Change of mind, not change of heart

Thursday, May 21, 2009

It has come to my attention as we make the round, saying goodbye to friends and family prior to our big move, that many are unaware of the change in my career path.

The majority of people still think (or thought, prior to being corrected) that I am going into pediatrics.

And when I tell them that, no, I'm actually going to be an anesthesiologist, there is the unavoidable explanation.

I'm always met with variations of the same conclusion.

"So, now you hate kids?"

I thought I would take this opportunity to explain why I changed my mind.

When I first went to medical school, I thought that I was going to be an anesthesiologist. For all of two weeks.

We had a lecture series for first year medical students that taught us about different specialties. I was very excited for the anesthesia lecture. But the physician giving the lecture ruined it for me. He kept saying how great it was because you got to be a doctor, but you didn't have to talk to people. I knew that I wanted to interact with people (if I hadn't wanted this, I could have just stayed in my plant lab.) So I left the lecture and never thought about anesthesia again.

After my first pediatric rotation, I was sure that I wanted to be a pediatrician. I loved the children. And the normal hang-ups that people have about pediatrics didn't bother me. Sick children didn't depress me. Demanding parents didn't irritate me.

(Okay, I also really wanted to be an OB/GYN for a while. But I had vacation right after my OB/GYN rotation, and realized how much I liked my time off.)

I also strongly believe in primary care. Being the portal into health care and the first point of interaction, continuity of care, and care of vulnerable populations all appeal to the idealist in me.

So, I created my schedule to best prepare me for pediatrics.

I took pediatric neurology and pediatric IV team. Then I took my pediatric sub-I. (Background: a sub-I is an opportunity for a fourth year medical student to act similarly to an intern (or first year resident) They get more autonomy and more responsibility.)

My sub-I was the most miserable experience of my entire medical school. I was abused by the other interns. I never got to sleep on my call nights. I was told that no one would cover my patients if I went home early on post-call and "golden days" (paperwork only days.) I was so emotionally beat down that I was close to a mental break down. I told my friends, my adviser, and my family that I was going to quit. I couldn't see any end in sight to the emotional disaster that my life was becoming.

One day, near the end of my rotation, I was rounding on a patient that had a severe intestinal condition. His parents had been at the hospital with him every single day since he had been admitted 13 days earlier.

I suddenly realized that I was envious of those parents. Yes, their son was sick. But at least they got to see him. I hadn't seen my children awake in over two weeks.

I came to a realization right there that I liked my children much more than I would ever like anyone else.

I knew that I couldn't do pediatrics. But I didn't know what else to do - besides quit.

About a month later, I rotated in anesthesia. I immediately was drawn in by how happy everyone seemed. Yes, they worked hard. Yes, the work was stressful and demanding (but honestly, in medicine, what isn't.) But they didn't have the same beat-down, lifeless look to them that other residents had. And they had a life outside of medicine. Residents and attendings would talk about movies during cases. Residents had time to see movies?!

And at the end of one day, when I was told that I could go home, I was shocked by how fast the time had gone. I hadn't been constantly checking the clock. I wasn't resentful of the time I had to spend at the hospital.

A week later, Hubster asked me what rotation I was on. Anesthesia.

"Well, you should do this. You haven't asked to drop out for weeks!"

Since then, I have completely fallen in love with anesthesia. The procedures, the physiology, the pharmacology. Everything was intriguing.

When I first told some of my classmates that I was going into anesthesia, there was disbelief. "But you have such wonderful bedside manner. It will be wasted in anesthesia!" "But, what about your feelings on primary care?"

I still get to talk to patients. The better the bedside manner, the fewer sedatives required before surgery. I'm the last one they get to talk to about their fears before going into the OR. I'm the last face they see as they fall asleep.

And I realized although I love the idea of primary care, it wasn't the right avenue for me. I may not ever practice in a small, rural clinic, taking care of people no one else would otherwise, but I still get to be an advocate for my patient. I can make suggestions for better pain control, for better nausea prevention, for faster recover.

I can still be there for them.

A better introduction

Sunday, May 17, 2009

Residency is just a little over a month away.

I've been trying not to think about it. I've been so happy during my time off. Playing with my boys, picking Bug up from school, reading to Monkey every night, catching up on my own reading.

I knew that it, like all vacations, wouldn't last. But it is so easy to pretend.

My first year, or intern year, contains a variety of clinical experiences. So that I have a broad variety of experiences on which to draw when I start dedicated anesthesia training during my second year.

I start in the emergency room.

I think my biggest fear about starting residency is being taken seriously. It never really happened during medical school. No matter how often I introduced myself as "Katherine, the medical student on the team," I was consistently called something else by patients.

