Thicker skin

It has been a while since my last entry, and there is only good news to blame. I reached the 32-week milestone in my pregnancy two weeks ago (the time when most babies' lungs are fairly well developed and many can survive outside the womb without ventilatory support), and since then I have been able to modify my bed rest routine more and have actually gotten out of the house a few times.

And yet, I have the nagging feeling that something has been lost. It's almost as though I was in a protective bubble, one in which I have really never existed for any length of time in my adult life, and in which I was able to more introspective and reflective than I ordinarily am. At baseline, I would consider myself to be a bit less introspective than the average person, certainly less so than my Viennese husband and his family, but probably more so than the rest of my own family. I have always admired my husband for this quality, but only through bed rest have I been able to actually make myself more like him in this regard. How quickly I reverted to my old habits, though!

In any case, I have one bittersweet anecdote to share, one that is probably best categorized under "Growing Pains of Young Parenthood." I saw adds online for a Christmas concert at a local church by a wonderful adult a capella singing group, Musica Sacra, whom we have heard before and loved. The concert was listed on a number of local parenting websites and the adds described it as "family-friendly, children of all ages welcome." Since I could be dropped off at the door and would be sitting the whole time, I thought this would be a perfect low-risk pick-me-up from months of bed rest. So, we packed up the little one and off we went.

Perhaps the lack of other children younger than about ten in the audience should have been a warning when we took our seats in the audience. My son was happy as a clam, listening for a while to the first set of songs in rapt attention but then beginning to wander, mostly in silence but of course a bit noisy from time to time, as most toddlers are. My husband took him to the back of the church to listen so that he had the option of darting outside if the noise worsened. You probably know where this is going...

After the first song set, the director turned to the audience of about 100 and welcomed everyone warmly. She then said that she took her son to his first concert when he was three and a half. After a pause, during which I innocently thought that she was about to welcome the children in the audience, she said, "AND THAT WAS TOO EARLY." She proceeded to offer up the "green room," where we could listen to a broadcast of the concert and feel "more comfortable" than in the sanctuary. No matter that we later found out the green room didn't exist. I thought I would melt in my seat. I felt all 200 eyes on me, sitting alone in full view of the rest of the church while my husband and toddler were out in the narthex.

And so I did what any self-respecting, third trimester, hormonal mother would do: I gathered up our coats, headed for the exit and was in tears by the time I got there. It was of no particular consolation that the executive director of the choir (and the one responsible for the advertising) apologized profusely to my sobbing self on the way out; she clearly hadn't clued in the choir director that this was a kid-friendly event.

Aside from hormones and the desperation I was feeling to get out of the house and enjoy a nice evening of live music, I think the reason I took the incident so poorly is that I would never have brought our son to the concert in the first place, knowing that he would surely make some noise and disrupt others a little, if it hadn't been clearly advertised as an event for "all ages." Any good white Anglo-Saxon protestant knows that children should be seen and not heard, right?

Anyway, I'm not sure there is any great lesson to be learned from this, except to say that I should grow thicker skin. Or, as my husband commented that night, not plan to move to Vienna anytime soon if this kind of thing bothers me. I'm a little surprised that it took 18 months to get to this point, actually, and I'm sure it won't be the last time we get kicked out of a concert. At least I hope not :)

The toddler takeover

I really, really want to get my son a kitchen playset for Christmas.

There, I've said it. I have been thinking about it somewhat obsessively for the past week. He would love it, insofar as an 18-month-old can truly love any toy. It would be fleeting, but for a period of time, he would love it.

But I can't do it. You might say, what would be so bad about a kitchen playset? They come in all shapes and sizes, and I'm sure there is a set out there that is understated, non-plastic, and able to fit relatively unobtrusively into a corner of my kitchen. Here are some examples. (Not that I've been looking.)

And after pricing new cars all week, since our current 6-year-old car needs a $2300 new clutch, even the priciest kitchen set fit for a prince seems blissfully cheap right now.

The truth is, a line began to take shape for me even before my son was born that I have been trying very hard not to cross. Everyone has one, to be sure, and it fades in and out of view at various stages of life. At times it is sanity itself. On mine right now sits any number of things, not just toys or products but also attitudes and behaviors.

