Life is a gift

I went on a ski trip this past weekend. It has been our 2nd anniversary that week, as well as my husbands birthday, and we decided to make a 5 hour journey to a spectacular mountain with 2 of our friends. We brought baby for the adventure. I am glad I went. I am behind in my work and sleep this week...but really, I am chronically this way to various degrees, so it makes no difference!

I had a brutal oral exam on Friday, surrounded by 7 staff docs and 1 other resident. it was an hour long, and I was more nervous then I expected to be. I found that I would provide an answer and be met with such stoney faces, that I would rephrase the same answer a 2nd or 3rd time. "Yes the recurrence rate is approximately 5% after 5 years. Um, between 5 and 10 years the recurrence rate is over 5%. " ahem. cough. squirm. I stupidly once retracted a correct answer because of nerves. I stated that I would follow the patient with 6 month - yearly CT scans. I got the comment "and expose the pt to all that radiation?". I retracted my answer. WRONG. the right answer was to follow the patient with CT... I was just very flustered at that point. It wasnt pretty. These exams are a practice for our final Royal College exams, and are intended to HELP us. I feel that they can be damaging, but maybe in later years I will disagree.

I arrived home from work and my husband was loading our car and getting us ready to go. I felt so small, and my spirits so low. I told him I shouldnt go. I told him I was so weak and I needed to stay home and study. I was on the verge of tears when our friends showed up to go. Everyone was excited. So... I went.

I went and I skiied just like a normal person. It felt so freeing and so nice. I had a cold nose and I waited in chairlift line-ups and I drank real ski-lodge-style hot chocolate ! we ate a ski-lodge s pubs with big fireplaces, where everyone has messy hat-hair and rosy cheeks. Baby girl went to day care during the day and would fall asleep on my shoulder during dinner. That is, after she smiled at everyone she possibly could!

It makes me wonder. Life is such an irony. I see patients who are diagnosed with cancer, who are faced with their mortality, who develop a whole new sense of their life. I had a successful and wealthy CEO patient, with a diagnosis of prostate cancer. He told me to hug my daughter and love my husband. "Dont do what I did, spend TIME with your family and loved ones. Life is a gift."

Yes... and I drove home from our trip, sleepy, and feeling sick to my stomach --- Re-living the Friday experience, and knowing the life that was waiting for me.

My husband is gone for 2 weeks to for work. I am really proud of everything he has accomplished, so I urged him to go. He is shooting a documentary on winter surfing this week, then next week, he heads to Real Screen in Washington to drum up business. His main success in my eyes, is not that he runs a small successful company, it is that he inspires people everyday. He loves life, and loves people, and loves their stories, and this is contagious.

However, his absence make it very hectic for me. It is a very tight schedule to get my sweet daughter to daycare and picked up on time (which he usually does). This morning, we were both up at 5:00 a.m. I arrived at her daycare steps at 7:15, then went to work. I have to park a 10 minute walk from the hospital, so I zoomed through rush-hour in traffic (in freezing rain), parked and ran. (did I mention that I was carrying a 10 lb text book, and a bag?). I arrived, and decided to run the 10 flights to the inpatient floor (the elevator is always on a milk-run at that time of day.) I rounded, and ran 10 floors back downstairs to rounds and presented my patients. A full-work day, and then reverse the order of my morning. I picked her up, and decided to try the gym (it has been 5 days, i need this for my sanity). So we drove to the gym, and lugged her in her car seat, her diaper bag, and my big backpack...dropped her in their daycare and ran my heart out, and finished with some tricep dips for good measure, packed her back up, back out into the storm, and made it back home. I ran the 3 flights into the apartment twice to unload all the stuff from the car... made her dinner, fed her, changed her, read her a story, sang and rocked her to sleep... and now, I am just about to start work...again. And I am still in my gym clothes. Wow, one day down, and only 9 more working days to go!

One thing I did yesterday was make up a whole bunch of pureed veggies for her , and froze them in ice cube trays. I also made a huge salad and some grilled chicken for my quick dinners and lunches. ( I am lucky my home call yesterday was slow! ) I am trying not to buy the 7.00$ salads at the hospital cafeteria these days... I am starting to need to budget for all of this childcare I am needing to pay for.

And you know, the family thing, I don't regret it. It is the " all right" part of my life. It is an absolute privilege to prepare pureed peas to scoop into her smiley little mouth. I am lucky to teach another joyous human being how to clap their hands. And my husband amazes me; my life is enriched by him. My career, I am undecided on about how I truly feel about it. Things were easier in medical school. I think I was just unlucky and hit a really unhappy residency program, and I am not sure how to handle it. I think of quitting almost everyday now. I know that is not cool. I know that life is too short. So, I just have to figure it all out somehow.

J-club and red noses

Not much to write tonight except that I have one of the worst colds of my life, and I am on call for the whole weekend, and hoping my body recoups by Monday. I have got to the point of exhaustion, after having had 3 exams in 3 weeks, and then on Friday, i finished the cycle with an intense Journal club presentation.

