The rolodex in my head

Elementary school was an uneasy time for me. I used to stand in front of the mirror in my closet every morning and go over a list of what was worrying me: my parents had a fight, someone at school was mad at me, I still hadn't been invited to a specific birthday party. I would mentally check off each worry by offering myself a reassuring comment. Often I felt better when I changed my outfit a few times. After donning something I felt confident in, it was like magic. I was ready for the day.

This habit served me well in residency. I would keep a running checklist in my head of all my patients that were worrying me, a list of any tests or results I had to follow up on. I learned along the way to get up early for the outfit changes and to address my worries throughout the day, not just in the morning. For every important event in my life, I have always had a well planned (and slightly magical) outfit, including all the births of my children and for Max's surgeries.

Today I was driving home from work and noticed that same uneasy feeling in my chest, a sort of wobbly insecurity. The same thing from my closet as an elementary school-girl. The rolodex in my head started to flutter. What is wrong? Why am I worried? Is it work? Did I forget to follow up on a patient? Is it Brad, did we have a fight? Is it my mom? My sister? My dad? My kids?

Is it Maggie? Maybe, she has strep throat but I got her treated. She feels better. I waited a minute, but no change in the wobbly feeling. So no, it's not Maggie.

Is it Izzy? No, I have to watch her for fever or sore throat but she is okay so far.

Is it Max? The wobbly feeling worsened. It is Max. So I move down the algorithm. What is it about Max? He doesn't have a fever. He wore his eye patch this morning. He wasn't fussy. He ate breakfast well. His color was good, his activity level normal.

I am still going down my list as I walk into the house and there it is, a form from the pediatric genetics office with lime green highlighter glaring angrily at me. Under the "things to bring with you to the genetics evaluation" is says: "...pictures or medical records from other family members...find out if anyone has had birth defects or mental retardation...."

My heart starts racing. I hate medicine. My son is not defective. I suddenly felt a huge wave of sadness and guilt for having referred countless patients to genetics: I'm so sorry. I didn't know it made you feel like this.

But then I started my auto-reassurance: We already had him screened for one fatal genetic disorder, 22q11, and it was negative. He has met every developmental milestone. We do not have a family history of genetic problems or birth defects. He is not dysmorphic, he is handsome. He just has three birth "defects."

I think I just figured out why some parents no-show for specialist appointments. And I am definitely going to need a new outfit for this appointment.