I finally tackled the paper pile in the living room so I could get to the glass cabinet where we store serving pieces.  The pile had bills going back to 1997.  It also had photos and old letters and magazine clippings.  I found dozens of birthday cards sent from my grandma.  Sorting through bills was a bit mind-numbing, but I got to relive old favourites such as multiple bills from the Philadelphia hospital for a miscarriage, requests for payment on unsuccessful cycles, and a prescription receipt for zofran.

I unearthed old theater tickets and notes from Josh.  An essay about my great-grandmother written by one of my great-aunts.  Agency agreements, old lesson plans, feeding specialist instructions.  This is why I love cleaning.  It’s not just the sense of peace you feel afterward when you look in the corner of the room and find order.  It’s the peeling back of time.

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The Weekly What If: what if you could find one piece of paper from your past–a lost story you wrote, a letter, a report card, a picture you remember drawing–in a pile while cleaning up.  What would it be?  It doesn’t need to be specific; it could also simply be a birthday card from your grandmother or one of many random notes passed back and forth in high school with a friend.

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It was the 500th issue of the LFCA this week.  In order to keep the LFCA trucking for many more years to come, I wrote about the changes that have taken place over the years, why the LFCA is as it is, and how people can help use the space in the future.  I’d love it if you dropped by and caught up on how the space continues to evolve.  Give your thoughts and ways the LFCA has helped you over the years.  Those stories help me to make smart tweaks in the future.

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It’s getting towards the first cut-off for the Creme de la Creme.  It’s not that you don’t have plenty of time to get on the list (after all, it doesn’t truly close for good until March 1, 2010), but if you want to be guaranteed that you’ll be on the list when it goes up January 1st, you need to have submitted your choice by December 15th. Which is next Tuesday. If you fill out the form after December 15th, you will go up as I keep adding to the list, but you probably won’t be up there when the first wave of people start reading on January 1st. So if you’ve been dragging your heels on picking a post, I’d get on it this weekend.

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Tonight is the first night of Chanukkah which is sort of one of my unfavourite-ish Jewish holidays.  But we’re having over family and friends for latkes and we’ve dragged out chanukkiah and decorations.  Equally as exciting is the DC IF bloggers (otherwise known as TOOTPU or The Order of the Plastic Uterus) cookie exchange on Sunday which I will be live blogging on my on the road blog just to be more annoying that usual.  Look there Sunday starting around noon EST for pictures, video, and quotes from the DC bloggers.  You’ll practically be able to taste the brownies I’m bringing.

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And now, the blogs…

Still Passing Open Windows has a gorgeous post about the benefits and drawbacks of home.  It is about reflecting backwards and looking at the possibilities that come with an open door.  It is about loss and the unknown.  It is wistful and quiet and the entire post reads like a sigh.

Out, Damned Egg!  Out I Say has a post that will make you smile.  It begins with her anniversary; how this year is different from all other years and then moves into a happy announcement for a fellow blogger.  It is about the bonds we make with others along the same journey.

The Girl Who Wants to be Anywhere but Where She Is has a post asking where her friends are when she needs them.  It’s a simple cry, a straightforward stating of need.  And it’s just beautiful in its honesty.

And lastly, Frustrated Musings of a Seemingly Calm Gal has a post about waiting.  She wonders if her difficulty with waiting is tied to being an only child, or if it is merely the fact that when you are waiting, you are still being confronted daily with your infertility.  The post meanders into appointment news and other musings, and truly, it is the fact that this post is a little slice of the infertility blogosphere–as accessible as apple pie–that made me bookmark it as I read it.

The roundup to the Roundup: Clutter gone.  Answer the Weekly What If.  It was the 500th issue of the LFCA.  Get in your Creme de la Creme submission by Tuesday if you want a guarantee to be on the list when it first posts.  Join the TOOTPU cookie exchange via live blogging.  And lots of great posts to read.

Show and Tell is wasted on elementary schoolers. Join several dozen bloggers weekly to show off an item, tell a story, and get the attention of the class. In other words, this is Show and Tell 2.0. Everyone is welcome to join, even if you have never posted before and just found out about Show and Tell for the first time today. So yank out a photo of the worst bridesmaid’s dress you ever wore and tell us the story; show off the homemade soup you cooked last night; or tell us all about the scarf you made for your first knitting project. Details on how to participate are located at the bottom of this post.

