Dear Mothers in Medicine,
I've been following your blog for a couple of years now, and every single post has worked for me as an inspiration to stay strong and fight for what I love, medicine. But today, I have found myself in a confusing position and I really need advice on a special subject, residency application and motherhood. I'm currently an MS4, yayy!! And as application day approaches, I have been working on my personal statement however, I'm encountering that one of my biggest assets (or so I feel) is being a mother. I have been advice by all my friends at medschool to not even mention my family, husband or 2 daughters (2yrs and 5 months). According to most people having a family will make me a less reliable resident than someone without strings attached. However, this is my story:
I married after college a few months before beginning medical school, my husband and I had been accepted to the same school, and things sounded great. During the first year we adapted to the new environment, developed our studying skills and set our expectations for matching one day.
Fast forward 1 year, and baby #1 came along. She was born during our 2nd year. We managed to fix our schedules for studying around the clock and created routines that allowed us to keep up with classes/exams while taking turns to care for our daughter. No LOA requested/no gaps, we were lucky enough that our baby#1 was born right before one break so we had 2 weeks off to adapt to our new family, and organize. Somehow, we survived and made it worked. Now, let's fast forward one more year and baby#2 came along (we wanted our daughter to have company as our families live across the country). Once again, we worked our way around it. I was able to get 1 week off during one of my rotations and resume the following monday. The attending was very understanding and seem surprised to see that I had decided it to keep going and again no LOA, no excuses given.
Today when I look back, I see that everything that I have done until this day has shaped me to who I am at this point. My desire to pursue medicine, and my determination to continue has remained strong while building the family that I always dreamt of. I always thought of medicine as a career choice not a life changer. As a mother, I feel that I learnt to be more organized and time efficient, I proved myself to be dedicated and goal oriented. So far we both remained on top of our class and have shown the same commitment since day one (I say we because this took teamwork). I took my step 1 and Step 2 CK/CS while breastfeeding/pumping because I wanted to continue to care for my daughters while working really hard to accomplish my goals. I wasn't willing to stay behind. Being a mother helped me connect with patients at more than one level, becoming very understanding of their concerns. I will applying to pediatrics because not only did I mentioned it on my personal statement when I applied to medical school as I always had a passion for peds but during these 4 yrs I realized that I'm drawn toward the field naturally. So I wonder, how can I write a "personal" statement of who I really am and why if I cannot mentioned how I became me and why I think I can be a good asset? I feel that a good physician should be able to show balance and commitment while remaining human and empathetic. Us moms, do this every day at home and on the field. Some people even believe in not even mention it during interviews but to be honest I am proud of being one and hope to become a great physician one day. Please any help or guidance. I am really confused right now.
Thanks in advance for all your help.
An MS4 hoping for the best!!
Monday, July 31, 2017
Friday, July 28, 2017
End of training!
Hello Mothers in Medicine readers,
I am Geraldine Chang. I go by Geri. I have been X-ray vision for a couple years now. Thank you for reading about my struggles of balancing motherhood, long distance marriage and residency and then fellowship. It has been hard for someone like myself who is an open book to be anonymous. However, I was always cautious during training to be so open about my thoughts and opinions.
Anyways, that ship has sailed! I officially graduated from my breast imaging fellowship on June 30th, 2017. I am currently very much enjoying unemployment, which is coming to an end. I did my residency and fellowship in San Diego and now I will be starting a private practice job in Los Angeles. After two years of being apart, my family is now all under the same roof! It has been absolutely wonderful.
But now reality is sinking in. I am about to start my FIRST attending job, which begins next Monday and I am hot mess of emotions ranging from fear to excitement. I hope to be honest and open about my endeavors as a first time attending, expanding my family in the near future and continuing this balancing act all of us workings mom do!
I had it in my head that a lot of the problems during residency and fellowship as a mom would magically disappear when I became an attending! Silly right? But I needed some of that ignorant bliss to get me through all the training but as I was ending my fellowship, I realized there is no magical solution to balancing motherhood and a career. You just have to do what's right for you.
My mom has been pretty much my only source of child care the first two years of little C's life. I am forever grateful but it has been hard on her and also our own relationship. She's no longer an option. After being with little C alone for 2 years in San Diego while big C was doing his fellowship in New Haven for 1 year and another year as an attending in Los Angeles, I grew a lot as a mother and as physician. People asked me how I did it all the time. To be honest, I don't know. When you have to do something, you just do it. And it never ends. But a lot it is just perspective (and a lot of coffee!).
Right now, I am feeling grateful for this new job. I am grateful for the flexible schedule, the obvious increase in pay and mostly, I am grateful that I get a provide my daughter with an example on how you really can do it all. Do you remember me? I wrote a guest blog on this very website. Here it is--http://www.mothersinmedicine.com/2013/07/guest-post-hard-decision.html
I wish I could give that girl a hug. She really needed one. I still can't read that post without crying because the overwhelming guilt I felt comes back and I feel it to the very core.
But now I know, it all works out. I tell myself this as I am getting ready for a whole new set of growing pains, which includes new job, new school and nanny for little C and overall, a new routine and with that I know will come with some degree of mom guilt.
Thanks for being my support. Thanks for listening! Now that I am no longer X-ray Vision, you can also read my personal blog to little C at www.doctormomwifealloftheabove.blogspot.com or follow me on instagram at gerichangmd.
I am Geraldine Chang. I go by Geri. I have been X-ray vision for a couple years now. Thank you for reading about my struggles of balancing motherhood, long distance marriage and residency and then fellowship. It has been hard for someone like myself who is an open book to be anonymous. However, I was always cautious during training to be so open about my thoughts and opinions.
Anyways, that ship has sailed! I officially graduated from my breast imaging fellowship on June 30th, 2017. I am currently very much enjoying unemployment, which is coming to an end. I did my residency and fellowship in San Diego and now I will be starting a private practice job in Los Angeles. After two years of being apart, my family is now all under the same roof! It has been absolutely wonderful.
But now reality is sinking in. I am about to start my FIRST attending job, which begins next Monday and I am hot mess of emotions ranging from fear to excitement. I hope to be honest and open about my endeavors as a first time attending, expanding my family in the near future and continuing this balancing act all of us workings mom do!
I had it in my head that a lot of the problems during residency and fellowship as a mom would magically disappear when I became an attending! Silly right? But I needed some of that ignorant bliss to get me through all the training but as I was ending my fellowship, I realized there is no magical solution to balancing motherhood and a career. You just have to do what's right for you.
My mom has been pretty much my only source of child care the first two years of little C's life. I am forever grateful but it has been hard on her and also our own relationship. She's no longer an option. After being with little C alone for 2 years in San Diego while big C was doing his fellowship in New Haven for 1 year and another year as an attending in Los Angeles, I grew a lot as a mother and as physician. People asked me how I did it all the time. To be honest, I don't know. When you have to do something, you just do it. And it never ends. But a lot it is just perspective (and a lot of coffee!).
Right now, I am feeling grateful for this new job. I am grateful for the flexible schedule, the obvious increase in pay and mostly, I am grateful that I get a provide my daughter with an example on how you really can do it all. Do you remember me? I wrote a guest blog on this very website. Here it is--http://www.mothersinmedicine.com/2013/07/guest-post-hard-decision.html
I wish I could give that girl a hug. She really needed one. I still can't read that post without crying because the overwhelming guilt I felt comes back and I feel it to the very core.
But now I know, it all works out. I tell myself this as I am getting ready for a whole new set of growing pains, which includes new job, new school and nanny for little C and overall, a new routine and with that I know will come with some degree of mom guilt.
