That's So Meta...

My blogging started off way back in July of 2006. I began blogging for a number of reasons, the first being that one of my good friends had a blog about her life that I enjoyed reading, and loved how it was like a journal that could "talk back" to you, so, I totally copied her idea. The second reason was because I enjoyed writing and wanted a creative outlet, the practice of day-to-day medicine does not often lend itself to creativity. The third, more distant reason, was as an anonymous outlet for the frustrations surrounding my job at the time.

Since that time, my job and circumstances have changed for the better, but, save a handful of people, I try to keep my blogging anonymous. I do worry about being "outed." Not so much because I don't stand behind every word I write (because I do), but because I know that not knowing where I am/who I am affords my patients (and me) additional protection/anonymity. Not to mention the fact that it is more and more tempting to self-censor if your identity is known. I do a lot of "keeping up appearances" in my day to day life. I like to have a place to let it "all hang out." At times I worry about what my new partners would think of my blogging, but, at other times, I also have urges to spill about the blog. My husband knows (and he wants to "out" me all the time), a select few of my friends know, and some of the lovely ladies with whom I blog know "the real me." Sometimes I wish that I were not an anonymous blogger, mostly because I'd like to direct my family or friends to certain posts to let them know how I feel about particular issues, and, let's face it, sometimes because I am proud of the blogs that I write and want to brag a bit. Most of the time, however, I am very content to remain anonymous.

Life often gets in the way of blogging for me, and so many times I am struck with the urge to spill all of the thoughts from my head onto the screen. I love blogging. I love that it brings patients and physicans to a common ground, so the better to communicate as people, rather than 'doctor' and 'patient.' I also love the community of blogging physicians, it is so nice to share stories, laughs, and frustrations with those of us in the trenches, and it is also great to provide information and guidance to upcoming residents and medical students alike. Sometimes, however, I feel obligated to blog. I feel as though I am letting people down when I don't write. Then, if I feel obligated to write, sometimes the ideas don't flow as freely.

Ultimately, blogging has changed the way I think about people, patients, and medicine. In many ways, it reminds me every day to think of my patients as real people and not just problems to be solved or diagnoses to be made (or numbers to force through the treadmill). I try to keep in mind that even though it may be my 9th delivery of the day, it is *the* delivery of the day for my patient. I am thankful to be part of this blogging community, and hope to be blogging for many more years to come!

Hate mail, non-anonymous blogging and a favourite comment

I started my personal blog in October 2007, when I was working part-time and mother to a one-, three- and six-year-old. It made perfect sense to me that I take up blogging during the very busiest time of my life: blog posts were tidy, tangible, creative packages I could set afloat on the Internet, when everything else in my life felt messy and abstract.

I knew that if my blog attracted any kind of readership, I could expect hate mail. I prepared myself by deciding that when the first nasty comment arrived, I would see it as an accomplishment, a marker of an ever-widening circle of readers. Then someone called my kids f***ing ugly and interpreting that as a mark of success proved more difficult than I had anticipated.

All posts are vetted by Pete. On more than one occasion he's responded with, "I'd actually file that in the Who Cares Department." I post those ones anyway and invariably they're particularly well-received.

I've never blogged anonymously. For one, I wanted to take responsibility for what I wrote. I also wanted full credit for it. When I write, I consider that anyone could be reading: patients, employers, ex-boyfriends, my mother, my child's teacher. This keeps me cautious, and keeps blogging from landing me in any sort of real trouble. That also means that out of respect for family, friends and even institutions, most of the very best fodder for writing is off-limits.