Let’s begin.

This is how I won an Olympic gold medal.

I was really sad watching the 2002 winter Olympics, so I went to school and told my students about how I could never reconcile the fact that I had no chance of winning an Olympic medal.  I’d forever think about it with each Olympics, and I asked them if they would help me achieve this dream by holding our own Olympics at the school with events within my capabilities such as holding very still or standing on one foot for a long period of time.

Over 100 students agreed, and the principal allowed me to organize it and run it during a series of lunch times and recesses.  We kicked off the opening ceremony with the running of a paper torch during a school assembly.  People came to cheer on each other during events or participated in the “sports.”  I won a gold medal for synchronized eating (a group of four–me and three students–had to choreograph a routine to music and we made smores in unison and consumed them while dancing.  And yes, I made Josh miss work to come video tape us performing.  We would have won the silver, but the gold team was eliminated by using inappropriate music).

The principal knew how much it meant to me, so during the next school assembly, she called all the winners on stage and gave us gold, silver, and bronze medals that she had purchased.  Another teacher got up on a ladder and held the flag over my head and the entire school rose and sang the national anthem.  And I bawled.

Years later, when I was leaving the school to stay at home with the twins, the new prinicipal threw a chaotic pizza party at lunch time in my honour.  It was a new management team who didn’t know me at all and couldn’t tell that pizza was a terrible idea to “honour” my many years with the school.  One of my synchronized-eating teammates was in the upper school and she told my students about the Olympics from years earlier.

Near the last day of school, a student asked me to come out into the Commons to help with something and when I walked out, a group of about 50 students–current ones and old ones who came down from the upper school–stood up and sang the “Star-Spangled Banner” for me.  And yes, I bawled again because the kids got what the adults couldn’t.

And yes, I cried again writing this.

I’m going to wear my medal to watch the Olympics this winter.

What are you showing today?

Click here or scroll down to the bottom of this post if this is your first time joining along (Important: link to the permalink for the post, not the main url for your blog and use your blog’s name, not your name. Links not going to a Show and Tell post will be deleted). The list is open from now until late Friday night and a new one is posted every week.

And that is probably not how you say “blog post” in French except my French studies ended in 1992 when I passed my exam at college and I haven’t used French on any real basis since 1999.  And apparently, people didn’t talk about blogs back then so it never came up as a vocabulary word so…at a loss on that front.

But today is lovingly known as Xpol, the brain-child of Mission: Impossible.  People sign up, are matched with another blogger, you both post each other’s blog posts on a given date, and readers need to try to guess the original writer of the piece.  Get it?  So my post for today is free-floating somewhere around the lovely Internets and you need to guess who has it (that person would be the author of the blog post below).

So read this post.  BEFORE you even hover anywhere close to that hyperlink answer at the bottom, leave your guess in the comment section.  Did you hear that?  Before your mouse gets anywhere close to that hyperlink.  Then click over to read my thoughts that I posted over there.

Let’s begin…

Bonding

When I first was told that I’d be having twins, I have to admit I fantasized about the relationship the two of them would have. I envisioned two little toddlers who’d want to spend every waking moment together. They’d play together and get along famously. Boy, was I sorely mistaken. For whatever reason, S and J have acted less like the way I expected twins to behave and more like competitive, out-for-blood brothers.

While they were babies, I told myself that their lack of closeness was because they had spent so much of their early months apart. I overlooked the fact that each saw the other as nothing more than an obstacle to climb over or from which to take a coveted toy. The screaming fits and crying jags that erupted in this house over the simplest of things were enough to make your ears bleed on a regular basis. What one had, the other wanted. If one was in my lap, the other literally tried to rip the first out it in order to take his place. It was never ending.

I tried to tell myself, the bond was there. I just needed to be patient. But, I have to admit that it was getting harder and harder to hold on to the hope.

