Observations from an ICU

The film on the windows in the ICU casts the room in perpetual dusk. The fluorescent light, while politely dim, only adds to the gloom. The effect is meant to help the patient sleep, I suppose, but sleep seems to wait at the door for the constant shuffle of clog-clad feet and the business of monitoring, checking, asking, helping. Since we got in here, Dad has been in a half-sleep, like he's covered in the same film from the windows. His surgery went well — less than the four hours we were warned it might take, and they took the ventilator out right after surgery. He lies wizened and tiny in the big hospital bed, arms folded over his chest and whole body covered with a blanket, which hides the various devices and tubes that do more of the business of monitoring, voiding, squeezing and helping him get better. Which it looks like he is doing, thankfully.

Hospital New Hampshire

Last week, I drove all around the state of New Hampshire with a film crew, talking to various community health clinics, physician group practices and hospital-associated groups about a radical new concept called Patient-Centered Medical Home: the idea that every patient should have a primary care doctor in a consistent setting. Where a patient is known and welcomed. Where all aspects of their medical care are coordinated (even those things may not immediately seem related to medical care, like getting a ride or getting all your forms filled out). Where a patient is an active consumer of healthcare, an accountable partner in their own health outcomes. Where healthcare providers are paid not only for a visit or procedure, but for all the services they and their staffs provide, from phone calls to referrals to refills. Where people get better — and the system gets better. Really, the idea is not so radical or new: it's old-fashioned family medicine, the kind my grandfather practiced. They are doing good things in New Hampshire. Wherever you stand politically, we can probably all agree that our very flawed healthcare system should realign around people getting better.

After five days in New Hampshire, I landed in Austin and fetched my much-missed children, only to receive the phone call that Jim Dear (Granddaddy) was being admitted to the hospital with an abdominal aortic aneurysm. The fact that they caught it is a miracle, and while the situation is serious, we are optimistic that Dad will recover from the surgery scheduled on Tuesday. We've been happy with the care he's received so far: mostly efficient, caring and effective.

But it's nothing like what I witnessed in New Hampshire. It would mean the world to me and my sisters and my dad to have a Medical Home right now: someone to call and ask the 72 odd questions we have, someone to help us understand what the hell the out-of-pocket maximum is for Medicare Part A (oh, and what the hell is the difference between Part A and Part B), someone to help us get a second opinion about the stent vs. the open surgery. We are Medical Home...less. For all the good care he is receiving, we are adrift in a sea of questions.

Ah, New Hampshire. Keep up the good work.

First Steps

Milo has been dangerously — and I do mean dangerously — close to walking for about a week. So I've been watching his teetering more closely than usual. I admit, I have not watched him as closely as I should have at times. I shudder to think of the THREE, count them, THREE seconds I turned my back on him in the kitchen last week with the dishwasher open and I turned around and he was holding a KNIFE. Gingerly. In my direction. As though to say, "Woman, hello? I am holding a knife?" Why am I telling you this? I am not that bad of a mother. I am just a bad editor.

Milo's first real steps happened on Saturday at Kevin and Patrick's house. We spent a delightful weekend with them in Dallas, where we had better accommodations than the Four Seasons. Patrick kept asking Lucy, "Are your needs being met?" Um, unlimited limeade, Duck Tales, and princess-style bubble baths in a sunken tub? The answer is "Yes, thank you." Although the first time he asked her, she said, "I don't know how to answer that question." Patsy even came to help babysit, while Jason and I went to the Rangers/Yankees game Saturday night (thank you!).

It was only fair that Patrick and Kevin got to see Milo's first steps and I didn't: I was taking an extra-long shower in their fantastic guest bathroom, perfectly decorated with a subtle island theme. Of course Milo first wobbedly-walked around their thoughtful house filled with breakable decorative items, expensive electronics and fresh paint — early signs of good taste (or a death wish).

One

One year ago today, one year ago RIGHT NOW, we were sitting quietly in a hospital room with a mewling, darling new creature. He'd been born at 7 oh something p.m. with minimal-to-medium fanfare. The fanfare: there had been the ruckus with the driving to the hospital at about 7 centimeters dilated, which makes Mopac feel like a VERY BUMPY ROAD. Then there was the waiting in the seemingly closed waiting area, after pressing the buzzer, which made such a lonely sound, like no one would answer EVER. Then there was the filling out of forms, which no one really wants to do EVER, but certainly not at EIGHT CENTIMETERS. Lastly, the news that the dreaded VERY HANDSOME DOCTOR would be delivering this baby: I clung to my doula, said several curse words and repeated my strong opinion that this good-looking doctor should not be allowed to see my private parts without several dates beforehand. Alas, we had no time for dates. There was some more gnashing of teeth and cursing before the real work started.