Thanks for being my support. Thanks for listening! Now that I am no longer X-ray Vision, you can also read my personal blog to little C at www.doctormomwifealloftheabove.blogspot.com or follow me on instagram at gerichangmd.
Thursday, July 20, 2017
Great article on STAT on female leadership and health care reform.
Genmedmom here. I simply to call attention to a wonderful article on STAT written by a kick-ass healthcare administrator/ CEO and mother of SIX children (yes, six, and TEN grandchildren, per her profile) Annette Walker. It's titled More female leadership: a different kind of health care reform and it's spot-on.
She points out that "women hold only 26 percent of hospital CEO positions and 21 percent of executive positions at Fortune 500 health care companies even though they make up 78 percent of the health care work force". This despite the fact that "Study after study has demonstrated that organizations with gender-balanced leadership are more successful than their homogenous counterparts."
The best part of this short piece is her emphasis on solutions. What she has accomplished in her own hospital system can surely be adopted in others. She lists:
This blog is certainly helping to "shine a light on the challenges of balancing family and work needs" of doctor-moms, so let's acknowledge what MiM brings to the battle! We can also take a look at this list and think of what may be applicable in our own practices, hospitals, and medical schools.
Ladies, let's take some inspiration and motivation from Annette Walker, impressive mama and hospital CEO.
She points out that "women hold only 26 percent of hospital CEO positions and 21 percent of executive positions at Fortune 500 health care companies even though they make up 78 percent of the health care work force". This despite the fact that "Study after study has demonstrated that organizations with gender-balanced leadership are more successful than their homogenous counterparts."
The best part of this short piece is her emphasis on solutions. What she has accomplished in her own hospital system can surely be adopted in others. She lists:
- Flexible work arrangements
- Training opportunities for women to build leadership skills
- Increased visibility of female role models
- Connecting junior employees with female senior-level mentors
- Transparent advancement opportunities and clearly charted pathways to leadership
- Shining a light on the challenges of balancing family and work needs
- Support for community programs that promote opportunities for women in our service areas
- Emphasizing STEM and academic programs for women
This blog is certainly helping to "shine a light on the challenges of balancing family and work needs" of doctor-moms, so let's acknowledge what MiM brings to the battle! We can also take a look at this list and think of what may be applicable in our own practices, hospitals, and medical schools.
Ladies, let's take some inspiration and motivation from Annette Walker, impressive mama and hospital CEO.
Monday, July 17, 2017
The Devil You Know - A Book Review
I get really annoyed by those people who declare, "I only read non-fiction." And it's ok, if that's you, but don't say it snootily at a party when someone asks you if you've ever read this great fiction book. That's left me speechless and a bit shameful on more than one occasion - the person acts like fiction is non-fiction's red-headed bastard stepchild. And really, if I could go back in time - let's do that right now - I'd tell that person off. Fiction, I'll argue, is way more difficult to pull of than non-fiction. And I'll be damned if you can draw a straight line between the two. Fiction authors often weave autobiography into their own work, but instead of just spitting out what already happened they birth a new child. And that's pretty impressive, in my opinion.
I met Fizzy on Mothers in Medicine years ago when I first started. We became e-mail friends, she supported me through my divorce, I learned a little about her life. She is a very private person. I've met her for dinner once and I still don't know her last name. I respect that, and it comes with mystery and intrigue. We don't e-mail as regularly as we used to, but when she asked for me to read her new book a few months back and let her know what I think I felt like I had received an e-mail from Madonna (that's a nod to the book, by the way). I read it in one afternoon. Well, it bled into the evening a bit.
I read the first book, The Devil Wears Scrubs, years ago. I loved it, and talked about that here. What I loved about that book was how it captured the angst of medical school and training. What I love about this more is it captures the angst of mothering and working as an attending. It is a stand alone book - you don't have to have read the first one, but it was fun for me to reminisce about old characters as they were brought up again throughout the book.
Warning: This book will make you laugh out loud. A lot. Fizzy has always had a great sense of humor and in The Devil You Know she doles it out constantly. There was this one part about glitter - I almost put in a quote but I don't want to ruin it for you - where I was laughing so hard I had to put the book down. She perfectly combines the mayhem of being a doctor and a mother and a spouse - and doing it very imperfectly perfect. If you are taking yourself too seriously this is the book to pick up. I read it again to make this review better and it was a bunch of fun the second time around. One of the best things about it for me was I got a great big glimpse into my very private friend's - one whose blog - A Cartoon Guide to Becoming a Doctor - I've followed for years - life. No one can write a book like this without experience.
I could go on and on about the hilarious patient interactions and bumbling cast of characters at the VA (one of my favorite places on Earth where I trained) but Fizzy herself would stop me - I tend to get long-winded. JUST GO GET THIS BOOK ALREADY: HERE. You won't regret it!!
Side note to Fizzy - who ribbed me years back for never having read a book on a Kindle etc. - I have now read one book on my computer and phone exactly twice - yours.
I met Fizzy on Mothers in Medicine years ago when I first started. We became e-mail friends, she supported me through my divorce, I learned a little about her life. She is a very private person. I've met her for dinner once and I still don't know her last name. I respect that, and it comes with mystery and intrigue. We don't e-mail as regularly as we used to, but when she asked for me to read her new book a few months back and let her know what I think I felt like I had received an e-mail from Madonna (that's a nod to the book, by the way). I read it in one afternoon. Well, it bled into the evening a bit.
I read the first book, The Devil Wears Scrubs, years ago. I loved it, and talked about that here. What I loved about that book was how it captured the angst of medical school and training. What I love about this more is it captures the angst of mothering and working as an attending. It is a stand alone book - you don't have to have read the first one, but it was fun for me to reminisce about old characters as they were brought up again throughout the book.
Warning: This book will make you laugh out loud. A lot. Fizzy has always had a great sense of humor and in The Devil You Know she doles it out constantly. There was this one part about glitter - I almost put in a quote but I don't want to ruin it for you - where I was laughing so hard I had to put the book down. She perfectly combines the mayhem of being a doctor and a mother and a spouse - and doing it very imperfectly perfect. If you are taking yourself too seriously this is the book to pick up. I read it again to make this review better and it was a bunch of fun the second time around. One of the best things about it for me was I got a great big glimpse into my very private friend's - one whose blog - A Cartoon Guide to Becoming a Doctor - I've followed for years - life. No one can write a book like this without experience.
I could go on and on about the hilarious patient interactions and bumbling cast of characters at the VA (one of my favorite places on Earth where I trained) but Fizzy herself would stop me - I tend to get long-winded. JUST GO GET THIS BOOK ALREADY: HERE. You won't regret it!!
Tuesday, July 11, 2017
Bridging the Wellness Gap
I have to give a shout out to my hospital (University of Utah*) and my department (Anesthesiology). We are trying. In the age when burnout is rampant and physicians are frequently leaving clinical medicine, we are working to foster camaraderie and resilience. A few examples:
The women in my department recently held an ad hoc Ladies' Lunch. We do this every once in a while, approximately once a year, but we should work on making it more frequent. It's merely a casual potluck lunch held at a faculty member's house for all the female anesthesia residents and attendings, but for me it represents more. Because I work part time in such a large group, I can go weeks to months without seeing some of the other faculty. Anesthesiologists practice their specialty alone, so in order to process work-related issues we have to consciously make an effort to seek out those connections. Our blue scrubs and hats were replaced with sundresses and sandals, and the conversation turned from patients to children, schools, and summer vacation plans. Resident MDs who have yet to venture into practice ate lunch alongside veteran tenured professors. Many of us are moms, with children ranging from 8 weeks to 19 years old. I learned some useful school information from a few of my colleagues with grade school-age girls. It was also interesting to talk to a couple of the ladies who work exclusively in the pain clinic, sharing stories about work environment and frustrations with the medical system. Two babies even made appearances: one wide-eyed, active 11 month old and one brand new infant attached to her mother's breast at the buffet table!