Nurse.

Now, I'm not trying to belittle nurses or say that I'm better. Because without nurses, there could be no doctors. But the point is, I'm not a nurse. I'm a doctor.

Many school makes their medical students wear short, hip length white coats. This was to help differentiate medical students from residents and attendings. My school didn't do this. I wore a long white coat like everyone else. But despite this, I was never once "accidentally" called doctor.

Only nurse.

When people would ask what I was in school for, I would respond, "I'm in medical school." I got the same reaction from acquaintances, relatives, and strangers on the bus. "Oh, you're going to be a nurse!"

No. I'm not.

Once when I was admitting a patient from the emergency room, his cell phone rang. He answered it, talked for a moment, and then said, "Sorry. I need to go. There's a really pretty nurse here asking me some questions."

I know which emotion was stronger. I was flattered that he had referred to me as "very pretty" and not "nurse who looks like she hasn't slept in days, had time to comb her hair, and has the biggest, darkest circles under her eyes I've ever seen." But I was frustrated that he just assumed I was a nurse, despite my careful introduction.

It's not just my gender that have worked against me being taken seriously. It's my age. Or more accurately, my perceived age.

I think I can sum up this problem accurately with a single patient encounter. I had entered a room to place an I.V and take a patient back to the operating room. The patient turned to me before I had time to introduce myself and patted my arm.

"It's so nice they let high school students volunteer here."

Aww, thanks.

In the past, being seen as something other than I was and younger than I was made me timid. No one took me seriously, so I stopped seeing myself seriously. It wasn't until the end of medical school that I started to get a little confidence back.

This time around, I'm going to try to not let this past experiences hinder my confidence in anyway.

And this time, I can actually introduce myself as "Doctor Katherine." Maybe that will help.

Through and Through

Sunday, May 3, 2009

Whenever Hubster and I hear anyone refer to themselves as geeks or nerds, we just laugh.

Because we know the truth.

They have nothing on us.

It took a while, but we have completely accepted that we are true nerds, through and through. And now, honestly, we are quite proud of it.

I was a biology major with a minor in chemistry. Hubster got a double major in mathematics and physics. I was president of the science club in high school, winning silver metals in state competition. Hubster led his class to a championship in the "Knowledge Bowl."

And we are doing the best we can to instill these precious attributes in our boys.

They have a model solar system hanging from their bedroom ceiling. We encourage them to "play" on Google Earth for computer time. We spend afternoons at museums. Family movie night? Your pick: Planet Earth or Blue Planet. And for fun...

"Guess what we're going to do today?"

"What?!!!"

"Grow salt and sugar crystals!!!"

And that's what we do. And each day, they would oh and aw about how much the crystals had grown. Until finally it was the day to take them out and eat them.










And then I saw these flash cards on Uncommon Goods. And I WANT them for my two year old!



This is all for their own good.

With a physician mom, and a dad applying for dental school, being a nerd can really pay off. Well, we hope so. Someday.

I'm done with waiting

Wednesday, March 18, 2009

After all the drama and build up, the match is tomorrow.

The not knowing is truly the worst. Worse than where I might end up. Worse than not getting my first choice. It's just going months and months without knowing. Not being able to plan.

I'm not as nervous as I thought I would be. I think my brain has shut off just a little. The real nerves will come, I think, tomorrow morning, as I'm holding my envelope with my family.

I'm trying to keep perspective about this. Building up to this day, it feels like Match Day is the most important day of my life. But it's not. It will never compare with my wedding day, the birth of my sons, or even the day I was accepted to medical school. This, instead of being a milestone, feels a little more like a speed bump. Just one more hoop to jump through.

The agony of waiting isn't anything like trying to create the rank list. That was hard. Every aspect of compromise, everything that marriages and relationships are founded on, was put to use.

Early on in the interview process, I thought I had found my perfect program. I loved the program. I loved the people. I loved the city. If they had offered me a position right then and there, I would have taken it without a second thought. I called Hubster in delight. "I've found it!" I said gleefully.

However, it was not to be. The graduate program there was a poor fit for Hubster. As in, not a snowball's chance. So, sick to my stomach, I tried to put my dream program out of sight, out of mind.

Everything worked out. Later in the interview process, I went to a program that, well, just felt right. The more we thought about it, the better it felt. In fact, it felt right enough of both Hubster and me that I was able to easily forget the initial dream residency.

That's what tomorrow is really about. It's the culmination of sacrifices on both my part and my family's part. It's evidence that compromise works for everyone.

And most importantly, it's the end of the waiting.

Just a little nervous (the real nerves come later this week)

Sunday, March 15, 2009

Tomorrow I get an e-mail to tell me if I matched or not. Not where. Just yes or no.

