babies and parents are up again.  And then comes the worry. The worrying about weight gain and weight loss, strange rashes and dry skin, deciphering crying and temper tantrums, development and the possibility of autism. The list goes on and on. As a parent, we put on a cowl of worry the very second that precious squirmy wiggling baby is placed into our arms.

Raising a child to reach the age of 18 (or 22-30 nowadays) is a painstaking gram by gram process. Every ounce of breast milk or formula is recorded in a parent’s mind. Every mustard seed yellow stool and sopping wet diaper is changed with care. Stools that are “atypical” are examined and sniffed and deliberated over. We cheer when our constipated child has finally pooped out that ginormous stool. Some overzealous parents may even do the post-poo-poo dance. I know I do. Every pound and inch is lovingly measured against a doorway or growth chart.

The time and love it took to nurture these 20 sweet angels (and consequently let them fly off to grade school) is what makes me so sad. These Newtown parents have made it through the difficult infant, toddler and preschool stage. The teething has ceased and the temper tantrums have finally abated!  The funny comments and insightful hugs have begun. The sweet smiles and fragrant kisses abound. Kindergarteners and grade school kids can be so much fun. They recount the silliest stories and have a way of regarding the world that always turns the cloudiest day into sunshine. The parents were on the precipice of enjoying soccer games and Little League practices and gymnastics meets. They were rearing to race to piano lessons and clap at tuba recitals! These children were starting to read in Kindergarten and dreaming of changing the world in first, second and third grade. They may have had their own aspirations to be a teacher or musician or doctor or athlete. At the age of five or six, the possibilities are endless. This slate was starkly wiped clean and young lives were called home much much too early.

These families have had their guts wrenched out of them. They will be burying their little ones in lieu of attending holiday pageants and stuffing striped stockings. My heart grieves with them, but cannot possibly comprehend the keening sorrow and despair they are going through. I will pray for them now and nightly. I will hug and kiss and squeeze my four spicy dumplings with my own arms tonight.

Phyllo dough layered mothers

As a pediatrician, I meet a plethora of mothers who come in and out of my office. Some of these mothers do not work outside the home, but certainly work assiduously inside the home. Some mothers work part-time (2-3-4 days per week) and many mothers juggle full-time jobs with day care drop off, laundry & housecleaning, and the raising of their children.

Regardless of these mothers’ full time or part-time status, I regard each of these mothers in their primary job: to love and nurture their children, to tend to their children’s health and well-being. Our appointments are typically very meaty or hearty – a veritable beef vegetable barley soup to consume in a short 30 minute well-child care exam. Depending upon the age of the infant or child, we discuss diet and nutrition, sleep patterns and snoring, elimination and bedwetting, school performance and developmental milestones, activities and mood. Sometimes I am so focused on making sure my patients and their parents have all their questions addressed and then relaying my anticipatory guidance, that I don’t ever truly get to know these mothers as individuals.

Over the years, I have learned that not only are mothers amazing and patient, kind and giving, anxious and angry, they also have such a rich and interesting life outside of their children. I have met many mothers who are marathon runners, yoga instructors, dancers, champion ice skaters, world travelers. I have met mothers who are physicians, dentists, nurses, police officers, scientists, engineers, teachers, accountants and financial advisers. A mother may appear to be anxious or harried (of course sleep deprivation never helps) but they may also be a CEO running a Fortune 500 Company. Other moms are multi-tasking by launching a creative children’s clothing company. I love to see that many mothers have phyllo dough layers beneath their robe of motherhood!

After the office visit, I am sometimes lucky enough to have a little extra time to spend with these amazing mothers. I love hearing about their experiences outside of their childrens’ lives. What I have learned through the years is that the evolution of a serene and measured mother takes time. More often then not, the infant and toddler years are sacrificed to the physicality of the children’s needs. The grade school years can draw great emotional or mental upheavals. The adolescent years can be entering a different galaxy altogether. Through this time, the most relaxed and collected mothers tend to be the ones who sacrifice immensely and provide unconditional love, but also try to sift through the bedlam and glean a couple of seconds or minutes or even one or two hours for themselves. These mothers may run 5 miles daily or practice yoga or play tennis. They may learn to paint, take piano lessons, go to church alone for quiet reflection, or take an astronomy class. It is so important to keep a little segment of time for oneself, maybe while the kids are taking a nap or learning in preschool or tumbling in gymnastics lessons. It is important to realize that although children should be the Ichiban priority, a mother should never lose sight of her former self before children. A mother will never be the same after welcoming a new baby or child into her life, but that primordial self can now be enhanced and illuminated with maternal love, rather than detained or suppressed. As mothers, we probably all need to learn to be a teeny bit selfish. The 20 minutes of meditation or piano playing or exercise in lieu of a clean house or extra sleep may be all it takes to make us become a happier, healthier, and more temperate mother.