We started an intra-department monthly wellness newsletter (managed by my colleague Dr. Jennifer DeCou), which not only includes interesting personal tidbits about faculty members but also links and info for wellness resources. In addition, Jen has spearheaded a plan for immediate support, in the forms of work relief and counseling, when any anesthesiology practitioner experiences a sentinel event or a bad outcome in the OR.
Our hospital just opened a Resiliency Center on the medical school campus. It provides a space and some resources for relaxation, but the main advantage of this addition is a dedicated space where for on site, free and confidential counseling services. I have personally utilized the services of the third party counseling group on two occasions during my employment already: once when I experienced a health scare during my residency, and again when I underwent infertility treatment. It was invaluable to me, and now it will be even easier for employees to access the benefit since it will be in such close proximity to our workplace.
The piece de resistance... our hospital recently opened a faculty lounge that feels like an airline sky club. Attending physicians from all specialties are invited to use it for eating, changing, working, conferencing, meeting, sleeping... it has all of those features. Not to mention two fully automatic coffee drink dispensers! We have never had a physicians' only lounge before, and I'm excited to socialize there more with doctors of other specialties.
Where we could do better: childcare. As physicians, our schedules are often unpredictable and out of our own control. I live in fear of the midday call from my daycare that my child is sick on a day that my husband is unavailable to extract her, or the moment I get stuck in the OR with no one to pick her up at the end of the day. Some physician friends work at places where there is on sight, low cost childcare with extended hours, which to me would be the ultimate benefit. Within the past year, my hospital has at least added a backup care resource to their benefit package, but my experience using it so far has not been seamless.
Does your hospital, clinic, or practice group offer any unique services or facilities to enhance your work experience and promote wellness? Share them here so we may all get ideas to bring back to our own places of work!
* The opinions expressed here represent my own experiences and are not those of my hospital or department.
The women in my department recently held an ad hoc Ladies' Lunch. We do this every once in a while, approximately once a year, but we should work on making it more frequent. It's merely a casual potluck lunch held at a faculty member's house for all the female anesthesia residents and attendings, but for me it represents more. Because I work part time in such a large group, I can go weeks to months without seeing some of the other faculty. Anesthesiologists practice their specialty alone, so in order to process work-related issues we have to consciously make an effort to seek out those connections. Our blue scrubs and hats were replaced with sundresses and sandals, and the conversation turned from patients to children, schools, and summer vacation plans. Resident MDs who have yet to venture into practice ate lunch alongside veteran tenured professors. Many of us are moms, with children ranging from 8 weeks to 19 years old. I learned some useful school information from a few of my colleagues with grade school-age girls. It was also interesting to talk to a couple of the ladies who work exclusively in the pain clinic, sharing stories about work environment and frustrations with the medical system. Two babies even made appearances: one wide-eyed, active 11 month old and one brand new infant attached to her mother's breast at the buffet table!
We started an intra-department monthly wellness newsletter (managed by my colleague Dr. Jennifer DeCou), which not only includes interesting personal tidbits about faculty members but also links and info for wellness resources. In addition, Jen has spearheaded a plan for immediate support, in the forms of work relief and counseling, when any anesthesiology practitioner experiences a sentinel event or a bad outcome in the OR.
Our hospital just opened a Resiliency Center on the medical school campus. It provides a space and some resources for relaxation, but the main advantage of this addition is a dedicated space where for on site, free and confidential counseling services. I have personally utilized the services of the third party counseling group on two occasions during my employment already: once when I experienced a health scare during my residency, and again when I underwent infertility treatment. It was invaluable to me, and now it will be even easier for employees to access the benefit since it will be in such close proximity to our workplace.
The piece de resistance... our hospital recently opened a faculty lounge that feels like an airline sky club. Attending physicians from all specialties are invited to use it for eating, changing, working, conferencing, meeting, sleeping... it has all of those features. Not to mention two fully automatic coffee drink dispensers! We have never had a physicians' only lounge before, and I'm excited to socialize there more with doctors of other specialties.
Where we could do better: childcare. As physicians, our schedules are often unpredictable and out of our own control. I live in fear of the midday call from my daycare that my child is sick on a day that my husband is unavailable to extract her, or the moment I get stuck in the OR with no one to pick her up at the end of the day. Some physician friends work at places where there is on sight, low cost childcare with extended hours, which to me would be the ultimate benefit. Within the past year, my hospital has at least added a backup care resource to their benefit package, but my experience using it so far has not been seamless.
Does your hospital, clinic, or practice group offer any unique services or facilities to enhance your work experience and promote wellness? Share them here so we may all get ideas to bring back to our own places of work!
* The opinions expressed here represent my own experiences and are not those of my hospital or department.
Wednesday, July 5, 2017
Refining
So this is my introduction to you! I’m excited to be a regular contributor to Mothers in Medicine. I practice family medicine by day and wrangle my brood of three small children by night. My oldest just finished kindergarten and my youngest just turned one. I’m approaching my ninth year in a busy primary care practice in the Pacific Northwest. I enjoy the privilege and challenge of caring for a variety of patients, from newborns to nonagenarians. I used to practice obstetrics as well, but haven’t since having my own babies. I miss it sometimes.
After finishing residency, I studied tropical medicine in London and have worked at a rural teaching hospital in Kenya. My teacher husband and I dream of living and working abroad with our young family; maybe when the majority of them are out of diapers.
I began writing in earnest after I had my first child in 2011. I did write throughout medical training but it took the refining aspects of motherhood to get me to take my writing seriously. Nothing like even less time and an unveiling of your faults for some forced self-introspection! I’m curious if any of you have found motherhood to be similarly clarifying? I’ve studied narrative medicine and bioethics and have taught narrative medicine workshops. Particular interests include medical ethics, global health, motherhood as vocation and the intersection of religion and science. I blog regularly on these topics, among others, and I’m currently working on my first book. I still always cringe a little when I hit “publish” or “send.” I imagine it will always be hard, as a type A introvert, to put myself out there.
My third, and presumably last, baby just turned one and I finally feel like I can breathe again. It feels like a milestone, reaching this point, after having three children in five years, settling into my primary care practice, letting myself take my passion for writing seriously and expand into that vocation.
My life has been disrupted many times in the past year with unexpected challenges and writing and community have pulled me through. I think much in medicine and in motherhood is refining: the pressures of medical school and residency, the intensity of caring for babies and children who need so much.
I’m excited to join you all in this journey; to learn from your wisdom and laugh alongside you. If medicine and motherhood have taught me one thing, it’s that we all need each other desperately - for kindness, for encouragement, for understanding. These are the things to cling to and to provide for each other in this world. Thanks so much for having me.
After finishing residency, I studied tropical medicine in London and have worked at a rural teaching hospital in Kenya. My teacher husband and I dream of living and working abroad with our young family; maybe when the majority of them are out of diapers.
I began writing in earnest after I had my first child in 2011. I did write throughout medical training but it took the refining aspects of motherhood to get me to take my writing seriously. Nothing like even less time and an unveiling of your faults for some forced self-introspection! I’m curious if any of you have found motherhood to be similarly clarifying? I’ve studied narrative medicine and bioethics and have taught narrative medicine workshops. Particular interests include medical ethics, global health, motherhood as vocation and the intersection of religion and science. I blog regularly on these topics, among others, and I’m currently working on my first book. I still always cringe a little when I hit “publish” or “send.” I imagine it will always be hard, as a type A introvert, to put myself out there.
