The Chowning Alliance

Hello blog-nerds! It has been Monday all day. Mondays and chaos seem to share an inexorably intertwined fate akin to the bond between a tick and a fat hound. Despite the Monday doldrums, I managed to leave work at 5:25pm and decided that with all my extra time I'd update you on our journey down the bumpy road toward parental bedlam.

Apparently, children, especially of the infantile variety, do strange things like puke and poop a multitudinous pallet of colors that completely bewilders the mind when compared to the monochromatic stuff that actually went into them. Supposedly, this mystical ability to transmogrify infant formula into liquids and solids across the spectrum can, in certain situations, be indicative of, or predict health, sickness and various other conditions.

This of course begs the question: can the emesis of babies be examined and interpreted to find the winning lotto numbers? Stay tuned. I'm sure the answer will befall us.

You may wonder why one would suddenly be interested in poop health, and if you'll shut the hell up and quit interrupting, I'll tell you. According to our research, and the demands of the Maternal Birth-Nerd, it became necessary for us to find a pediatrician. Simple enough right? Not so much.

As soon as you realize you need something, and that there are numerous choices, you find yourself instantaneously plagued with the fear of choosing the wrong one! This is quite an alien feeling for me as I make decisions for a living. Aside from making decisions that sway millions of dollars and profoundly affect people's lives, I decide things like what I want for dinner, what I want to wear to work, and whether or not to take a break now, or try and hold it until I get home.

There are even lots of people that depend on me to make decisions for them or about them, like the marketer who asked what I thought about her look to which I responded, "Sweetheart, the hair, the ankle-length denim? Honestly, you look like a Pentecostal. Can we at least do something fashionable with a haircut and some accessories"? In hindsight, the decision to recommend a few changes was correct and warranted. The decision to make a comparison, probably not - seeing as how, unbeknownst to me she was a Pentecostal.

WHOOPS! Open mouth, insert politically incorrect foot.

Anywho, lots of decisions. These don't typically prove difficult, but as with any decision, the endless research ensues. A brief consultation with the all-knowing interweb as interpreted by the metatron Google, reveals a plethora of pediatric people from which to choose.

Search terms like, "how to choose a pediatrician", generated countless lists, each with their own criteria. One thing I've learned though my years in healthcare is that you want doctors that are board-certified. Nowadays it may be tougher to find someone restricting their practice to pediatrics that isn't board-certified. Nonetheless, you'll want to be sure to avoid taking your child to a doctor who just got tired of doing breast implants and Botox and swapped out the sign on their door. Besides Babies would just look weird with the Hollywood frozen face.

A board-certified pediatrician means the doctor completed high-school, four years of college, passed the MKAT (entrance exam), then four years of medical school, then 3-5 years of residency in their chosen specialty, like pediatrics. They've also passed numerous exams along the way to get their license. They're also required to complete hours of continuous education each year to keep both their license and board certification.

Damn, I should've been a doctor. Had I known where my surplus education was taking me early on, I probably would've been. Probably would still, but the Spousal Unit has forbade me from the pursuit of further education for fear that my brain will SPLODE (and probably because he misses me when I'm a bookworm).

Ok, so board-certified. Next, distance. Let's face it, no parent (maybe with the exception of my mother) who is sleeping a couple of hours a night is going to want to have to get up, get dressed, pack-up, and travel to a remote doctor at the end of a 500-mile yellow-brick road, only to find out they were dreaming the whole damn time and Auntie Em was really there all along.

So we decided to begin our search with board-certified pediatricians within a ten-mile radius of home. We found the healthgrades website which helped. The parameters help narrow search results.

Since our chosen doctor will likely be following the Progenal Unit (yes, my word) until she is much older, we didn't want a doctor who had already aged enough for their face to look like a scrotum with eyes, which would no doubt cause her to run screaming from the exam room. It wasn't all about looks, as it was also important that we be able to relate from a generational perspective with him/her.

