Thursday, July 30, 2009

One of the good (and bad) things about moving is the opportunity (or requirement) to go through every single thing you own.

(Or in some cases, just sweep everything off the desk and figure that you can take the time to sort it at the new house.)

With the walls painted and the new carpet just in, we can finally start unpacking.

(Yes, that's right. Nearly two months of being at our new home, and we are just starting to unpack.)

As I was moving boxes to the master bedroom, I came across my collection of old journals.

Yep. That's right. Collection.

As a pre-teen and as a teenager, I was a prolific journal writer. I wrote every singe day. I filled at least a dozen journals full of my scrawling, ever changing handwriting. I poured my dreams and ambitions, insecurities and heartbreaks onto those multi-colored lined pages.

(Maybe that's why I love blogging so much. A new forum to share those same emotions. Hopefully in a slightly more articulate manner.)

When I met Hubster, the journal writing slowed. It's gotten now to the point that I haven't filled a page in nearly 7 years.

Part of the reason, I think, is that I didn't need the journal as much. I had finally found someone that I could share all my fears, hopes, and joys with.

At the bottom of the stack of journals was a thin yellow book with a cluster of orange poppies on the cover. The first page reads, in my best calligraphy...


I had forgotten all about this book. I started it when I was about 17 years old. I was growing apart from many of my childhood friends, for multiple reasons, many of them due to my lack of self-identity at the time. I had started this book as a chance for me to discover what was actually true in life and what was just peer-pressure and popular.

I continued to write my "discoveries" in the book until just after Bug was born.

Re-reading, as it always is re-reading things your younger, less-experienced, naive self wrote, is both painfully hilarious and reassuring at the same time.

I've decided to occasionally share the discoveries my younger self made that I find to still be true now.

This does not include entries such as

"Letting others be the idiot sometimes will save you from being one," or...

"Plants to not handle stress tests very well,"or...

"Sometimes, all it takes is white fluffy socks to make your day."

Yes, apparently my teenage brain thought these were fundamental truths that should be documented.

Okay, enough of the funny (or painful) ones.

Turning the pages, there were things that still resonated with me.

"Despite what the magazine covers say, weight gain does not automatically make a person unattractive."

"Not every single thought I have needs to be deep."

"Allow room in our comfort zone for those close to you to grow in their own ways."

"I do not need to apologize for other people's mistakes."

"In the long run, I will be the only one responsible for my decisions."

When ever my blog material is running dry (as it has been with the mental fatigue of residency) I've decided to turn to my little book of Discoveries, to see if any of the realizations I came to as a teenager as still true now.

What do you think?

What discoveries have you made along the way?


Sunday, July 26, 2009

Even after four years of medical school, I feel like I know very little.

And I've forgotten at least half of what I used to know.

That's what residency is for. To re-establish and build up the knowledge base that eventually will become second nature.

But everyday, I feel overwhelmed. I feel that I just don't know enough. I'm not always sure how to approach a patient's problem.

It probably doesn't help that this under current of anxiety is coupled to my personality. I'm not a very outgoing person. When I'm with a group of people and someone else is willing to lead (or even dominate) the conversation, I'm more than willing to let them. I'm not a person who will chime in with a thought or opinion. (Note: this is referring to public settings, not interactions with my family, since in those cases I'm more than willing to blurt out my opinion at any time.)

I'm worried that this combination often comes across as a lack in confidence.

I watch my fellow residents (and as much as I hate to admit it, the medical students working with me.)

Everyone acts so much more confident than I feel. So much more sure to make suggestions or even act on decisions.

However, I know for a fact that most of them do not know more than I do.

When we undergo "pimping" sessions, I am able to answer more questions than most. (For the lay person, to "pimp" has no sexual connotation in the medical field. It refers to attendings or senior residents asking questions with the sole purpose to show a junior resident's or medical student's weaknesses in their medical knowledge. It is a very unpleasant experience.)

I did extremely well in medical school and received very high board scores. I spend a lot of time studying.

So, by my calculations, I know at least as much as most the people around me.