My third, and presumably last, baby just turned one and I finally feel like I can breathe again. It feels like a milestone, reaching this point, after having three children in five years, settling into my primary care practice, letting myself take my passion for writing seriously and expand into that vocation.
My life has been disrupted many times in the past year with unexpected challenges and writing and community have pulled me through. I think much in medicine and in motherhood is refining: the pressures of medical school and residency, the intensity of caring for babies and children who need so much.
I’m excited to join you all in this journey; to learn from your wisdom and laugh alongside you. If medicine and motherhood have taught me one thing, it’s that we all need each other desperately - for kindness, for encouragement, for understanding. These are the things to cling to and to provide for each other in this world. Thanks so much for having me.
Monday, July 3, 2017
Time To Move On
Hi, I’m new here. And very honored to be here, at that. I’m a
pathologist, in private practice for > 5 years (settling in to the flatter
portion at the top of the exponential career curve of knowledge/abject terror), but
< 10 years (I suspect, the point on that curve at which cynicism overrides all other basal
functions and drives one towards a retirement countdown sticker chart).
Over a period of years, I
had somehow found myself struggling to get through the work day, doing twice as
much work as is safe to do, getting paid a quarter of the money being made off
of my back. I had become everything to everyone in my office and to the
clinicians in the hospital, and nothing to myself professionally. I hated every
minute of it. And my marriage was suffering for the long hours, which I finally figured out after hearing myself in every conversation trying to justify my
absences. It just didn't sound authentic to me. Working 60+ hours a week as a pathologist is not particularly normal. But it took a while for me to figure this out -- Stockholm syndrome is real, ya'll. And then, nearly exactly two years
ago I had a gorgeous baby girl, induced at 36+1 weeks for oligohydramnios,
weighing in at a whopping 4 lbs 15 oz. And my placenta was just as small as
that tiny girl, 5th percentile. Everything was "fine" until it wasn't. I've since learned that many of the
births to female docs in similar situations to myself are premature for various reasons, commonly
for oligo……………can’t help but think there is a link there.
I’ve worked with some
wonderful people over the years while doing this job. Most of the ones
who have stayed for longer than a year are the type that persevere long past
the expiration date, and they just keep on going. Each seems to have his or
her own reason for doing so: 'finish what you start', 'I cannot be defeated',
'everyone will like me eventually', 'it’s not really that bad', 'I deserve this
pain', 'it is too hard to change'. What is my reason? I’ve already
made too many mistakes. This can’t be another one. I can make this
work. My family is depending on me.
Life is too short to stay in a
job that is soul-crushing. No job is perfect certainly, but no job should harm your
psychic core or fizzle your spark. If you don’t recognize the person that
you were, that idealistic nerdling resident, marveling at those exquisite enterocytes
mingling with those gorgeous goblet cells, and you can’t find her deep down in
there somewhere………..it’s time to make a change. And preferably before that gal has packed up her
shit and moved to the outer recesses of the universe, never to be seen or heard from again. Mistakes will
always be made, some big and some small, but they can always be
corrected. Be the change, as they say (whoever they may be). You
always have the power to make things better. I have become a path beast
during my time here, and now I’m doing my best not to become a pathological
beast. Put yourself into the situation that you want to be in, whatever that may be. It could take awhile, sometimes may even take eight years and some major life changes.
Remove yourself from the people and entities who take everything from you and give nothing back
in return. I’m doing just that in short order. Even though
it’s a move to a more backward state than the one in which I currently reside,
but that’s yet another story for another day………
Take care of yourself first, the rest will follow.
Progress and peace to my fellow burnout warriors :0)
TheUnluckyPath
Take care of yourself first, the rest will follow.
Progress and peace to my fellow burnout warriors :0)
TheUnluckyPath
Saturday, July 1, 2017
Monday, June 26, 2017
Control Issues
Hello everyone! I am going by Kicks, and I am 4 days away from finishing up my intern year in family medicine residency! We're currently pregnant with our first and can't wait to absorb all of this community's wisdom and advice. :)
Today was a rough day.
It started out okay. I'm on inpatient wards now, and I knew most of my patients going into the day. I had a very reasonable goal of being done by 3 to make my 3:45 OB appt with plenty of time to spare.
I enjoyed my AM visits with my patients, however I was late to group table rounds due to a few chatty cathys - one who had plenty of demands before going home tomorrow and one long conversation regarding an abusive situation. Rounds went until 1, however I knew I would still have time to do notes and do my last minute tasks before 3. And, being pregnant, obviously deserved a quick lunch break for nachos in the cafeteria. I have been trying to be a good role model for well being for the medical students on the service, and try to make an example of making time for lunch (although sometimes when they're not there, I try to sneak by with a Naked juice and cottage cheese break occasionally. Baby-to-Be loves the Naked juices).
After lunch, one of the medical students went with me to discuss MRI findings with one of our patients. We both were stuck in front of our loading EMR for awhile, and I made it a point to tell her that sometimes watching the EMR loading bar and being stuck in one place not being productive for a few minutes was a reminder for me to take a deep breath and remind myself I am not always in control. (Again, when I don't have a witness I've also been known to lightly slap the computer monitor). The MRI showed a likely tumor, so the discussion took awhile. I also had to stop downstairs and discuss the abusive situation from above with one of our social workers.
So clearly I am already running late. However, I hammered through my notes and was able to escape by 3:30 - so if all went well I would make it exactly on time to my 3:45 appointment 15 minutes away. Very doable.
I was not even one block away from the hospital when I got stuck. I have no idea why this van was stopped in the middle of the road, but it was surrounded by other cars who couldn't get around it. I waited at my light a few rounds before realizing this van wasn't moving one inch. I tried to go around the block - along with the rest of the world. Some random construction also popped up. Within half an hour, I had not made it 4 blocks away from the hospital.
I called the OB office in almost tears from my frustration. I felt terrible - the other intern was covering for me leaving early and I couldn't even make it to my stupid appointment. The scheduler on the line sounded slightly alarmed at how upset I was, and reassured me it would be okay and I could always call back in the morning to reschedule.
I felt awful. I don't think I have ever missed a doctor's appointment before. Where did I go wrong? Should I have taken a shorter nacho break to leave earlier? Should I have tried to write a note or two while the other residents presented during table rounds? Should I have delegated more of my afternoon tasks? The guilt piled on when I realized this was still pre-baby life. I had a mental image of Baby-to-Be sitting alone outside of the deserted daycare waiting for me, the long lost parent not yet able to make it home from work. And it got worse when I got home - and saw the laundry, dinner needing to be cooked, messy table and counter tops, Dog in sore need of a walk, and again realized - this is pre-baby life during residency and I am already exhausted. I cried into Husband's hug, and he promptly suggested leftovers for dinner and a nap for me.
I can say now I am a more functional person tonight s/p nap. And the dog did get a walk, but everything else is still dirty and that's okay. And it's okay to miss an appointment here or there - because one has to assume one can travel 3 blocks in a 30 minute time span on a usual day. Crap happens, and - as I was hypocritically telling the medical student just hours earlier - I am going to try and take more of those forced unproductive moments (like sitting in traffic) to take a deep breath, and carry on.
4 days left of intern year, guys. Just 4 more days.
Sunday, June 25, 2017
Moving with Boxes: The Milk Update
My
Monkey (3) wants to go home. One night this week, he started crying,
sobbing, about milk. He is a bit speech delayed, so it is hard to
understand him sometimes, but while we can usually figure it out; this
time, we had no clue.
Monkey(5 AM): "Milk with cow! More milk!"
Me: You want another bottle?
Monkey: NO!! Milk with cow!
Me: What?
