The Medical Engineer

Oof, do I!

Ok here we go:

1. Consider surrogacy or adoption if marriage/longterm relationship is optional for you. Or sperm/egg donor situations. A friend of mine had a baby by sperm donor and surrogate right after graduating residency and I think that was a great option for her. I went the adoption route because I didn’t have the need to have my own genes duplicated and I didn’t feel a strong draw to physically carry my own children.

2.Cultivate your village now. Parenting single is hard. You need an abundance of time, money, or help to do it, preferably 2-3/3. Having kids will help you find out who your real friends are. The ones who told me they’d love to help me as a foster parent quickly disappeared when I asked for actual help. You need 3-4 babysitter options on hand at all times, and as a physician you need sitters who will work long/odd hours. I have been fortunate to find two who are willing to come stay with my kids at midnight if I get called in for a delivery. Living in the same town as family is ideal, but I live 6 hours from mine so I had to build the village on my own. Also consider getting a teenager or college student “mother’s helper” in the evenings. I had one briefly and she bathed the kids while I did dishes or laundry and it made bedtime routines smoother.

3. Don’t try single parenting while still in residency. People do it, sure, but it’s not ideal. If you can stand waiting a few more years, do. Residency schedules are wild and daycares typically aren’t open all the hours you’ll need help.

4. Think hard about your specialty choice. Surgical specialties are going to make single parenting considerably more difficult. It’s pretty hard to make it to a 7am case if daycare doesn’t open until 7:30, and delivering babies at 3am is hard when your own baby is at home asleep. Specialties with busy call schedules will also make having a village of sitters necessary. Consider an outpatient-only specialty or one with a lighter call schedule.

5. Similarly to #4, think through your work hours. Maybe working 0.6 or 0.8 is more conducive to single parenting. I work 1.0 but I have 2 admin half-days a week that I often utilize for my kids’ doctors and therapy appointments. The little things add up. When will you get your oil changed and your hair cut? Will you be able to take kiddo with you grocery shopping and to your own appointments?

6. Find a family-friendly work environment. My first two jobs were not conducive with single parenting for a variety of reasons (location too far from daycare, no flexibility of schedule, overwork, too many work expectations outside of work hours). I’ve been lucky to work in an academic setting in a residency program that is VERY family oriented, so there have always been people available to jump in and take over for me when I had to get a sick kid from daycare or when my youngest was hospitalized for a week. Will your job allow you time and space to breast feed if you choose to? Will they balk when you have to take a day off to care for a kid with the flu? Do they offer parental leave for adoptions? All stuff to think about.

7. Make a will. Have your end of life planning set. I’m sure you’re probably young, but when you have dependents this is something that really has to be done. Who will take the child(ren) if you are incapacitated or die? My sister told me no after I assumed she would be an automatic yes. Set up trusts for your kids so they’ll be financially ok if something terrible happens to you.

8. Figure out how you’re going to take time for yourself. Single parents often go, go, go and don’t take time to refill their cups. Find a hobby, a gym, a church or civic group, or a book club that you can contribute to and benefit from on a weekly basis so you can have some grown up time. Play dates for the kids don’t count. This is something I still haven’t been good at doing but it’s so needed. Maybe it’s a weekly babysitter or mom’s morning out daycare appointment. Maybe, like me, you have a friend who volunteers to take the kids one Saturday a month so you can have quiet mom time. But definitely find time for that massage or nail appointment that makes you feel human again.

9. Work on your own emotional regulation. I’m preaching to myself and all people with children here. People who parent with partners often have the option to say “give me 20 minutes to chill” and the partner takes over for a bit. You will not have this option as a single parent, so make sure you have ways to regulate yourself in the moment when you’re really frustrated with your kid so you don’t end up saying or doing things you regret.

10. Consider the burden single parenting has on the children themselves. I felt like I could be independent and do the parenting thing on my own, but my boys talk all the time about wishing they had a dad. They point out single men in stores and ask if they could be their dad. They miss out on dad things at school. They wish they had someone to help them with sports. They just want a second parent. I didn’t really consider how my contented singleness could potentially be a burden on my children. It may not change your plans, but give it some thought.

there are a lot of fun ones listed here and here but for the most part, they were made years ago and are now a dying breed. i get why. there's no money in it. factoring in the cost of web hosting and servers, it probably costs money. it's just sad that it's a dying art form.

anyway, here's some of my favorite browser-based interactive projects and games, if you're into that kind of thing. 90% of them are on the lists that i linked above.

A Better World - create an alternate history timeline

Alter Ego - abandonware birth-to-death life simulator game

Seedship - text-based game about colonizing a new planet

Sandboxels or ThisIsSand - free-falling sand physics games

Little Alchemy 2 - combine various elements to make new ones

Infinite Craft - kind of the same as Little Alchemy

ZenGM - simulate sports

Tamajoji - browser-based tamagotchi

IFDB - interactive fiction database (text adventure games)

Written Realms - more text adventure games with a user interface

The Cafe & Diner - mystery game

The New Campaign Trail - US presidential campaign game

Money Simulator - simulate financial decisions

Genesis - text-based adventure/fantasy game

Level 13 - text-based science fiction adventure game

Miniconomy - player driven economy game

Checkbox Olympics - games involving clicking checkboxes

BrantSteele.net - game show and Hunger Games simulators

Murder Games - fight to the death simulator by Orteil

Cookie Clicker - different but felt weird not including it. by Orteil.

