ten on ten… or something like it

You know those people who are so very responsibly organized about making sure the most special moments of their kids’ childhoods are well documented, accessibly stored, and backed up? I need one of these people to come to my house and tell me how to live my life.

I have these great pictures from Ezra’s first birthday which was this totally magical, actually-lived-up-to-its-ridiculous-expectations kind of day but I can’t tell you for the life of me where they are. I think I have like four that I backed up somewhere online. The rest are… I don’t know… On my old computer? Which is… Oh you get the point.

I used to participate in this photo project called ten on ten, which (as far as I can tell) is no longer a current thing, but since resurrecting the Cannon I am deciding to revitalize it for myself. It’s so awesome to be able to reminisce in photographs (and to have an excuse to actually use a camera that is not attached to your smartphone), and I think the things I will most cherish looking back on will be the glimpses into everyday life as a young family.

Yesterday was my first day back at it. I don’t know which came first, the day being simply wonderful or my determination to document it, but whatever the case it was a particularly enjoyable Saturday–one of my very favorite kinds. Jer just started his first week back at school last week, so we’re still on the tail end of summer, but close enough to fall that we can no longer deny its impending existence. I woke up early to a quiet house (well, after feeding the baby of course), a rainstorm, and nearly two hours on my own before the little ones were up for good (a rare gift!). We walked to the famers market in a mid morning drizzle like PNW’ers (which I like to pretend we are sometimes; we are not), had donuts, ran into friends from the neighborhood. I had some one on one time with each of my kiddos, some rest time, Jer worked in the yard, took Ez to Home Depot, I cleaned and rested a bit, and we ended the day by hitting up our street’s epic block party (not pictured) and watching Band of Brothers (a newish weekly tradition, also not pictured) with our buds the Smiths. If only every Saturday could be like yesterday! Ok! Enough jabbering! Here come the photogs!

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Just some snaps of my sweet babes

I was feeling stressed this morning, for no real particular reason. It was just one of those mornings the baby’s mild unhappiness had the hairs on the back of my neck standing on end, and the house was (is) a disastrous mess.

It never quite works to have a plan for productivity around the house when you have little people in your care. There are those rare days when all the stars align: your two year old decides to play independently for the first time ever, the baby adds an hour to her morning nap, and you find yourself with time to give attention to the things you’ve totally neglected for a stretch of time. But in my experience they almost never come when you plan on them.

Sometimes you just need to turn a blind eye to the things that will always need doing. Today I got out my old camera and spent the day trying to be a little more present with these babes who are just growing up way to fast.

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deep breaths

My toddler is NUTS right now.

I mean, he’s a great kid. Maybe even a particularly great kid, for his age? But he’s at that two-and-rounding-the-bend-about-to-hit-that-apparently-infamous-terrible-THREES stage, which means some days are just complete and utter insanity. Like I-cannot-even-understand-what-you-are-saying-I-don’t-understand-you-were-just-totally-fine-WHAT-are-we-freaking-out-about-again?? insanity. Comical insanity, even, when I’m on my A game. Immediately followed by GIGGLES and KISSES ON THE FACE of course. HOW does one KEEP UP?

The funny and sort of terrifying part of this stage is that nearly every time he is flipping out, asserting his iron toddler will, insisting on having the last word, or seemingly unable to cope when something doesn’t go quite as he planned I think to myself my goodness that child is HIS MOTHER’S CHILD.

I’m not sure if its because of all the infamous stories from my childhood–several of them caught on home video [there is literally a VHS tape in my parents basement somewhere that is marked “ERIN BITE” on which from a distance you see me nearly exactly Ezra’s age slow-biting a neighbor boy twice my age square in the stomach after he refused to move out of my way on our indoor mini trampoline], my own early childhood memories, OR the fact that there is still a little tiny-toddler-Erin inside of me today, but when I see that little dude encounter conflict the way he does, I think THAT KID IS ME.

I wish I could just have patience, one hundred percent flexibility, perfect grace, ALL the time. With my kids, yes, but also just with everyone and everything. I would rather not have to acquire these things through hard work and prayer and the slowww process that is sanctification. Motherhood is not what I need these things for, it just does a really great job at reminding me how much I do not have them on my own. Add sleep deprivation on top of toddlerhood and my own normal disposition and it can feel like a lost cause all together sometimes.