Occasionally I saw glimmers of the possibilities. There were the times that S was so sick in the hospital. J was never quite himself until the moment S started to feel the tiniest bit better. As S improved, J seemed to snap out of his own funk at exactly the same time. And, there was also their annoying habit of tag teaming their over tired parents at bed/nap time. One would fuss for what seemed like forever. When he would finally quiet and go to sleep, his brother would take the reins and start fussing in his place. Back and forth they’d go until they had driven us both crazy with frustration. Something was happening between the two of them. So what if their desire to drive us mad was the glue that stuck them together, right? At least it was something.

S and J have just turned two, and the bond I’ve dreamt about is finally emerging. One is no longer always the rival of the other. Dare I say it? Playing together has actually been seen around this place as of late.

Now, instead of stealing a toy from his brother, J will offer S a replacement so they can trade. S is honing his comedic abilities and tries as hard as he can to get a good laugh from J. Little examples of how much they love each other are witnessed all the time now.

It makes my heart sing to see the two of them together enjoying each other’s company.

This weekend, the boys were in their cribs in their bedroom. S was frustrated and wanted to get out of bed. It was still a little early, so I ignored him and tried to get a little more sleep instead. (A girl’s got to dream!).  Over the monitor I could hear the two of them talking. J tried to comfort S and told him several times “no cry.” S calmed down some. Soon after, I heard the first “Boo!” For the next seven minutes they played peek-a-boo. They laughed and giggled as they took turns scaring the other. It was one of the cutest things I’ve ever seen and heard.

All was right in the world.

It took that moment before it hit me. S and J are close. There is a strong bond between them. I need to stop worrying about their relationship resembling something from my head and let them figure out how it will look.

You know what?

It now looks like they are doing a fine job all on their own. 🙂

Okay, so now you need to guess the author–who wrote the piece above and what are your thoughts on it?  Once you’ve guessed by leaving a comment in the comment box, click on this link to go to Mel’s post from today and find out if you guessed correctly.

Directions: answer the question in the comment section.  Then leave a comment on the blog of the commenter directly before you (so it’s a chain.  #2 comments on #1, #3 comments on #2, etc).  The first person who comments gets a free ride and does not need to leave any comments.  The last person who comments gets…screwed.  My answer is below the picture.

Interpret this question broadly–trophy can be any type of award from a Pulitzer to the Nobel Prize to an Olympic gold medal.

In case you can’t read it, the card states: WHAT KIND OF TROPHY WOULD YOU LIKE TO WIN.

I have always wanted to win an Olympic gold medal and stand on the podium and have them lower the American flag over my head and have everyone sing the National Anthem.  During the 2002 Olympics, I was so sad watching the athletes and knowing I would never achieve this.  But I won’t be sad this year when the Olympics roll around again.  The reason will be this week’s Show and Tell.

A post where Melissa gets all nice to doctors…sort of.

This has been on my mind ever since I started using Posterous as an annex space from this blog, instantly uploading pictures, sound files, stories, and videos from my phone. Where I would have had to wait until I returned home from a party or event, hooking my camera up to the computer, downloading and sizing the photos, slowly uploading them individually to my blog, they now are sent instantly and I return home with the whole night already blogged and commented on from people reading at home.

Same goes for using Twitter or Facebook while on the road.  These three pieces of software are but a few of the options out there for creating a lifestream rather than a static blog.

It’s a wonderful and scary new world.

The wonderful part is obvious–thoughts popping up in all corners of the world are accessible and exchanged in real time as events unfold. There is something raw about lifestream writing, unfiltered, unedited.

The scary part takes into consideration a larger picture. Whereas Tweets disappear into the ether and do not show up in a Google search (Twitter does have its own search engine) and Facebook status updates are somewhat protected, sites such as Posterous are not only open to the public unless set otherwise, but these posts are Googleable in the days, months, and years to come. They operate in the same way as a blog, but provide the immediacy of Twitter.

Therefore, when the circumspection afforded by the drive home to get to the computer or the emotional cooling off time after something hurtful has been said now ceases to exist, there is room for regret both on the part of the writer and the object of their wrath.

Doctors, nurses, clinics, and agencies have plenty to fear from the power that live-blogging affords. The online world has become the equivalent of the backyard fence, with bloggers constantly exchanging advice and opinions with one another. It can be a frightening thought in a consumer-driven area of medicine such as fertility treatments or in the area of adoption agencies (not to mention donor gamete or surrogacy agencies), knowing that the information once contained between two people at the backyard fence is now accessible to anyone Googling for information before making a decision about a doctor or agency.  And they are receiving that opinion out of context, without knowing anything about the speaker other than what is shared online. Get enough angry patients stating their thoughts online and the reputation of a clinic or agency can be sullied for future patients.