For example, I won't write about:

• being actively discouraged from pursuing medicine by family
• being raised in a small, religiously and ethnically homogeneous community wherein women pursuing careers was rare and having a child in formal daycare was unheard of
• the refining of my Christian views as medicine affords me glimpses into human hearts, lives and suffering
• the complexities of relationships with friends who home birth, don't vaccinate and seek medical advice through Facebook status updates
  

Though I no longer blog at freshmd.com for reasons detailed here, I continue to blog at Mothers in Medicine for several reasons. For one, writing is a good exercise in putting one's thoughts in order. I agree with Emily Carr:

It seems to me that it helps to write thoughts and things down. It makes the unworthy ones look more shame-faced and helps to place the better ones for sure in our minds.

For another, I value having records of events. I am certain I would not remember the small details of my son's radial/ulnar fracture had I not documented it. I'm grateful I made the effort to describe what my typical day looks like. For me, writing captures memories far better than photography does. It also feels like the most authentic me; my writing represents me much more accurately then my CV, or my wardrobe, or my library.

But what I enjoy most about blogging is having others derive pleasure from my writing. The best blog comment I ever received was from someone who wrote:

When I saw that you were gonna describe each of your morning patients I got so excited I actually got a bowl of chips and some coke to thoroughly enjoy the read.

When I tell a story face-to-face, the response is immediate. When a piece is published in a journal, that very fact is affirmation enough. But a blog audience, for the most part, reads in silence, and that inscrutability can be unnerving. Learning that someone out there is settling in with a snack to enjoy a post is a huge incentive to continue.

Metablogging

Blogging about blogging. I had never heard the term "metablogging" before this topic week, and I love it. There are people out there wondering about why we blog, and how our families feel about it.

When I first started blogging in November of ’08, I didn't really understand what it was, I was just following a suggestion from someone I know. I felt kind of vulnerable, and my now ex voiced his opposition to being subject matter - I honored that as best I could. I chose an anonymous name, and made up names for my kids. Occasionally I would weave him into a tale involving a great parenting moment with the kids.

Blogging became an emotional release for me. Although being anonymous felt somehow protective, I was still cautious about what I blogged about, understanding that when you are putting yourself out there on the web you are never truly anonymous. I had my mentor from residency read my first few blogs and give me tips about what to include and exclude. When I compose stories about work, I often bend the encounter to a point beyond recognition and make sure the time frame of the blog is far removed from the interaction. It was frustrating at first, because I am a stickler for details and precision, but eventually it became fun to fictionalize.

Positives about blogging:

A sense of community. Something to do besides reading after the kids go to bed. I have met a lot of incredible women, and made some amazing friendships through e-mail. Having people read and comment on my own blog makes me feel a little less alone. I do not keep my blog secret from my friends and family, and it has pulled me closer to my brother and his wife, who live pretty far from me, and my other brother who is in law school in another state. Local family generally doesn't read it, because they get enough of me as it is. I was honored when KC asked me to join MiM last fall, and my presence here has widened my blog social horizon significantly.

Knowledge. These girls are smart! I get tips on mothering, doctoring, books, politics, history, and life. When you are a professional and a mother, especially single, there is little time to nurture relationships with other moms at school through activities and play groups. Blogging, following blogs, and commenting on blogs supplements that. Some of my favorite blogs are SAHM blogs. It's great getting mothering tips from those who get to spend 24/7 doing just that (a sometimes escape fantasy for me, on my bad days).

Entertainment. Smart=funny. Nowhere is that more true than our own Fizzy’s cartoon blog. I remember when she started I was instantaneously enamored. Now she has a million more followers than me (not jealous!). Recently, her hosting of Grand Rounds led me to a lot of other blogs that I enjoy following.

Negatives about blogging:

Well, there really haven’t been any.

I’ve been blogging a little less lately, because moving and divorcing are stressful life events - both occurring for me in the last two weeks - but I also made partner Friday, which almost outweighed the negatives. Instead of blogging at night, I’m unpacking boxes. But I was off Monday to meet the U-verse man, so that should change.