During pregnancy, the baby swing was on the line. Things like trendy expensive car seats and fancy bassinet strollers were clearly over the line. Later on, adhering strictly to a sleeping schedule, particularly in the evenings when doing so would keep us from maintaining ties with friends, was mostly over the line. But time has a way of shuffling the deck. As I've written about before, the baby swing was taken off the line and brought into our dining room in under 2 weeks.

And so it may be with the kitchen set - if not now, perhaps next Christmas, when there are two little rascals to occupy during dinner preparation rather than just one. At present, my sanity is still more closely aligned with the appearance of an "adult house" than with a pint-sized budding chef. I think he still prefers the grown up pots and pans, anyway.

Actually writing the check

Today is a big day for me, and one that seems long overdue. I donated to Women for Women International, both on behalf of my closest girlfriends, in place of a Christmas present, and in my name, by sponsoring a woman for a year. Scores of individuals donate money to an international organization each year, so I know I am not alone in this, nor have I given a particularly substantial amount. In fact I don't feel entirely satisfied now that I have actually carried out the donation. Why it has taken me so long to do so, and the source of my ambivilance about, is what I am interested in exploring.

In other words, I'm not as interested in why people give charitably to others, but rather why not. And since I can't carry out a large study from my perch on the couch today, I will settle with exploring my own motivations, and hope that at least some of them are common to others.

The first hurdle that comes to mind is activation energy. As day-to-day life unfolds, I often lack that extra boost that is needed to stop whatever else I am doing, focus on selecting an appropriate charity, and carry out the steps, including locating the ever-evasive postage stamp if the solicitation has come in the mail, necessary to actually give. In the age of the internet, I can't really blame stamps, but I do think that information overload plays an increasingly important role.

For me specifically, I began thinking seriously about supporting an international women's charity much earlier this year, when I read Nicholas Kristof and Sheryl WuDunn's book, Half the Sky. This husband-and-wife team of journalists tells the story of dozens of women around the world who have been affected by sex trafficing or forced prostitution, gender-based violence and maternal mortality, and they make the case that addressing these 3 critical issues is central to unleashing the economic and social potential of men and women worldwide in the next century. They helped me overcome the daunting task of selecting a worthy charity by providing a short list of reputable organizations, which is how I came to choose Women for Women.

Okay, so in this instance, Kristof and WuDunn helped me solve the activation energy problem, and the ability to donate online also made it easier. But in my mind there are other, less tangible reasons why I don't give that are larger barriers than the "I have alot going on" excuse. For example: pessimism that my small donation will make any bit of difference to such a big problem; guilt that I haven't given more in the past; lack of direct feedback to motivate me to give again; worry that most of the donated money will go to organizational and overhead costs rather than the intended recipients themselves.

For me, I decided to try sponsoring a woman for a year because it will address at least one of these concerns. As part of my pledge, I will exchange letters with a specific woman in one of the dozen or so countries served by this charity, and receive (and give) direct feedback. I think this will be both a challenge and a great learning opportunity for me over the coming year. It's something I've never done before, and I'm excited to see how it plays out. Hopefully it will make me more inclined to get involved in the future as well.

Particularly with a toddler and a new baby on the way, I find it frighteningly easy to become more and more self-absorbed in daily life, both individually and as a family. And without pauses for reflection such as this one, how can I expect otherwise? So here's to the holiday spirit - just write the check!

Waiting for baby

Sometimes, a picture says it all.

December already?

I can hardly believe it's December already and I'm secretly hoping for snow. Easy for me to wish for a blizzard, of course, since I'm not working and I haven't even brought my winter coat up from the basement yet. But it would make such a nice scene from my warm and cozy couch, snuggled beneath my blanket. All I would need is some hot chocolate and marshmallows.

What things make you look forward to winter? (For the technically challenged, like me, I think you just click on the word "Comments" below to leave to note. Hint hint.)

Happy Thanksgiving

Odds and ends

I was planning another nutrition entry for this week, but I had some sort of stomach flu yesterday and the last thing I can think about today is food. I am currently willing the dry piece of toast that I ate for breakfast to stay down and doing my best to fend off another pity party.

Earlier this week, I gave my blog a new header using a very easy and intuitive online photo editor called Picnik. This was much simpler to use than Photoshop, didn't require any software downloads, and was free! With the help of The Blog Guidebook, where I found a great tutorial that included the key piece of information that I had been missing - dimensions - I was able to try my hand at very basic graphic design. What do you think? Not time to quit my day job, I know. But it was a fun diversion for a few hours.

