Confession

I have a confession to make. I have struggled with whether or not I actually wanted to admit this out loud, but in the end decided that not saying it doesn't make it any less so, and isn't confession supposed to be good for the soul?

As you are all well aware, the whole job search was incredibly frustrating for me. I am not sure what I expected, but after 10 years of training at some pretty great places, I certainly didn't expect to have trouble finding a job. I almost imagined a fight over who would get blessed with my training and skills. A few months into my search when it became apparent that there was no stampede to my door, I sat down with a few of my attendings to discuss the issue.

To the one, they all (after a good deal of prompting) told me the same thing. If it had not been so frustrating and disheartening, it would have almost been comical. None of them were willing to just come right out and say it. They would all sheepishly look at their desks, computers, hands. No one could quite look me in the eye.

What was their big revelation? I am female! Hold the presses. It was quite a shock to me. I had wondered what those lumps on my chest were all those years. I joke about it now, but I was devastated, but perhaps not for the reason I should have been. I was devastated because it was the one thing I couldn't change. If I was coming off too confident, or not confident enough, t0o shy, too outgoing - those were things that I could change, but my sex - sorry "Chaz" I am not willing to go there.

Why was I not frustrated and irate that my chosen profession was so openly sexist? I have a harder time answering that question. By all rights, I should have been livid that it was suggested to me that another candidate although less qualified and with less technical ability would make a better colleague because he had testicles. The more interviews I had, the more it became glaringly obvious too me that these men were scared to death that I wanted to take their job and then become some baby making machine.

My most horrible confession - a part of me gets it. Now before any of you hunt me down to set me straight, hear me out. A little part of me sees that it must be incredibly frustrating to hire a new surgeon, invest a lot of money in salary, OR toys or laboratory stuff and then have them take off within the first year on maternity leave. It is also quite common in my profession for these women to not come back at all. In my heart, I know that women should be able to make choices based on the data they have at the time. Women should be allowed to have all the same opportunities as men, and should have choices about how they wish to fulfill themselves. However, a small part of me sees the other side.

I am not blaming my entire frustrating job search on my sex. Lots of things go into it some of which were in my control some not. However, I will admit to coming out of this experience with a little less rose coloring on my glasses. I knew that I was going into a male dominated profession (female cardiothoracic surgeons now make up 2% of all cardiothoracic surgeons). However, I perhaps unrealistically felt that it wouldn't make a difference.

Out like a lamb?

I am going to admit to being a little disappointed this morning. I just completed my last ever night of call so one could question my sanity, but here is my point. I have had a "black cloud" my entire surgical call career. I am the only person that has never had a "no hitter" on call. Not only do I get "hits", I usually get to knock a few out of the ballpark.

Therefore, on this my last night of call, I came prepared for nothing short of Armageddon. I mean seriously this is the last chance that call fate has to hurt me. I figure it would at least make it interesting. I even felt somewhat invincible. I mean after you have survived 10 years of surgical training, you feel that you can survive anything for 24 hours. I felt sure that we would at least have a dissection or esophageal perforation - transplant maybe. Alas, we had nothing. I talked to a few outpatients to reassure them that it is normal to have some discomfort after open heart surgery. I had one septic patient on the floor and one in the unit, but that was child's play. I mean where was my emergent open chest, ECMO cannulation, anything.

It is a little hard to believe that I will never have to spend the night at a hospital again. It has been such a huge part of my life these ten years. I won't say that I will miss it, but the adrenaline rush could be addicting. I do want to say a Thank You to all of my patients, nurses, and residents who have taught me so much over the last 10 years of call. Now I am going to take a nap.

Last Call

Ten years is a long time to be a resident. Anyone that tries to convince you otherwise is crazy. However, I can say that it has gone by incredibly fast. I remember my very first night on call. It was "home" call at University hospital. I lay awake all night petrified every time the pager went off. I was still looking up how to order Tylenol.

I have spent a large portion of the next ten years on call. My heart no longer races when the phone goes off, and thankfully the only medications that I regulate these days are pressors, but at the end of the day call hasn't changed all that much. It is still an exhausting and at times exhilarating experience. However it is one that I am willing to give up.

I am 7 hours into my last 24 hours of resident call ever. I expected a certain amount of giddiness today perhaps even a little swagger. Maybe as the day wears on it will show. As of now, tomorrow still seems to far away. It probably doesn't help that I only got 3 hours of sleep Friday night and 5 hours last night. I have been trying to take a nap this morning, but have been inundated with patient calls.

Another thing that hasn't changed, I survive call by dreaming of the things to do post call. It is often as simple as a long hot shower. Tomorrow I have to run a few errands, and then I want to revisit some of my favorite Philly places. It may be my last chance before I leave. Here's hoping that the rest of my call cooperates with my plans.

