The kids are all well again and back at school. My husband is back from his trip. I only worked about 50 hours last week. I got to wake up in my own bed without an alarm both days this weekend. And to top it off, my 10am-10pm EC shift on Sunday ended at 8pm when my attending sent me home. Clinic is crazy at times, terrible inefficient and not the way I would like to run things, but it's such a lovely break from the rigors of ward months and call nights.

I feel almost giddy. I smile for no particular reason. I feel like myself again.

The good news is, it took less than a week for me to get back to my happy optimistic baseline. The other good news is that I don't dread going back to the wards in January.

Now I just need to get back to exercizing and eating right. A few weeks of rarely eating and being too exhausted to work out really killed my good habits. It's so hard to get back, too. Why is that? Life would be so much easier if treats and watching tv didn't equal weight gain and flabbiness! :laughing:

Hmm, I could have sworn I'd written since this last post. Maybe it didn't take.

Well, I'm just checking in to say that all is well. I've been enjoying my month of sleeping in my own bed every night and never working more than 12 hours at a time. :p

My kids have been sick and my husband was laid out with a bad head cold for nearly a week, but it's still been a good month overall.

I just have one issue now. I don't want to delve into too much personal stuff, but it's a "female issue." :rotfl:

Christmas was wonderful and perhaps even more appreciated since I only had 2 days off for the holiday. (and I was lucky to get that!) The visit with my parents was really nice. Both of them seem much happier than they have been in recent years.

I'm on another ward rotation this month. Q5. Can't really complain except that I somehow wound up with the Neuro floor again. *sigh* Every resident repeats one of the months, but it could be anything including a non-call month. Why I have to repeat this floor when Neuro is perhaps my least favorite specialty is just Chance laughing in my face. :p I did this floor as a Sub-I, as a 2nd month intern and now again halfway through intern year. I've seen all I need to see of seizures. They make me sad and they make me feel powerless. Not a favorite physician combination, to be sure.

Kids are back in school. Husband is working new job and seems very happy. Sun is shining. Life is good.

You really never know what you are capable of until you try.

I ran the Half Marathon yesterday. Hardly trained at all. Haven't run more than 5 miles in over 2 months. Probably haven't run a total of 40 miles in the last month. Maybe less than 30.

But, I had signed up for it last year and I thought "What have I got to lose?" Well, actually, what I feared losing was my self respect and the respect of my running buddies. I'm 7-8 lbs heavier than I was last year and in nowhere near the same fitness shape.

But by golly, I decided even if I had to walk 3/4 of the race, at least I'd be able to say I did it.

So I got out there and I just started jogging. I took it easy and just kept saying nice things to myself, uplifting things, positive things. And would you believe, 10 miles into I realized I was gonna run (jog) the whole damn thing! I finished in 2 hours 31 minutes! I had told my husband to expect 2:40-2:50 and he missed seeing me at the finish line because I was so early! :goodvibes:

Fatigue and burnout happens to us all.

I woke up yesterday morning at 4:30am as I have been doing for a couple of weeks now. I usually try to roll over and wait for the alarm at 5:20, but often just lay there wide awake. So yesterday I decided to go for a run instead. I barely eeked out 2 1/2 miles and felt crummy the entire time.

I stopped at my Starbucks as I do every working morning and got my grande soy latte (lactose intolerant). I also got a berry stella, since this is supposed to be a healthy option and I'm painfully aware of the weight I've gained thus far in intern year.

I was still tired and cranky, which is unusual for me. A run will usually wake me right up and start my day feeling a little righteous. Instead, I struggled to wake up. Drank my entire coffee before I even got to the hospital. My eyelids felt heavy during the drive. I closed my eyes briefly at a stop light and then abruptly jerked awake. It had only been a few seconds, the light was still red, but it scared me.

Once at the hospital, I felt resentful that I had to be there. I wanted to throw my pager across the room everytime it went off and it only went off a couple of times in the first hour. I felt like every patient was being difficult and every attending/fellow/consultant was trying to make my job harder. I wanted everyone to go home and leave me alone.