Another new addition to the blog is "Artwork of the Week," which I have added to the left hand margin. I pulled my college art history textbook, Janson's History of Art, down off the shelf the other day and just the smell of the pages brought me back to Professor Chapell's lecture hall at dear old William and Mary. Would you believe that he tiny slips of adhesive paper that I used as a study aide to cover the captions below each panel are still in place?

In the spirit of Thanksgiving, I want to take this opportunity to thank everyone who has helped us out over the past 6 weeks. I'm half-way to 36 weeks from where I started at 23 weeks, so time is passing, albeit slowly. My own little turkey continues to bake inside, which is where he should be, and I'm extraordinarily thankful for that.

Rethinking healthy eating, Part 1

Eating has been on my mind lately, and not just because I am sitting at home all day long, staring from my perch on the couch back towards our kitchen. As my toddler grows into an increasingly robust, but at the same time highly opinionated, appetite, I am thinking more about what I put into his mouth, as well as what I put into mine. The carefree days of breastfeeding, when - as long as I stayed away from alcohol - I knew he was getting a perfect diet, are long gone!

I also stumbled upon a few other items that peaked my interest. One was an article in the New York Times  about the often conflicting messages of the USDA with regards to the diet and nutritional health of the U.S. at large. The article draws attention to the fact that many pizza chains, under the advisement of a federally-funded marketing firm, have greatly increased the cheese (and thereby fat) content of their pizzas recently as a way of selling more dairy products and ultimately more pizzas. Not surprisingly, the pizzas are tastier, and sales are better than ever! This makes Domino's, as well as the dairy industry (and by a complex web of associations, the USDA and the government) very happy.

The problem is, the USDA is also in charge of advising the public on healthy eating habits. Remember learning about the food pyramid in elementary school health or science class? Well, the composition of the pyramid reflected not just the best available science but also the influence of many parties in the food industry with vested interests in the eating habits of Americans. This is not to say that there is no value in the USDA's food pyramid. But like Mom always said, not everything you read is true, and consensus statements, particularly those coming from large organizations, can be influenced by the politics of the day and can also become rapidly outdated by advancing science.

I found a nice summary of the history of the food pyramid and the evolving state of nutritional research at the Harvard School of Public Health's website, The Nutrition Source. Here, researchers propose an alternative to the USDA's food pyramid that attempts to integrate more recent data about healthy eating.

Two points that I found most interesting were the following:

1. Calcium and vitamin D are important for bone health, but milk is not necessarily the ideal source of these nutrients. The powerful message that milk is good for your health, drilled into all of us since childhood, may have quite a bit more to do with good marketing by the milk and dairy industry than actual research and health outcomes data.

2. The traditional limits placed on recommended fat intake are likely artificially low, since they do not differentiate between saturated and unsaturated fats. Good sources of unsaturated fats, such as olive, peanut, canola, and other plant-based oils, can likely be used much more liberally than previously thought and contain important nutritional value.

Most importantly during this exercise, I came to realize that many of my general feelings about what it means to eat a healthy diet are at best slightly outdated, at worst based on myth, and the discussion above clearly just skims the surface. Which is why this entry is entitled "Part 1." In the weeks to come I hope to tackle other topics related to nutrition, come up with some concrete goals of my own for improving my diet, and collect more web-based resources for healthy cooking and eating. Bon appetit!

View from the window

Every fall I give thanks to our neighbors, Fred and Margot, for the beautiful Japanese maple that stands outside our dining room window. The tree was planted on the occasion of their marriage. Its leaves turn relatively late in the fall - just before Thanksgiving - when many of the surrounding trees have already lost their leaves, which just adds to the beauty. Happy fall!

In my spare time

I've hit a new low. Coin wrapping. But a profitable one: any guesses on how much this stack is worth?

These are a few of my favorite...words

Though of little interest to anyone but me (and my loving husband), the vocabulary of my 17-month-old is a constant source of amazement and delight right now. It's hard to do justice to the topic without audio recordings, but sadly I'm not technologically savvy enough to swing inserting sound-bytes. So I'll have to rely on phonetic spelling to capture some of the cute factor that comes along with each of these words.