Monkey: Cow! Milk with the cow!
After 20 minutes of taking everything out of the fridge, his suitcase, and the pantry, I finally realized he was talking about the brand of milk we used to buy. The milk I bought had the wrong logo and all he wanted was a different brand of milk. So, the next day, we went to super specialty fancy store to get the milk he wanted. (Because here, in NEW CITY, they don't stock it in the general local grocery store).
Like the milk, we are slowly figuring things out. We are still in mattresses on the floor, because our truck is somewhere in the middle of America. The old washer that came with the house made rust stains on all our clothing. We ate 5 days of pizza/hot dogs and fast food takeout. But it's been a LOT more fun and a better adventure that I was anticipating.
I know my post last week was super intense. With the whirlwind of the first week in a new home and new city behind me, I can happily say this one will be a lot lighter!
So, here is my update list:
1) Your village can be online. The minute we got on the plane, my sister, brother-in-law, and other siblings got together virtually to order a whole box of essentials on Amazon Prime Now to be delivered to our new home. That first night, after straggling off of the airplane/Uber journey with 2 very very overactive children and 1 anxious dog, I felt such a surge of relief, joy, and gratitude when I noticed the familiar Amazon logo. We already had a stock of tissues, toilet paper, dog food, dog bowls, Cheerios, hand soap, and Cheerios waiting at our doorstep. It was as if my entire family was there, hugging us, welcoming us and cheering us on.
2) Make new friends but keep the old. My mom's old childhood friend, who I knew well as a child, but have had little interaction with in the past >20 years, lives in our new city. My mom reached out to her and as she is such a gracious woman, she has been like a second grandma to us the past week- bringing us dinner, allowing us to swim in her pool, and giving me lists of handymen, gardening advice, and other helpful pro-tips about our new town. I miss my mom so intensely, but having someone here is making that void a little less raw.
3) Be open-minded. My husband has a sister in our new city (the one saving grace for my husband). With medical school obligations for most of my marriage, I have not had a chance to really form a super close friendship with her (we see her maybe 1x/year). She has her own family and obligations, and I was tentative about asking too much of her. But she brought us dinner our first night, and has been SO above and beyond helpful, kind, welcoming, and supportive. I am looking forward to getting closer to her and actually forming a proper relationship.
So, even though all 4 of us have all been sharing 2 towels for a week because our truck is MIA and I refuse to buy stuff we already own, I think we can call week 1 a success! Orientation starts tomorrow, so hoping the good times continue!
- Boxes
Thursday, June 22, 2017
Hostage
Tonight there will be no ransom paid, despite the long list of demands:
wash the dishes
clean the kitchen
wipe down the highchair
finish charting
return emails
analyze research results
research preschools
order Spiderman pj's
check yoga schedule - missed it tonight, maybe tomorrow
pay bills
fold laundry
feel guilty for not doing more
Tonight, the hostage will be released after being locked away too long. Into open arms it will stumble, what was once so comforting feeling foreign, unsure how to proceed. It is time to disregard the ransom, knowing such a sum will never truly be paid: best just to let it go, start anew.
Tonight there will be no ransom. Only the freeing of that long-awaited, so often yearned for, prisoner:
Sleep.
wash the dishes
clean the kitchen
wipe down the highchair
finish charting
return emails
analyze research results
research preschools
order Spiderman pj's
check yoga schedule - missed it tonight, maybe tomorrow
pay bills
fold laundry
feel guilty for not doing more
Tonight, the hostage will be released after being locked away too long. Into open arms it will stumble, what was once so comforting feeling foreign, unsure how to proceed. It is time to disregard the ransom, knowing such a sum will never truly be paid: best just to let it go, start anew.
Tonight there will be no ransom. Only the freeing of that long-awaited, so often yearned for, prisoner:
Sleep.
Moving with Boxes
Hi! I am so excited to join this community. I have been following since applying to medical school 6 years ago and now, med school and 2 kids later, am honored to be able to share with this community more regularly.
I am usually an upbeat, sunny side up, West Coast girl. But I would like to introduce myself with a post that bares my soul and reflects a more raw version of myself. Below is what I wrote 3 days ago, the night before getting on a plane with my husband, kids, and dog, to fly across the country to start EM residency. With the chaos of moving I didn't have a chance to share until today. I'll hopefully post a more positive update later next week!
I'm flooded. And overhwlemed. and the dam that has been holding my emotions at bay has broken and every thought, fear, feelings of guilt, absolute fear, and sense of desperation keeps washing over me, unrelenting, like a wave, as I fight the current in the tumult of emotions that keeps pounding relentlessly.
I am usually an upbeat, sunny side up, West Coast girl. But I would like to introduce myself with a post that bares my soul and reflects a more raw version of myself. Below is what I wrote 3 days ago, the night before getting on a plane with my husband, kids, and dog, to fly across the country to start EM residency. With the chaos of moving I didn't have a chance to share until today. I'll hopefully post a more positive update later next week!
I'm flooded. And overhwlemed. and the dam that has been holding my emotions at bay has broken and every thought, fear, feelings of guilt, absolute fear, and sense of desperation keeps washing over me, unrelenting, like a wave, as I fight the current in the tumult of emotions that keeps pounding relentlessly.
Wednesday, June 14, 2017
Greetings from TXgal
Howdy wonderful MIM community!
I am excited to have joined MIM as a regular contributor this year! I’m TXgal, a name fitting not only because I am from the great state of Texas, but also because I have been trying to escape it for years. One thing or another has kept me here: being close to family, landing an awesome job after graduation, the low cost of living, having babies, and now it’s the ridiculously low medical school tuition when compared to other states. Jealous yet? You don’t have to be, it is freaking hot. But I am starting to accept that this is home, and even loving it!
I am 29, and in 6 months I will be 30. This never bothered me until last month when I looked in the mirror and I saw wrinkles. I won't go into how much grey hair I have. I always thought I would age with grace and acceptance, but right now I am longing to be 25, rocking my pre-baby body. I am also starting medical school in 2 months, which I imagine will only accelerate the aging process. (Especially frown lines). Both of these things have got me in hammer mode. Last 2 months of freedom before starting the rigorous path of medicine, and last two months of freedom in my 20's. I have got to get the best body of my life, meditate, read, write, start my blog, finish projects around the house, learn Spanish, do all the hobbies I won't be able to do once school starts, stop wasting time on Facebook, teach my kids to swim, potty train etc. etc. etc.
But I am also beyond excited to start medical school. I am a non-traditional student with a background in nursing. I landed my dream job right out of nursing school at a Level I trauma ER. The first day of my new job the charge nurse gave me some advice. I didn't listen to her. She said don't date ANYONE here. Not the doctors, not the cops, not the paramedics, or firemen. Especially not the doctors. Perhaps I should have listened. But I fell for a resident, and after a year of dating I got pregnant with my son. Thanks Plan B. What a little darling he is. Into my life he came, and out went all my plans. Like many other premed students, I am a control freak. I like order. I like plans. No, I NEED plans to function. I was going to do a year of travel nursing, and spend a year abroad working for MSF, and then go to medical school, and somewhere far down the road, far, far, FAR down the road I would start a family. I quit my job as a nurse and stayed home with my son while completing my pre-med courses. This was a difficult time for me. It was lonely, and isolating. The entire time my head was spinning with thoughts like "how will I be a good doctor AND a good mom?" "How will I go to med school with a baby?" "When should I go? When he is 2 or 10?" "How will I ever work for MSF?" "Maybe I could just be a stay-at-home mom, or a nurse, or a teacher, or a wildlife photographer, or a stripper." The thoughts literally and metaphorically made me dizzy. (This is when I discovered this LIFE SAVING blog)
I have learned a lot since then. I learned that I am not a stay-at-home mom. I learned to let go of control over my kids. That they are OK, and even thrive at their daycare. They are OK with a sitter, and they are OK at grandma’s. They LOVE grandma. I learned to find balance in school/family life. Yes the load in premed isn't anything like med school, but I learned some tricks. Like don't even attempt to study around the kids unless you want scribbles all over your books. And, don't expect to take a 7 hour timed practice MCAT test and score well with a newborn in lap, so GET A SITTER! Also-DON'T. LAY. DOWN. You WILL fall asleep. Oh, 15 months after my son was born, my daughter came along. Another unplanned little darling.