My husband is of course one of the people who knows me best and has had the pleasure of encountering my shortcomings on a daily basis over the course of a good chunk of my years (lucky him!). I can’t tell you the number of times in our marriage he has paused, looked at me, and very kindly and noncondemningly said, “let’s take a couple deep breaths together.” I used to hate it. Actually, I probably still do, when I’m in the heat of feeling really upset and really convinced I have to be right (of course). But I have to say, I hear his voice in my head, and take those deep breaths sooooo often on my own in this season of life. Not just because THE KIDS. Because life, work, stress, house, kids, etc. etc. etc. Even on the kids’ best days, its a fight for peace and patience all the time.

There is a way to have peace when life’s circumstances are just not peace-filled. I know its possible. I know it is because its promised to me in Scripture. Because the Lord calls his Holy Spirit my comforter, my counselor, and a gift that has been given to me, to the church. But its amazing what a daily struggle it is. We need grace upon grace every hour, and constant patient guidance and strength, even on the good days.

I am thankful for a God who doesn’t give up. Who sees and cares about the tiny little troubles of my daily life. Who has paid for my sin in full, and promised to grant me re-dos upon re-dos. Take comfort, friends. Every moment is a new one. There is nothing the Lord is unable or unwilling to redeem. Deep breaths.

please excuse me while I ramble

I have no well-formed ideas in my head about what needs to make its way from thoughts in my mind to words on a page, but I’m telling myself that’s not so much what this is for, so it’s cool if I ramble a bit. You don’t mind, I’m sure?

Motherhood, man. It’s heartbreaking and crazy-making. Allow me to explain.

I was not one of those little girls who has been waiting my whole life for the day I’d start a brood of my own. I have still-vivid memories of just loathing babysitting as a teenager, and I was never one of those people who was just great with kids (or knew much of anything about them, for that matter). But let me tell you something just switched on when these babies of mine came along. I seriously think women immediately gain what I like to call MOM POWERS when that baby pops out of the womb (or walks into your life, if your babe originated in someone else’s womb). Some people are just born with them, but for people like me, they come upon entry into motherhood.

It’s a strange, powerful, new, fierce, DON’T MESS WITH MY PEOPLE kind of love that brings the MOM POWERS, and along with them, the heartbreak. And the crazy.

The heartbreak seems to manifest itself in two forms in these early days. The heart-wrenching you feel when your little person is struggling (or when you hear about someone else‘s little one who is seriously sick, or taken from them, or being mistreated or traumatized), and the heartache that comes from knowing deep in your bones you fall dreadfully short of what you believe these precious little souls need and deserve as a parent.

I do fairly well not to get overwhelmed with empathy when I encounter patients who are facing seemingly impossible challenges as a result of the world’s brokenness. But when one of the kids I see is having serious problems after something they have seen or experienced, it stays with me. When Nora will not fall asleep but is dead tired and I have to leave her crying, it is just agonizing; I get irritable and can barely focus on anything until she’s resting peacefully.

The crazy-making is related. Its what I believe naturally happens in the mind of a mother with the heartbreak who allows her mind to give in to her natural, fallen will. Not everyone struggles with serious anxiety, and not everyone is prone to worry, but I have to imagine that some form of this is in all of us to some degree. I find myself in the prone-to-worry category, but even for a worrier some self identifiably CRAZY THINGS run through my mind sometimes as it relates to my children.

Yesterday it stormed for like five seconds in the evening. On my drive home from work there was tonnns of lightning in the skies, but not much thunder (we called this heat lightning as a kid; I don’t know if that’s actually a thing). Nora is currently sleeping in our attic at night, in our guest bedroom. And I LITERALLY thought to myself Ahh I love all this lightning! Uh oh, what if Nora got struck by lightning because she’s at such a high point in the house? By the grace of God I heard my crazy self and told my crazy self OH MY GOODNESS YOU ARE TALKING ABOUT YOUR CHILD GETTING RANDOMLY STRUCK BY LIGHTNING INSIDE A HOUSE THAT HAS PROBABLY HAPPENED TO LIKE TWO HUMANS EVER AND THEY WERE PROBABLY STICKING WIRE HANGERS INTO THE LIGHT SOCKETS DURING A SEVERE THUNDERSTORM OR SOMETHING. But let me tell you, the crazies can spiral out of control sooooo fast, no matter how much of a reasonable human being you thought you were before children.