This list is in (approximate) order of acquisition:

Hi! (with an exaggerated diphthong, i.e. Ha-eeeee!)
Bow Wow
Cheese (Tssssss)
Sit (started out just Sssss, now morphed into Seht)
Bye Bye (Bah Ba-eeeeeeeeeee!)
Da Da (Da Daaaaah)
Ma Ma
More (Mah, said at the same time as the sign, and virtually indistinguishable from the preceding Ma Ma)
Milk (pronounced "Mo", and very hard to distinguish from "More")
Water (Wah Wah)
Please (originally pronounced "Bwee," now "Peez," and always accompanied by the sign and an angelic, hopeful smile)
Cracker (Krah Kaaaah)
Bath (more like "Bass")
Wash (more like "Wass")
Shoe
Bubble
Baby
Car (said with an undeniable Boston accent, i.e. Caaaaaaaaah)
Banana (Na Na, with the tongue sticking out between the teeth)
Apple (Bap-el)
Row (as in, Row row row your boat)
Thank you (usually comes out "Do Do," but you know it's thank you because it comes along with the sign)
Bus
Wheel (with an exaggerated diphthong, i.e. Whee-yel)
Beep beep!

So there you have it. With only about 25 words to express oneself, no wonder there is still so much whining and pointing. It will be fun to look back in a few months and realize how far a child can come in a short time period. I have read that between 18 and 24 months, kids pick up as many as 10 new words per day! I can't wait!

These are a few of my favorite...toys

In the spirit of my last post, and as a nod to my failing memory, today is the first in a series of logs to document various aspects of my every-changing darling. This week I thought I would start off with toys. As I have mentioned before, we don't have many, but even so, a boy has his favorites.

Much to my chagrin, the winner right now, at 2 days shy of 17 months, is the brightly colored, entirely plastic, 6-wheeler dump truck that makes beeping noises (including the high-pitched beep of a truck in reverse). The giver of this gift shall remain nameless (but you know who you are!). A close second is the smaller, but no less plastic and even more shrill, red fire truck (see Away with the singing truck! from last week). Thankfully, a few silent toys have made the list, including the ever-popular recycling bin (which, depending upon the amount of glass, is more or less silent).

Oh to be a toddler again! Next week will be favorite words, and then perhaps favorite parks the following. Are there classic toys out there that my little one is missing out on? What were your favorite toys at this age?

The passage of time

I have been thinking lately about the intense emotions that washed through me during the days and weeks after my son was born last year, and wondering whether they will return with the birth of our second: coming home from the hospital and sobbing at the dining room table, utterly unable to imagine how we would make it through the night together; a very literal and physical feeling that my heart would break in two if anything happened to my son; and most poignantly, a sharp awareness of the inexorable passage of time.

The latter feeling, which has necessarily dulled over the past year - or how could I have ever returned to some semblance of my pre-baby life? - made the deepest impression on me. It was a piercing sense of mortality, a sorrowful realization that every day that passed, my baby was different. The baby that I knew the day before was never to be seen again, and my memory of him in that state was fading quickly.

At the time, my husband pointed me to Shakespeare's 126th sonnet (and this week's poem in the left hand margin), which perfectly captures the tension between nature's beauty and ephemeral time. Upon re-reading it this morning, I am again comforted by it's wisdom.

In some ways, I miss that poignancy, and I wonder where it has gone. To be sure, the cocktail of sleep deprivation and hormonal swings that defined those early days and weeks played a big role. Now passed, many things seem more manageable, not just grappling with the relentless progression of infant development. Perhaps I have learned to suppress it myself in order to cope and carry on.

But every once in a while, I think it is healthy to reflect and embrace the sorrow of time passing. It serves as a reminder to embrace every minute, to take in the vibrancy and color of each passing scene, to be grateful for the miracle of young life and the ambivilance of early parenthood.

Highlights of the day

The delivery man commenting on the Caravaggio print in the living room.

The road construction crew just below the window taking an early lunch.

 The smell of black bean soup simmering on the stovetop.

A fall-fresh breeze sneaking in through an open window.

A call from my husband.

Discovering that the latest novel by a favorite author is just as good as the last.

It's amazing how perspective can change when you have some free time on your hands!

