What the future holds

Well, intern year is over.. so I guess I won't be interning any more. To be honest, I am not missing that part of my life right now. I thank God every day that I am at a family friendly program and that I have been able to spend a good amount of time with my son. I am at the end of a 3 month q4, q5, q4 stretch and I am starting to enjoy being an R2. There has been so much learning. I can keep even very sick patients alive and run a code and do practically any procedure an internal medicine doc would do. I am starting to think about the fellowship application process. I'll be doing heme-onc, and I am thinking of staying at my home program as it would give the best start possible to my small family and meet all my needs.

Wise words from a "Doctor Dad"

Enjoy your kids. Enjoy the time with your kids. Make time for your kids. And the reason for this unexpected, though welcome advice, "My kids never remember all the times I was there, but they do remember all the times I wasn't."

Interning and Mothering...

How I survived being an internal medicine mom:

Some things are not going to be perfect. Your house won't be clean. You won't read as much as you like. You won't spend as much time with your child(ren) as you like. You won't spend as much time with your husband as you like. If you are like me, you are going to (try to) find balance. You will strive to always be better, but you will not be perfect. And this can be a problem for a profession that demands perfection.

Some things my friends have done to counteract this...
1. Hire a maid. We didn't do this but that is because I married a super-husband. If he weren't so good at keeping the roaches at bay, there is no question I would have done this.

2. Read every night. If you are going into an intellectually stimulating career like medicine, it is important that you do something to increase your learning every day.

3. Try to exercise. I do zumba, ballroom dance classes and yoga when I can. Some months it doesn't happen at all. But I always try. And it is such great stress relief. Plus, our gym has free daycare and it gives me and the husband a chance to reconnect and do something good for ourselves.

4. Spend time with your kids. Even q4 I made sure to get home early and spend "quality" time with my son. We'd go to the pool, go to the park or do crafty stuff. But it was just me and him and it was rejuvenating. Plus it helped to curb that mommy guilt.

5. Let go of the mommy guilt. Not sure how this accomplished, but I try.

6. Find some mommy friends. Preferably some outside of medicine. And beg them to excuse you while you miss play dates, etc. because of stuff that comes up. Oh, and does stuff come up.

7. Encourage your spouse to do his share. Or more than his share. And own up to it when that is the case. Parenting and interning are two 80+ hour per week jobs.

8. Consider taking an internship where you will have help. Grandparents are useful.

9. Get a babysitter and go on dates with your over-worked husband. And then refer to #5.

10. And most of all, revel in how you really have it all. You've got a life and a career. Congrats!! You can do it.

The problem of women in medicine

Some people from work have brought up some of the problems that women bring to medicine. Like, for example, how on average we work less than our male counterparts. That we want time off. That we leave our partners to deal with it. And how this lack of man-hours (or should we say, women-hours) is going to adversely affect medicine in the future.

Its true, I don't want to work 80 hours a week for the rest of my life. Our predecessors were q2. Q2! I don't think many people (men included) still want that.

They complain that the balance we desire comes at a huge cost, to our patients and our partners. I am not quite sure what to say about this. I can't say that I will never burden my partners.

Being balanced makes me a happy person. Being a happy person makes me a good doctor - not the type that is going to quit seeing patients to find some non-clinical work. Hopefully if I can stay balanced, I will continue to love medicine for decades the way I do now.

One particular person argued with me that you can be a good dad working 80 hours a week. I think this is particularly difficult. Funny how people are always asking, "how can you be a good mom, and be a doctor," but they never wonder about dads who are doctors.

This is just food for thought. Wish I had had a decent retort, but I don't.

Life in the ER

So I am doing my month in the ER. It is an ACGME requirement(I think). I've already been informed by staff that we slow them down, get in the way and generally cause them to make less money. Also, that when he came here he didn't realize that teaching would be required - so "scram." Except the other docs down there were equally annoyed. Gotta make that money and keep from getting sued seems to be the mantra of the ER. They did let me do some procedures for them - a couple central lines when I was supposed to be getting off.

Sadly I had an open mind about this experience. I worked as a scribe in another ER and I had a blast doing that 40 hours a week for a year making, "choke," $7 per hour. It was fun to stabilize patients, and sometimes you would even figure out what was wrong with them.

On my last shift I took care of patients with absolutely no supervision. I am half-way through my intern year, and I can handle the simple stuff by myself but I had some pretty complicated patients. I needed permission to ask to have them admitted. This did not come until 6:55, 5 minutes before I was supposed to be leaving. I had only had 7 hours sleep in 3 days due to my own inability to sleep during the day for various reasons. (Hmm... maybe my plan to become a nocturnist is not such a good one.) It took me another 2 hours to get them admitted. I got admonished by admitting doc - who then yelled at my "attending" ER physician. I literally snuck out of the hospital. All is well with the patients, at least. I have 9 more ER shifts. I have 2 spa visits planned for this week. I am definitely going to need some exercises in deep breathing to get through this month. And, I really thought I would love the ER.

First Day Off...

Just came off a series of night shifts where I never adjusted (aka could not sleep during the day due to various causes - phone ringing, child screaming, hammer paging from attendings from previous months).

I went to a fabulous restaurant for New Year's Eve. Our child had all night daycare available just for the occasion with his favorite caretakers. All my best friends were in attendance. They all ordered the filet. I got the gourmet ravioli and creme brulee (all the desserts were super-heavy). The creme brulee wasn't quite right- couldn't quite explain it... thick, custardy - not smooth and creamy. I thought I had heartburn from the rich foods when I got home, took an H-blocker.

I slept fitfully, woke up, threw up all the contents from previous nights dinner. At first I thought, this is good... I didn't want that all to stick to my hips. You may think I am crazy, but I had eaten way too much. Then I started with the chills, and body aches, including a little back pain. I wondered, is this pyelo, something else , as I am NEVER sick.

When my fever reached 101 I was feeling quite ill, too ill to even get up off the couch, I considered going to the ER. Tylenol would not bring my fever down... but I could keep fluid down in the form of popsicles and decided to wait it out. My head was hurting a bit, probably from the fever - but every possible horrible diagnosis filled my head. I essentially slept for 24 hour straight.

Then I awoke with a temp of merely 99. Could this all be passing? I was actually able to eat a little. No throwing up. And the fever subsided. We were supposed to leave for our ski vacation today, but I can hold off until tomorrow and I plan to. Doubt I have enough strength to fly down the mountain, but hoping I will in the next couple of days. I felt good enough to have tacos for dinner. That BRAT diet didn't really have my interest and I have never been one to follow the rules.

Figures as soon as I get a bit of a break my body, which has been putting up with unbelievable stress, finally gives out. Based on the time course, it may have been salmonella, but we won't ever know. And I will never go back to that restaurant... and I am probably off of tomato sauce and creme brulee for awhile as just don't seem all that appealing.

Vacation!!!!!

Image by Telstar Logistics via Flickr

2 more days until vacation. What possessed me to go 6 months of my intern year without vacation? We'll never know. But I am two days away from vacation bliss. We're taking the baby skiing - the resorts have daycare so hubby and I can get some much needed R & R. We are renting a house with my parents. Something luxurious and at the center of the town's activities. So excited. In fact, so excited planning my next vacation. Hopefully a Royal Caribbean cruise.