I read a fabulous book last week called The Year of Wonders by Geraldine Brooks. The author was a Middle East correspondent for The Wall Street Journal when she happened upon a small town in England that lost 2/3rds of its population to the Plague (Yersinia pestis) in 1666. She was drawn to the history of the town, and studied all patterns of 1600’s sociology from witching to farming to medicine to personal accounts in her research. The tale she wove about a handmaid to the preacher was exquisite. I especially recommend it to Mom TFH, Dr. Whoo, and Rh+ because a midwife passage was one of the most incredible I have ever read - I don't want to spoil it but my eyes got a little shiny and the words blurred. The main character, Anna, lost her whole world in a year, but instead of folding into depression she worked and created a new life for herself. I’m not sure where this book came from, but I found it last weekend in a box when I was desperately looking for an escape, and the story I encountered made me feel the find was serendipitous. We always look to others to buoy us in hard times, and that certainly helps, but the strength we need usually resides within ourselves.

That is what blogging has been for me. An escape, an emotional outlet, and a way to find myself. I’m not tending plague victims, but it has been equally important to me. A couple of years ago, I was desperately lost. Was blogging my only savior? No. My family, my kids, my friends, my partners all helped. But blogging has been invaluable in getting me from there to here, where I'm much happier.

Blogging ad infinitum

In 2006, my daughter was 1. That first year was so full of everything new: new feelings (both good and awful -hello, postpartum loveliness), milestones, joy, challenge, humor...I made some lame attempts to record what was going on in a journal, but I always felt like the richness of that year was lost forever. Sure, I had plenty of pictures (digital camera + first baby = photojournalism insanity).  But, it didn't seem quite nearly enough.

I  soon thereafter discovered blogs, well, mommy blogs (as unappealing as that phrase is to me), and realized what I had been missing. Here it was, the richness. I particularly recall coming across Dooce's blog and being captivated/jealous/inspired by her monthly letters to her daughter which captured the essence of that month in her daughter's development.

I want to do that, I thought.

So, I started a personal blog, mainly intended to be devoted to my daughter. I wanted our family and friends to know about what she was doing, learning. And, I wanted to write (again). I (also) started a monthly tribute to my daughter on my blog, but instead of a letter, I decided I would post her developments in the form of a software update, complete with new features and known operating failures: Version 14.0 was the first release.

At first, the only people who knew about my blog were my husband (who would always be the first to read my posts no matter what) and a few friends and family. I soon discovered a whole community of supportive bloggers whose writing I admired - I'd post comments on their blogs and they would on mine. It was like having a cheerleading section with you - along for the ups and downs on your life ride.

Pretty soon, I was writing on a regional moms blog, freelance writing a blog for Disney (long story, but short version: they found my personal blog and asked me to write for them), and blogging was suddenly a very big part of my life. My husband has always been my number one reader-fan and despite my writing for multiple outlets, always made sure to read my posts and murmur supportive things about them. He sometimes would half-joke that everything - every funny conversation we had -might make it onto the blog. I tried to be sensitive about that since he's more of a private person than me. He once actually guest-wrote about what it was like being the husband of a blogger (me) on one of the blogs I was writing for. I loved reading his perspective.

My family knows about my blogging (even though it still weirds me out when I can see that my retired Dad has refreshed my blog page 20 times or more in one day) and my co-workers. In fact, a whole lot of people who know me know, apparently, sometimes catching me off guard. Mothers of friends have mentioned certain posts to me, and the other day, a former intern of mine stopped by my office to talk about a mutual patient when he mentioned HE was reading Momicillin and wanted to congratulate me on my pregnancy. (In my mind, I manually closed my jaw with my hand. In real life, I smiled back and said, "Thank you!!!")

Over time, I've tended to mask the identity of my family more and more while unmasking my own- I guess I'm making it more about me than about them which I think has more to do with giving them more privacy and exposing myself than about narcissism. (Hopefully.) Personally, I have come to believe in taking ownership for my words and my thoughts and standing behind them, for better or worse.