I pushed. They proclaimed: GOOD JOB, GREAT PUSHING!

I pushed more. More praise.

Pushing. Praise.

Pushing. I was feeling the lack of results. "WHAT AM I DOING WRONG?"

Pushing. Much encouragement and news of a head with dark hair. Dark hair? I made a creature with dark hair?

I pushed some more and [there is no punctuation, no drumroll fitting this]...

Milo.

Not too long later, we had this cone-headed animal, all cleaned up and swaddled. He smacked and snorted, but hardly cried. I had been reluctant to have another baby. HA. I kept saying to his bundled self, "Are you kidding me?"

Milo is such easy joy. He has blonde hair now, and he looks like me. He delights in the opening of doors, the turning on of lights, Beyonce, whoever he sees when he first wakes up. He wrinkles his nose when he smiles and he probably likes you, but he plays hard to get.

Throwing Out the Scale on "Work-Life Balance"

"Work-life balance." While the phrase is meant to describe a healthy approach to doing both things well, for me it calls to mind the image of literally — and constantly — weighing one against the other. Is it more important if I miss this meeting or miss kindergarten field day? Shift the weight. Work late with the team or get home in time for dinner? Shift the weight. Spend dinner enjoying the macaroni or glancing at email on the sly? Nudge the weight. "Work-life balance" means work and life physically work in opposition to each other. The demands of agency life, even an agency as generous as mine, made for constant trade-offs that seemed out of my control. And for us, it hasn't been...working. So I've decided to throw out the scale and erase whatever artificial boundary separated work from life. It was a blurry line to begin with — every facet of my life informs my work; my work (when it works) is inspiring, joyful fuel for my life. Becoming my own boss gives me better control over both. Forgive me while I hunt for a better analogy here: levers? hoses? I'm not sure how to describe this new version of work/life but the goal is certainly more "and" than "versus." Stay tuned. And I welcome any wisdom.

Graduation Day

WARNING: CORNY Today was my last day at T3, the place I've worked for 12 years and 267 days. T3 has been as much a part of the "Kate brand," as my boss Jay would say, as any other aspect of my adult identity. T3 was the setting of many of the major events of my life: two of the bricks Jason sent me during his elaborate proposal were delivered there. When I went into labor with Lucy, I stopped by the office before we went to the hospital (still had some stuff to wrap up, naturally). As infants, both Lucy and Milo were raised by the village that is T3. It has given me so many amazing friends. Oh, and I learned to do advertising along the way. I grew up there.

And yet, as grown up as we think we are, we keep growing still. So I have graduated — to a new life of freelancing. I am stepping into it with all the excitement (and fear) that any new graduate has, both feet moving forward, but allowing myself a few wistful, grateful glances over my shoulder at where I've been.

Tell Me the Story of Your Life, Part 2

I love the moment, in passing or somewhere in the interview portion of the evening or even in a movie, where I discover something truly surprising about someone. You don't know me: you think I am a ______, but really I am a...blue belt in judo! Accomplished belly dancer! Mountaineer! Cellist! These moments can be the stuff of spy fiction, but they happen in real life too. Like when my friend Pie, someone I like to think I know quite well, totally moved and surprised me with her cello choir concert on Saturday. I knew she was rediscovering the cello, taking lessons, practicing with the choir. I'd even heard her play some on her own and with the burgeoning family band (longer, later post here). But I didn't really understand her secret cello identity until I heard her play with the cello choir. It was as surprising as if she'd given a speech in Farsi onstage. It was stunningly good, all those strings together, Pie a part of them.

So. Please, stun me, tell me more about your surprising self because it wakes up my capacity to live bigger, to show up to my life in more ways. Even if I am a little tone deaf.

You Know Summer is Over When...

...Lucy throws a shoe and a few other things at you and says, "I hate you again, Mom, just like I did earlier. You are the worst." I just continued making cookies, which is a better reaction than the time about 30 minutes earlier when she also hated me. She has been a shrill, angry wreck since we got home from El Paso: the victim of too much fun and not enough sleep, and maybe some nerves about first grade thrown in to season the furious stew.

Surely tomorrow will be better. Or least someone else's problem for 8 hours or so.