Away with the singing truck!

If I hear the jingle coming from my son's red firetruck ("Did you ever see a puppy...driving a red truck?" to the tune of "Did you ever see a lassie?") one more time, I might just throw it out the window. Sadly we're only on the second floor so I'm not sure this would accomplish anything - the truck is pretty sturdy. Rather than dream up better ways of doing in the singing truck, I decided to make a CD of children's songs I actually can stand to hear more than once.

This turned out to be alot of fun. The NIH actually has a website that lists over a hundred classic children's songs, with lyrics and tunes, in alphabetical order. This was a good place to start, but I also wanted to include some contemporary songs as well as some songs from old musicals or movies that double nicely as kid's songs. In the process I came across a few very clever websites and blogs that review recent children's music releases, most of them created by musically-inclined parents who found themselves similarly fed up with the red firetruck jingle. Zooglobble is one such site that I could spend hours purusing. Another is called Kids Music that Rocks.

I quickly realized that I couldn't possibly cover everything on one CD, but I have to start somewhere! So here's my first 'playlist.' My next mix will probably consist of foreign language songs, or maybe lullabies. I retrieved many songs from itunes, so in total the CD cost me about $10 to make - the rest I downloaded from CD's in my own collection.

Whistle While You Work - from the original Snow White recording

A Bushel and a Peck - Doris Day singing classic from "Guys and Dolls"

Put on a Happy Face - I am a sucker for the Dick Van Dyke version

Five Little Ducks - this is one of the few songs from a traditional "kids" CD

My Grandfather's Clock - version by Johnny Cash

If I Had a Hammer - Peter, Paul and Mary (who else?)

Little White Duck - Danny Kaye

Waltzing Mathilda - an Australian classic

La La La La Lemon - I fell in love with this song from the Barenaked Ladies kids album

Super Frog - another great discovery from the 'adult' band "Asylum Street Spankers"

Yellow Submarine - The Beatles

On the Sunny Side of the Street - recorded by Swing on a Star Band

Side by Side - version by Dan Zanes

Rainbow Connection - original Muppets recording (Kermit singing)

Baby Mine - I've never heard a more moving version than Bette Midler's from the Beaches soundtrack

You Are My Sunshine - Carly Simon recorded a beautiful rendition

Wiegenlied (Braham's Lullaby) - orchestral version to wrap things up

So there you have it. Just the tip of the iceberg but a good start, nonetheless. I would love to hear suggestions for my next mix! Happy singing!

Listening to my fortune

For the first two weeks of bed rest, I was in remarkably good spirits. I read 7 books in that span and wrote (most of) the first draft of a paper I had been putting off. I caught up on all my diapers.com ordering and stocked the baby's closet with diapers and wipes. I picked topics that were interesting to me and wrote about them every few days on this blog.

But by week 3, I hit a wall. All I could thing of was the things I couldn't do. I had no interest in blogging. I began to dread the afternoon, watching the minutes on the clock tick by until my family came home (when I couldn't pick up my son). My fortune cookie mid-week seemed like a cruel joke:

So, at the beginning of week 4, I'm doing my best to turn over a new leaf. To focus on the things I can do. Or at least, counter each can't with a can. Here's my list so far:

Can't  ->  Can:

Work out : Do arm weights (here's to perfectly sculpted biceps!)
Help out at daycare : Make a CD of favorite kid's songs for the daycare to play (more on this one later)
Cook : Relax, there will be plenty of time for making dinners that the kids don't appreciate and refuse to eat!
Host friends for dinner like we're used to : Have potlucks instead, or pick earlier times in the day for visits when a big meal isn't required

Anyway, the list could go on and on. But the mental exercise of countering each "can't" with a specific "can" is a good one, I think, and not just useful in my situation. So wish me luck. And feel free to add to my "can" list (but not the can't, thanks anyway - I don't need ANY help with that one!).

Knitting for Save the Children

Yesterday morning I came across a plug for knitting newborn caps for Save the Children at www.designmom.com. The instructions are provided here. It really couldn't have been easier!

I am a VERY novice knitter, and by the looks of my "craft box" in the closet (which contains no fewer than 3 half-knitted baby blankets), not very persistent. So if you are anything like me, this project, which gives a finished result in less than 3 hours, is just the thing for you!