We also hoped to find someone a little bit nerdy, like us. Nerds are good peoples. Next, we went to the Texas Medical Board's website and researched the licensure of the few that we'd narrowed it down to. We zeroed in on just a couple that we wanted to interview in person.

Next we compiled a long list of questions from the almighty interweb and our own values. We reviewed the questions and decided on the answers we wanted to hear from the doctor prior to hearing the doctors answers. The healthcare executive side of me wanted to pick apart the business of the practice to ensure fiscal responsibility and solvency. The nurse side of me wanted to delve into the standards of care and compliance. In the end, the adoptive parent side of me had me all squishy and receptive. Totally weird.

The first test was an email to the practice to inquire about a meeting with the physician of choice, Dr.
Chowning of Alliance Pediatrics. Of note, I think it would be AWSEOME TO THE MAX if he changed the 'H' to an 'L', but then I recall children on the playground calling me Byron "Pounds" instead of Bounds and wonder if he endured similar torment. Better keep that thought to myself.

The email signature, "Thanks, Byron and Jonathan Bounds", would give us a chance to say, "Hey, we're adoptive parents, and we're same-sex adoptive parents". Yes, we know the world has grown up a lot, but you never know when a doctors office or, say, a fast-food chicken sandwich chain will voice their opposition to your family. And to Chick-fil-a, learn to spell your logo, you dumb bastards - it's Chicken Fillet.

Surprisingly, the response to our email was not only immediate, but an exuberant warmth seemed to exude from Terri's words (the gal who replied). Of those emailed, Dr. Chowning's office was the only that replied. Family acceptance test: CHECK, Responsiveness test: CHECK.

We made an appointment according to Terri's directions and went by the practice after hours. It looked cute as a button, smelled clean, and I didn't notice cobwebs. Cobwebs are a sign of complacency! Also, despite having droves of children through each day, the books and magazines were surprisingly straight and organized. Appearances test: CHECK.

Then we got to visit with Dr. Chowning. Nerdiness test: CHECK.

He was awesome. Despite our preparedness, it was an experience that made me a bit nervous. This is weird, because I don't do nervous. Dr. Chowning was in no hurry. He answered all of our questions as though he had been prompted for the interview beforehand. He appeared green enough to be passionate but learned and experienced enough to handle whatever, especially since he has FOUR CHILDREN of his own! He's only a year or two older than I am which means his parenting experience will be fairly relevant to ours.

When we were satisfied with his answers and what we could glean of his character of the brief encounter, we decided to end the meeting, but had a distinct feeling he would have liked it to be longer. Again, this is weird. Most docs are in a hurry and of a mind to give little credence to your inherent lack superior knowledge. Dr. Chowning was weird. Weird is kickass!

Pediatrician found: CHECK!

On the Moon of Baby

Life goes on, and life begins.

Having recovered somewhat from the intense feelings that led to my last post, I press on to the experience of new things.

This story begins on November the 11th, 2013. Actually it begins long before that with what the Spousal Unit calls nagging, and I call friendly reminders. A while back, we decided that a last hoorah was in order. Aside from not having taken a proper vacation in about five years and having become nearly lifeless, cheese-chasing automatons, we thought it would be nice to spend some time alone.


We needed to say goodbye to it being "just the two of us".

We decided on spending a week at a lovely spa resort in Puerto Morelos. The week would touch on five areas of life including: Physical, Cognitive, Social, Spiritual, and Nutritional. Each of these areas will change and grow in the near future.

As it happened, day 1 would prove to be highly stimulating cognitively. See, the Spousal Unit is a special creature. If one doesn't make the correct noises when approaching, it may become spooked and growl or bite. So, to get anywhere, you have to hold your mouth just right. Let me give you an example:

Spousal Unit Safe: "Dear, do you think we should plan for the trip by making a checklist prior to our departure weekend?"

Spousal Unit Unsafe: "Please make a list of everything we need to pack. We don't want to be unprepared."