Blogging invaded my academic life and I started using private blogs for reflective writing with medical students and in 2008, this blog was born. I've had to give up some of the other blogging gigs along the way, but this blog, with its community of readers, with its writers, with its stories, is still one of my proudest bullets on my CV. I owe MiM for producing some of my most valued IRL friendships. These women I write with here are simply amazing.

And the versions? They continued  on until Version 42.0 when I thought my daughter was getting old enough that it was becoming less my stories to tell in so much detail. Like Fizzy, I went back and published all of those old posts in a book, to give to her eventually. Now, I'm up to Version 33.0 XY for my son (although these have become far more sporadic like hers did at the end and plan to publish his own book of posts one day. In a few months, I guess I'll be starting all over at Version 1.0 XY(2)...and so it goes.

Fat Doctor, Versions 1-3

Hello, my name is Sarah Parrott and I am a recovering blogging addict.

In October of 2005, I struggled with emotional adjustment to a health crisis. Because I needed to write to heal, I Googled "online journal", found Blogger and decided my blog's title should be The Fat Doctor, because that's what I am. I chose the username bigmamadoc. My first post was brief, raw and full of anger. I still believe it's the best I ever wrote.

I thought the blog would be just for me, but after a week or so, I realized that taking my blog public would give me more "reason to write." I'm the type of gal who loves an audience. I signed up on medlogs and eventually a few people started to comment on my posts. After I hosted a couple of Grand Rounds, the readership increased. Somewhere along the line I started thinking about my blog as a brand and renamed it "Fat Doctor" and changed my username to that as well. Readers addressed me as FD.

My blog friends became increasingly more important to me. TBTAM, Doctor Anonymous, all sorts of bloggers felt as real to me as the friends I met for movies and dinner. During my hospitalization in San Francisco in April of 2006, Husband printed out the comments on my blog and bring them to me every day. In the heyday of my blog, which was probably Fall of 2006, I was getting about 800 hits a day.

In May of 2007, I was outed at work. Too many personal details...it was bound to happen. My department chair came to my office and said that he was particularly dismayed to read my comments about a recent faculty meeting. He did not ask me to take the blog down, but I did just that. I moved to WordPress and my posts changed tone. Fat Doctor Lite, if you will. It wasn't that much fun anymore.

After changing jobs in July 2007, which probably was a result of the embarrassment I felt about being outed (and the lure of twice my salary), I kept that boring blog going. When I was laid off in 2009 and I needed to find a new job, I took it private, allowing only usernames I trusted to see it. Fat Doctor still exists, and I post there a few times a month, but only a handful (if that) of the 100 or so registered users read it regularly. I believe that blog has started the agonal breathing that signifies impending death.

Meanwhile, it seems a lot of bloggers have outed themselves. What a refreshing concept! I started a new blog as just plain old me. It, too, is extremely boring. I won't discuss work at all. I'm not sure this blog will work out, either, but it feels good not to hide behind an eponym.

Funny, but I don't seem to need blogging anymore. It really served a role when I was worried about dying, but I'm now convinced I'll live forever. Similarly, blogging served a role when I was miserable at my first two jobs post-residency because I could "safely" complain, but that kind of backfired. Now I love my work and want to stay where I am until retirement.


I need a new addiction, perhaps, but I certainly won't choose anything related to exercise. After all, my blogs may come and go, but I'll always be Fat Doctor.

Mom, Are You Blogging About Me Again?

Did you know that more than 133,000,000 blogs have been indexed by Technorati since 2002? That is an amazing number. Now regardless of how many remain active is difficult to assess but it does prove that numerous individuals have found the idea of blogging attractive enough to start one. So, why do we start to blog?

The majority of people want to be heard and known. They want to share their life experience as if the more people know about it, the more meaning it will have. Some want to share their expertise and create a stream of income. Yet others want to blog about family, friends or problems. One of the most popular blogs is a young mother who suffered from post partum depression and her airing of problems resonated with a large audience. She now supports her family with her blog.