This, of course, has been true for years with the advent of blogging, but it is the immediacy of sites such as Posterous coupled with the Googleability of those sites that changes the playing field. Prior to this point, if a patient had a bad interaction with a doctor or nurse, that information was tempered with the time it took to get from the clinic to the computer. In that time period, the person may have the emotional clouds part to examine how their actions can affect another person. There are things I’ll consider doing while upset that seem simply hurtful in retrospect when I have time to calm down. Posterous removes the cooling off zone.

And while this may not seem like a problem for patients and therefore none of our concern (after all, it’s hard to feel a lot of empathy when you just ate $10,000 on a failed cycle), it is when you consider it through the lens of HIPAA.  Just as these laws have been set up to protect the privacy of patients, to ensure that doctors are giving the people they care for respect, the impulse needs to flow both ways if patients and doctors want to continue having a respectful relationship.  I am not talking about the micro-level–your relationship to your personal doctor–but an overall climate.  Doctors need to know they can trust patients in order to do their job well.

I think of it in the same way as traffic cameras.  They sound like a good idea in theory–making sure people obey the speed limit–just as stating your opinion online sounds like a good idea in theory–you could protect someone from receiving the same crappy treatment you received.  But the reality of traffic cameras and speed traps is that they cause more traffic accidents because people are focused on not getting a ticket rather than driving well.  Doctors need to focus on practicing medicine and not protecting their reputation.  At least, that’s my feeling.

While the idea of live-blogging pitfalls applies to all health care situations as well as other facets of life including relationships, family interactions, and education, I’ve been looking at it through the lens of infertility since infertility is an emotional disease that thins the skin as time passes in the family-building arena. When emotions are already running high and emotional reserves are depleted, small mistakes can feel huge.

I think there are many things doctors and agencies can preemptively do. A frank discussion can go a long way. Doctors can state their expectations about blogging in regards to patients during the initial interview, explaining why problems with the clinic should be brought to the attention of those able to remedy the situation rather than simply shouting about it on the Internet. Adoption agencies can ask those who are going to blog about their journey to keep their blog set on private.  Just as patients are reminded about HIPAA laws the moment they fill out the paperwork with a new clinic, patients should also be reminded that respect needs to flow both ways.

A way to register a complaint within the clinic (or agency) and have it heard (in other words, follow up given to the patient that shows the clinic is taking the complaint seriously) is key. Doctors should provide a clear-cut way for patients to give the doctor or nurses feedback directly rather than having them turn to the Internet as a way to voice their ire. Provide an email address for someone in charge of patient relations or an online form that patients can fill out after a bad appointment, with the patient understanding that their words are not going to affect their treatment at the clinic (or, in the case of adoption, agency). After getting this information, doctors should follow up with the patient in a timely manner, making sure that as they’re treating the physical side of infertility, they are also doing their part to make the emotional side easier.

Doctors and agencies finding poor reviews of their service online shouldn’t write off the words as simply angry spoutings from a thin-skinned patient. Instead, use that information to make tweaks in service and address concerns not with the patient directly (which doesn’t allow both parties to save face and feel comfortable), but with the clinic as a whole. For example, if a doctor is noticing that people are consistently blogging about the long wait between blood draws and result calls, shift the system so that expectations are set concretely (for example, “we will only call after two o’clock and will call before five o’clock”) and move bad news phone calls to earlier in the day before the good news or maintenance calls go out (hint: no one complains when they get a call however late with a positive beta).

What responsibilities do patients have to doctors with this powerful medium in place? How can doctors best address blogging and lifestream writing with patients? And what other ways do you think clinics and agencies can show patients respect and help defuse tension before it hits the Web by making tweaks to their clinic protocols and procedures?

I know some people have been confronted about blogging by your doctor.  Have others ever had expectations set by their RE or an adoption agency?  How did they do it?  If you were upset with your clinic, would you pause before you blogged or would you say fuck the clinic for ruining your day?

Somewhat cross-posted with BlogHer