Revisting 2016 Goals

At the beginning of this wretched year, I, in my naivete, set some goals for 2016. They weren’t necessarily resolutions, just things I wanted to get better at. Well, 2016 had other ideas. Let’s take a look, shall we?

My first goal was to finish school. In this, I succeeded. Not only did I finish school, I also passed my CPC exam and became a Certified Medical Coder. So, not so shabby so far.

Goal the second was to eat better and exercise more. I have just one note on this one: HAHAHAHAHHAHAHAHAHAHAHA. Yeah. That didn’t happen.

My third goal was to audition for Listen To Your Mother. In January, I auditioned and I allllllmost made the show but in the end did not. When I saw the show in May, it was clear why I wasn’t cast; my piece just didn’t fit the rest of the show.  But the ladies who WERE cast were AMAZING. 2017 will be the last year for Listen To Your Mother and I will be sad to see it go.

Goal #4: Get better are balancing my responsibilities. Well. Ain’t this one a bitch? I suppose you could say that I did accomplish this – it took divorce lawyers and separation but I certainly know where my responsibilities lay now. Looking back, I meant this goal to reflect my need to somehow organize myself better and prioritize my responsibilities better. What it turned out to mean was that I needed to reevaluate just exactly what my responsibilities are. It gets a lot easier to balance things when you start shoving undue burdens off your plate and refusing to accept more. Funny how that works.

Goal the fifth: Blog more. Oh hell, that didn’t happen at all. I think I blogged less than a dozen times all year. I had so much to say and so many terrible things to scream into the void of the internet. I wanted to do that. But the divorce meant that I couldn’t. I still can’t. If I had blogged like I wanted to, there would have been a new post up every other day. As it is, I have to hold those things in, as much as I don’t want to.

This year has been brutal in so many ways. From the loss of so many icons of my youth to the election of an admitted sexual predator as president. It wasn’t any better on the personal front; every time I thought I’d caught my breath, another blow landed.

I can’t wait to see the back of this terrible year. I have only a small nugget of hope that 2017 will be any better. But I still hope. Don’t let me down, 2017. Don’t let me down.



Maybe there’s a way out of the cage where you live
Maybe one of these days you can let the light in
Show me
How big your brave is
–Sara Bareilles, “Brave”


I moved on Thursday last week and it’s been hitting me all weekend at random intervals: I did it. I got out. It’s done.

Then, this morning, I got in the car to go to work, the above quoted song came on, and I started to cry. There was a way out. I did let the light in.

I showed him how big my brave is. I showed myself how big my brave is.

It turns out that my brave is pretty goddamn big.

This is the hardest thing I have ever done in my whole life – and I’ve gone through some pretty shitty times – but it has taught me more about who I really am and what I’m really capable of than anything else I’ve been through. Divorce is terrible and awful and demoralizing and ghastly.

Divorce is also empowering.

I never knew I had it in me. But, GODDAMN, look at the size of my brave.

Wonder Woman Ain’t Got Nothing On Me

Ok, so I’ve been a wee bit absent here. Given what my last post was about, I’m sure you can understand why.

The divorce slogs ahead. It’s not going all that well, to be honest. I’m not allowed to talk specifics as to why (the lawyers would be pissed if I did) but let’s just say that what has happened so far could have happened without the expense of $15,000 in professional fees. I sometimes think it would have been faster and easier to sue him for divorce, move out, and file for emergency support. But that’s water under the bridge at this point.

However, there is some movement and the big news is that I am moving out. Scot dragged his heels long enough that I threw up my hands and decided enough was enough. I found a house for rent near to where we live now, I took a loan from my parents (because they are wonderful people who are bailing my ass out), and I move December 1st. I can’t wait. The house is just the right size for my needs, there’s room for the kids, and the dog has a big yard. I signed the lease last week and I will have keys a couple days before the move date. I can’t wait. It’s going to be exactly what I need.

A clean break. A new start. For the very first time in my adult life, I will have a place of my own that is MINE and mine alone – I’ve always had roommates or a husband.