I started blogging because I find it fulfilling to write, share my medical and parenting experiences, and I love to interact with people in a variety of modes including the internet. Now, many times I do blog about my family and friends. What do they think about this? Well, to tell you the truth my family doesn’t even read my blog. They wouldn’t have a clue that I wrote about them unless I told them. I really don’t mind because the last thing I want to deal with is the possible criticism. “Why did you say that?” “I would have said this…” Blah, blah, blah!

Blogging is a release from my daily reality for me. It is my time to share a funny story and get feedback from a mostly objective audience. Sometimes I will write about something that has lit a fire under me like watching the movie, “Super Size Me.” Oh my goodness, that got me going about the junk we feed ourselves and family, and personal responsibility that seems to have gone by the wayside in much of America. Everything is always someone else’s fault. See, there I go again! 

So, in summary, I blog for me and for you my audience…if anyone is out there. My family may think I am crazy, wasting my time, etc. But the benefit outweighs the possible criticism, at least for me.

My secret life of blogging

Ever since I was a little kid, I always wanted to have a diary.

When I was about eight years old, my grandmother bought me a little pink diary. With a lock and key! And multi-colored pages! I was so excited, I started writing in it immediately. However, I recently rediscovered this diary and found it was a mish-mosh of entries every 3-6 months, mainly focusing on either my latest math test or my latest crush. I guess grade schoolers don't have that much to say.

During college, the internet was becoming pretty big (although clearly just a fad), and I found a few interesting blogs online. In the midst of studying for my midterms during sophomore year, I decided to give it a go.

Everyone I knew was informed about this blog, which was how I found readership. My parents would make comments like, "You sound a lot more bubbly and happy on your blog than you do in real life." (In real life, I'm apparently chronically depressed.) My blog was also a good way to inform my boyfriend that I was pissed off at him. But for the most part, the entries were shit: brief random musing that had nothing to do with anything. This is a sample entry, that I presumably wrote after learning about Mendel and Martin Luther:

Monks have made a lot of important contributions in history. So I don't want any more monk-bashing, ya hear?

But somehow knowing people were reading kept me going and I wrote in the blog all through college. Then in med school, I took my blog offline, but I kept writing. And now I wrote in-depth entries about my experience going through the oft-times fun but mostly pretty horrible training process. (Anyone who says "I love med school," just know that I hate you. You and med school should go get a room.)

After med school, I discovered Livejournal, and I moved my blogging over there. It has a great format in that not only can you lock individual entries, but you can filter entries so that only a handful of trusted people can read the more personal, gut-wrenching stuff. I've been blogging there for the last five years, with all entries locked. That way I don't have to worry about that thrill of fear in the pit of my stomach when a colleague or family member discovers my blog.

It's nice to have a public web presence though, which is why I like blogging for Mothers in Medicine. But does my family know about it? Other than my husband, no. There have been tons of times when I wrote an entry that I would have loved my mother to see, but then I realized that if I showed it to her, I'd have to constantly be censoring myself here.

I do censor myself somewhat though. It's a mistake to think that anyone on the internet is completely anonymous. Whenever I write an entry, I ask myself if I would be in any trouble if everyone I knew saw this entry. If the answer is yes, I don't post it. A few times I've complained about resident colleagues on here, but I was secretly hoping they'd find the entry and realize what a dick they'd been.

When I started my cartoon blog, I fully intended to tell my parents about it. However, I showed my father, a psychiatrist, this cartoon and he declared it "not funny." I decided that I'd prefer to stay anonymous than deal with any more negative critiques. My husband reads the blog though and he says he appreciates my "really immature sense of humor."

I think the best thing about blogging is looking back on old entries. After my intern year, I went back and collected all the entries into a book, which I published on Lulu for myself:



Recently I was having lunch with some friends and one of them mentioned the idea of starting a travel blog and was looking for advice. I kept my mouth shut, not mentioning that I contribute to three blogs. If I go around telling people that, I may as well tattoo a big L on my forehead. So really, it's my little secret.... not so much because it's scandalous, but more because it's a little embarrassing.