I couldn't even remember how to cast on, so I went to You Tube and found more than I needed in terms of guidance (casting on). And then I was on my way!

This is what the cap looks like about a third of the way through. The pattern that is provided in the Save the Children pamphlet couldn't be easier - just a series of knit and pearl stitches, plus a few "knit two together" rows at the end.  And two hours later: VOILA!

I can't think of a better project for moms on bed rest. I think I might make one cap for every week I'm on bed rest and send them off to Save the Children with a $10 donation for each one (see website - this nominal amount provides valuable postnatal instruction to one family that can make a big difference).

So get out those yarn scraps and start knitting for a good cause!

The Grinch that Stole Pregnancy

One thing that has struck me again and again in the two years since my son was conceived is how much commercialism surrounds babies and new parenthood. Mind you, I am the first to admit that I flip through the pages of Pottery Barn Kids, dreamy with thoughts of the perfect coordinating nursery in calming shades of porcelain blue and cream, before tossing it in the recycling bin.

But it's not just the prices that stop me (although my Scottish roots definitely give me pause). Or the thought of offering up a perfectly adorable crib bumper to the crib death alter. It's the fact that I'm distracting myself from the realities of parenthood - the good and the bad - by adding layers of perfection and sheen to a reality that is far from predictable. Doesn't this just set us up for disappointment and disillusionment? And leave us unprepared to deal with the challenges to come?

Maybe, maybe not. There is something very important about the excitement and anticipation of pregnancy, particularly a first pregnancy. It can focus us on the journey ahead. It can encourage us to adopt more healthy habits, for the sake of the new life growing inside. It can connect us with the greater community of parents who have been through this miracle many times before.

But the culture of overblown baby showers, of promoting the idea that every last inch of a baby's nursery need be in place before the baby arrives, that certain products and items are indispensable to new parents, runs contrary to the reality that we learn by trial and error. That not everything plays out according to plan.

This is not to say that sometimes, it would be easier to just accept the advice you are given. When we were expecting our first child, we tried very hard not to crowd our small apartment with what we considered to be unnecessary, commercial items such as baby bouncers, baby swings, video monitors and the like. We took a certain pride in resisting the advice of wise parents who had gone before. And so we still laugh heartily about the desperate late afternoon run to Children's Orchard that ensued on our son's first week home from the hospital when we realized that a baby swing was exactly what we needed to avert yet another evening of restless crying!

But it is lighthearted moments like these, and the more weighty ones left unsaid - the unexpected bumps and valleys - that teach us the most about ourselves and our cherished little ones. As we anticipate the birth of our second child, we have already been thrown a curve ball with the threat of a very premature birth and a prescription for bed rest. And I would submit that no catalogue could have prepared me for that!

Simple pleasures

I'm short on words today because I spent the morning writing a review on brain tumors that is draining every last ounce of literary spontaneity out of me. So here's a pictoral list of things I'd rather be doing and times and things worth treasuring, as modeled by my son. The list is purposefully short in hopes that others will add their own!

Apple picking in New England

Hand-knit sweaters

Birthday cupcakes



Sleeping in on vacation

Learning to walk on the beach

No rest for the wicked

Tonight, after my husband

rushed back to daycare in the early afternoon to examine a rash on our son's face (which later disappeared),
spent two hours with ten toddlers for our weekly parent shift,
stopped at the library on the way home and checked out every item on my wishlist,
fixed dinner for the three of us,
put the baby to bed and cleared the dishes,

he lay down on the couch in my arms
and within 30 seconds was fast asleep.

Dear, sweet man.

First poem of the week retired

I chose the first poem of the week, Langston Hughes' Jazzonia, simply because my son has a classmate at daycare named Langston, and I realized when I met Langston, the toddler, that I didn't really know much about Langston, the poet. That was two months ago. And now, thanks to bed rest, I have the time to revisit the question and learn a bit more about this great African American poet.

The poem is also of sufficiently short length to allow for memorization, which is one of the intended uses of poem of the week. (For me, that is. Others are under no such obligation!)

James Mercer Langston Hughes had an exceptional and diverse extended family. His maternal grand-uncle was the first African American from Virginia to be elected to the U.S. Congress, in 1888. His maternal grandmother, Mary Patterson, was of African American, French, Native American and English descent and was one of the first women to attend Oberlin College in Ohio. It was Patterson who raised Hughes during his early childhood years after his parents divorced and his father moved to Cuba and later Mexico.