If yes, my nerves will settle down just a little. If no...well, if no, I plan on just crawling back into bed and crying and maybe or maybe not plan on rejoining the world in the future.

Actually, I won't get to. Because I will be very busy being involved with the infamous "Scramble."

Where poor fourth year medical students who didn't get a residency position fight it out for any remaining open slots across the country. A two day process involving a lot of phone calls, waiting, and further hits on your self esteem.

I really hope that doesn't happen. How terrible to work this hard for this many years and not get a residency position. And possibly end up somewhere you've never heard of and don't know anything about.

Or worse, end up in a different specialty all together. To not be an anesthesiologist, but a family medicine doc or an internist.

Here's to hoping for the best.


-This is cross posted here-

The Next Step

Friday, March 13, 2009

Next week, my fate is decided.

It's something called "the Match," a complicated process in which fourth year medical students are giving residency training positions.

(For the "complete" inner working of the process, see here.)

And it happens next week.

And you can all be incredibly grateful that you don't live with me. Because this is all that I have talked about for months now. Hubster is sick of it.

I have been waiting for this day for years. As soon as I was accepted into medical school, my mind immediately skipped forward, like it always does, to the next step: residency.

I took specialty questionnaires, and then researched residencies for the specialties the questionnaires pointed me to during first year. I thought I had made up my mind during second year and researched pediatric residencies (looking mostly at call schedules and insurance coverage.) Third year, well, I was too tired to think about it. But then fourth year again was spend studying residencies, first pediatrics, then family medicine, and ultimately anesthesiology.

After waiting so long, it's a little unbelievable that it is happening on Thursday. It's actually going to happen.

I'm a sloshing mess of anxiety, excitement, panic, relief, jitters, dread, and anticipation. Most of the time, I'm not sure which emotion is dominant.

Not knowing has held us all in limbo. "Are you guys going to the family camp-out?" Don't know yet. "Will you be able to come of vacation with us?" Don't know yet. "So, where are you guys going for residency?" Don't know yet.

A week from now, I will know where my family and I am going to be living for at least the next four years. A week from now, we will be house hunting for real, and not just wistfully. A week from now, I can start planning again.

A week from now, I will be one step closer.

Resolutions

Tuesday, January 27, 2009

I've been a little behind. Not just regarding posting here, but in things in general. And I suddenly realized that January is about to slip away.

And I realized that because I haven't posted any New Year's resolutions, people may think that I didn't make any. (It's still January, so the year is still new enough.)

I did make resolutions, but I'm hoping that actually writing them down will make them easier to keep.

So here it goes...

I will be softer. I will be gentler. I will yell less and listen more.

I will learn to bite my tongue. Just because something should be said doesn't mean that I have to be the one to say it.

I will complain less. I know that the year holds more difficulty ahead, but I did make the choices that lead to that. I will recognize my role in the difficulty and the role my complaining has on my family. I will do my best to minimize the latter and live up to the former.

I will be healthier. I will cook more meals at home, eat sugar less, take fewer second helpings. (Hopefully this year, more of the meals I make at home will actually appeal to the people living there.) I will try to have one fruit or vegetable at each meal. My boys like broccoli and spinach and nothing else. So I think those will work (That's a lot of spinach for one year though.)

I will stick to my exercise plan. I know that I feel better when I exercise, but I am always falling off the wagon. I'm great for the first two weeks, but, you know, something always comes up. Like my pillow. I will try to stick to it this year. I will try for 5 days a week, but at minimum do 3 days a week. (My goal with the last two resolutions is to lose 15 pounds by next Thanksgiving. I need to lose more, but by starting with 15 pounds this year, maybe it won't sound so overwhelming.)

I will take time to paint. I will paint at least one picture this year.

I will work on my sleep routine. I will try to go to be before midnight and wake up at a normal time, even on the weekends (but still reasonable. Don't expect me to be the one all wide-eyed and bushy-tailed at 7 am Sunday morning.)

I will plant a garden.

I will finish at least one of the scrapbook projects I have started. Maybe the planets will align and all four will get done. But I'm only promising one.

I will continue to kiss my children before I go to sleep, even if they have been asleep for hours.

I will continue to make snuggling, hugs, kisses, and silly songs part of our daily routine.

I will try to make a new friend and invite them over to my house. (This one is probably the most difficult one for me.) But especially as I may be moving to finish my medical training, I don't want my family living like hermits any more.

While I know that there are thousands of other things I could choose to work on this year, I'm pretty sure that this will keep me plenty busy. I made sure my list wasn't too long, so there will be plenty of things to work on in the coming years.