Next week: Metablogging Topic Week

We're having another Topic Week next week on MiM, this time, the topic is metablogging (blogging about blogging).

The topic was suggested by a reader who wrote:

I love reading your website. All of the women are so inspiring. My suggestion is, what do your families/friends/whoever you write about feel about your blogging? Do they ask you to leave things out, are they uncomfortable, do they support it? Do they know? 

So, look out for our posts next week on this topic. We also invite any other bloggers out there to contribute guest posts. Who knows about your blogging? Do your co-workers know? What is your relationship with blogging - why do you do it? What have you gotten from it? Any regrets?  Basically, anything related to blogging is fair game.

Please send guest posts or ideas for future topic weeks to mothersinmedicine@gmail.com.

Bunco Night

A year ago we moved into our new house. Same city, just managed to take advantage of the great real estate prices to make a nice upgrade. In our previous neighborhood, the neighbors were polite, but we had never really connected with anyone, and I was certainly never felt welcomed into the social circles of the SAHMs on the block. The new neighborhood has been completely different. Neighbors are friendly and there are several kids my son’s age. After, reading Anesthesioboist’s post on friendship, I have really tried to go out of way to make time to nurture these new friendships. So explains my joining of the monthly ladies Bunco club. Bunco is a fun but mindless game that makes an excellent excuse for gossiping socializing and alcohol refreshments. Hey what’s not to like about that?

I try my best to make it to Bunco, but often have to miss due to call or childcare obligations. Last month however I was all set to go. I was not on call and even made it home from work on time. I literally had my hand on the door knob to walk out when my pager went off. The number was labor and delivery, followed by those dreaded numbers…. 911. My stomach dropped, you know that feeling when rollercoaster hits the crest of its hill, multiply that times ten. I immediately got in my car, and called back on my way .

“What’s going on?” I asked the secretary who answers. Your partner’s in the OR doing a c-section, she said she needs you right away. Not good. My partner is extremely capable; if she’s calling in emergency help then things have taken a turn for the worse. I arrive in the OR in exactly 7 minutes. There is blood everywhere. It’s not clotting either. Definitely, a bad sign.

“What’s the story?”, I ask, as I enter the surgical field.

“Ruptured uterus from a VBAC” she says.

We work for an hour attempting to salvage her uterus, we fail, but we do save her life. Finally with patient stable, I leave and let my partner close. I change back into my skinny jeans and return to my car. I notice my hand shaking slightly as I start to turn the key, so I stop and take a few deep breaths.

As I pull into the neighborhood I notice there are still lots of cars at the Bunco party. So I go on in. Everyone is mingling and making small talk as they finish up. “Where were you?” they ask.

I open my mouth to answer, but in that moment a hundred different images flash through my mind. Finally I just smile and say, “It was a long day at the office.”

Starting my internal medicine rotation

I started my clinical rotations in July of this year. (These traditionally occur during the third year of medical school. For me, it's my fourth year, since I did a fellowship year.) I have been able to ease in - my first two months were surgery, which is normally a difficult rotation, but is a fairly mellow one at my rotation site. This past month I have been on my psychiatry rotation, which has also been a low demand rotation, time wise. I have still been able to cook dinner most nights, and have been (mostly) keeping up with the cleaning and the laundry. I was even able to pull off a birthday party for my newly six year old younger son this weekend.

Well, the easy street is merging into the internal medicine superhighway. I have three months of internal medicine starting October 1st. I am really nervous about it. I have back up to help me with the kids, but I am still dreading it. I am especially concerned since my stint stretches over October, November, and December, and all of the holidays associated with these months.

