Isn't it amazing how one little thing can change your entire prospective. It is no huge secret that I haven't been in the best of Holiday spirits. I am in another new city . . . trying to figure out my job . . . getting to know people . . . and seeing Santa walk around in shorts and a T-shirt. Until yesterday, I just wanted the entire thing to be over.
Then, the unexpected happened. I received the BEST Christmas present. . . notification that I passed the written portion of my Thoracic boards. Since I was almost certain that I would be taking them again next year, I was very pleasantly surprised. Happy is not even an adequate word to describe how great I feel right now. Bring on the decorated palm trees, I am now officially in the Spirit.
Tuesday, December 22, 2009
Wednesday, December 16, 2009
Nostalgia for days past
I am just going to say it - I miss the pre -80 hour work week. For those of you who don't know, a few years ago, the federal government established limits and conditions on resident work weeks. (Of course this happened after it would really affect my resident life, but I digress.) The theory was to improve patient safety, and the working conditions of the last legal group of indentured servants. The theory has met with some serious reality.
I am not morally opposed, as many of my colleagues are, by big brothers interference. I am a liberal - we like big brother. Sometimes big brother is necessary to help us see the big picture. There are many ridiculous things that I did as a resident simply because my senior level resident or attending had to do "it" when they were in my shoes. These tasks contributed absolutely nothing to my education. I am not opposed to residents having lives. I don't begrudge them a life just because I never had one. Nor am I convinced that not sleeping for days on end really made me a better surgeon. (I am convinced that it directly contributed to the lovely bags under my eyes.) However, there were some very important lessons that I learned that I fear are now being missed.
Lesson One: Patient Responsibility - I learned VERY early in my training (my first week when Bassam yelled at me for not replacing a patient's potassium) that I had a direct contribution to my patient's well-being. It was made very clear to me that every i had to be dotted and every t crossed to insure that my patients left the hospital alive. I was taught that this is a very sacred responsibility that had to be taken seriously It could not be ignored because I was tired, wanted to go home, or had been up all night.
Lesson Two: Camaraderie - For better or worse, I spent way more time with my fellow residents than I did with everyone else in my life combined. Did we argue, fight and basically get on each other's nerves? Absolutely!!! However, we also laughed, talked, commiserated, and all knew at the end of the day who had our backs. We were in the trenches together, and trying to get as many of us as possible out the other side alive. To this day, some of my closest friends were made in those trenches. (Even Bassam who yelled and made me cry.)
Lesson Three: Satisfaction of a job well done - My trainer keeps telling me that it is good that I am sore after our workouts. She cites this as evidence of a productive work-out. Was I a little "sore" after my surgical training. Sure, but I walked away feeling that I actually accomplished something. I knew more than how to operate - I knew how to care for patients. I never want to go through it again, but I wouldn't take anything for the memories that I have of that time.
Lesson Four: The benefit of watching others - When I was walking to school up hill both ways in the snow, we would come in hours early to get our work done so that we could go to the operating room and scrub into a case. We were usually the second or third assistant standing somewhere behind the medical student, but we were there and ultimately that was all that mattered. The lesson you ask? Many. I learned patience. If you stood there enough, you would eventually get to do something. Preparedness. If you could correctly answer a question about the patient or the case, a reward usually followed. Technique. I will simply say that it astounds me for anyone to think they can do a procedure regardless of how simple it is having never seen it.
Lesson Five: Work ethic - There is something in knowing that you cannot go home until the work is complete. It puts a little extra drive to actually accomplish tasks. You really do try a little harder. You also learn that life isn't fair, and that being on call for the fourth straight Christmas sucks, but it doesn't kill you.
I could go on, but I have to go to a meeting with the general surgery residency coordinator. The "CT" service has had a complaint from a first year resident about the "working conditions". Therefore, the girl who has only been here for 2 months gets to go defend the "system".
I am not morally opposed, as many of my colleagues are, by big brothers interference. I am a liberal - we like big brother. Sometimes big brother is necessary to help us see the big picture. There are many ridiculous things that I did as a resident simply because my senior level resident or attending had to do "it" when they were in my shoes. These tasks contributed absolutely nothing to my education. I am not opposed to residents having lives. I don't begrudge them a life just because I never had one. Nor am I convinced that not sleeping for days on end really made me a better surgeon. (I am convinced that it directly contributed to the lovely bags under my eyes.) However, there were some very important lessons that I learned that I fear are now being missed.
Lesson One: Patient Responsibility - I learned VERY early in my training (my first week when Bassam yelled at me for not replacing a patient's potassium) that I had a direct contribution to my patient's well-being. It was made very clear to me that every i had to be dotted and every t crossed to insure that my patients left the hospital alive. I was taught that this is a very sacred responsibility that had to be taken seriously It could not be ignored because I was tired, wanted to go home, or had been up all night.