So why does everyone else appear so much more confident? Even the medical student who can't come up with a decent differential diagnosis?

My conclusion...

They're faking it.

Settling In

Monday, July 20, 2009

It's been over a week since my last post. The last time something like that happened was when I had no access to the internet and moved across the country.

This time, I don't have the excuse of no internet and a Big Move.

My only excuse is being flat out, beat down exhausted.

While my current residency schedule is not overly demanding, currently just 9 hour shifts 4-6 times a week, the mental fatigue is surprising. Decisions I make actually matter. So I put a lot more thought into every decision. Not that I always get it right. My attending physicians correct my treatment plan just as often as they agree with it.

But don't worry. No patients have been injured in the training of this physician.

If the mental fatigue I feel at the end of each shift isn't enough, there is a home renovation waiting for me when I get home. Between tearing out shrubbery and invading vines, laying floors, and ripping out carpet, I'm physically exhausted too.

Between the two I've barely had enough energy to read a few pages of Harry Potter each night before falling asleep. Let alone blogging.

But I realized today that I haven't shared my thoughts on my new home/town/state.

Salt Lake City is by no means a "Big" City. It's got nothing on LA, Chicago, Dallas, or New York. But it is definitely an up-and-coming city, with many of the amenities of much bigger cities: pro sports teams, aquariums, art museums, ballet, theatre. Costco. IKEA. And it is definitely a city and not a town.

My new home is technically a city. Although the hospital is the tallest building. There are no 20 level business buildings. Farmer's markets are held "down town" (down town in quotes because down town is two streets lined with cute boutiques and amazing restaurants. But no big buildings.) It may be a city, but it feels like a town. The fastest I've driven in a week is 35 mph.

I do miss some of the amenities I had grown used to in bigger Salt Lake.

But I think I like this better.

It is easy to live here.

City living can feel high maintenance. The worry about traffic, the crowds, movies being sold out, restaurants being crowded. All together it just adds a layer of stress that I almost didn't even notice. Until it was gone. The worst traffic I have been in for the month and a half I have lived here is when there were 6 (yes a whole 6!) cars in front of me at the only traffic light I go through on my way to work. 6! Versus the usual 1.

I love where we live. Our home is next door to Bug's new elementary school. The school is in front of a reserved green space. Which means no homes can be built in the heavily wooded area that lies just the other side of the school.

Our neighborhood is very quiet. The people we have met so far have lived here for 15-20 years. People move into this neighborhood and then stay put. There are not a lot of young couples with young kids. I'm a little disappointed about that. I had partially hoped for a neighborhood swarming with kids, yards cluttered with their toys, where Bug and Monkey would have easy access to potential friends. That's not how things are. We don't see many other children. But I'm sure that will change when school starts back up in a month.

And I love our neighborhood, even without herds of children.

Everyday, when I drive up this road, I feel happy about where we live.

Road leading to our neighborhood

We have fireflies here! Before we moved here I had never seen a firefly. I could go on and on about how much I love them. We often sit as a whole family on our back porch and watch them. The boys are slightly squeamish about insects and so they don't run around catching them in jars. But there is still nothing like fireflies.

Our yard is also frequented by cardinals, goldfinches, robins, rabbits, chipmunks, and squirrels. Every morning, there is some new wildlife that causes the boys to call for me, while they alternate between squealing with excitement and hushing each other to not scare it away.

We are happy here. Life is easy here. We are definitely settling in.

Back of my mind

Saturday, July 11, 2009

When I was an undergrad, and then again when I was a medical student, I spent most of my times thinking about my children. Nearly every second was spent wondering if they were okay. How long Monkey continued to cry after he was dropped off at daycare? Were the other kids being nice to Bug? How did Bug's spelling test go? Did Monkey get his nap on time? What time was Hubster able to pick them up? Did they get dinner on time? It's bath night, did Hubster remember? Did they get read to before bed?

I resented every minute that medical school kept me away from my children and my husband.

Even when I took several months off and was home with the boys, I would think about Hubster a great deal. Wondering how his day was going, when he would be home, how that project or meeting went.