There’s something good at the heart of these instincts of course. It is a good thing that it is wired into our DNA for us to protect and sacrifice and feel deeply for our children in dramatic ways. They’re vulnerable, they’re small, they’re clumsy. We as humans need a lot of close support and supervision in the early months and years of our lives.

But this new fierce love that comes with motherhood has got to be stewarded well.

There is nothing in my short life that has made me feel more in need of help, guidance, direction, encouragement, grace, forgiveness, and the Gospel than motherhood. Entering into parenting a toddler and adding a second have just compounded my own proclivity to have some false sense of control over our lives, followed by regular and glaring reminders of my utter need for Christ.

Parenting is a daily grind. Christianity is a daily grind. Endurance, perseverance and repentance are not strong suits of mine. But I take comfort in knowing I have a Savior who knows me intimately and is patient to continue his work of sanctification in me, regardless of its pace. And that the Lord, who is mighty, is whom my children truly belong to. I only need to let go of my grasp on them and trust that He cares for them perfectly, immeasurably more than I ever could.

hello from the other side

Who. has. the. time. Its something I think a lot these days. Its been my approach to writing like this these days. And by these days I’m generally talking about the last two years, with a particular emphasis on the past seven months. I’ve completely let writing fall by the wayside, and with it the commitment to devote any real mental space to regular reflection.

I look back on even my previous, one-child-to-wrangle self these days and think ohhhhhh giiiiiiiirrrll you had no idea. I think, She would paint her nails. HA! She would wear her long hair down nearly every day. HA! What a dear sweet baby love I was, young and free, thinking I had such little time for myself anymore. Guys, that was not even SEVEN months ago.

Its amazing how quickly and drastically things can–and do–change. I don’t wish those days of old on myself, perhaps because children make mental people out of us parents due to how much looove we can’t help but have in our souls for them. [Its a parental cliche, but I can hardly imagine life before the babies became a part of it. On paper, choosing parenthood over DINK-hood (laugh cry emoji) on the other side of the jump, doesn’t quite add up. But in life, it more than adds up. Those squishy, toothless-grinned bobble headed babes and their curious, crazy, high-pitch voiced, not much older siblings win our hearts from day one and we’re stuck for good.] Despite the sleepless nights and early mornings, the messy kitchens, the scarcity of time alone, we’re happy to be on this side. At least, I am. Truly, I am.

But I still can’t help but feel the teeniest tiniest tinge of prideful contempt at my old self sometimes. It is so so easy to feel like a martyr. To crave recognition for what I’ve so sacrificially given up for motherhood. Which, by the way, I entered into so conveniently unaware of what it really requires of you. Can I get an amen?

So no one has. the. time. k? In her own way, that old self of mine was being stretched just as I am today, albeit in in slightly different ways. I don’t want to use my current circumstance to excuse myself from the Lord’s good slow work of sanctification, and I think reflection is one small piece of letting Him do His work in me.

I make no promises. But here I am today, from the other side.

And you’re welcome, for lodging Adele right into the front of your brain there.

For those of you who like birth stories…

THIS one is a doozy.

For some background: Ezra, my firstborn, came after about 15 hours of steadily progressive labor, and three (you read that right: THREE) hours of pushing. He was born two days after his due date, on September 28th, in our dining room (on purpose) in a tub, like a hippie earth mother baby. Baby sister’s due date was the day after Ezra’s birthday, and this time we planned to have her at a hospital near my clinic, where our midwife practices.

K. Here we go. Sunday September 27th was a normal Sunday. We went to church like usual, I don’t even remember what we did during the day, but there was certainly no inkling of impending labor that evening as we went to sleep. Felt totally normal.