Lesson Two: Camaraderie - For better or worse, I spent way more time with my fellow residents than I did with everyone else in my life combined. Did we argue, fight and basically get on each other's nerves? Absolutely!!! However, we also laughed, talked, commiserated, and all knew at the end of the day who had our backs. We were in the trenches together, and trying to get as many of us as possible out the other side alive. To this day, some of my closest friends were made in those trenches. (Even Bassam who yelled and made me cry.)
Lesson Three: Satisfaction of a job well done - My trainer keeps telling me that it is good that I am sore after our workouts. She cites this as evidence of a productive work-out. Was I a little "sore" after my surgical training. Sure, but I walked away feeling that I actually accomplished something. I knew more than how to operate - I knew how to care for patients. I never want to go through it again, but I wouldn't take anything for the memories that I have of that time.
Lesson Four: The benefit of watching others - When I was walking to school up hill both ways in the snow, we would come in hours early to get our work done so that we could go to the operating room and scrub into a case. We were usually the second or third assistant standing somewhere behind the medical student, but we were there and ultimately that was all that mattered. The lesson you ask? Many. I learned patience. If you stood there enough, you would eventually get to do something. Preparedness. If you could correctly answer a question about the patient or the case, a reward usually followed. Technique. I will simply say that it astounds me for anyone to think they can do a procedure regardless of how simple it is having never seen it.
Lesson Five: Work ethic - There is something in knowing that you cannot go home until the work is complete. It puts a little extra drive to actually accomplish tasks. You really do try a little harder. You also learn that life isn't fair, and that being on call for the fourth straight Christmas sucks, but it doesn't kill you.
I could go on, but I have to go to a meeting with the general surgery residency coordinator. The "CT" service has had a complaint from a first year resident about the "working conditions". Therefore, the girl who has only been here for 2 months gets to go defend the "system".
Monday, December 14, 2009
Brace yourself
Okay everyone take a deep breath and brace yourself. I have some devastating news. Ready? . . . . I have lost the will to shop.
I know this is quite shocking for everyone. I too am still coping with the news. I never thought something like this would happen to me. I did all the right things. I read Glamour and Cosmo. I watched Sex and the City and What Not to Wear. I only watched award shoes to comment on what everyone was wearing. I even got an education so that I could support my habit - (I am missing the gene that says that $800 is too much for a pair of shoes). How did this happen?
I have had slumps in the past. Times where I had to talk myself into the mall. However, once there I always had a good time. Shopping is therapy for me. The simple act of walking through a mall lifts my spirits. I don't even have to purchase anything - although buying helps.
Whatever shall I do? Is there a doctor for this kind of thing? My other therapy is eating - not a good alternative.
I know this is quite shocking for everyone. I too am still coping with the news. I never thought something like this would happen to me. I did all the right things. I read Glamour and Cosmo. I watched Sex and the City and What Not to Wear. I only watched award shoes to comment on what everyone was wearing. I even got an education so that I could support my habit - (I am missing the gene that says that $800 is too much for a pair of shoes). How did this happen?
I have had slumps in the past. Times where I had to talk myself into the mall. However, once there I always had a good time. Shopping is therapy for me. The simple act of walking through a mall lifts my spirits. I don't even have to purchase anything - although buying helps.
Whatever shall I do? Is there a doctor for this kind of thing? My other therapy is eating - not a good alternative.
Thursday, December 10, 2009
Well . . .umh. . . actually
A survival technique during residency training is to blatantly and sometimes quite outrageously lie to oneself. The lies start out harmlessly enough. They are simply a way to make it through the call night, but somewhere along the way a problem develops. . . you start to believe them. For example, I convinced myself that once I finished "training" all of my stress would magically disappear. Not sure where I thought it would go, but reality seems to have little basis for the lies I told myself.
I will concede that the stresses certainly changed, but they new ones seem bigger not smaller. Don't get me wrong, I still love what I do and am so excited to finally be doing it "for real". However, the happily ever after - nothing but time on my hands - Utopia I imagined has not come to fruition. Luckily, my mom never told me life is fair, so I have taken this new development with what I feel is reasonable aplomb. I decided to put on my big girl panties and deal. I needed a plan. (Even just the illusion of control is important for me.)
My first step was to prioritize. A clean house if very high on my list. If my house is a mess, it is usually symbolic of a deeper level of disorganization in my life (sorry took one to many English classes on symbolism). It turns out that another priority for me is not being the one to clean it. I have put off hiring cleaning help because I kept thinking of all the better ways to spend the money. As someone out of work for 4 months, I have many areas of my life in need of cash. However, recently I decided buying furniture can wait - not cleaning the bathrooms not so much.