Since residency starts (a whole 11 days ago) I found myself realizing that I wasn't thinking of them as much.

I would have a quiet moment to sit down and get a drink of water and work on a patient's note, and suddenly realize that I hadn't thought about Bug or Monkey for several hours. Or nearly my entire shift.

And that realization bothered me.

Hubster and I have talked about this before. I would tell him that I thought about him and the boys practically all day long. And he said that he didn't. It wasn't anything against us or mean that he didn't love us or care about us. He just...didn't think us at work.

He thought about work.

I used to chalk this up as one of the many differences between men and women. That men were able to compartmentalize their lives easier than women were. That women worried more. That women were more attached to the people they loved.

And suddenly, I'm faced with the reality that that might not be true.

I've been trying to figure out why. Why, after I've spent years being angry about being gone and worrying about my children with every passing breath, am I suddenly not constantly fixated on how they are doing.

Hubster and I talked about this as well.

For the first time in my professional career, I'm actually responsible. I'm actually making decisions that can affect patients.

I'm also very busy. I've only had the chance to go eat lunch (or breakfast, depending on the shift) once out of my 10 shifts. I see 6-12 very sick, complicated patients a shift. And then there are the consults to call, the labs to order and review, the prescriptions to order, and the notes to write.

And, for the first time, I am the one responsible for providing financially for our family. It really makes a difference when you know that you are being paid for the time you put in. And not paying for it with student loans. There is a lot less resentment there when you are being reimbursed. (And I know, I know...I signed up to be a medical student, I asked for it, it was what I wanted. But that doesn't mean that it is a very difficult, degrading, humiliating, exhausting process.)

It could be any of those things. Maybe just one of them, maybe all of them.

Hubster agreed. He said that when he was doing his job, that's what he was doing.

But I thought of another thing. In the first time in 6 years, our children are being taken care of, at home, by someone who is truely invested in them.

I think that knowing Hubster is home with Bug and Monkey has taken some of the worry that constantly nagged at the back of my mind. He knows that Bug likes only peanut butter and not jam on his sandwich. That Monkey needs to take a 2 hour nap at 1:30. That Bug has a special shirt he likes to wear on Saturdays. That Monkey needs his stuffed dog to fall asleep.

To know that my children are safe and loved and happy takes a lot of weight off my shoulders. Weight that I didn't even recognize I was carrying until I noticed, suddenly, that it had disappeared sometime over that last 11 days.

I don't think this means I'm a bad mother.

I need to be focused at my job. I need to learn everything I can to be a better physician.

My children may not be in the front of my thoughts constantly like they used to be.

But they are always with me.

Which group are you in?

Sunday, July 5, 2009

When I first started this blog, I didn't want something that was just about parenting, or just about medicine, or just about books. I wanted my blog to be pretty much like me. A little bit about everything and a whole lot of love and passion.

In an effort to keep things that way, I am not going to talk about how intern year is going (all 5 days of it.) Because that would have made four posts in a row about internship and medicine, and that is plenty.

So, I'm going to talk about Harry Potter.

I like to put people in categories. People who are readers and people who are non-readers. People who like where they live and people who don't.

I think people fall into three general categories when it comes to Harry Potter. They love Harry Potter, they are completely neutral about Harry Potter, or they hate Harry Potter (either because of the social hype or from some other issue: and believe me, there are people who have issues with Harry Potter. Even though I think that is a waste of time: be concerned about the economy, or global warming, or AIDS in Africa. Let's not get all out of sorts about children's literature... I'm not saying don't have an opinion about it. Because I love opinions. Just, whoa, calm down! But like always, I digress.)

I happen to be in the first category.

I love Harry Potter. I was first introduced to him in college. That's right. College. My roommate was reading the book, I teased her about it, and she basically said "Don't judge until you read." So I read.

And now I'm convinced that everyone would be in the first category, if only they would read.

When I first met Hubster, he was definitely in the category of "non-reader." He hadn't read a novel since his required 12th grade English reading. The last novel he read for pleasure was probably in elementary school.