As a working mother, I am still learning to find that daily peace and equilibrium. When I first became a mother, I was immersed in the 120 hour work weeks of my last year of medical residency. I didn’t feel like I could do anything extra for myself and needed to rush home to soak up time with my oldest son. Eight years later, I have noticed a tremendous decrease in my anxiety and frustration with my children when I cut my little slice of personal time and then take a nibble or a bite. Don’t forget to swallow! I often do. I sacrifice sleep and a completely orderly house in lieu of these precious moments. I run, practice yoga, play the piano and of late, I blog!

Do geeky parents beget geeky children?

Because my husband and I are transferring our boys to a different school, I realized they would need some new clothes. The boys’ previous school required uniforms. There was predictability and safety in the orderly school attire. I could simply set out their khaki or navy pants and white or maroon polo shirts the evening before, to ward off the mad dash in the morning. I didn’t buy as many casual pants or shirts for the boys because 5 days out of the week, they had fixed outfits to wear.

I decided to buy some new clothes for the boys and started with online shopping at Gymboree. While I was scrolling down different screens, my husband dryly hinted that perhaps 8 year olds weren’t wearing Gymboree anymore. My mind scanned through my boys’ wardrobes – there was a lot of Hanna Anderson and LL Bean shirts and pants, but frankly my finger was not on the pulse of grade school fashion. I tried to recall what my 6 and 8 year old male patients wore to the office (they typically were in a gown for their physicals) so I really had no idea.

So as I am wont to do in matters of fashion (or lack thereof), I decided to wing it. I went to Target to buy their new school supplies and perused the racks for boys’ clothing. Maybe superheroes and Angry Birds and Star Wars shirts were still trendy for the grade school set? I also went to Old Navy and purchased many different graphic tees. But frankly, I really don’t have a good idea what would be cool or acceptable for that age range and I know my boys really didn’t care either.

This disinterest in clothing spurred me to wonder whether my geeky attitude is rubbing off on my children. I know when I was in grade school I was always one year behind in Northeast Ohio fashion trends. The year everyone was wearing Tretorns I was running around in Kmart shoes. The next year I would be proudly wearing shiny new Tretorns whilst everyone moved onto Keds! Although I ran cross country in Junior High and played mediocre JV tennis in high school, I primarily focused on academics and extracurricular activities that would get me into an Ivy League college. I was in the trifecta of Science Olympiad, Math Club and Asian Students Society for goodness sakes! I loved my geeky clubs – Vice-President of the Volunteer Club, Co-Editor of the school newspaper, and Secretary of the National Honor Society.  Since I did well in school and loved to read, I was undoubtedly labelled as a bookworm or a geek.

Almost 20 years later, I observe my boys and notice quite a bit of myself in them. My oldest son loves to read – he has read all 7 Harry Potter books in second grade and reread them at the beginning of this year. He has blown through all the Roald Dahl books last year and all the Percy Jackson books series this year. He taught himself how to play chess in the beginning of third grade and can best some adults. Although he can run 5 miles, has a black belt in Taekwondo, loves swim team and can do 200 push ups and 200 sit ups in 20 minutes, he would much prefer to play Legos or play video games or read. He will only play basketball or football under extreme coercion. My second son loves Legos as well and loves to draw. He is sensitive and sees the world with different shades of lenses. He loves to educate me with his math facts. I see a little bit of my dorky traits in both of them and certainly so much sweetness and innocence as well. After careful reflection, I am quietly thrilled that my boys are bright bookworms and love math and science. I adore their personalities and curiosities. I laugh when they quiz each other in math problems at the dinner table. I like the bit of awkwardness in them, it will build character and shape them into creative talented adults. I hope their geeky traits steer them in the right path of hard work, strong morals, quiet conviction. If I can breed children who will become productive members of society, bring on the geek any and every day.