On the work front, things are also improving. One of the other results of the divorce process is that the timetable for me to take my CPC (Certified Professional Coder) exam was accelerated. I would have preferred to wait until life settled down a little bit because, HELLO STRESS, but certain parties insisted that I needed a second job – this one full time – and so I dove into exam prep.

The CPC exam is no small thing. It’s a 5 hour and 40 min exam consisting of 150 questions that cover ICD-10-CM, CPT, HCPCS, medical terminology, and coding conventions and guidelines. You have to score 70% or better to pass and only 40-50% of examinees do so on their first attempt. It cost me $800.00 in fees and books just to take the exam. So, there I was, in the middle of the most stressful and difficult time of my life, about to take an exam that was no easy task on the best of days.

I took the exam on November 12th. I walked out feeling like my brain was mush. I used almost the whole exam time and I did manage to answer every question. Still, I had no clue how I did. One woman I met there was on her SIXTH attempt at passing.

I found out today that I passed. I am officially a CPC. I am also officially a Certified Bad Ass Lady. (CBAL, for short.)

I am now on the hunt for a full time job. I’ve applied to six jobs in the last few days and will be putting more time in on that as I go along. The faster I get a job, the better off this whole mess will be, the faster I will be able to get the divorce finalized.

In the meantime, we had an election here in the United States. And I have two words to summarize how I feel about the results: We’re doomed.

I’m not trying to be funny when I say that. I mean it, sincerely. We are so incredibly fucked as a nation. I’m wondering how long it will be until they try to deport my ass because only 3 of my 4 grandparents were born here. The real question is where they would deport me to. I have equal claim to four countries; if they choose Ireland I might not mind so much.

Anyway, over the last few months I’ve learned a lot about myself. I’ve learned that I’m even stronger than I knew. I mean, I knew I was strong when I was holding up the whole family single-handedly. But I’ve found out that I can do SO MUCH MORE than that. I’ve proven to myself that I can do any goddamn thing I put my mind to. I am a force to be reckoned with.

I’ve learned that there were a million little ways I let Scot dictate how I lived my life. Things like never going anywhere there is likely to be a large crowd and thus avoiding anywhere during peak times. Things like being scared to find my way around by myself in the city I’ve lived in for FIFTEEN YEARS because he made me scared to do it. Pittsburgh is not an easy city to navigate, this much is true, but it’s not as hard as all that. GPS is a wonderful invention and I’ve learned so much more of this city in the last 3 months than I learned in the previous 15 years. What the hell was I so afraid of?!

I still have a lot of work to do with my therapist; there’s still trash that needs to be bagged up and left at the curb. But I’m miles better than I was even 3 months ago. I’m finally beginning to accept that I don’t always have to put myself last. It’s ok to take care of myself and my emotional well being. It’s not only ok, it’s necessary for me to be a good parent.

This year has been miserably hard in so many ways but I’m finally starting to climb out of the worst of it. There are times I thought I was going to be trapped in this place forever. I was convinced he would never let me out. But I found my strength. I found my resolve. I found out that being a bullheaded, stubborn, redheaded Taurus is one hell of thing to be.

Look out, world. Here I come.

A Long Time Coming

Things have been very quiet here on the blog for the last several months. It’s been a conscious choice on my part. There were things I wanted to write about but it just wasn’t the right time to share them. Events are finally pushing forward now and the time has come for me to be able to share them.

Scot and I are divorcing.

This has been building for many years and it has finally come to a head. We are broken. We cannot continue on this course; we cannot continue to be married. For the sake of our children, we must divorce.

I never thought I would have to say the words, “I want a divorce.” I never thought we would be a statistic. I never thought that we would be That Couple in our circle of friends that didn’t last. Everyone who knew us when we got married said we would be the kind of couple that would last.

And yet, here we are.

We still have a lot of details to work out. For the moment, we are still all living in the same house; a circumstance that is not very comfortable for anyone involved but it’s what it has to be at this point. We are working with the appropriate parties to figure out how to separate our lives after 15 years of them being entwined. We are trying to do this very difficult thing as peaceably as possible for the sake of the children we both love so much. I don’t know exactly what the future holds for the kids and I, but I know that it HAS to be better than where we are now.