So, coffee? Check. Comfortable shoes? Check. Penlight? Fresh batteries. Big fat pocket book that promises to have all the information on all of the diagnoses, drugs and lab results that I may see in the units? Ordered and on its way.

Sigh. Any other recommendations for surviving these next three months?

Too good for NEJM, JAMA and The Lancet

THE EFFECTS OF WEEKLY MOTHER-CHILD BUBBLE BATHS ON STRESS AND BONDING*

STATEMENT OF PROBLEM:
Solitary bubble baths have been shown to reduce stress and provide relaxation in otherwise busy lives. Yet, when wild-type offspring are introduced, this usually signals the end of all things peaceful for at least several decades. It is unknown whether dual mother-child bubble baths decrease stress associated with child-rearing and increase bonding.

DESCRIPTION OF INTERVENTION:
A weekly mother-child bubble bath ritual was introduced in a chaotic home with a possibly hyperactive, high-needs child with an uncanny resemblance to a sumo wrestler. The mother, an occasionally stressed out professional woman with pores the size of Canada, herded the child into the bathroom during two random afternoons. A bubble bath was initiated and all parties were disrobed fully, including protective undergarments. Attention was paid to blowing puffs of bubbles into each other's faces and sticking the most amount of bubbles onto exposed body parts. Both were instructed specifically not to urinate during the intervention, and any gross violation of health codes or sanitation would require immediate evacuation of the tub. A one-time, re-fill with warmer water was permitted.

FINDINGS TO DATE:
Despite the near-abortion of the first bath due to an egregious urination episode, the first intervention provided a much needed stress release and increased mother-child bonding significantly. During the repeat session, these findings were reproduced nicely, and fortunately, no witnessed urination was documented. There was, however, submersed flatus on part of the sumo-child, and one can only assume there was plenty of other covert underwater pollution occurring. Water samples for toxic waste and sewage were not performed.

KEY LESSONS LEARNED:
A regular series of mother-child bubble baths can decrease stress and increase bonding. The main adverse effects were water/noise pollution, although not enough to result in tub evacuation.


*I just rediscovered this post study that I was first author on over 3 1/2 years ago when my daughter was 2 and wanted to share the results with the larger MiM scientific community. We here at MiM welcome submissions from MiM researchers conducting their own related research and would welcome publishing any such reports here.

MiM Mailbag: Shared residency

Hi all!  I love your blog, and have already utilized so much of what I've learned from your posts.  I'm an M1 with a seven month old.  Although I am very far from making any decisions regarding specialty options, the fact that I will be deciding in the next couple years has been on my mind lately.  And while I know it shouldn't be the only factor I consider, I would be lying if I said that lifestyle wasn't an important player for me.  So, when I heard about the possibility of a shared residency, I became very curious (and even, yes, a little excited).  I am sure these things are few and far between, as well as incredibly competitive, and chock full of faults of their own, but what do you ladies think about them?  Anyone do one, or know someone who did?  I would love to know more about them, but am hesitant to ask people at my school, for fear that they'll make assumptions about me. Thank you!

Hello There MiM!

Hello everyone! I am new to MiM and looking forward to learning about everyone here. My name is Laurie Marbas and I am a family doc in rural Colorado. I just finished a stint in the USAF and now my family and I are adjusting to the civilian world. We are loving every minute of it, especially the part of no more deploying!

Just a little bit about my family and I. I am married and when I started medical school (go Texas Tech!) my kiddos were 5, 3, and 10 months. Well, now they are 16, 14, and 12. Needless to say I have a few more wrinkles and not sure about the gray hair because I feel compelled to keep the local beauty parlor in business. During med school my grandmother also lived with us. She suffered through breast cancer my 3rd year and a stroke my 4th so I have learned some tough lessons and am looking forward to sharing these with you all. I also have my own blog at http://laughingdoc.com.