Therefore, my new "cleaning lady" came yesterday. I was supposed to be there to show her around, but it didn't exactly work out as planned - see yesterday's blog. When I finally got home a little after 2 this morning, it was to a spotless place. There was even dinner to warm up in the fridge. She had also left me a note telling me all that she did and asking if there was anything else that I wanted. A few suggestions were offered of additional tasks that she would be happy to perform. One of which was to wrap the pile of presents currently living on my guest bed. Here is the rub - how do you tell a lady that while you are too lazy to clean your own house, your favorite part of Christmas is wrapping presents?
I will concede that the stresses certainly changed, but they new ones seem bigger not smaller. Don't get me wrong, I still love what I do and am so excited to finally be doing it "for real". However, the happily ever after - nothing but time on my hands - Utopia I imagined has not come to fruition. Luckily, my mom never told me life is fair, so I have taken this new development with what I feel is reasonable aplomb. I decided to put on my big girl panties and deal. I needed a plan. (Even just the illusion of control is important for me.)
My first step was to prioritize. A clean house if very high on my list. If my house is a mess, it is usually symbolic of a deeper level of disorganization in my life (sorry took one to many English classes on symbolism). It turns out that another priority for me is not being the one to clean it. I have put off hiring cleaning help because I kept thinking of all the better ways to spend the money. As someone out of work for 4 months, I have many areas of my life in need of cash. However, recently I decided buying furniture can wait - not cleaning the bathrooms not so much.
Therefore, my new "cleaning lady" came yesterday. I was supposed to be there to show her around, but it didn't exactly work out as planned - see yesterday's blog. When I finally got home a little after 2 this morning, it was to a spotless place. There was even dinner to warm up in the fridge. She had also left me a note telling me all that she did and asking if there was anything else that I wanted. A few suggestions were offered of additional tasks that she would be happy to perform. One of which was to wrap the pile of presents currently living on my guest bed. Here is the rub - how do you tell a lady that while you are too lazy to clean your own house, your favorite part of Christmas is wrapping presents?
Wednesday, December 9, 2009
Busy career woman seeks wife
No I haven't started batting for the other team, but I have come to a much better understanding of the so called "glass ceiling." I don't think women's failure to advance in traditionally male fields has anything to do with men being unable to "see" women in these roles, and everything to do with women not having wives to run their lives so they can concentrate on work.
For instance, I have a laundry list of life tasks that need to be accomplished - not least of which is actual laundry. I am somehow supposed to perform these things, and yet still spend 12-16 hours a day at the office and be on call every other week. I am willing to throw money at most of my problems, but at the end of the day I actually need to show up for some things - importantly at the moment a hair cut.
I thought I had a solution. I operated yesterday late into the evening so that I didn't have any cases to do today. My plan was to spend the morning catching up on the piles of paperwork that no one warns you about during residency, and take the afternoon off to do some Christmas shopping, get a haircut, go to the dry cleaners, drop some things off at Goodwill, etc etc.
Bet you have already guessed how this story ends. As I was turning off my computer, and telling my AA goodbye my phone rings. We have a transplant and need you to help. The case was supposed to start two hours ago, and yet here I still sit waiting. Number of things accomplished on my list - zero.
All qualified applicants encouraged to apply.
For instance, I have a laundry list of life tasks that need to be accomplished - not least of which is actual laundry. I am somehow supposed to perform these things, and yet still spend 12-16 hours a day at the office and be on call every other week. I am willing to throw money at most of my problems, but at the end of the day I actually need to show up for some things - importantly at the moment a hair cut.
I thought I had a solution. I operated yesterday late into the evening so that I didn't have any cases to do today. My plan was to spend the morning catching up on the piles of paperwork that no one warns you about during residency, and take the afternoon off to do some Christmas shopping, get a haircut, go to the dry cleaners, drop some things off at Goodwill, etc etc.
Bet you have already guessed how this story ends. As I was turning off my computer, and telling my AA goodbye my phone rings. We have a transplant and need you to help. The case was supposed to start two hours ago, and yet here I still sit waiting. Number of things accomplished on my list - zero.
All qualified applicants encouraged to apply.
Thursday, December 3, 2009
OR conversations
At the END of my second case yesterday, I was sitting at the computer filling out the ridiculous amount of paperwork that comes with the title of Attending. My patient was being extubated and moved off the OR table.
All of a sudden the OR nurse comes over to me and says: "you have to help with the move until you are the attending". I reply: "I am the attending". Her response: "Oh, I assumed you were a new fellow or resident".
My question - if the only two people that had scrubbed either of my two cases that day were me and the fellow that the nurse knew - who and more importantly where did she think the attending in charge of the case was?
All of a sudden the OR nurse comes over to me and says: "you have to help with the move until you are the attending". I reply: "I am the attending". Her response: "Oh, I assumed you were a new fellow or resident".
My question - if the only two people that had scrubbed either of my two cases that day were me and the fellow that the nurse knew - who and more importantly where did she think the attending in charge of the case was?
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