When I was probably too young to use computers, my dad showed me how to use our Windows 95 PC. He opened up Paint, let me doodle for a while, and showed me how to save. He closed the window, pointed to the icon we created on the desktop and said "Click on that twice and you can look at it whenever you want."

I double-clicked, but my masterpiece didn't appear. Nothing but a tiny monochrome hourglass. I was confused, a little frustrated. I said "Where is it?" and my dad pointed at the humming computer tower and said "It's thinking." Not a second later there was my art once again.

I can not overstate the impact of the idea that the computer is often just "thinking" and needs a second. This single-handedly made me so much more patient with technology in general.

I remember having a friend over and showing her Barbie Fashion Designer and whenever there was a loading screen she would furiously mash the left and right mouse buttons until the next thing happened. And this was the first time I experienced empathy for the machine. Like, I knew logically that computers were objects and not people, but seeing the impatient clicking still felt like I was watching someone getting hurt - being abused simply for needing more time to think than a person might.

"What is wrong with you?" is what I wanted to say. But I also figured she was never taught it that way. In a sense, my dad was also teaching me to be patient with people when they don't understand something. So I just said "We don't need to do that, it's just thinking."

She continued to mash the clicker on every loading screen.

As an adult when things go awry on the computer I find myself handling things a bit more thoughtfully, entering problem-solving mode and even asking my PC gentle questions aloud. Going into task manager to see if maybe it just has a lot on its plate, or if some app is bothering it, or if maybe I've given it a big ask just now. I give it room to breathe, I clean it, I shut it down so it can rest.

"Can I ask y'all a favor?" I said

"Of course!" they replied, probably since they knew I had no more results I could ask them to call patients about

"Remember how Partner had a goldfish in his office that died of old age, and how I've been threatening to get him a replacement office pet ever since?" I said

"Sure!" they replied

"Well, I've hidden 30 of these little plastic goldfish in his office, so he can be mildly tormented by me even when I'm not here," I said, holding out about a dozen more. "Can you periodically put some more in his office?"

He was a doc of few words, but was reported to be a good teacher if you wanted to learn, so I was expecting to be hunched over the whole surgery but also glad to be learning and cheerfully willing to tolerate the resulting back pain

Instead, he looked up across the table, looked back at Anesthesia, and said, "Raise the table for Dr. Hedgehogwnt, please"

He then looked at the RN circulator and said, "Please bring me a stool"

Then he looked up at me again, looked back at the RN circulator, and said, "Actually, bring two"

Me when I contact IT and tell them yes I restarted and followed any instructions I could but computer still angry and IT says they are escalating this because it is an actual issue: I am getting a good grade in service desk ticket. Something that is both normal to want and possible to achieve.

XKCD: Degree Off

“Smallpox was.”

For most of history, smallpox was (!!!) the scourge that haunted human civilisations. We have evidence of smallpox from mummies c. 1350BCE in Egypt. It’s speculated to be one of causative agents of the Plague of Athens c. 430BCE. There were outbreaks of smallpox in Angola in 1484, in South Africa in 1731 that wiped out entire clans of Khoisan people. There was at least one major smallpox epidemic almost every decade across Europe.

Smallpox was transmitted by droplet/aerosol infection; it tore through even the smallest population centres. Typical smallpox incurred a blistering fever, raised pustules, debilitating joint and back pain; if you lived — and that was a fat fucking if, as typical smallpox had a mortality rate of 30% — you’d have tell-tale pockmark scarring, and face stigma for the rest of your life. Some were left blinded.

The worst form of the disease was haemorrhagic smallpox; all the agony of typical smallpox, with the addition of skin haemorrhage and pinpoint haemorrhage in the spleen, liver, kidneys and gonads. Near-universally fatal, haemorrhagic smallpox made up 5-10% of all cases. Of this number, 72% were children.

The global smallpox vaccination campaigns of 1958 to 1977 were a monumental effort by the World Health Organization and its global associates, backed by incredibly diligent public health work and epidemiological monitoring.

Wherever there were outbreaks, there was herd immunisation. Health bodies campaigned tirelessly for the general population to be immunised. In the ‘70s, a concerted effort was made by the WHO to ensure vaccines were administered in the most remote and vulnerable communities in the Horn of Africa, South Asia and the Pacific.

In 1980, the world was officially, finally free of one of it’s oldest adversaries; universal vaccination had been achieved, and there was no population that could act as a reservoir for smallpox.

If mankind has only one great achievement, it’s the smallpox vaccine; to date, smallpox is the only human disease to be completely eradicated.

After over two millennia of suffering, mass disability and death, humanity finally had the means to give one of it’s biggest threats the biggest possible fuck you, and through scientific and public health collaboration, careful epidemiological monitoring and countless hours of on-the-ground vaccination efforts, managed to blot it from existence entirely.

Where there is vaccine coverage, childhood diseases with high morbidity and mortality rates like whooping cough, diphtheria, influenza B and have dropped.

We have vaccines for TB, another of our greatest and longest adversaries.

With enough effort to counter misinformation, more people fighting for vaccine equality, patent free medication for communicable disease, and universal vaccine coverage, and everyone making sure to keep up to date with their vaccinations, one day, we could be fortunate enough to be able to say;