Get it? One is all about his ideas, the other is not. The latter of the two may be unpredictably dangerous.

I have a "big picture" perspective in life, while the spousal unit has the more detailed "pin-point perspective". Both are beneficial. The Spousal Unit will often help me avoid being overly-concerned with that which has yet to happen or to have fun in the moment, while I help him draw connections and switch focus. Despite our symbiosis, on occasion, these opposing perspectives ever so gently bump one another like sub-atomic particles in the Hadron Collider.

After a handful of "friendly reminders" I have two options: get frustrated, or let it go and trust that everything will work itself out. Day 1 of our vacay didn't turn out to be one of those instances where it all worked out. We missed our flight.

OH LAWD! You would have thought someone was murdered. "Let's just forget the whole damn thing! This is fuckin' stupid and pointless", the Spousal Unit was heard to say while his face turned an ever brighter shade of nuclear fuschia.

When one of the people of Wal-Mart, masquerading as TSA agents, began raising her voice at the crowd to "MOVE TO THE RIGHT PEOPLE", I worried briefly that I would have to restrain the Spousal Unit from slapping her nicotine-stained, gold-toothed mouth so hard that the Aqua-net shell on her bleached-blonde, beehive bangs would shatter into shards and injure the surrounding crowd. Thankfully, I was eventually able to calm the beast and we caught the next flight out.

When we finally made it I was surprised to see just how jungley Puerto Morelos is. EVERYTHING was green and lush. During our stay we enjoyed a fantastic excursion that included a tour of four cenotes (sink-holes). When the shuttle arrived to take the group from the hotel we were a little taken aback when the tour-guide said that we should move further forward in the bus because we'd be going off-road shortly!

He was SO not joking. After what seemed like an hour of driving through jungle so thick we could scarcely see the sky, and thinking at least twice that we were being kidnapped and sold into slavery, we arrived. The cenotes were beautiful. We snorkeled, zip-lined, kayaked, and rappelled through and in underground pools and rivers of electric-blue waters.

The only problem I had with the whole experience was when it was my turn to rappel from a high-platform down into a rocky hole in the earth to the waters below. We were told that a staff member would be atop the platform holding our brake line to gently lower us in. When I surmounted the structure, I noted the nice Latino gentleman charged with my brake was about 5' tall and weighed something like a young girl. I'm 6'2.5 and 225lbs.  

I questioned him for assurance that he would be able to keep me from splattering on the rocks below. Of course he said, "No, senior, is ok. You go". I went alright - damn near down my legs. When I departed the platform I heard a large grunt behind me and felt the rope jolt as I dropped suddenly about two feet before he said, "Iiiee", and managed to stop the rope. You'll be happy to know that I made it safely into the cave, although it was tempting not to relieve myself once I was in the water.

By the second day, we'd relaxed into this magical aura of forgetfulness that allowed us to focus completely on one another, and the rest of the world to melt into nothingness. We ate beautiful foods, took long walks on the beach, napped in hammocks, went horseback riding through the jungle, shopped, played in the sand and even treated ourselves to a spa day.

On the final day of our babymoon, preparatory ritual, we adopted new names. We each had the little crafts-man make us a bracelet. One said "Daddy" and one said "Papa". We wrote our names in the sand and dedicated the rest of our life to one beautiful little-girl-to-be.

The entire experience was sublime and one we can recommend emphatically.

The Hole

This will be a sad post.

It seems like people from all walks of life deal with loss whole host of ways. Professionally, we refer to the process of coping with loss "grieving". Some people deal with loss by surrounding their self with friends and loved ones. Some people turn to a bottle of some sort. Some internalize everything, dimming their light just by a little for the rest of their lives.

Elizabeth Kubler Ross  taught that there are five stages of grieving: 1. Denial, 2. Anger, 3. Bargaining, 4. Depression, and 5. Acceptance. Although for a long time this was commonly accepted wisdom, it was erroneous in its presumption that people slowly and predictably recover from loss.