I woke up to mildly painful, fairly frequent contractions around 12:45am on the 28th. No way this is the real thing, I thought, but I had better keep track of these just in case. I started timing contractions, which were pretty variable in frequency, less than a minute long, and comfortable enough to be laying in bed through. I kept expecting them to stop, but they kept coming. After an hour I thought, Well there’s no use waking Jeremy up just yet. It’s only been an hour. I’m still pretty sure these are going to stop, and not be actual labor. So I kept timing. I think I had something like 8 contractions in an hour, but sometimes they were 2 1/2 minutes apart, sometimes 7 1/2 minutes apart. They were all just baaarely a minute, but by the end of the second hour I could tell they had been getting more painful, and I started to think Oh crap. This might be actual labor. I woke Jeremy and told him I thought we might be having this baby today.

Over the next hour or so, we debated on what to do. “Do you think I should call the midwife?” “I don’t know… maybe you should try and go back to sleep?” With Ezra, I had labored through the night, and in the wee hours of the morning two years prior I remember thinking “YIKES I AM IN SERIOUS LABOR” only to call the midwives and be told, “nah, sounds like you’re still pretty early… Just try and get some rest, and call us back in a few hours.” As we chatted and debated, my contractions were getting stronger, and I could no longer stay in bed through them. We finally landed on texting my midwife around 3:30am. She responded right away, “That sounds promising. You feeling like you need to head in yet?” I wasn’t sure, but I didn’t feel super confident. I mean my contractions were paaaaiiiiinful and intense, but holy wow I had only been laboring for a total of almost 3 hours! And some of my contractions were still 5+ minutes apart, and a little less than a minute long. By 3:45ish, my midwife offered to come to my house and check me OR meet her at the hospital in about an hour. I couldn’t imagine going to the hospital in only an hour made sense (I mean we had at least like four more hours to go, right?!), so I asked her to come check me, which she was happy to do.

My midwife got to our house around 4:30am, and by that time I was thinking heading to the hospital was not such a bad idea. Things had gotten way more intense, and seemed to be moving way faster than they did with Ez (still a steady progression, just quicker). I remember thinking Oh man, these contractions can’t get any worse because HOW WOULD I SURVIVE THEM. And also this does not seem like an ideal time for a 20 minute car ride.

My midwife barely checked me, and pretty much instantly said, “OK yup you’re 8cm, it’s time to go now, we need to get in the car.” Jeremy had already called the neighbs (for Ezra) and texted Ez’s daycare to let them know he’d be coming last minute. Before we left, my midwife asked me, “Do you feel like you have to push?” It wasn’t super obvious to me at first, but after she asked I was like OH CRAP THIS IS HAPPENING because YEAH I DID. “Ok, that’s going to get worse when you’re sitting in the car so just make sure you’re really cognizant about breathing through your mouth,” she said soooo calmly. “Are we going to make it???” I asked. “Yes, totally we’re going to make it,” she said (also very calmly and confidently). And just as cool-as-a-cucumber she added “If you need to stop and pull over on the way, just give me a call, I’ll be right behind you guys.”

We got in the car and all I could think was “Sweet Jesus, sloooowwwwww the contractions and let us make it to the hospital!” I was literally praying between each one THAT WE WOULD JUST MAKE IT IN TIME. Jeremy did a great job keeping his cool (I think he was still thinking, “this girl pushed for THREE HOURS, we got time right?!?!”) but was driving at a clipping pace to the hospital. Thankfully there weren’t many people on the road at 4:40am, since he was flying through every stop sign we came to. It took us 19 minutes to get to the hospital, and the minute we got there I got out of the car and if they hadn’t already, our lives turned into a WOMAN ABOUT TO GIVE BIRTH IN FIVE SECONDS SITCOM EPISODE OR MOVIE SCENE. I literally stopped outside of the ER and started screaming like a crazy person, and PUUUUUSHING because THATS JUST WHAT MY BODY STARTED DOING TO ME. I think that’s the point in all of this where Jeremy realized things were moving along quicker than he’d expected and also like HOLY CRAP MY WIFE MIGHT HAVE THIS BABY ON THE STREET IF I DON’T DO SOMETHING.