At about 9am, having missed Grand Rounds because I was moving too slowly, I decided it was time to try eating more breakfast. Something I forgot to mention was that I was also getting mad everytime I walked into a patient's room and smelled their hospital pancake and bacon breakfast. Now that's just crazy. I knew something wasn't right! So I went to the hospital cafeteria and got a "heart healthy" breakfast burrito and more caffeine. I sat in the doctor's area on the floor, ate my breakfast and tried to write my morning notes. Slowly I started to feel better.

For the rest of the day, I just tried to get through. I made a visit to the NICU to try and remind myself that there's a career ahead of me that I want. I told my upper level I felt burned out. I ate M&M's with a fellow intern and commiserated over the fact that I hadn't had a vacation since September and wouldn't have another 'til March.

I went home and talked with my kids. I ate chips and a burger for dinner. I tried to watch tv and didn't like anything on. I tried to read a funny book and got annoyed.

I went to bed at 8:15pm.

I woke up at 8:20am.

I'm not mad anymore. I realize I'm exhausted. It's January of intern year and it's wearing me down. I have 6 1/2 more weeks of wards and then a "light month." In March I have a golden weekend (both days off) and a week of vacation.

In the meantime I need to find some balance. I need to find a way to take care of myself. I need to eat right and not gain weight and I need to exercise. But I also need to do it in a way that gives me energy, not wears me down.

I emailed my Dietician friend and asked for her help last night. You'd think as a doc I'd know what to do. You'd think as someone with as much experience and as much interest in exercise and nutrition as I have, I'd know what to do. It's not the knowing, it's having the mental energy to devote to the execution of that knowledge that's dragging me down.

Perfectionism is a blessing and a curse. It's a necessary trait for a physician, but it's also something that works against our ability to find balance and peace. It's a risk factor as well as a coping strategy.

We are, afterall, only human. But we deal in human lives everyday and the sense of responsibility is at times overwhelming. The desire to either do everything right in my personal life or to blow it all off because I haven't the energy to devote to it is a constant struggle. The middle ground seems so hazy and hard to identify.

For some reason, I'm willing to write things down here that I wouldn't say elsewhere. That's probably a good thing and a bad thing. I do try to keep things realistic. If I'm happy, I'm happy. If I'm struggling I try to share that, too. It's only fair. I've been accused of having rose-tinted glasses, but that's my personality. It's also my life, to be honest. I'm extremely blessed.

So the thing that's been weighing on my mind and apparently affecting more than I realized is a certain appointment I had to day. I saw my Gyn a month ago and she referred me for a mammogram and ultrasound. I wasn't expecting that. I'm a little young for someone with no history of breast CA in the family to be getting a mammogram. I'll jump to the good news, everything looked fine. *whew* It's not that I really thought anything was wrong, but when your doctor is a little concerned, it's, well, scary.

Nothing like being a patient for a few hours to remind you about how little fun it is to be on that side of the stethoscope, so to speak. Also, tiny little "cape" gowns in a waiting area are neither comfortable nor humane! :laughing:

I feel a huge sense of relief now that this is over. I'll never dread it the same way either. Mammograms aren't fun, but they're not nearly as bad as I've heard some women describe them. I guess it's kinda like labor, everybody has horror stories.

As for being an intern, I feel more prepared to keep working now. Guess I just didn't realize how much the fear for my own health was affecting me. I suppose when you're chronically tired, things that seem small can have a big effect. Fatigue changes how well you deal with life's twists and turns.

Still, 5 more days of the Neuro floor and that's just fine with me. I hear my next floor is equally trying, but at least it's something different! :p

There's something I want to write about, but don't think today is the day to do it. First of all, I'm postcall and tired. Second of all, I'm still pretty raw about the whole thing.

Med school prepares you for a lot of medical questions and pimping on wards and likely pathogens, physiology, and all that good stuff. What it doesn't prepare you for is the majority of day to day stuff you deal with on the wards. You learn how to do cross-cover by doing it. You learn how to talk to parents who've received bad news or give bad news by doing it. You learn how to field phone calls from angry parents and their lawyers by being the unfortunate intern on call when the phone rings... Yeah.