The difference a year makes

As some of you might recall, when I started this blog one year ago, I had just been royally screwed by my movers. Therefore, as you might imagine, I approached this whole move with much trepidation. Oh what a difference. As promised, the movers called yesterday to tell me exactly what time they would be here this morning. Then, they actually showed up right on time. Four men with gruff Philly accents that I have never met, then proceeded to touch everything that I own. I admit that part takes some getting used to, but the sitting here while all the packing and loading is done is great. I will never move myself again.

As I sit here mooching off someone's Internet, the guys are loading up the last of my belongings. There has been much ribbing about how many clothes that I have (they actually had to call and have some deliver more boxes), but the move has gone smoothly. They also commented on my obsessive organization, and laughed at me as I walked around behind them picking up trash. I can't help it - I can't leave trash on the floor. Once everything is out of here, I am hoping to grab a quick shower and then I am off to my Sugarland/Kenny Chesney concert. I am actually glad that I have plans because sitting here in a empty dark apartment would be depressing. Last day of in house call ever is tomorrow. I am WAY excited, but after last call expecting the worst. I officially leave Philly on Wednesday. Looks like the last of the boxes are heading out - do you tip these guys and if so how much???? Guess I should have thought of this earlier.

Lazy - Guilty as Charged

I had such grand plans. I would work here at Penn for July, take August off to move and be ready to start my new job on September 1st. Then I started doing the math - I don't like math, but was always good at it. Between now and my anticipated start date of September 1st, I need to accomplish the following:

1. obtain Florida license
2. obtain privileges for University of Miami Hospital
3. obtain privileges for Jackson Memorial Hospital
4. obtain privileges for Miami Veteran Affairs Hospital
5. fulfil billing criteria for University of Miami Physician Group
6. fly to Miami and find place to live
7. Move to Miami
8. Apply for my Thoracic boards
9. Study for my Thoracic Boards which are in October
10. Drop 40 lbs and increase my bust size by at least 3 cups

Oh, and did I forget that I was still expecting to hold down a truly "full time" job plus extra shifts on the weekend for money. What planet am I living on?

I have spent the better part of the last two days trying to accomplish number one, and am still days away from being even close to filing - much less obtaining a license to practice medicine in Florida. (No offense Jessica, but attorneys complicate things.) I spent much of my day at the police station being fingerprinted. I can't even wrap my mind around the remainder of the list. Don't worry #10 is a joke - at least mostly.

Therefore, today I came up with a new plan. Seven days from today will officially be my last day of training. After 10 years of post-graduate training, I am taking a break - a two month one. I decided after 120 months of residency - two months off would not cause the world to spin off it's axis. (Now this is just a theory, so if gravity starts failing us in July we know that I am to blame.) Hopefully this will not only allow me to complete my list, but add a few fun things to it. Perhaps visit some friends, get some munchkin time with Matt and Grace, sleep - dare I even say relax.

A voice inside of my head keeps telling me that this makes me lazy. It is probably right - I'll just learn to be okay with it.

Expectations

I expected that finding a job would offer me: a huge sense of relief, a good night's sleep, freedom from stress, a couple of day's of rest. What it has given me: a ridiculous amount of paperwork to fill out, stress over finding a place to life, insomnia from inability to turn off my brain. Be careful for what you wish.

Apologies to Ella Fitzgerald

At last my job has come along
My unemployed days are over
And life is like a song

At last the skies above are blue
My heart loves the ocean
My job I finally found you

I found a job that I could speak to
A job that I could call my own
I found a job to look forward to
I job I never dreamed of

I saw the Ocean and the spell was cast
Now I'm moving to Heaven
For the job is mine at last

At last my job has come along
My unemployed days are over
And Life is like a song

Miami here I come!!

thanks for sticking it out with me everyone.

Confidence

Webster's defines confidence as a "a feeling or consciousness of one's powers or of reliance on one's circumstances." If asked, most people would describe me as a very confident person some would even use the word arrogant. The people who know me best would tell you that a fair degree of my "confidence" is an act to hide my insecurities. I think that is true about a lot of surgeons. Our "arrogance" is often an over exaggerated confidence that we are using to hide our insecurities. The insecurities can come from lots of places, and believe me mine do.

However, my performance at work has never been my insecurity source. I may not be the smartest doctor on the planet, but I am a good surgeon. I have good judgement, good bedside manner, and great hands. Or at least I once thought. The most frustrating part of this whole job search saga is that it has rocked my confidence the one place that it was true and not an act. It has made me question my abilities as a surgeon. I hate it! Why am I giving away power to these men?

I think somewhere deep down inside the confident resourceful girl still exists. I just need to dig deep and find her.

Sleep Deprived Musings

Fact - 6 hours of sleep in 48 hours is not enough for my 36 year old brain. Now I can proudly tell tales of "when I was a resident before the 80 hour work week" and we lived at the hospital. Stories of every other night call and days with almost zero sleep. Those stories would be true, but they were a different time - most notably, I a lot younger me time. I mean 10 years is a LONG time (decade as a matter of fact), and I personally think surgical years count something like dog years - each year should really count for at least three.