I am also grateful. I originally got accepted into a program 800 miles away. BD (baby daddy) would have had to stay in our current city for work, and I would be leaving two sets of wonderful grandparents. 2 weeks before our moving van was scheduled to whisk me away with 2 toddlers to start med school alone in a new city, I got an acceptance to a school close to home at an institution known for its (relatively) laid back atmosphere, and relaxed schedule. I am so grateful for this. I am grateful I have so much support from BD, my parents, and BD's family. Grateful to my 26 year old self who continued to complete premed classes despite being so uncertain, who started studying for the MCAT with a 2 weeks old (and eventually got a sitter). Grateful for my kids' teachers, and babysitters that fill their day with joy.
So now as I move closer to med school, I am no longer dizzy with thoughts of uncertainty. I know it'll be crazy, and stressful, and hard. But I know I cannot see myself doing anything else. (Even if sometimes I wish I could). I know at times I will miss my kids, but they are surrounded by friends and family that love and care for them as much as I do. And the obsessing over the wrinkles? I know it’s a phase. They are beautiful just like my grey hairs. Who would really want to be 20 again anyway?
-TXgal
The Shorter version:
TXgal is an about to be 30 year old, nontraditional, incoming MS1 with two toddlers (born 2014 and 2015) and a nontraditional life living with her supportive BD (baby daddy). She has spent the past three years pregnant, or breastfeeding while completing her pre-med classes, and MCAT. After years of uncertainty, she is happy to start medical school knowing there is nothing else she can see herself doing, (well maybe a photographer for NatGeo, but that’ll come later) She is forever newly discovering how she identifies as a mom, individual, almost 30 year old, and soon to be medical student, and looks forward to blogging about the joys, struggle, stress, and victories in finding this balance. She also has a gazillion hobbies, and likes that include: gardening, yoga, reading, coffee, rock climbing, running, traveling, hiking, visiting National Parks, photography, healthy eating, Latin dancing, planning her life, re-planning her life after plans fail, family vacations, studying, and watching NatGeo with toddlers, cheering for the prey when they get away.
I am excited to have joined MIM as a regular contributor this year! I’m TXgal, a name fitting not only because I am from the great state of Texas, but also because I have been trying to escape it for years. One thing or another has kept me here: being close to family, landing an awesome job after graduation, the low cost of living, having babies, and now it’s the ridiculously low medical school tuition when compared to other states. Jealous yet? You don’t have to be, it is freaking hot. But I am starting to accept that this is home, and even loving it!
I am 29, and in 6 months I will be 30. This never bothered me until last month when I looked in the mirror and I saw wrinkles. I won't go into how much grey hair I have. I always thought I would age with grace and acceptance, but right now I am longing to be 25, rocking my pre-baby body. I am also starting medical school in 2 months, which I imagine will only accelerate the aging process. (Especially frown lines). Both of these things have got me in hammer mode. Last 2 months of freedom before starting the rigorous path of medicine, and last two months of freedom in my 20's. I have got to get the best body of my life, meditate, read, write, start my blog, finish projects around the house, learn Spanish, do all the hobbies I won't be able to do once school starts, stop wasting time on Facebook, teach my kids to swim, potty train etc. etc. etc.
But I am also beyond excited to start medical school. I am a non-traditional student with a background in nursing. I landed my dream job right out of nursing school at a Level I trauma ER. The first day of my new job the charge nurse gave me some advice. I didn't listen to her. She said don't date ANYONE here. Not the doctors, not the cops, not the paramedics, or firemen. Especially not the doctors. Perhaps I should have listened. But I fell for a resident, and after a year of dating I got pregnant with my son. Thanks Plan B. What a little darling he is. Into my life he came, and out went all my plans. Like many other premed students, I am a control freak. I like order. I like plans. No, I NEED plans to function. I was going to do a year of travel nursing, and spend a year abroad working for MSF, and then go to medical school, and somewhere far down the road, far, far, FAR down the road I would start a family. I quit my job as a nurse and stayed home with my son while completing my pre-med courses. This was a difficult time for me. It was lonely, and isolating. The entire time my head was spinning with thoughts like "how will I be a good doctor AND a good mom?" "How will I go to med school with a baby?" "When should I go? When he is 2 or 10?" "How will I ever work for MSF?" "Maybe I could just be a stay-at-home mom, or a nurse, or a teacher, or a wildlife photographer, or a stripper." The thoughts literally and metaphorically made me dizzy. (This is when I discovered this LIFE SAVING blog)
I have learned a lot since then. I learned that I am not a stay-at-home mom. I learned to let go of control over my kids. That they are OK, and even thrive at their daycare. They are OK with a sitter, and they are OK at grandma’s. They LOVE grandma. I learned to find balance in school/family life. Yes the load in premed isn't anything like med school, but I learned some tricks. Like don't even attempt to study around the kids unless you want scribbles all over your books. And, don't expect to take a 7 hour timed practice MCAT test and score well with a newborn in lap, so GET A SITTER! Also-DON'T. LAY. DOWN. You WILL fall asleep. Oh, 15 months after my son was born, my daughter came along. Another unplanned little darling.
I am also grateful. I originally got accepted into a program 800 miles away. BD (baby daddy) would have had to stay in our current city for work, and I would be leaving two sets of wonderful grandparents. 2 weeks before our moving van was scheduled to whisk me away with 2 toddlers to start med school alone in a new city, I got an acceptance to a school close to home at an institution known for its (relatively) laid back atmosphere, and relaxed schedule. I am so grateful for this. I am grateful I have so much support from BD, my parents, and BD's family. Grateful to my 26 year old self who continued to complete premed classes despite being so uncertain, who started studying for the MCAT with a 2 weeks old (and eventually got a sitter). Grateful for my kids' teachers, and babysitters that fill their day with joy.
So now as I move closer to med school, I am no longer dizzy with thoughts of uncertainty. I know it'll be crazy, and stressful, and hard. But I know I cannot see myself doing anything else. (Even if sometimes I wish I could). I know at times I will miss my kids, but they are surrounded by friends and family that love and care for them as much as I do. And the obsessing over the wrinkles? I know it’s a phase. They are beautiful just like my grey hairs. Who would really want to be 20 again anyway?
-TXgal
The Shorter version:
TXgal is an about to be 30 year old, nontraditional, incoming MS1 with two toddlers (born 2014 and 2015) and a nontraditional life living with her supportive BD (baby daddy). She has spent the past three years pregnant, or breastfeeding while completing her pre-med classes, and MCAT. After years of uncertainty, she is happy to start medical school knowing there is nothing else she can see herself doing, (well maybe a photographer for NatGeo, but that’ll come later) She is forever newly discovering how she identifies as a mom, individual, almost 30 year old, and soon to be medical student, and looks forward to blogging about the joys, struggle, stress, and victories in finding this balance. She also has a gazillion hobbies, and likes that include: gardening, yoga, reading, coffee, rock climbing, running, traveling, hiking, visiting National Parks, photography, healthy eating, Latin dancing, planning her life, re-planning her life after plans fail, family vacations, studying, and watching NatGeo with toddlers, cheering for the prey when they get away.