Hughes eventually settled in Harlem, where he became influential in the burgeoning black cultural movement known as the Harlem Renaissance, beginning in the early 1920's. Also a novelist and playwright, Hughes is best known for his Jazz poetry, which incorporated the syncopated rhythms and improvisation of music from contemporaries in Harlem like the great jazz musician, Duke Ellington. Jazzonia was published in 1926 as part of Hughes' first collection of poems, The Weary Blues. By the time of his death from complications of prostate cancer surgery in 1967, Hughes had published over 50 novels, plays, childrens stories and collections of poetry and short stories. In the following link, hear a recording of Hughes reading his well-known poem, I, too.

Home entertainment

For the past few years, as our local movie stores have slowly closed, one-by-one, I have resisted the seemingly ubiquitous Netflix subscription. But after eight days of bed rest, my resolve is fading. Yet there is still something holding me back. Am I just an old-fashioned stick-in-the-mud, or are there others like me out there who still cling to NPR and their local library cards?

Apparently, not many. Not surprisingly, TV's are heavily penetrant in U.S. households. According to the U.S. Census Bureau, in 2009 there were about 114.9 million households (and a total population of 307 million), and according to the Nielsen ratings, there were 114.9 million TV-viewing households in the same year (with an average of 2.2 TV's per home).

The more depressing statistics follow: the average American watches more than 4 hours of TV per day; TV's are turned on for an average of nearly 7 hours per day; and 66% of U.S. families admit to watching TV regularly during dinner. So much for conversation! Video use shows similar trends, with daily video rentals doubling the number of books checked out at public libraries across the country. As for NPR, well, the frequency of fund-raising drives makes me think that the number of Americans listening to radio (or at least the money going to fund radio programs) is diminishing rapidly as well.

In the interest of preserving my safety from atop such a high horse, I will forgo more statistics (including those pertaining to infants in children). Needless to say, there are many ways in which to spend one's leisure time, and I don't begrudge the temptation to "veg" from time to time. In fact I am being forced into it full time for the next few months. But I hope that by the end of my stint on bed rest, I can at least say that I've read as many books as watched videos, I've avoided the temptation to tune in to Oprah every day of the week, and I've followed my husband's good example of always reaching for the newspaper before the remote control.

The origins of empathy

Last night my 16-month-old walked up to the couch where I was lying and planted a series of unsolicited wet kisses right on my nose. When prompted for the same by my husband, he demurred. It was as though this little boy, whose vocabulary at the moment is comprised of the words cheese, go! and NO!, recognized my plight as clearly as one who had seen it many times before. How early do children recognize emotions like sadness or grief in themselves and others?

I first considered a related question about two months ago, when I read Roger Rosenblatt's memoir, Making Toast. Mr. Rosenblatt, a journalist, novelist and playwright, lost his daughter, a pediatrician and mother of three, to sudden cardiac death. He and his wife moved in with their son-in-law and grandchildren, ages 14 months through six years, for the next year, and his memoir is an account of this experience. (It is written in heartbreakingly concise, unsentimental prose, and I highly recommend it to anyone with a box of Kleenex to spare.)

The most poignant scene comes towards the end of the book, when the author's youngest grandchild, now almost two, wakes up crying one evening, asking, "When is Mommy coming home?"  The child, 14-months-old and preverbal at the time of his mother's death, clearly experienced her loss and held onto the memory until he could express himself in words. This was a revelation to me as I sat watching my own one-year-old putter around the house, not obviously aware of anything or anyone but himself and the recycling bin.

It turns out that emotional awareness and understanding can be observed and studied in children as young as one year and in primates like chimpanzees. By the age of 12 months, infants begin to comfort victims of distress, and by 14-18 months, children display spontaneous helping behaviors. The capacity for empathy and sympathetic concern is linked closely with the development of self awareness, termed mirror self-recognition (MSR), according to leading social scientists (Video of MSR). MSR has been demonstrated not only in humans and chimps but also dolphins, elephants and even magpies (for those cartoon fans out there, think Heckle and Jeckle!).