Sibling rivalry

The dynamics between my children have endlessly fascinated me. I love observing the interactions between them. I giggle behind my hand while listening to their serious or absurd discussions about Santa Claus, the Tooth Fairy and the Elf on the Shelf. I try not to interject while they discuss the best way to manipulate their somewhat strict mother into letting them play their DS or forgoing piano practice. And I contemplate plucking out every strand of my black but greying hair when they fight over virtually everything.

This interest in sibling exchanges most likely stems from the intense rivalry I had with my twin brother. We have been staunch buddies since an early age and each other’s nemesis since even earlier. My mother commonly would remind us that we started fighting at 9 months of age. He would say “Jie Jie (big sister in Mandarin, albeit by 3 minutes), bye-bye!” He would turn his head away and I would start wailing and kicking. I would retaliate and say, “Di Di (little brother), bye-bye!” Over the years we would find anything and everything to disagree on. On our way to preschool every morning, we would drive by a Ponderosa restaurant in the process of being constructed. Every single day, we would wage battles over who would be the lucky kid to sit on the passenger side of the back seat so we would have a pristine and unobstructed view. Whilst the sulking kid behind the driver side would frantically crane his/her head, the other would try to block the view of such glorious 1970’s building construction with his or her arms. The rivalry probably worsened in high school and the fights become more complex and meaningful.

Our loyalty to each other also grew as well. In high school during a precalculus class, my classmate became angry because I was selected by the teacher to present a trigonometry problem instead of him. This classmate struck back by saying, “Why don’t you go back to China where you belong!” I never understood the venom behind his words, it really was just a math problem! However, this particular classmate made me cry several times during junior high and high school. When my brother heard this story, he was livid. As the valedictorian of our class, he could basically chose any university to which he applied. He purposely applied to Duke University without serious intention of ever going, just to block this classmate’s dream of attending the school. My brother was accepted, the ignorant classmate was rejected. My brother went to Harvard instead. I don’t think I realized the extent of my brother’s loyalty at that time. I heard the story several years later. When my brother and I parted ways during college, it was then that we started truly appreciating each other.

Because my brother and I did bicker over the most diminutive, paltry issues, I certainly received my comeuppance when I had my four feisty children. There could be indefatigable altercations when the four of them are together. My children’s fights can be over a toy, a desired chair or spot on the couch to repose, a thoughtless exchanged comment, a hurt feeling or body part, copying a picture or idea. Before the rhubarb reaches a boiling point, I have tried counting out sharing times, splitting kids up in separate corners of the house, and simply leaving them alone to figure out their own skirmishes.

Despite the daily havoc in my household and its subsequent effects on my sanity and greying hair, I have rationalized that the fracas is a good thing. My kids will be better prepared for the challenges and dissensions they encounter in school, extracurricular activities and work. I hope they won’t shy away from confrontation, but instead meet it head on. I hope they will try to resolve problems and  work things through, rather than shutting down or retreating or avoiding the  problems at hand. My husband and I are constantly introducing the mantra into our children’s impressionable minds, “Your brothers and sister will always be your best friends. Friends may come and go, but you should always count on your siblings forever.” Siblings live with your stinky morning breath, your laughter after a stellar report card, your tears after someone breaks your heart. I hope my children continue to be each other’s closest confidantes, as my brother is one of mine almost 38 years later.

Toddler and preschooler idiosyncrasies

“Sometimes,’ said Pooh, ‘the smallest things take up the most room in your heart.”
― A.A. Milne

This quote is so quintessentially true about the love and joy instilled by children. Children are such little gigantic souls, brimming with energy, spices and emotions. They can be such a ray of sunshine to a doleful humdrum day. They can surprise you with their bliss or lift your spirits with their hope. A child’s smile can turn a stressful workday into such an inconsequential thing.

Conversely, they can also puzzle me with their litany of idiosyncrasies. When I became a new mother of a toddler, I was frankly unprepared for the many flavors of frustration, anger, and downright grumpiness that a bambino can unleash! The myriad of quirks displayed by little ones can be bamboozling to the unsuspecting parent. For instance, no amount of medical training ever prepared me for the terror of post-nap crankiness! Certainly this is not a medical terminology, but all four of my kids experienced it with the force of a hurricane during their toddler and preschool years. At times, it could be so torrential that I would much rather skip the nap than face the post-nap sequelae.