Monday, June 12, 2017
Stay at Home Starchitect
All Spring my husband researched options. He had a great job, and they loved him so much they gave him leave without pay to get extra vacation time with me and the kids (standard for architects is 2-3 weeks and I get much more than that), but he was tired of working on multimillion dollar housing projects in other cities - jobs that take months to complete. After exploring other job offers, he met with my financial advisor and decided to take a plunge from the corporate world and form an LLC. He would work from home and start his own business. He gave notice at his job a couple of months ago.
The first week he was home it was as if the boil of logistics that was our life, a life I knew no variation of in this marriage or my last, was lanced. He has always pitched in as much as he could, but this was different. Someone to be there to get packages. Let the bug guy in the house. Get one of our kids to the impossible 2:00 in the afternoon orthodontist appointment. Grab the cake for the birthday party. Get the honey we forgot at the grocery store last weekend that left my morning eggs unbalanced and naked. As end of school transitioned to summer, it became even more rewarding. My kids at 14 and 12 are old enough to be alone now, but having an adult at the house to check in with before they walked to the local pool to meet their friends and receive them when they return is a huge bonus. Someone to drive them to a sleepover earlier than 5:00. Someone to eat lunch with them. And we agreed, most importantly, the bonding of their relationship, stepdad to kids, as the kids are reaching an unprecedented age of independence.
He has already turned our guest bedroom into a sleek home office and is starting to craft a business card and do some research. The many contacts he made in the past have already landed him side gigs. And he is happier - getting a long bike ride in every other day. Not having the pressure of 8:30-5:30. That happiness makes our house happier - not that we weren't before, but it's better in a way I could not have imagined. So much so that I suggested he take some time off. Take it slow. We are traveling much in the month of June, so maybe wait to gain traction until July. He is more than amenable.
I don't want him to become the carpooler come Fall - we both want his business to succeed. So I'll put boundaries around his time - maintain an aftercare driver to get the kids from school and to all their activities. But this level of support is nothing short of mind blowing. So I was surprised one night last week when jealousy reared its ugly head. I didn't share my feelings with him at the time, but it was 12-15 hours of why do you get to do this and I don't circling my angry brain and it came off as crankiness and being short one evening. I was jealous he had lunch with the kids. I was jealous of his time during the day to exercise.
Now, to be fair, last week was one of the hardest weeks I've had in a while - call duties, high caseloads every day, terrible work drama, some family drama, and autopsy drama of all things. So I was grinding my teeth getting work done and working very hard to center myself and approach every issue with as much grace and calmness as I could muster. And I think I succeeded, and am happy I sold away my call weekend so I could get in some much needed chill time. But I knew I needed to explore this jealousy thing, so I did one morning at the scope.
He is very different than me. He tends to work better without boundaries around his time. He can adhere to our family schedule, and plug in to work at night when the kids are not with us. Not me. In the past, when I had time off between my first marriage and med school, I quickly lost myself to entropy. I watched Lifetime all day long. I quit exercising. One or two hours on the couch turned into one or two months. So much so that my then husband worried. "I think you always need a job. Please tell me you will always have a job or be in school." To be fair, I didn't have kids back then, and I was in my twenties, but I think he was right about my personality. I need to be responsible to someone or something in order to feel personal reward. Schedules anchor me. My cases, the patients behind them, the frozens, bronch lab, interventional radiology, it's a fuel that keeps me going and performing. Last week was too much, but most weeks aren't filled with all of that. I would not want to be a stay at home pathologist, not only because I don't think that's possible yet but I also need space away from my house to be productive at what I do. The hospital is my sacred space.
So I breathed and apologized the next night for my crankiness and told him about where it came from. He agreed to make space in the evenings for me to work out like we used to together on nights without kids instead of wanting to eat as soon as I get home. And he brought the kids to work one day to eat lunch with me - the kids hadn't done that in a long time and I know we will do it again this summer we all had a blast.
I remember when I was going through my divorce or maybe a new single mom KC won a well deserved prestigious award for starting this blog. In an acceptance speech she was tasked with advice to being a successful mother in medicine. Her first piece of advice was to marry well. I'm proof that if you don't get it right the first time, for whatever reason, it's possible to get it right the second time.
The first week he was home it was as if the boil of logistics that was our life, a life I knew no variation of in this marriage or my last, was lanced. He has always pitched in as much as he could, but this was different. Someone to be there to get packages. Let the bug guy in the house. Get one of our kids to the impossible 2:00 in the afternoon orthodontist appointment. Grab the cake for the birthday party. Get the honey we forgot at the grocery store last weekend that left my morning eggs unbalanced and naked. As end of school transitioned to summer, it became even more rewarding. My kids at 14 and 12 are old enough to be alone now, but having an adult at the house to check in with before they walked to the local pool to meet their friends and receive them when they return is a huge bonus. Someone to drive them to a sleepover earlier than 5:00. Someone to eat lunch with them. And we agreed, most importantly, the bonding of their relationship, stepdad to kids, as the kids are reaching an unprecedented age of independence.
He has already turned our guest bedroom into a sleek home office and is starting to craft a business card and do some research. The many contacts he made in the past have already landed him side gigs. And he is happier - getting a long bike ride in every other day. Not having the pressure of 8:30-5:30. That happiness makes our house happier - not that we weren't before, but it's better in a way I could not have imagined. So much so that I suggested he take some time off. Take it slow. We are traveling much in the month of June, so maybe wait to gain traction until July. He is more than amenable.
I don't want him to become the carpooler come Fall - we both want his business to succeed. So I'll put boundaries around his time - maintain an aftercare driver to get the kids from school and to all their activities. But this level of support is nothing short of mind blowing. So I was surprised one night last week when jealousy reared its ugly head. I didn't share my feelings with him at the time, but it was 12-15 hours of why do you get to do this and I don't circling my angry brain and it came off as crankiness and being short one evening. I was jealous he had lunch with the kids. I was jealous of his time during the day to exercise.
Now, to be fair, last week was one of the hardest weeks I've had in a while - call duties, high caseloads every day, terrible work drama, some family drama, and autopsy drama of all things. So I was grinding my teeth getting work done and working very hard to center myself and approach every issue with as much grace and calmness as I could muster. And I think I succeeded, and am happy I sold away my call weekend so I could get in some much needed chill time. But I knew I needed to explore this jealousy thing, so I did one morning at the scope.
He is very different than me. He tends to work better without boundaries around his time. He can adhere to our family schedule, and plug in to work at night when the kids are not with us. Not me. In the past, when I had time off between my first marriage and med school, I quickly lost myself to entropy. I watched Lifetime all day long. I quit exercising. One or two hours on the couch turned into one or two months. So much so that my then husband worried. "I think you always need a job. Please tell me you will always have a job or be in school." To be fair, I didn't have kids back then, and I was in my twenties, but I think he was right about my personality. I need to be responsible to someone or something in order to feel personal reward. Schedules anchor me. My cases, the patients behind them, the frozens, bronch lab, interventional radiology, it's a fuel that keeps me going and performing. Last week was too much, but most weeks aren't filled with all of that. I would not want to be a stay at home pathologist, not only because I don't think that's possible yet but I also need space away from my house to be productive at what I do. The hospital is my sacred space.
So I breathed and apologized the next night for my crankiness and told him about where it came from. He agreed to make space in the evenings for me to work out like we used to together on nights without kids instead of wanting to eat as soon as I get home. And he brought the kids to work one day to eat lunch with me - the kids hadn't done that in a long time and I know we will do it again this summer we all had a blast.