I only hope that I can manage to walk this path with dignity and grace. I know there are times when I’m so angry it’s awfully hard to find any grace much less dignity. But I continue to pick myself up and put one foot in front of the other because I don’t know what else to do. I try to remind myself that the definition of grace is not that we never stumble and fall but that we get back up, we keep trying, we work to make each day a little better than the last. Breakdowns will come but I can’t let that mean that I give up.

A new life will rise from the disaster of this year and I can only hope that when I get there, it’s better than where I am now.

And so all of this is why I haven’t been blogging. There was too much to say and too much chance I’d say the wrong thing. I still won’t be sharing too much about the details of all this in this space (I’m sure you understand why) but I hope to not be such a stranger.

Becoming A Medical Coder

As I near the completion (finally!) of my certification in medical coding, I’ve had some people ask me about my schooling and how I got here. It made me ruminate on the ways in which all the disparate things I’ve done before now have neatly come together into this one profession.

To start, I grew up the daughter of two veterinarians. My Dad owned a vet clinic and my Mom worked first as the vet on staff for their county animal control and then as a relief vet in private practice. (Mom and Dad practiced together before my sister and I came along.) So, medical jargon was the norm in my house. Mom and Dad discussed surgery over the dinner table at night; we listened to Dad take emergency calls from clients; I helped at the clinic every now and then; I watched and assisted as my Mom or Dad spayed/neutered various pets of mine.

My Dad even put stitches in my toe once. But that’s another story entirely.

When I went to college, I studied Archaeology. I have a BS in Anthropology from Michigan State University. I concentrated on Classical Archaeology – Rome and Greece – so I took two years of college Latin. (I graduated before I could start taking Greek.) I also enjoyed Physical Anthropology, in particular Human Origins, which includes a fair amount of anatomy knowledge. The summer between my junior and senior year of college, I completed an archaeological field school that taught me the process of how a dig works.

During the summers of my college years, I worked for the local urgent care in the billing office. I wasn’t a coder or biller then, I was just a general office grunt but one picks up more than just one’s own job if one pays attention. And I did. I gained knowledge in the workings of insurance companies, how claims are filed, medical records keeping, etc. This was in the days before the electronic medical record so it was A LOT of paper management.

When I graduated from college, I made the decision not to go to graduate school. It’s a long story that is partially bound up with the guy I was supposed to marry and didn’t, but suffice it to say that the world of academia wasn’t really something I thought I could successfully navigate. I still think that – the required political maneuverings would have me eating my foot in about 2 seconds flat. That’s assuming I didn’t tell my advisor to stuff it somewhere in the Ph.D. process.

Instead, I worked a series of clerical/administrative assistant type jobs. One of those jobs was as a legal secretary for a law firm that did largely subrogation law. That’s insurance law. Before motherhood, that was the hardest 40 hours a week I ever worked. (Motherhood, however, is the real butt kicker.) The work was incredibly detail-oriented and fast paced to boot. I had no experience as a legal secretary at the time so I had a steep learning curve. But I learned A LOT from that job, not just about the law, and I’m glad I did it.

When I left that job, it was to move cities, come to Pittsburgh, and get married to Scot. I worked for Carnegie Mellon for 4 years as a faculty assistant. I supported 10 professors, all of whom had a claim on 20% of my time. You do the math.

I lost that job in a layoff when I was newly pregnant with Liam – just 7 weeks along. I worked a temp job or two while pregnant but ultimately decided to just be a stay at home parent a few months before I was actually a parent.

That snowballed into a decade at home, at the tail end of which I decided to go back to school to become a medical coder.

I did my program entirely online through AHIMA – it was entirely self-directed and self-paced. I had intended to be done with school by October 2015 – when the ICD-10 code change became effective – but life circumstances prevented that and I’m about 9 months late to the party. Code change was a big deal, with many places scrambling to find coders certified in the new code set in time for implementation. I knew the job market would be open to me, even as a newly minted coder, because I focused my efforts on learning the new coding system just as it was about to be implemented.

I also picked up a part time job that allowed me to gain some experience while I was finishing school.

So how does this all fit together?