In my work, I've given numerous talks on the subject to audiences from all walks of life. What we now know is that while these "stages" of grief are fairly common, how they are experienced is not. They are best viewed as common elements of grief rather than stages experienced in a linear progression. A person may not experience each of the stages. They may experience them in any order, go back and forth between them, or get stuck on one forever. Nowadays, we even recognize something called anticipatory grief - coping with a loss that hasn't even happened yet.

Carl Gustav Jung, a contemporary of Sigmund Freud, some would say outdoer, hypothesized that whatever it is that makes up the psyche exists beyond its confinements in time and space. He also fathered an archetypal dynamic known as the Wounded Healer. In his day, before the age of having a plethora of instantly gratifying information to hand, he postulated some pretty amazing shit. The mythological origins of the wounded healer stem from ancient Greece and Asclepius, a sainted physician whose own wounds gave him the power to heal the same wounds in others. The problem is that he was unable to heal his own wounds. When studied later for validity or vanity, psychologists have found that nearly 80% of people who train as healers (whether psychological or otherwise) carried wounds that bore significance on their choice of profession.  

Yup. I've read a lot. Even before nursing school, even before undergrad or graduate studies, I was fascinated with all this shit. I've even talked with neuroscientists like Paul Nussbaum, who say there is sufficient evidence to eliminate the need for belief in an after. Yet despite my myriad obsessions like the brain, and neuroscience, and psychology, and logic, and academia, and sociology, and helping people, and striving ever, quite vainly, to be the smartest person I know; despite it all, it seems nothing can make me an expert in helping myself.

It is no surprise then how bad I hurt. Yesterday, Orson, our blue british shorthair, was having a hard time breathing. I may not know much about veterinary medicine, but having worked as a hospice nurse several years, I know labored, agonal breathing when I see it. Maybe it was just a side effect of the medication he'd been taking. Maybe it wasn't the lymphoma the vet strongly suspected when his pupils quit working two weeks ago and collapsed.

My brain, in a subdued and quiet panic, vacillated between reason and insanity; selfishness and gestalt. I reasoned that it was probably nothing, but just to be sure, we'd take him in so the vet could tell us we were just being paranoid. Once there, Orson was scared. We kept trying to reassure him by petting him and calling him a good boy while nuzzling his face.

They decided an x-ray was necessary. I hated that because I know they tie their front and hind legs with rope and stretch their bodies across a table to take a clear and steady picture. Then, because he was so stressed by the experience, they put him in an oxygenated kennel after trying to aspirate some of the fluid around his lungs with a long needle while he was still restrained.

The vet then called us in to look at the x-rays. She showed us how his lung was collapsed and his heart was displaced, probably by a large tumor, she said. She advised us that in this type of situation, aspirating the rest of the fluid would be painful and very temporary. She said it might buy us a day at a time. She said it was her recommendation that he be humanely euthanized.

No words could have hurt worse in that moment. My sweet fluffy baby had to go through all that just to be surprised with an untimely end. She sent us back to the exam room to wait while she put in an I.V. Then they brought him in so we could tell him goodbye. So hard.

After a while, they entered the room. He looked so scared, but I kept scratching him under his chin in his sweet spot, locking his eye in contact with mine, telling him I loved him so much. The vet put the first syringe in the IV and depressed the plunger. He meowed like it hurt. Then his eyes no longer seemed to be looking and his pupils dilated slowly. Once he was unconscious, she gave him the two final shots, listened to his heart and told us he was gone.

I have sobbed so much. You may think my response to the loss of a cat is unwarranted or dramatic, if so, fuck you! I have lost my loyal companion, the fluff that sucked up my sadness, the soul with no agenda but loving me and food that has been by my side for nine years; without judgment, or condition, or any malice.

I will have many joys in my life, each standing on their own merits, but none will serve as substitute for Orson. None will replace him. There will always be a hole where he once was.

I love you Orson. I wish you were here.