Again, thanks KC for the opportunity to share.
LaughingDoc

Friendship and Female Physicians II

Over a year ago I wrote a post about the challenges of making friends as a female physician. I cross-posted it on my own blog, and the comment boards on both blogs were pretty interesting. I'm back for a visit here because the topic has generated a lot of reflection for me lately, once again.

One of my best friends in med school was an O.B. nurse. Though she has moved almost all the way across the country and I haven't seen her since I was in school, we're still in touch and expect to be seeing each other at last in a couple of months.

By some coincidence one of my best friends now is also an O.B. nurse. I'll call her Ziva (yes, I watch a lot of NCIS). Ziva is from Israel. She is smart and funny, a lover of books and movies and good music and good food, talented and competent, and above all a great and generous person I would entrust with my children's lives. Ziva and I can talk about just about anything - silly "girl stuff," deep intellectual stuff, spiritual questions, moral/ethical dilemmas, work stress, kids, comic moments from day-to-day life, worries about tough problems, faults and failings, embarrassing secrets, cultural differences, things that inspire us or bring us joy.

For some reason, her colleagues are very uncomfortable with our friendship and underhandedly persecute her for it with snide comments and not-so-veiled criticisms. One time I arrived to provide a spinal for a C-section. Ziva was already in the room counting instruments, and one of the other nurses said, "Oh, are you happy now - your friend's here." Another time she happened to mention that she and I had recently discussed the mechanics of intubation, and in front of all the other nurses one of her other colleagues made some critical remark about her being friends with me. When Ziva called her on it, saying "What's wrong with that? T. is SO nice! She's totally adorable," the other nurse said, "I have no desire to be friends with T. I have my OWN friends." Ziva found this nurse's comments and the tone in which she said them disrespectful and hurtful. Many of the other nurses can barely conceal the clouds of disapproval and resentment that darken their looks when Ziva and I greet each other cheerfully at the nurses' station.

"They feel threatened," my husband said.

"But if I were a single, tall, good-looking MALE doctor it would be FINE for a nurse to be close to me, right? Isn't that totally self-demeaning of these women? Sure, it's ok to befriend a man in a position of authority, but it's somehow wrong if it's a woman?" I was totally frustrated and irritated that the culture in this workplace wouldn't tolerate a genuine close friendship between a female doctor and a nurse.

Ziva and I do not flaunt our relationship in professional situations. I feel I am just as business-like with Ziva while delivering patient care as I am with any other team member, and conversely, just as nice with the other team members as I am with her and with the patients and with any colleague. But there's a lot going on here. Gender issues. Cultural issues. Xenophobia, or, even worse, maybe some anti-Semitism. And perhaps status issues. Maybe they think nurses and doctors can't or shouldn't be friends (unless, of course, it's a dating situation between a male doctor and a female nurse). Or maybe they feel Ziva's smarter and more highly trained and better educated than they are and they just can't stand it.

I am feeling exasperated and a little angry. This type of collective attitude is completely stupid and unnecessary. I don't know that there's much I can do about it. I'm certainly not going to change this blessed friendship for the sake of a few small-minded harpies who aren't comfortable enough in their own skin to show some tolerance, respect, and support.

-T. from Notes of an Anesthesioboist

MiM Mailbag: Pumping intern

Hi there,

I'm glad I found this blog. I have learned a lot from the posts, and I suppose I'd like to ask everyone's advice if that's okay.

I am working as an intern next year in Melbourne, Australia, and my baby will be 8 months when I start. I am planning to continue breastfeeding him. I get some ideas about expressing whilst working but to be honest, I am still very nervous about the whole thing: Will I be able to fit pumping into a hectic internship work? What should I do if I get paged in the middle of pumping session? I have a relatively slow let-down reflex, what if I cannot pump much at work? (I tried manual pump --it's hopeless, havent tried electric one yet though). Which pump should I use --Medela handsfree style or just normal one? (can you actually realistically do some intern works while using freestlyle breastpump?)

If you have some tips or experience to share, I'm all ears :)


-internmama-