Jeremy ran inside and I heard him say, “I NEED A WHEELCHAIR! I’VE GOT A PREGNANT LADY OUTSIDE!” After the whole ordeal he told me for a hospital they seemed surprisingly underprepared to handle a lady about to have a baby walking into the ER. Anyway he got the wheelchair, ran outside, and I sat right down in it (stiiiiiill puuuuuuushinggg–NOT MY FAULT).

I heard someone ask, “how far along is she?!” “9 months!” said Jeremy, and I managed to say, “my midwife is here somewhere.” Some lady grabbed the wheelchair from Jeremy and said, “I’LL BRING HER UPSTAIRS!” and we were off. When we got to the elevators, she made Jeremy take some other way to get us registered (!), so it was just me and transport chick. I don’t think she was a fan of all the pushing (and yelling!) I was still doing in the elevator on our way up, because she kept saying “STOP PUSHING!” and when we got upstairs she said, “why did you wait so long?!?!” I LITERALLY almost said, “LADY I AM GOING TO CLOCK YOU,” but even in labor my Minnesota nice blood kept my mouth shut. This poor lady was freaking out, because when we got up to L&D all the doors were locked, no one was around, she didn’t have her badge or something, and I was ABOUT TO HAVE THIS BABY AND APPARENTLY SHE WAS GOING TO BE THE ONE TO CATCH IT. She was literally banging on the doors of the L&D unit yelling, “SOMEBODY LET US IN, I’VE GOT A PREGNANT LADY OUT HERE PUSHING!!!” Finally someone must have heard her because the doors opened and she was all “I NEED A ROOM! SHE’S PUSHING!!!!”

They directed us to a room, and I basically jumped on the bed immediately and started (kept?!) pushing. A nurse and a couple other people ran in, and I remember someone saying, “are you going to wait for your midwife, or do you want Thomas to deliver you?” I remember thinking WHAT THE HECK KIND OF A QUESTION IS THAT?! I remember sort of stumbling over my words and saying something like, “Uh, I don’t know I think my midwife is here somewhere?” A couple of them (in unison!) were like “THEN DON’T PUSH.” And I remember saying, “IF MY BODY’S GONNA PUSH, I’M GONNA PUSH, I DON’T CARE IF THOMAS DELIVERS ME.” (WHO IS THOMAS ANYWAY?!) About a second later I heard my midwife get there, and I heard her say, “SOMEBODY GO GET HER HUSBAND, I DON’T CARE IF HE’S REGISTERED. AND TELL HIM TO RUN.” Jeremy got there in a few more seconds and maybe three pushes later, miss Nora was HERE. Our intake papers say we got to the hospital at 5am, and Nora was born at 5:03.

SO glad we called the midwife when we did. Cuz oooohhhhhhh MY, we JUST made it. All was well that ended well, and we could not believe things went down the way they did. We had a fine experience at Mount Sinai and were home the next afternoon. Miss Nora is healthy and sweet, and Ezra is doing a great job as big brother so far. Thank you Jesus!

the hardest thing

A Community Health Center is not an easy place to work. It’s not an easy place to spend your first year as a new Nurse Practitioner. Even with solid co-workers and bosses that genuinely care about you, its very difficult work. Patients are scheduled to be seen in fifteen minute appointment slots; patients who have a myriad of complex medical problems, social issues, and limited resources.

Several months in, I asked my medical director for some more support. Specifically, I asked if he thought I could start meeting on a regular basis with one of the experienced physicians at Lawndale, Nikhil Siony. I had worked with Siony a number of times, gone to him for help and advice, and just generally liked the guy. Siony was happy to help, so we started meeting every couple weeks.

I couldn’t overstate what a help this became. Aside from providing solid medical advice when it came to treating my patients and working them up with a variety of diagnostics, Dr. Siony was a breath of fresh air in the midst of very challenging job. A straight and to the point guy with a dry sense of humor, Dr. Siony came to Lawndale in 2005 after working as an attending at a New York City hospital. But I can’t remember a meeting we had which he didn’t start by checking in with a, “Hey how’s it going though? Ok? You handling everything ok?” My typical response was something of a general yes, likely followed by some rambling about how I worried I missed something here or could of done something better there. Dr. Siony would always very matter-of-factly tell me there was no reason to stress about anything, especially in your first year of practice. That for the first year you are always learning, and that that was the case for even him when he first came to Lawndale, and that nobody should stress.