I remember when I was going through my divorce or maybe a new single mom KC won a well deserved prestigious award for starting this blog. In an acceptance speech she was tasked with advice to being a successful mother in medicine. Her first piece of advice was to marry well. I'm proof that if you don't get it right the first time, for whatever reason, it's possible to get it right the second time.
Tuesday, June 6, 2017
Is it time for me to break up with nights?
I am post-call, yet again. Which is short-hand for the mild-to-moderately disabling condition my family knows too well at this point -- foggy-brained, labile, cotton-mouthed, impatient, irritable, overwhelmed by the smallest unexpected twist in the plan. I have difficulty making decisions, even tiny ones. I eat way too much, my body confused by the question of whether it needs sleep or food. Instead of answering an important email or using this precious time while my child is at school to sleep, I watch a movie I have watched 40 times before and scroll mindlessly through the perpetually unfulfilled promise of the internet, catching myself a hundred times as I almost nod off and drop my phone onto my own face. I feel like a pint of ice cream with only a film of sticky soup remaining at the bottom: not good for much. My body aches. My mind, if such a thing is possible, aches. My view into the future is suddenly bleak, and even though I know that all these sensations and thoughts and feelings will resolve after a good night's sleep, I have to live through them all day and they are not pleasant.
I love nights in the hospital. A quiet purpose takes over -- the formality of the day softens and people are focused on what is most important. I am united with my patients' families in their sleepless vigil. I have had some of my most profound moments of intimacy with my patients and with the practice of medicine between the hours of 7pm and 7am. People are born and die at all times of the day, but at night there is an aura of primordial magic to it, both light and dark -- the baby's first cry as my ears are still ringing from being woken up by the delivery pager, the mothers sharp sobs as she holds her sick child for the last time. The night feels like life's secret workshop and despite all the sorrows I have witnessed there, I have loved my time in its shadowed chamber of turning gears.
But lately, I feel like the nights are killing me. It takes me longer to recover. My fatigue and disorientation stretch into my post-post-call days. I can never establish any kind of routine. My schedule is never the same twice and the nights fall on different days and in different configurations and it feels like I am inventing my life from scratch every single week. On paper, it doesn't look so bad: I "only" work overnight about 3-4 times per month and 1-2 of these are 24 hour shifts. But the weeks when I don't work a single night feel so much better, like I am finally climbing out of the canyon. I eat better. I exercise regularly. My family is able to settle into a consistent routine of time together in the evenings. I get to play the piano and talk to friends and read books and taste my food. I feel like myself again. And then another night looms and I slip back into survival mode -- the life of just trying to get through to the other side in one piece.
In order to give up nights, I would have to give up the ICU part of my job which would feel like a huge loss. The muscle of acute care that is strung taught and strong across my frame would atrophy. I would miss the real-time critical thinking through the most pressing problems of physiology. I would miss the sense of internal strength that comes from running towards instead of away from disaster. I would miss my colleagues so much. And most of all I would miss the patients so much. I know there would be other patients and other satisfactions, but I have stroked so many little heads amidst the wires and tubes and lines and a part of my heart will always be hovering over an isolette, cheering a tiny life into the future.
Is it even appropriate to step away, I wonder? I harbor some machismo about the self-sacrifice of nights and call and when I imagine giving it up my inner voice says things you might expect a drill sergeant to say to a new recruit. In other words, not nice things. I compare myself to people who have accomplished incredible things and who seem to sleep much less than I need to -- surgeons, authors, CEOs, innovators, politicians, my colleagues who have even more children and even more responsibility. And I think to myself: Was I put on this earth to sleep? Why, I wonder, do I need rest and consistency and slow mornings and the Goldberg Variations over a hot cup of tea and the colors the afternoon sun makes in the trees to feel like myself when others can be animated solely by the imperative of their work? What, I wonder too many times a day, is wrong with me? Or perhaps more kindly framed: What right do I have to prioritize my own needs over the potential to serve the needs of others? And then other questions, usually held in shadow, emerge: Does the poet part of me deserve the same airtime as the doctor part of me? What if I love being more than doing?
As you can see, the question of nights has become about more than than the question of nights, which makes it all the more difficult to decide on the right course of action. For the moment, I have shifted my responsibilities for the coming academic year and will be doing less time in the ICU and by extension fewer nights. I will see how that feels. Likely, no choice will ever feel 100% right, but I hope that a bit more sleep will allow me to attend more closely to my own intuition, that a little piece of that primordial magic will glow in my own life and light the way.
I love nights in the hospital. A quiet purpose takes over -- the formality of the day softens and people are focused on what is most important. I am united with my patients' families in their sleepless vigil. I have had some of my most profound moments of intimacy with my patients and with the practice of medicine between the hours of 7pm and 7am. People are born and die at all times of the day, but at night there is an aura of primordial magic to it, both light and dark -- the baby's first cry as my ears are still ringing from being woken up by the delivery pager, the mothers sharp sobs as she holds her sick child for the last time. The night feels like life's secret workshop and despite all the sorrows I have witnessed there, I have loved my time in its shadowed chamber of turning gears.
But lately, I feel like the nights are killing me. It takes me longer to recover. My fatigue and disorientation stretch into my post-post-call days. I can never establish any kind of routine. My schedule is never the same twice and the nights fall on different days and in different configurations and it feels like I am inventing my life from scratch every single week. On paper, it doesn't look so bad: I "only" work overnight about 3-4 times per month and 1-2 of these are 24 hour shifts. But the weeks when I don't work a single night feel so much better, like I am finally climbing out of the canyon. I eat better. I exercise regularly. My family is able to settle into a consistent routine of time together in the evenings. I get to play the piano and talk to friends and read books and taste my food. I feel like myself again. And then another night looms and I slip back into survival mode -- the life of just trying to get through to the other side in one piece.
In order to give up nights, I would have to give up the ICU part of my job which would feel like a huge loss. The muscle of acute care that is strung taught and strong across my frame would atrophy. I would miss the real-time critical thinking through the most pressing problems of physiology. I would miss the sense of internal strength that comes from running towards instead of away from disaster. I would miss my colleagues so much. And most of all I would miss the patients so much. I know there would be other patients and other satisfactions, but I have stroked so many little heads amidst the wires and tubes and lines and a part of my heart will always be hovering over an isolette, cheering a tiny life into the future.
Is it even appropriate to step away, I wonder? I harbor some machismo about the self-sacrifice of nights and call and when I imagine giving it up my inner voice says things you might expect a drill sergeant to say to a new recruit. In other words, not nice things. I compare myself to people who have accomplished incredible things and who seem to sleep much less than I need to -- surgeons, authors, CEOs, innovators, politicians, my colleagues who have even more children and even more responsibility. And I think to myself: Was I put on this earth to sleep? Why, I wonder, do I need rest and consistency and slow mornings and the Goldberg Variations over a hot cup of tea and the colors the afternoon sun makes in the trees to feel like myself when others can be animated solely by the imperative of their work? What, I wonder too many times a day, is wrong with me? Or perhaps more kindly framed: What right do I have to prioritize my own needs over the potential to serve the needs of others? And then other questions, usually held in shadow, emerge: Does the poet part of me deserve the same airtime as the doctor part of me? What if I love being more than doing?
As you can see, the question of nights has become about more than than the question of nights, which makes it all the more difficult to decide on the right course of action. For the moment, I have shifted my responsibilities for the coming academic year and will be doing less time in the ICU and by extension fewer nights. I will see how that feels. Likely, no choice will ever feel 100% right, but I hope that a bit more sleep will allow me to attend more closely to my own intuition, that a little piece of that primordial magic will glow in my own life and light the way.
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