I convinced him to take me to see the first Harry Potter film when it came out. After we saw the movie, he bought all the books that were out (it was four at the time.) He read them all.

And he has since gone on to move into the reader category. He reads all the time. I've said it before: Sometimes just reading is more important than what you read. I would rather my family read lighthearted novels all the time then a serious book once in their life. (I'm not saying that serious books aren't important: they are. But first, let's just get people reading!)

Before each Harry Potter movie comes out in theaters, Hubster and I both re-read the entire series.

Which makes this my eighth time reading Harry Potter and the Sorcerer's Stone. (Because I read it a couple times before I saw any of the movies.) It is just as entertaining and engaging as the first time.

J.K. Rowling is a superb story teller and creates vivid characters and shocking plot twists. Often dismissed as "just children's literature" her writing is strong enough to hold its own for any audience.

The sixth movie, Harry Potter and the Half-Blood Prince, comes out next week.

Considering I'm still reading the first book, I don't think I'm going to get through the entire series before I see the movie. (But maybe the same craziness in my life that has prevented me from reading more may prevent me from seeing the film until I've read all 7 books again. Stranger things have happened.)

But regardless...

I'm excited to see the movie. And I'm thoroughly enjoying what may be my favorite books of all time again.

(And believe me...this is not the end of my posting about Harry Potter...there will be more.)

The second first day of the rest of my life

Wednesday, July 1, 2009

I had hyped myself up to expect the worst of today.

I had images of being a third year medical student all over again. Lost, confused, intimidated by every other person around me, scared out of my mind, and overwhelmed by the slightest thing.

It wasn't like that.

I did have to ask stupid questions. Questions like, "So, are we really diagnosing her with constipation?" " that normal?" "How do you print discharge instructions?"

Stupid questions are part of every learning curve.

As far as first days go, today was awesome. I felt on top of my game. I charmed the nurses, impressed my attending, had a patient tell me how wonderful I was. Not bad.

About halfway through my shift, I had a revelation.

I like medicine.

I've been trying to convince myself for years that I hate it. That medical school was the biggest mistake that I had ever made. That it was never going to be worth the sacrifices I had made. I've been depressed. I've been angry.

But today...I was happy.

I enjoyed seeing patients. I got excited over radiology reports and lab results.

For a moment, I was able to forget about the Power Point presentations about depression and suicide and divorce rates among resident physicians. I was able to forget about my bitterness about the things I've given up and missed out on.

Today, I felt like a doctor. And today, it felt like a pretty amazing thing to be.

(Although it will never be better than my real job of raising Bug and Monkey.)

During busyness of the emergency room, I was approached by a medical student who had come down to admit one of my patients to the hospital. She asked, rather timidly, about the patient's history. I started telling her about the patient's cancer, how the diagnosis was made, and about the complications she was currently experiencing.

Suddenly, I recognized all the emotions I experienced yesterday. All the feelings of being scared, overwhelmed, intimidated, lost, and confused were painfully obvious on the wide-eyed medical student in front of me.

"Hold on. What year are you?"

"I'm a third year medical student...And it's my first day." She looked like she was ready to cry. I could already see the signs of stress and sacrifice in her face.

"Okay, come sit down and I'll tell you exactly what your resident needs to know. Here are the patient's outside records. It's going to be okay. It's my first day too. And I'm pretty sure we're feeling the same way."

We talked about the patient. She thanked me. Then she left to report to her senior resident.

I learned two things from that interaction.

First, that I should always take the time to make someone's day a little easier. I sure wish someone had sat me down and said "Okay, this is how you do it." That a welcome smile and a little guidance can make a big difference.

And the second thing...

Wow, I've come a long way.

It Begins

In just a few minutes from now, I am heading off to my first day of intern life.

I start in the ER.

I'm not sure if I feel like "so it begins" all doom like, or "Let it begin! Let it begin" all enthusiastic hamster like.

Right at this moment, I'm more worried about acting more like a medical student than an intern. As in "Don't leave me! You want me to do what?"

I've finally decided that I am excited (and nervous. Horribly nervous.)

But regardless of what I am, it begins...