Not long after starting to meet with Siony, knowing that he would be in clinic as a resource, or that I could call him with a question anytime, or that I would be meeting with him soon to go over questions gave me a peace about being in clinic. I knew that no matter how tough the patient, or how complicated the medical problem, I could always get his advice, any day, any time. A few months ago, I received a biopsy report on a young patient of mine which came back showing cancer. It was a Saturday when I got the result, and it rocked my weekend. I had never faced anything like this before, and I didn’t even know where to start, how to get my patient seen and where. I called Siony, and within fifteen minutes, my patient was scheduled to see Heme Onc first thing Monday morning.

I remember being in clinic one day, seeing a patient for a simple complaint. She had an ear infection. I think I was discussing treatment with another provider, and Siony asked me what was going on. Before long, he was breezing through this patient’s chart. She’d been to the clinic for the same complaint a number of times. He asked me, “Why does she keep coming back for ear infections? Is she taking care of herself? It sounds like she is not taking care of herself. Let’s see what else we can do for her. Have her see behavioral health, let’s see what kind of resources we can get her connected with, yeah?” He was right. She was a single mom with several children and very little support. He had a way of seeing patients and identifying their needs that went way beyond simple medical care.

At one of our most recent meetings, I had asked Siony how he knew who to call for various things when his patients had immediate needs (like the cancer doc he called for my patient on a Saturday). Like, how could I get something like an immediate heme onc consult over the weekend, or a cardiac cath that needed to happen within a week, on my own. He told me, “You just call me, and I’ll take care of it.” But I said to him, “Yeah but what if you leave or something? What if I couldn’t get you to help me?” He responded with, “Where am I going? I am never going to leave Lawndale.” Even after 9 years of practicing medicine at Lawndale, the guy didn’t have a trace of burnout in him.

About a week after that meeting, I found him in clinic to help me with a patient I was seeing. He greeted me with his usual “Hola, doctora! Como estas?” (he often greeted us midlevels in Spanish, despite his thick Indian accent and the fact that he didn’t actually speak Spanish). Before I started with my question, he told me he had been thinking about what I had asked him about. He said he decided he’d give me the names of the specialists he would go to for specific things, as well as instructions for how to get in touch with them. He told me, “I thought about it. You can call them yourself if you want to.”

Friday afternoon last week I was at home working on some follow up (I was out of clinic because I’d work that Saturday). I had a sort of difficult situation I wanted some advice on, so I gave him a call. He didn’t answer, but I knew he’d get back to me when he could, as usual. Probably within the hour.

About an hour later I got the email: “Attention Staff- Many of you may have heard the news that Ogden provider Dr. Nikhil Siony was in a serious car accident on his way to Lawndale this morning. He remains in the ICU in critical condition. We will communicate any changes in his condition via email.”

My heart sank as I covered my mouth in disbelief. By the next morning, it was clear to me just how bad it was. That Siony may not be coming back to us. I went to the hospital that evening after work, and stood at his bedside, like so many others. I told him it was Erin Mann. That I saw a patient of his in clinic that day, who was wondering what happened to him. That I had tried to call him the day before. I had a question for him. I just wasn’t sure what to do about this situation I had with a patient he had helped me with before. I told him all about it. I told him I couldn’t find that list of specialists he gave me to call. That things would suck without him. That it was going to be rough without him at Lawndale. He lay there still, silent, badly bruised, in a coma.

Today I got the news. Siony died last night, in that ICU, surrounded by his family and loved ones. To be quite frank, I don’t know what we’re all going to do without him. I’m not worried about where he is; its clear he had a steadfast faith in the one true God. It’s the rest of us that have to manage in a world, at Lawndale, without Dr. Nikhil Siony. He was a mentor to me in many ways. I pray that God would somehow teach us all to keep running the race, without Nikhil Siony. That the God of hope would fill us with all joy and peace as we trust in Him