  • I grew up in a medical household. That meant that when it came time to learn anatomy and physiology, pathophysiology, and pharmacology I started with more that just the basic working knowledge of “the heart has 4 chambers.”
  • Between growing up as I did and taking two years of Latin, learning medical terminology came easy to me.
  • Archaeology taught me analytical thinking. An archaeological dig is nothing more than a large puzzle in three dimensions. You have to be able to take disparate elements and piece them together to form a larger picture. Abstracting medical records to code them out is no different. You look at the full record, extract the relevant information, and turn that into codes that report the full picture of a patient’s illness.
  • Working in a medical billing office is pretty clearly relevant here. I saw HCFA forms and how they were filled out. I learned how to keep medical records. I learned the convoluted ways in which insurance companies work.
  • Working at the law office and at Carnegie Mellon taught me time management and attention to detail. There is nothing so important in coding as the details. The biggest improvement in ICD-10 is that it includes expanded specificity. Oh? The patient is a diabetic? Type I or Type II? Insulin dependent? Any neuropathy? All of those questions affect the code chosen. You have to pay attention.
  • Then there’s my current job. It gives me experience I wouldn’t otherwise have had. I code, I bill, I call insurance companies, I maintain medical records, I stay aware of HIPAA compliance.
  • Last, motherhood. There is nothing so hard, so stressful, so exhausting as being a mother (or a father, but I’m a mother so that’s my experience). There are a thousand skills I use in raising my kids that translate to the workplace.

I’ve done so many different things in my life but it seems they were all leading me here. Finally, at the age of 40, I am on the cusp of having a REAL career. It took me a long time to get here.

My parents have always said that no education is ever wasted and they never made me feel like I wasted mine (or their money) for getting a college degree in a field I don’t work in. It turns out they were right; it wasn’t wasted. It was just one more step leading me here.

Lessons From My Father

Growing up, my father had a large extended family of Italian relatives. They were like all Italians – boisterous, loving, wanted to feed you – but they had their own notions of how one moves through the world and the ways in which you act in service to others.

My father internalized those lessons and he lived them out every day for my sister and I to see. From him we learned about Love, Respect, Courtesy, and Obligation. We learned from his example how those four words make the world turn and can make it a better place in the process.

My Dad once wrote about these lessons and, with his permission, I’d like to share his words with you.

When I was growing up, my Italian uncles used to talk to my cousins and me about “things.” Life.  How to live it.   How to get along in it.  How to make things work for yourself and others.  I didn’t pay much attention at the time, I thought it was just the ramblings of “old men.”   But as I’ve gotten older and hopefully wiser, I remember the things they said and have come to realize that I could have made my life much easier and made myself a more effective person had I listened more carefully.   

They talked about Love, Respect, Courtesy and Obligation.  Four very different but related and intertwined concepts; concepts I only understood superficially until recent years.

Love is what we feel for those closest to us.  Parents, spouse, children, close friends and relatives. Because we love them, we will (or should) naturally respect them, treat them with courtesy and always, always discharge our obligations faithfully.

Respect without love is what we have for those who we find admirable or even those who we don’t find admirable but who can affect our lives with their power.   By respecting them we will learn from those who we admire and we will not underestimate those we look upon as adversaries.  If we make that respect open and public, we can even curry favor and maybe turn situations to our advantage. Remember, these were Italians.

Finding advantage is second nature, even a bit Machiavellian.  By respecting those around us (and respect for self came into this as well, because by respecting others, we command their respect), we won’t allow ourselves to be taken advantage of nor will we take advantage of others, especially when it isn’t in our own best interests in the long run.

Self-respect also means we learn from what we see and avoid those who repeatedly treat us with obvious lack of respect or courtesy.  

Courtesy is the outward sign of respect.  It doesn’t mean you actually do love or respect someone, but it does lubricate the day to day friction of normal human interaction.  It can also put an adversary at ease and give you an advantage.  But mostly, it makes life work better because there is less conflict if one can find a way to be courteous to even the least important people we come in contact with.  My Uncle Tony used to say “Never do business with a man who treats a waitress rudely.  If courtesy in small ways isn’t in his nature, he will never show respect or courtesy when it comes time for him to meet his obligations. He will have no honor.”