Ahh yes, Journal Club....no... we do not do a "sit-around-and-chat style" j-club like they do in some specialties. I even know some programs who meet for wine and/or dinner after work for it! Sometimes, even a staff person presents an article after a resident presents one. Nope.... our program involves 2 articles, and a resident reading and preparing power point slides on each one. This works out to an average of 50-60 slides to prepare in total. The audience consists of fellow residents and the staff docs. During and after the presentation you are commonly grilled with random questions : " why did they put THAT in the exclusion criteria" ; "why did they power the study at 80%?", "what is the meaning of life?"... you know, simple questions, that in your sleep deprived state, while you are totally on the spot while everyone looks at you chewing their catered lunch, you try with all your might to think quickly and sound somewhat intelligent.

I rounded this morning with one of the docs who i am on call with (or FOR) this weekend. She met me this morning on the floor, and said, "Pretend I am not even here, I will just follow you around." Okay. So we saw the first patient. He has widespread metastatic esophageal cancer, and has lost over 100 lbs. I ask him how he was feeling, and then Dr "X" took over questioning. No problem. We leave the room, and she asked me what I noticed about him... hmm, i ramble off " alert and orientated, moving all limbs, pleasant, some petiechia on this right arm, cachexic" She keeps nodding, but I know I not getting the "right" answer. Finally she says "He is pale!! You should be questioning what his hemoglobin is!". Hmm... okay, well actually I did know what it was.. it was 112 today, and has been chronically for at least the past several months. And secondly....okay. He is in for labs again today... in fact, we are likely contributing to his anemia by drawing blood every day.

She watched me round on the remaining patients, and then when we finished, she said "okay, well i am off to do groceries. You should really use softer Kleenex's to blow your nose, it is getting red."

Maybe I am just too sensitive these days.

an interesting article.

http://www.boston.com/news/health/articles/2008/09/01/doctor_mom/?page=1

I shouldnt read stuff like this after a hard exam today, and as I am on my way to try to get some sleep for the night. I want the system to change. Must medicine require this type of sacrifice?

Better for me not to question right now. I really just need some sleep.

a weight on my chest

I left my sweet daughter with my husbands brother and made a quick trip to go to meetings about my research project. I was gone for 2 days... and in my after-work- packing-haste, I forgot my breast pump. Yup. I realized this as I arrived at my destination at 11:30 at night, ready to collapse from exhaustion and get ready for an early morning. Sh------t! I woke up early, with enlarging bust, and had no choice but to soldier on. My day was packed, and I allowed myself to pee only once, and I ate a babybell cheese at one point so I could keep the stomach growls on the down-low. By the time I was leaving my work day, I was in pain.. and by the time I made it home again,I couldnt even hug my little one to my chest! Wow.... if anyone is asking for saggy boobs, it is me, by pulling a stunt like that.

This is just how hectic I feel. And I am barely keeping up.

The most amazing thing is , that my sweet baby actually hugged me back when I picked her up. She was all smiles. She started to wave back while I was gone. She brought some peace back into my body.

the weakest link

First week back to a regular working schedule after the holidays. I could definitely feel the 'holiday hangover' in the air all week. We were all a little sluggish as we came down after our sugar/booze/lack of sleep/ and shopping highs.

I wrote a 3-hour exam at the end of the week. This was an exam was designed by the department, and intended to see what level of knowledge each of the residents are at. I literally felt consumed with anxiety for this. My fear is that this exam is going to reveal how much I have forgotten while I was on maternity leave. Our program director told us that our mark would be shared with all of the staff docs who we work with, so that they can help us work on our areas of weakness. (argh!) Apparently this is supposed to be a good thing, and will make me stronger. I am worried that it will have the opposite effect... that it will discourage me and point me out as a 'weak link' among the residents.

After writing for 3 hours and being relieved to finish...we were informed that part-2 is next week.

sigh.

A 'Journey" vs. a "Sentence" in 2010

My blog is to document my recent life that has exploded to include being a new mama, a new (ish) wife, competitive runner, a political activist (well, I try), and... someone who is trying to complete an intense residency program. Try balancing these roles while working 80+ hours per week, being quizzed and tested ALWAYS, and constantly needing to be on top of your game!

I have lots of female friends in medicine, however, none of them have made the leap to have a child and most have not taken the plunge for marriage. So, in my desperate search for a female Md-Mom as a role model, I thought I would start to document my journey. Perhaps this will blog will be my venting forum, BUT, perhaps another gal in my situation will stumble upon this and find comfort, and some useful tips on basic 'survival'.


Two years ago, I had just finished spending my second Christmas on-call. Yup, a merciless pager, and eating ice-cream-scoop-formed mashed potatoes. Although I felt very alone, at the same time, I was wondering if I should continue in my relationship with my now-husband, until after my residency...or really, any relationships for that matter. Hmm... now I find myself with a 'family'. Wow!


Women are increasingly entering the medical field...so, there will be growing numbers of mom-residents. And therefore, a growing number of us trying to juggle difficult roles. I would like to see women in medicine support each other, and mentor each other, more often. I could certainly use a reassuring word, like "yes, this is possible", or "no, your 4 month old will NOT be scarred because your mother-in-law had to dress her up for Halloween, or start her on solids, etc etc" . I could also use some shared experience from my female staff-doctors...but they are so tired themselves, and are appear to be burnt and bitter from what they have already endured. maybe I don't want to hear what they have to say.

Yes, residency is a bit of a 'sentence', but I am going to start of 2010 but trying to see aspects as a "journey" . My journey. I am passionate about medicine, but I am also newly passionate about my daughter.

So, here goes another year!

"Congratulations! today is your day! You're off to great places! You're off and away!" (~Dr Seuss)