I also was initially unschooled by the concept of “redo’s” or “repeats.” Sometimes, when my toddler or preschooler was unsatisfied with the way events played out, they would frequently demand a “redo.” This meant several reproductions of original events until deemed satisfactory to my 2 or 3 year old at that time. When I first started parenting 8.5 years ago, I used to try my best to dissuade such replays to occur, thinking that I would be setting a pattern for bad behavior if I was lenient. However, with more experience and waning sanity, I learned to better choose my battles. Perhaps my little one needed to feel a sense of control in a world where someone bigger was always in charge. Perhaps they needed to assert their overflowing independence. Perhaps they needed to establish a place in our larger busy household.

Today, it is simply easier to advise my 3 older boys line up behind my current 2 year old so she could be the first to go through a door, get in the car, leave the house. The boys don’t mind appeasing this bossy little lady and we candidly do not have the time for a 30 minute temper tantrum before Taekwondo or rushing to the school bus stop! For a 3 month period, my 2 year old also demanded to be the sole person in our household to turn off the light to every room we exit. She currently needs me to stand in a specific spot every morning after brushing her teeth and curly Q hair so she can look in the mirror, fluff her hair and say, “Pretty!” She needs me to sit in a particular seat at the dinner table and recite a precise phrase after reading certain Pinkalicious books and sing her bedtime songs in a categorical order. If the ABC song comes before Itsy, Bitsy Spider, I will be on the receiving end of her self-riteous anger.  I think she feels comfort and reassurance in order and decorum according to her 2 year old standards. As a mother, I need to sacrifice a slice of my own autonomy to placate her sour & salty quirks. I am constantly improvising and redirecting. Last night I had to bust out the “Santa Clause is coming to Town” song to curtail an impending tantrum and resort to scatologic   humor to evaporate those tearful oak brown eyes. She had rewarded me with a giggle, ” You are so, so funny, Mommy!”

Honestly, it can be difficult to differentiate between what is typical for the idiosyncratic 2 or 3 year old, and what is pathological or developmentally abnormal. The navigation of this period can be overwhelming for many parents, especially a neophyte but also for a well-seasoned mother. When in doubt, it is always important to ask the child’s pediatrician.

The choices we make for our children

As parents, we are bestowed the most mammoth responsibility when we give birth to a baby or adopt a child. We are essentially assuming the charge of another soul’s life. We are entrusted by God to take care of the most innocent of creatures, a helpless infant or an unquestioning child. This duty can be a glorious role or an albatross to the inexperienced parent. And despite all the years of babysitting, teaching kids piano lessons, mentoring young children and PEDIATRICS residency, nothing can fully prepare a first-time parent for the enormity of parenthood, most certainly including myself.

One of my greatest fears is the consequences of the active and passive decisions I make for my children. These decisions sometimes can seem like a kaleidoscope. To decide one plan may lead to an entirely different result. Sometimes my choices are knotty: to decide to reward when it is better to discipline, to love in lieu of admonishment, to advocate instead of discourage.

I have wondered if a wrong decision I have made will shape my child’s personality in an irreparable way. This week we decided to change schools for our two older boys. We are transferring them from a safe, dependable, loving school to an untried but equally excellent school that may provide better opportunities and challenges for our boys. Will this change in schools alter the previous destiny plotted out for them? Will my oldest son never encounter that teacher who would have inspired him to be a scientist or physician or writer? Will my younger son meet a friend at his new school that will be the buttress of loyalty for a lifetime?

In my careful reflection, I realize I may never truly know the true effects of the choices I make for my children and the outcome determined simply by chance. I also acknowledge this decision can be Lilliputian compared to the prodigious decisions made by parents who have a critically ill child.  Many parents of cancer patients may need to pore through numerous clinical trials and ultimately decide on a course of medical treatment that may determine the earthly fate of their child. The strength and resilience of those parents are my true paradigms. Fundamentally, I think any devoted parent’s penultimate goal is to thirst for the happiness and health of their precious beloved children.