Obligation is the last and, maybe in some ways, the driving force of everything.   If we commit ourselves to others, be it through marriage, friendship, business or social contact, we automatically take on obligation.  We may not like the persons involved, we may even look upon them as adversaries, but if we are to be honorable, we must always keep our obligations in mind and discharge them without fail. The world judges us more by how we handle our obligations than any other aspect of our behavior.  A person we’ve met for the first time will think less of us (we will have earned less of their respect) if we are not a person of our word.  If we accept responsibility, we must meet the demands of that responsibility.   It is upon us to make sure that all aspects of the situation at hand are covered and that anyone who is affected by the decisions or actions we take are informed and prepared for the action that will be taken and any potential consequences that can be anticipated. Just simple courtesy.   If we cannot fulfill our obligations, then it is incumbent upon us to inform those who will be affected, and to find ways to delegate or offer the power of decision making to someone else who may be able to do a better job, even if that means we lose the respect of those around us.  Never let your own failings or weaknesses spill onto others because you were too proud to admit that you were in too deep.  In the long run, they will respect you more for making sure your obligations were met and by admitting your own failings. You may also have created an opportunity to learn from someone else so that next time you’ll know better how to deal with the situation.  Once again, self-respect comes into play here both by taking advantage of the chance to grow and learn, but also in the positive feedback we give ourselves in having done the right things.  Uncle John said that we even diminish ourselves in our own eyes when we fail to meet obligations and that it becomes habit and self-feeding.  Eventually we are incapable of meeting any challenge.

Love. Respect. Courtesy. Obligation.   I’m sure that what I’ve written here only serves to scratch the surface. Maybe all I’ve done is make it obvious how little I understand of what my uncles tried to tell us.  I do know that when I look back on situations that have gone well and interactions that occur smoothly, it seems that these concepts have been applied, consciously or unconsciously.  

“It’s a simple thing,” they used to say.  Well, however true, I’m sure that as hard I may have tried, there are elements of these “simple things” that I have failed to live up to.  Failed miserably…any number of times.  As my very Catholic Uncle Louie used to say, that’s why we have confession and why we try to forgive others.  Forgive is part of respect and courtesy. All I ask from those around me (even those who don’t really love me) is the degree of respect that allows me simple dignity, the courtesy that would be afforded a waitress, and that those who have obligations that affect me discharge them with some measure of reliability, and in the end maybe a little forgiveness for my own failings. The rest is up to me.

Love. Respect. Courtesy. Obligation.

I hope that as I move through the world, I honor the ways in which my Dad taught me these lessons, that I live up to the ideals those words espouse. Just like Dad, I know I fail sometimes. Maybe too many times. What I do know is that I try. And tomorrow is always another day to get it just right.

Spectacular Seven

Last Friday (I’m a week late!) Jamie turned seven.

He is still the most challenging of the two of them but what he takes from me in frustration he gives right back in love and snuggles.

This last year has seen Jamie grow so much in so many ways. He’s finally learning how to express his anxieties so we can work through them. He’s is more willing to listen to us when we try to help him and his frustration level is much lower as a result. That’s not to say that he doesn’t get frustrated. He does. YES, HE DOES. But it’s less often and less intense than it used to be. He’s learning to deescalate.

He’s doing so well with school. Full day school was the answer we all needed. He has an amazing teacher who is kind and understanding and with all that he’s learning, he’s not bored.

He is his own self at all times; Jamie will be Jamie will be Jamie and I just love that about him. It can be frustrating, yes, when we clash, but in the end, knowing that my kid isn’t going to change to please others makes me happy. I know it will serve him well.

I just love having older kids and the more that Jamie leaves those early, dependent years behind him, the more delight I take in him (and Liam!). Babies are great but kids are AWESOME.

So, Happy Birthday, my dear Jamie! You brighten my days with your bear hugs and your snuggles. Never stop being you because you’re pretty great.

Yes, that's a pink cake. That's what he requested so that's what he got.

Yes, that’s a pink cake. That’s what he requested so that’s what he got.