Why am I sleep deprived? Well I took a tour of airports the last two days. I am working on becoming quite the connoisseur. I went up for my interview at U Mass Tuesday evening. My plane was 4 hours late leaving Philly. I didn't make it to my hotel room until midnight. My flight back yesterday was 5 hours late, and I crawled very meekly into my bed at 3 this morning. As an aside, there should be laws against alarm clocks that go off at 5 am. We have 8 cases today so no rest for the VERY weary.

My interview went well - I think. I no longer trust my read on these things. (As a matter of fact I am currently having a serious crisis of confidence, but will leave that to another day.) I found New England to be quite charming, and the job has definite possibility. I fly (or at least attempt) to Miami on Monday. This entire experience, for lack of a better word, has been a great character builder and all, but I seriously need it to be over soon. I am not sure how much more I can take - mentally or physically.

Three cases down - five more to go. Just got to hold on.

Bad Habits

I seem to have developed several bad habits lately. Well, that is not entirely correct, some of them I have had for a while, but they seem to be exacerbated lately. I have always felt that as long as you knew your short comings you were a step up, but am now willing to admit that is just laziness. One should not only recognize their failings, but actively try to correct them. Here is my list:

Cursing - interestingly I didn't start cursing until I became a surgeon. Even then it wasn't a conscious choice, it just happened. My mom is very anti swearing. So much so that to this day, she has never heard me curse. However, my swearing away from my mother has started to bother me. It was one thing when it was an occasional word said in the OR to get a point across. Now, it almost seems that it has become part of my normal vocabulary - I don't even recognize the words as offensive anymore. I am now making a concerted effort - so far so good.

Television - I watched a lot of TV growing up. I always argue this to my friends who don't let their kids watch any TV. I think I turned out okay (for a surgeon). During my surgery training, I all but stopped watching TV altogether. I had so little free time, there was always something else I preferred to be doing. Sometime during the last 9 months, I have become a TV junkie again. It started with TV for background noise, and then winter hit and I certainly didn't want to go outside so TV for distraction. Somehow it all spiraled and my TV was on from the time I got home from work until the time I went to bed. I was getting nothing accomplished. I decided to go cold turkey this weekend. I was post call on Friday. After my nap on the couch, I woke up and started to flip on the TV. I caught myself and realized that if I did that, I would accomplish nothing else that day. Post call days can be difficult days for motivation. Therefore, I walked over and unplugged it. I spent my entire weekend off sans television, and although hard at first, it turned into a very liberating experience. I remembered things that I enjoy doing. I cleaned, walked along the Schuylkill, went shopping, read in the park, did yoga, listened to music, relaxed, etc. I will probably plug my TV back in for a little CNN occasionally, but hopefully I will now realize that life can be good without the talking heads.

Planning my life instead of living it - now this one is harder. I have spent 10 years thinking about what I would do when I "finish my training". I have grand and glorious plans. However, as I approach the end of my training, I haven't really put any of these plans into action. I still keep thinking of all the things that I will do - some day. You know, planning a great life is a lot easier than living one. To live a great life, you have to be involved and take risks. You have to put yourself out there. I once knew how to do that, but am not sure that I remember how anymore. I don't just mean with guys, I am talking about in general. The last time I got involved in something, not medically related was a really long time ago, and I am sure that Kris made me to it. This also pertains to my last bad habit . . .

Hobbies or the lack thereof - I am currently looking for my lost hobbies. I am sure that I had them once, but seem to have misplaced them during one of my moves the last 10 years. Has anyone seen them? I tried to ask around and steal some of my colleagues hobbies, but they don't have any either. They don't even play golf with any regularity. Why is it that my career choice and hobbies don't seem to go together? I think moments of rest and relaxation (i.e. the definition of what hobbies provide) is something I would want my surgeon to have plenty. He/She should feel nice and refreshed before starting my case. I still read occasionally, but not sure that this qualifies. I want to learn to play tennis - someday. I am a girl desperately in need of outside interests - ideas????

Chivalry

I miss chivalry. I feel a little guilty making that statement, but it is true. The feminist in me points out that I am perfectly capable of opening my door, and that they make ladders for top shelves. However, the Southern girl in me knows that even though I am perfectly capable to do all those things, that there is something very nice about a guy that feels the need to do them for you.

Maybe it is related to where I grew up, or maybe it is just a character flaw that I have, but I find chivalry nice. I don't look at it as a "weaker" vs "stronger" sex. I see it as a way of showing respect and honor. I think it is okay to recognize that men and women are not the same.

That last statement will get me into trouble with some of you. It has before - it ranks right up there with my theory that women can't have it all. Perhaps it is because I mostly work with men, but the older I get the more I recognize that men and women really aren't from the same planet. I am sure that some of these differences are related to the way that boys are raised, but I am certain that some are hard-wired. I don't argue that one sex is better, but I do believe that we are different, and I think celebrating our differences is okay. Now - let the recriminations begin.