It's a little disappointing how much it's "every man for himself" when this sort of thing happens. Times like these when I'm so grateful that I've had previous work and life experience that allowed me to handle things coolly. Still, that didn't keep me from having a stomach ache for the rest of the night and from feeling like my job really sucked.

So I'll write some more about this later.

Fortunately, I really like my team this month and the floor is pretty cool.

Thanks to Residentmom for the reminder that I haven't been blogging.

Let's see, what to write about?

I'm on Developmental Pediatrics this month. A very lovely rotation for the simple fact that it is an outpatient month mixed with lectures and clinics and NO call nights. If Neonatology doesn't wind up being the things that makes me not care that I'll be on call for the rest of my career, I'm doing Developmental Peds. It's right my alley with my background in education and speech therapy. Development is the specialty that addresses normal pediatric development and whether or not those former premies or kids with autism or sensory deficits or learning disabilities, etc, are developing as they should be and whether or not they need additional services.

Clinics often consist of interviewing parents and playing with kids, literally. It's so much fun! And so much less stressful than spending your morning rounding in the hospital and trying to figure out what to do today for all the really sick kids and then defend that plan to every upperlevel, fellow, and attending you meet.

A drawback to my program, I think, is the complexity of most of the patients we see. Sure, we see the kids with bronchiolitis. But we also see kids with much more complicated illnesses. Matter of fact, I had 3 patients last month that I inherited from the resident who took care of them in January. I had to hand those same 3 patients off to the March resident last week. Didn't manage to "fix" them at all. Although one did finally get his diagnosis during my month, HIV. Another can't eat anything by mouth and is dependant on total parenteral nutrition (TPN), fed by a tube in his vein. The third had a couple of complications secondary to some major surgeries. They'll all go home eventually, it just didn't happen on my watch. Very frustrating.

I'm tired of intern year. I was ready to quit when my last call came around. It's not that it was bad last month. It wasn't. (except for the threatening lawyer incident) It's just that being on call is exhausting and the complicated patients are exhausting and working 6 days a week all year long is exhausting. I had a 2 day weekend for the second time this year this past weekend. It was wonderful! Time to sleep in, time to talk with my husband (poor man got an earful all weekend long!) time to hang out with my kids, take them to a carnival, etc.

So you can see why Developmental Peds is sounding really really nice right now. It's stuff I know and I know I'm good at it. It's clinics and it's no call. There are no developmental emergencies. No phone calls in the middle of the night. "Doctor, patient spiked a fever. Do you want tylenol?" :banghead:

Ooh, I forgot how much fun blogging is! I have to go get ready for work now (it's nearly 7am and I'm still in my pj's!!! ) I'll write more later!

Amazing what a week of decent sleep and no overnight call can do for my mood. Which is good because I'm about to tackle a somewhat longer week now. I've got a 10a-10p shift in the EC Sunday, a regular workweek, followed by another 10-10 shift on Saturday.

But once that's over, I'm on vacation for a week! I know I've got to let her learn her way around these issues on her own now, while I can still help if things fall apart. Better that she learn how to make schedule changes happen now than wait until college to call me and say she screwed up and didn't get registered for classes in time... Or better yet, lie about it for an entire semester until her parents want to see the grade report... (know a girl who did that in college!)

I still want to remind them to wear a jacket and eat a snack and do their homework and practice, etc. But I also know that my nagging no longer changes their behavior much and if they don't feel some consequences now they'll learn it the hard way later. Am I repeating myself? Probably because I'm trying to convince myself that it's okay if she doesn't get her schedule change or if my son gets put in regular classes next year because he can't be bothered to turn in his assignments. I can't do it for them, not anymore. *sigh* The thing that makes me crazy is that I was just like that when I was their age. I never "worked to my potential" and I paid for it in the sense that few of my teachers realized how smart I really was and neither did I. I'd love to spare them that heartache, but I can't. At least, I can't do it without forcing them into it. At least I got my act together in my sophmore year of college and pulled out a 3.5 GPA. And at least I always prided myself in ace-ing standardized tests. That went a long way in keeping doors open for me.

You can tell my kids' education has been on my mind a lot lately.