And so, this evening I hope to talk my husband into setting up our own rouge test (see video) on our little one, and in doing so we will be joining the ranks of social psychologists around the globe in delightful amazement and exploration of the human mind in all its glory.

References

Rosenblatt, Roger. Making Toast: A Family Story. New York: Harper Collins, 2010.

Warneken F and Tomasello J. The roots of human altruism. Br J Psychol 2009;100:455-71.

Bed rest: friend or foe?

A prescription for bed rest (the "rest cure") was first made popular by the 19th century neurologist, Silas Weir Mitchell, who believed that isolation, confinement to bed, dieting and massage were beneficial for a variety of nervous diseases, particularly hysteria.  His most famous, or at least prolific, patient was the feminist sociologist Charlotte Perkins Gilman, who was inspired to write the short story The Yellow Wallpaper based on her own experience with the rest cure. From the looks of it, the story may not be the most glowing review of the rest cure: the narrator is apparently driven slowly insane.

(I have just discovered that one can order short stories online through the Harvard library system, to be scanned and delivered by email! Very exciting for a woman in my current shoes. So, more on this tale later.)

As a treatment for threatened preterm delivery in pregnant women, bed rest is widely prescribed but has remarkably little (read: no) scientific evidence backing it. The Cochrane Collaboration, an independent, not-for-profit organization whose mission is to compile systematic reviews of primary research in health and health policy, reviewed bed rest for the prevention of preterm birth in high-risk singleton pregnancies (i.e. not twins or multiples) in 2004. They found only one (!) randomized study on the subject ever published. In this 1994 study of about 1200 high-risk women being seen at 8 different Los Angeles County prenatal clinics, women receiving extra education and clinic visits had a significantly lower preterm birth rate compared with those who received standard care. However, the specific intervention of bed rest (prescribed to about 400 of the women) did not significantly lower preterm births. This result could reflect the fact that bed rest really doesn't work to prevent preterm birth, or it could be that this study wasn't designed well enough (for example, didn't enroll enough patients) to show a benefit when there actually was one. The only way to know would be to do another, better study.

The potential harms of prolonged bed rest have been studied as well, perhaps with more gusto than have the benefits. Those who are sedentary have an increased risk of blood clots in the legs that can move dangerously to the lungs, bone loss, muscle deconditioning, hip and back pain, and depression. If a large randomized study of bed rest versus unrestricted activity ever does take place in pregnant woman, it should include careful measurement of these outcomes, since they are an important counterbalance to the potential gains.

And so, my husband and I and many others like us are left to wonder whether the age-old prescription of bed rest applied to the modern day is friend or foe. For now, neither of us is prepared to discount the accumulated wisdom of centuries of experience if it stands even a small chance of staving off harm to our unborn child.  But perhaps we'll think differently when the Charlotte Gilman text arrives.

References:

"The Yellow Wallpaper." New England Magazine 5 (1892): 647-56; Boston: Small, Maynard & Co., 1899
Sosa C et al. Bed rest in singleton pregnancies for preventing preterm birth. Cochrane Database Syst Rev. 2004;1:CD003581.
Hobel C et al. The West Los Angeles Preterm Birth Prevention Project. I. Program impact on high-risk women. Am J Obstet Gynecol. 1994;170:54-62.

First-time blogger

On Thursday last week I received the unexpected recommendation from my OB to go home on bedrest. For the rest of my pregnancy. And I am only 23 weeks pregnant. Wow.

By way of background, I am an academic physician working full-time in a field and job I love, with an active 15-month old son at home and a fabulous husband, also an academic physician.  I haven't spent more than 2 days in a row in bed since....well, since I last had the flu, which was before vaccinations became the norm for healthcare workers.

The good news: That backlog of New Yorkers never looked so appealing. And didn't I always want to recite the complete works of William Shakespeare aloud from start to finish?

The bad news: Where to start? The guilt over leaving my co-workers to cover my practice, with no clear benefit for them. The guilt over needing my husband to take over nearly EVERYTHING about the day-to-day care of our child and household (although admittedly he was already doing more than his fair share). The list could go on and on, with guilt appearing in most entries.

My goals in creating this blog are many:

• To work through some of the guilt...
• To brainstorm ways to pass the time
• To create a resource for other poor souls in this situation
• To have some fun while doing it!

And so, with 17 weeks to term, here's to the adventure!