As for medicine, well I had to make up my schedule requests for 2nd year already! And believe it or not, it's already time to start thinking about Fellowship applications. Applications open up at the end of this calendar year and interviews are a year from now. Time flies, eh?

I've been looking at various programs around the US and trying to decide what's important. Sure, I'd love to stay at my home program. But is that really the best thing for me? Med school all the way through Fellowship at the same program? I'll be so indoctrinated into "The Way," that I might not be able to think outside the box anymore! :p Besides, there are other cities and even states in the US. We never intended to stay here as long as we have. But then, my husband has a very good job with a lot of upside right now in an industry that is fairly limited geographically. My daughter will be starting her Senior year of HS when I start Fellowship. That's no time to uproot the family.

So, we'll see. I have plenty of time to consider my options.

Tonight I'm going out to dinner with my husband and wearing my red cashmere sweater dress that I got on a ridiculously good sale. It's 45 degrees here this afternoon, rather unheard of is these parts in mid March! Think I'll wear my boots as well. Look out world! :rotfl:

Time flies.

Another bday gone by this week. My last year to claim I'm in my 30's. I can't really wrap my mind around the fact that I'll be 40 next year. I don't feel almost 40! If I think about it, I feel like I'm in my early 30's. I like my 30's and definitely could hang around here for another decade. :goodvibes:

The kids were tremendously helpful and cooperative with all the camp chores. If only they could be like that at home!

Now I still have 5 days of vacation left and I'm thrilled. I've been sleeping nearly 10 hours a night! It's fantastic to be so rested and relaxed. Really brings home just how exhausted and stressed I am on a day to day basis in residency. But you know, I'm not going to dwell on that. I love my career. I can't say I love the job of being an intern everyday, but I know where it's taking me and where I want to be. Besides, before I started working this hard, I never really appreciated time at home like I do now.

As an aside, I was just thinking about how is it that I'm so fortunate that my kids think I'm great and really respect what I do? I think I know the answer. I think it is, in part, because my husband thinks I'm really great, admires what I'm doing, and respects me. Now how I got to be so fortunate to have found him, well I don't know. But I will be forever grateful. Our marriage has not been all roses or rainbows, no marriage is, but we have worked through quite a few things and ultimately we love and respect each other.

Anyone else watch Desperate Housewives? Thanks to tivo, I still do! I love the stories. Anyway, I was watching Sunday's episode last night and thinking about poor Bree and her business. Granted, she has done a lot to drive her husband into the situation he is in now. She's done more to verbally unman that guy than anyone would think he'd put up with. However, he wanted her to completely give up her business and her passion so that she could focus all her energy on being "Mrs Orson whateverhislastnameis." Wow. He wants her to give up the very thing that makes her want to wake up in the morning. The accomplishment she values most. That's not love.

So, my point is... despite the long hours and the exhaustion and the greater workload for my husband at home, he encourages me every step of the way because he knows how much this means to me. That kind of support is what makes my life possible. It's not that he's at home washing dishes or changing diapers, I did that for 10 years thankyouverymuch. I supported him through grad school and 10 years of career path, including nearly 3 years of weekly travel. It's that he recognized along the way that I couldn't do that for the rest of our marriage. That I had dreams and aspirations and desires for a career of my own. And he chose to support and encourage me.

Now we have adolescent kids and 2 busy careers and it'll be interesting to see how things pan out. His career is starting to accelerate again after being in a holding pattern for the last 4 years. I encouraged him to it because I know he wouldn't be any happier than me in the long run if he totally gave up his goals. But adolescent kids still need a lot of time and energy. :yes: How will we be as parents of teens? Will we be around enough to prevent those pitfalls of sex and drugs, etc? Those things happen when parents are at work, as we all know. We can't be home from 3-6pm every day to monitor the afterschool stuff and we're well beyond the nanny stage.

More questions to answer, more puzzles to, well, puzzle over. Parenthood doesn't get easier as they get older, just different. Different challenges, different worries, different needs.

In other news...
I've settled on Neonatology and I'm really happy about it. I struggled to keep an open mind about other specialties for years and now I'm happy to be at peace with the decision.

Sorry for the long post, I have so much free time this week!